Hip Flashcards by Hannah Bledsoe

What bones make up the acetabulum?

Ilium, ischium, pubis

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Describe the hip jt

Ball and socket jt between the femur and the acetabulum

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What part of the acetabulum is covered in hyaline cartilage and articulates with the head of the femur?

Lunate surface

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What is the deepest part of the acetabulum

Acetabular fossa

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Describe the acetabular notch.

60-70* opening in the inf. Acetabulum

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How is the neck of the femur angled with respect to the femoral shaft and distal femoral condyles?

Angulated so head faces medially, superiorly and anteriorly

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Angle of inclination of the femur

Between axis through femoral head/neck and longitudinal axis of the femoral shaft (frontal plane)

Typically 125°

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Coxa valga

pathological increase in angle of inclination of the femur

>125 ̊

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Coxa vara

pathological decrease in the angle of inclination at the femur
<125 ̊

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What is the function of the angle of inclination of the femur?

Optimizes jt surface alignment

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Coxa Vera and high BMI can result in what pathology in adolescents?

Slipped capital femoral epiphysis (SCFE)

Feature in the femoral neck (epiphysis)

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What are the negative impacts of Coxa Vara?

Increased bending moment arm > increased bending moment > increased shear force femoral neck

Decreased functional length of hip abductor muscles

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Negative impacts of Coxa valga

Decreased moment arm for hip abductor force

Alignment may favor jt dislocation

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Positives of Coxa vara

Increased moment arm for hip abductor force

Alignment may improve jt stability

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Positives of Coxa valga

Decreased bending moment arm > decreases bending moment > decreases shear force across femoral neck

Increased functional length of hip abductor muscle

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What is the normal angle of inclination

125

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Angle of torsion in the femur

Between axis through femoral head/neck and the distal femoral condyles (transverse plane)

15 ̊ of anteversion allows for optimal alignment and joint congruence

Norm=8 ̊ to 20 ̊

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What is the ideal angle of torsion at the femur

15* anteversion

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Excessive anteversion of the femur is found with…

Coxa valga

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Excessive anteversion is associated with

Increased hip IR and decreased ER

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Excessive anteversion (reduces or increases) hip stabilization

Reduces

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Retroversion of the femur is associated with….

May cause….

Increased hip ER and decreased IR

may cause impingement

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How may children display excessive anteversion? Why?

In-toeing gait

Improve jt congruency

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In-toeing during gate may have what effects on the muscles and ligaments that cross the hip? How would this effect the ROM of the hip?

Shortens muscles and ligaments

Reduces ER of the hip

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What is the position of the acetabulum?

Lateral with inferior and anterior tilt

What is determined by acetabular depth?

Femoral head coverage

Describe acetabular dysplasia

Shallow acetabulum

Describe Coxa profounda

Acetabular over-coverage (excessively covers the femoral head)

What is acetabular anteversion

20* How forward facing the acetabulum is, measured by anterior over-coverage

What is the Cam deformity? How could it cause impingement (femoral acetabular impingement)

Extra bone growth at the anterior-superior region of the femoral head Can press against the acetabulum during IR with flexion

What is the pincer deformity and how can it cause impingement?

Abnormal bony extension of the anterior-lateral rim of the acetabulum Impingement with flexion with IR

Pincer deformity is often associated with…

Deep acetabulum or overly retroverted acetabulum

What is the function of the transverse acetabular lig

Protects the blood vessels that travel beneath it to get to the head of the femur

Closed packed position of the hip is…. | Definition not position

The position where capsule and ligaments are most taunt, not where jt is most congruent.

Where is the hip most congruent?

Flexion, abd, slight er

Where is the position of max articular congruence in the hip utilized?

Diagnosis of hip dysplasia

Structural adaptations to wt bearing at the hip

Bending moment | Trabecular system

Tensile forces are applied ___________ to the neck of the femur from the weight of the upper body through the pelvis and GFR

Superiorly

Compression forces are applied ________ to the neck of the femur from the weight of the upper body and GFR

Inferiorly

Trabecullar systems in the hip provide ___________! | They are weakest and strongest where?

