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Hip Flashcards

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1
Q

pectineus

A

femoral, accessory obturator nerve
L2-3

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2
Q

psoas major

A

femoral nerve
L2-3

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3
Q

iliacus

A

L1
attaches distal at pectineal line

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4
Q

sartorius

A

attaches at ASIS-> superior medial surface of tibia

femoral nerve

L2-3

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5
Q

rec fem

A

AIIS -> quad tendon

femoral nerve, L2-4

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6
Q

vastus lateralis

A

prox: greatecr trochanter and lateral lip of linea aspera

femoral nerve L2-4

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7
Q

vastus medialis

A

intertrochanteric line & medial lip of linea aspera

femoral nerve L2-4

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8
Q

vastus intermedius

A

anterior/lateral surfaces of femur shaft

femoral nerve L2-4

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9
Q

adductor longus

A

body of pubis inferior to pubic crest–> middle third of linea aspera

obturator nerve (anterior branch), L2-4

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10
Q

adductor brevis

A

body and inferor ramus of pubs–> pectineal line & proximal linea aspera

obturator (anterior) L2-4

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11
Q

adductor magnus

A

adductor part: inferior pubic rami/ischium rami-> linea aspera medial, gluteal tuberosity
hamstring part: ischial tuberosity-> adductor tubercle

adductor part:: obturator (posterior) L2-4
hamstring: tibial nerve

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12
Q

gracilis

A

body/inferior ramus of pubis-> superior part of medial surface of tibia

obturator nerve (anterior) L2-3

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13
Q

obturator externus

A

obturator nerve (posterior) L3-4

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14
Q

quadratus femoris

A

lateral ischial tuberosity -> quadrate tubercle on intertrochanteric crest

nerve to quadratus femoralis & inferior gemellus
L5-S1

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15
Q

obturator internus

A

trochanteric fossa (distal attachment)

nerve to obturator internus & superior gemellus
L5-S1

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16
Q

glut med

A

ilium between anterior & posterior gluteal lines –> anterior surface of greater trochanter

superior gluteal nerve L4-S1

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17
Q

piriformis

A

anterior sacrum/sacrotuberous ligament –> superior border of greater trochanter

nerve to piriformis

L5-S2

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18
Q

gemellus superior

A

ischial spine -> trochanteric fossa
nerve to obturator internus & gemellus superior L5-S1

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19
Q

ligamentum teres

A

superior part of femoral head, attaches to transverse ligament. strong instrinsic stabilizer

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20
Q

femoral head vascular supply

A

MFCA- medial femoral circumflex artery

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21
Q

transverse ligament

A

inferior border of acetabular fossa
attaches to anterior inferior portion of labrum

