Hip

Question 1

What is the primary function of the hip?

Answer 1

To support the weight of the body

Question 2

Structurally, the hip is suited for _______ first, then _______.

Answer 2

Stability, mobility

Question 3

What are the muscles that attach to the ischial tuberosity?

Answer 3

Semimembranosus
Semitendinosus
LH of Biceps Femoris
Adductor Magnus
Quadratus Femoris
Gemellus Inferior

Question 4

Which way does the acetabulum face?

Answer 4

Laterally, inferiorly and anteriorly

Question 5

What is the function of the acetabular labrum?

Answer 5

Further deepens the cavity and grasps the head of the femur

Question 6

Which way is the head of the femur angled?

Answer 6

Medially, superiorly and anteriorly

Question 7

Which way is the femoral neck oriented in respect to the shaft?

Answer 7

Externally rotated

Question 8

Which muscles attach to the greater trochanter?

Answer 8

Piriformis
Gluteus medius, minimus
Obturator internus
Gemellus superior, inferior

Question 9

Where is the articular cartilage and joint capsule thickest?

Answer 9

Anterosuperiorly, where maximal stress and weight bearing occurs

Question 10

Where does the joint capsule attach posteriorly?

Answer 10

the lateral one-third of the femoral neck

Question 11

Where does the joint capsule attach laterally?

Answer 11

over the femoral head and neck to attach to the intertrochanteric line anteriorly

Question 12

Where does the joint capsule attach proximally?

Answer 12

to the pelvis, just lateral to the acetabular labrum

Question 13

Which ligament is the strongest?

Answer 13

Iliofemoral ligament

Question 14

Which ligament is the weakest?

Answer 14

Ischiofemoral ligament

Question 15

Which ligament is tight with extension? Which limits it?

Answer 15

Ischiofemoral ligament, Pubofemoral ligament

Question 16

Which prevents excess abduction?

Answer 16

Pubofemoral ligament

Question 17

Which ligament is “Y” shaped?

Answer 17

Illiofemoral

Question 18

What are the 3 bursae of the hip?

Answer 18

Iliopsoas bursa, trochanteric bursa, ischiogluteal bursa

Question 19

What is contained within the femoral triangle?

Answer 19

Femoral nerve, artery and vein

Lymphatics

Question 20

What is the resting position for the hip joint?

Answer 20

30 flexion, 30 ABD, slight ER

Question 21

What is the closed-packed position for the hip?

Answer 21

Extension, IR, and ABD

Question 22

What is the capsular pattern for the hip?

Answer 22

Flexion, ABD, IR

Question 23

What are the forces on the hip while standing? Standing on one limb?

Answer 23

0. 3 times body weight

2. 4 - 2.6 times body weight

Question 24

What are the forces on the hip while walking? Walking up the stairs? Running?

Answer 24

1.3 - 5.8 times body weight
3 times body weight
4.5 + times body weight

Question 25

Normal ROM and End-Feel for: | Flexion

Answer 25

110-120, tissue approximation or tissue stretch

Question 26

Normal ROM and End-Feel for: | Extension

Answer 26

10-15, tissue stretch

Question 27

Normal ROM and End-Feel for: | Abduction

Answer 27

30-50, tissue stretch

Question 28

Normal ROM and End-Feel for: | Adduction

Answer 28

25-30, tissue approximation or tissue stretch

Question 29

Normal ROM and End-Feel for: | External Rotation

Answer 29

40-60, tissue stretch

Question 30

Normal ROM and End-Feel for: | Internal Rotation

Answer 30

30-40, tissue stretch

Question 31

What is the normal angle of inclination?

Answer 31

125-130

Question 32

In coxa valga, a ______ in the inclination angle causes the femoral head to be directed more _______ in the acetabulum.

Answer 32

increase, superiorly

Question 33

What effects does coxa valga have on the available weight bearing surface? Overall leg length?

Answer 33

Decreases, results in increased stress applied across joint surface Increases leg length, impacting other components of the kinematic chains

Question 34

What mechanical disadvantages occur due to coxa valga?

Answer 34

Hip abductors are at a disadvantage because there is a shortened moment arm. Hip abductors must contract more vigorously producing increased joint reaction forces

Question 35

In coxa vara, a _______ in the inclination angle causes the femoral head to be directed more ______ in the acetabulum.

Answer 35

Decrease, horizontal

Question 36

Coxa vara: _______ in downward shear forces on the femoral head, _______ in joint compression forces.

Answer 36

Increase, decrease

Question 37

What is the angle of torsion?

Answer 37

Rotation that exists between the shaft and the neck of the femur

Question 38

What is the normal angle of torsion?

Answer 38

8-15 anterior to the mediolateral axis to the femoral condyles

Question 39

What measurement qualifies anteversion? What is this associated with?

Answer 39

35, patient usually have more hip IR than ER and toe-in

Question 40

What measurement qualifies retroversion? What is this associated with?

Answer 40

Less than 5, patients usually have more hip ER than IR and toe-out

Question 41

Force Couples of the Hip for Posterior Tilt

Answer 41

Rectus abdominis and external obliques | Gluteus maximus and hamstrings

Question 42

What tests and measures are used for the hip?

Answer 42

Observation, AROM/PROM, MMTs, Gait, Loading Tests, High Step, Unilateral Stance

Question 43

What must be palpated?

Answer 43

ASIS, Pubic tubercle, iliac crest, greater trochanter, PSIS, ischial tuberosity, sciatic nerve

Question 44

What are the goals of the acute phase?

Answer 44

Protection of the injury site Decreased pain/inflammation Restore pain free ROM in entire kinematic chain Improvement of pt comfort by decreasing pain/inflammation Retardation of muscle atrophy Min of detrimental effects of immobilization and activity restriction Scar management, if appropriate Maintenance of general fitness Independence with HEP

Question 45

What are the functional goals?

Answer 45

``` Restore normal joint kinematics Attain full, pain free AROM Improving muscle strength WNL Improving neuromuscular control Restore the normal strength and relationship if the muscle force couples ```