Structural resistance Strongest where they cross at r angles Weakest where they are thin and don’t cross

The hip jt capsule contributes largely to hip _____. Unlike the GH jt

Stability

The jt capsule of the hip is thicker _______________ and thin and looser ____________

Anterosuperior | Posteroinferior

The Iliofemoral ligament provides ________ and controls ________&_________

Anterior stability | IR an ER rotation

The pubofemoral lig controls

The ishiofemoral lig primarily restrains

What hip jt ligaments tighten with hyper extension

Ilioifemoral Pubofemoral Ischiofemoral

The function of the acetabular labrum

Deepens concavity | Acts as a seal to maintain negative intra- articular pressure

Function of Ligamentum teres

Blood flow to the femoral head and some lig function

What position can strain or tear the Ligamentum teres

Excessive ER

The Ligamentum teres is thought to have most function for what population

Children

Osteokinematics of the hip

Flex/ext Abd/add Er/ir

Arthrokinematics of flexion and ext at the hip

Flexion: anterior roll and posterior glide Extension: posterior roll and anterior glide

Arthrokinematics of abd and add at the hip

Abd: superior roll inferior glide Add: inferior roll and superior glide

Arthrokinematics of IR/ER at hip

IR: anterior roll and posterior glide ER: posterior roll and anterior glide

When wt bearing, the femur is fixed so motion at the hip occurs by…

Movement of the pelvis on the femur

Osteokinematics of the pelvis on the femur

Anterior/posterior pelvic tilt Lateral tilt Forward/backward rotation

Lateral pelvic tilt occurs in the frontal plane resulting in either _________ or __________

Pelvic hike | Pelvic drop

In a left leg stance, a right pelvic hike results in ________________ at the left hip

Abduction

In a left leg stance, a right pelvic drop with result in ________ at the left hip

Adduction

Arthrokinematics of lateral pelvic tilt

Abduction: superior roll and glide Adduction: inferior roll and glide

Arthrokinematics of ant/post pelvic tilt

Anterior tilt: anterior roll and glide | Posterior tilt: posterior roll and glide

Arthrokinematics of ckc abd/add of the hip

Abd: Superior roll and glide Add: inferior roll and glide

Lateral pelvic tilt is seen in ___________ while lateral pelvic shift is seen when ___________

Single leg stance | When both feet are planted

Forward and backward rotation of the pelvis can be seen in a bilateral stance but mainly occurs in ___________ when ________

Single leg stance | Walking

Forward rotation of the pelvis results in _______________ of the stance hip

Backward rotation of the pelvis results in _____________ of the stance hip jt

Arthrokinematics of forward and backward rotation

Forward rotation: anterior roll and glide | Backward rotation: posterior roll and glide

Closed packed position of hip jt

Full extension with slight IR and abd

Open packed position of the hip jt

Moderate flexion, slight abd, neutral rotation

Capsular pattern of the hip jt

IR=FLEX= ABD

What muscle groups work together to produce anterior pelvic tilt? What is this relationship called?

Force couple between hip flexors and low back extensors

Anterior pelvic tilt is associated with an increase in….

Lumbar lordosis

What muscle groups work to produce a posterior pelvic tilt?

Force couple with hip extensors and abdominal muscles

Moderate to high power hip flexion is achieved by coactivation of

Abdominals and hip flexors

To anchor the pelvis for femur movement, the __________ must produce a strong enough ____________ to neutralize the ___________ exerted by hip flexors

Rectus abdominis Posterior pelvic tilt Anterior pelvic tilt

In a single leg stance, the hip abductors must produce (more/less) force to overcome body weight. What lever is this?

``` More 1st class lever ```

Tight hamstrings can cause a posterior pelvic tilt, to augment that stretch perform an

Anterior pelvic tilt

To augment a stretch in the hip flexors, perform a

Posterior pelvic tilt