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22
Q

angle of inclination

A

angle between neck and shaft of femur

125-130 deg in adults

coxa valga vs vara

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23
Q

coxa valga

A

displaced more superiorly

140 deg

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24
Q

coxa vara

A

100 deg

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25
anteversion- normal & increased
normal: 12-15 deg increased: increased IR or toe in gait increased pronation, medial femoral/tibial torsion, lateral patellar subluxation
26
retroversion
toe out or increased ER, supination may compensate with medial rotation at knee, lumbar rotation on opposite side
27
craigs test
8-15 deg is normal
28
hip joint ligament capsule
iliofemoral ischiofemoral pubofemoral
29
iliofemoral
starts at AIIS, 2 distinct bands restricts hip extension & ER
30
ischiofemoral
posterior acetab rim, along iliofemoral --> medial femoral neck restricts IR restricts add when hip is flexed
31
pubofemoral
superior pubic ramus-> intertrochanteric line restricts hyperabd & ER
32
snapping psoas vs ITB
snapping- clunk occurs as hip comes from flex+abd+ER into Ext +IR, eminates from groin -can hear across room ITB: symptoms more lateral, TFL moves over greater trochanter with hip rotation -see across room
33
log roll test
most SP for intra articular NOT SN reproduce anterior groin pain
34
FABER ASLR Dial test Ober
FABER- anterior hip pain- joint problem; SI- feel more posterior Dial- anterior laxity Increased ER vs other when lying in extension supine
35
athletic pubalgia vs sporst hernia
passive flexion+IR would exacerbate joint problem but not sports hernia
36
alpha angle
between midline of femoral neck, and lien from center of femoral head to junction that first deviates from spherity of femoral head >50 may indicate CAM (normal 45)
37
center edge angle
normal = 20-25 deg *** borderline hip dysplasia NOT normal less = dysplasia
38
CAM FAI - anatomy
poor shape of femoral head
39
Pincer FAI - anatomy
extra rim/overhang may be associated with retroversion
40
SCFE (slipped capital femoral epiphysis)
teens sudden displacement of femoral neck from CFE- failure of growth place occurs due to shear forces head typically stays in place due to ligamentum teres while neck comes up and outward
41
glut min
ilium--> anterio surface of greater trochanter (same as glut med) superior gluteal nerve L4-S1
42
TFL
ASIS & anterior part of iliac crest --> IT tract superior gluteal nerve L4-S1
43
glut max
posterior ilium, dorsal surface of sacrum/coccyx, sacrotuberus ligament --> IT tract & gluteal tuberosity inferior gluteal nerve L5-S2
44
biceps femoris
long head origin: ischial tuberosity short head origin: linea aspera/lateral supracondylar line attachment: lateral side of fibular head, tendon split by LCL n: long head tibial nerve, short head common peroneal L5-S2
45
semitendinosus
ischial tuberosity--> medial surface of superior part of tibia tibial nerve L5-S2
46
semimembranosus
ischial tuberosity-->posterior part of medial tibial condyle; reflected attachment form oblique popliteal ligament tibial nerve L5-S2
47
stress fracture
risk factors: female, previous fracture sudden increase in volume vague thigh pain that may radiate to hip/knee patellar pubic percussion fulcrum test 1 SP & 1 SN
48
hip AVN special testing
hip ext <15 hip ER <60 pain with IR
49
Cam vs pincer M vs F
Cam- often young athletic male pincer- often active middle age women
50
FAI special testing
FADDIR: SN 0.91-.99 Flexion IR test: .96 SN
51
CPG - intervention for FAI
most have level evidence F (manual, education, ther ex, neuro re ed)
52
hip labral special testing
fitzgerald test SN 0.7-.98 Thomas test SN .11-.89, SP .67-.92 Impingement provocation test SN 1.0
53
hip OA special testing
resisted hip abd (pain) SP .9 FABER (groin pain) - not great test Scour - not great test
54
CPR for hip OA
-squatting aggravating -+ scour for groin/lateral hip pain -active hip flexion causing lateral hip pain -passive IR
55
OA CPG interventinos level of evidence
manual A flexbility, strength, endurance: A modalities: B pt edu: B functional, gait, balance training: C
56
athletic pubalgia - 4 regions
adductor hip flexor inguinal pubic
57
risk factors for athletic pubalgia
previous groin injury higher level of play decreased hip abd/add strength lower level of sport specific training MOI- kicking, change of direction, stretching, sprinting/running
58
inguinal athletic pubalgia- testing/symptoms
-TTP inguinal canal -resistance testing of ab muscles = pain (sit up, thomast + reisted hip flexion, vaslavla/coughing)
59
hip flexor related athletic pubalgia testing
resisted hip flexion 90 .79 SP thomas test resisted knee ext SP .82 thomas test + passive hip ext or knee flex SP .75/.89
60
adductor related athletic pubalgia testing
single adductor testing bilateral adducotr resisted outer range adduction squeeze test (0 and 45 deg) ^^ most with sp >0.9
61
greater trochanteric pain syndrome (GTPS) testing
SLS for 30 sec external derotation SN .88 obers FABER - lateral hip pain FADER + resistance ADD + resistance *all .85-0.9+ SP
62
hip OA guidelines
hip pain flexion <110 IR <15 pain with IR AM stiffness <60 min >50 y/o
63
ludloff sign
ilipsoas strain or avulsion fracture pain with hip flexion when seated
64
test for various layers of impingement at hip
trochanteric sub-spine impingement: 30 deg flexion, 30 deg abd * IR S/l hip ext: poserior impingement ER & extension: ischiofemoral impingement flexion, abd & ER: superior-lateral acetabular impingement
65
what muscle targets glutes and minimizes activation of TFL
clamshells
66
crossover sign (xray)
suggests pincer impingement at rim due to acetabulum projecting laterally
67
gilmore groin
athletic pubalgia - tear in external oblique aponeurosis and conjoint tendon
68
Hip OA Clusters I II
I: hip pain IR <15 deg flexion < 115 II, if IR > 15: pain with IR age >50 AM stiffness >60 min
69
Hip OA CPR
squatting is aggravating flexion ROM-> lateral hip pain scour+add->lateral/groin pain extension ROM pain IR <25 *If all 5 = 98 SP
70
SCFE
frog leg xray, Kleins line epihphysis in acetabulum + metaphysis moves anterosuperior
71
Freibergs test
Passive internal rotation of the extended hip places tension on the piriformis, which would result in a positive Freiberg's test.

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