HIP Flashcards
(193 cards)
1
Q
part of the hip bone that is a major attachment site for the glutes
A
ilium
2
Q
labrum is what shape
A
horse shoe
3
Q
labrum is a_____
A
vascular
4
Q
weakest part of hip joint is where
A
area without a labrum (pos and inf)
5
Q
most labral tears occur where
A
sup portion of hip bc labrum is thickest there
6
Q
Y lig is aka
A
Iliofemeral lig
7
Q
strongest lig in body
A
Y lig
8
Q
Y lig limits what motion
A
hip extension
9
Q
the other lig resisting hip ext
A
pubofemoral
10
Q
pubofemoral lig also tightens with what motion
A
abd
11
Q
so pubofemoral lig limits what motions
A
hip ext and hip abd
12
Q
on a pic, the pubofemoral lig is ant, the most
A
inf one
13
Q
most injured lig in hip
A
ischiofemoral
14
Q
why is ischiofemoral lig most injured
A
bc most pple have weak ER, and IR more common
15
Q
the main post lig in hip
A
ischiofemoral
16
Q
lig teres tightens with what motions
A
add, ER, flexion
17
Q
lig teres attaches what 2 structures
A
femoral head to inf acetabular rim
18
Q
where are the BV and nerves to the femoral head located
A
in sheath of lig teres
19
Q
3 main bursa in hip
A
iliopsoas
trochanteric
ischiogluteal
20
Q
coxa vara
A
like an upside down L
almost like a straight right angle
21
Q
what’s lengthened or stressed with coxa vara
A
glutes
22
Q
coxa valga
A
like a wide V
23
Q
what is shortened and tight with coxa valga
A
ER are really tight
24
Q
explain anteversion
A
increased angle
25
with anteversion, they will compensate by doing what
toe in
26
with anteversion, they will have lots of ____ and lack ____
lots of IR and lack ER (more end range ER)
27
Retroversion, they will lack ___ and have lots of ___
lack IR, but have lots of ER
28
Retroversion is toe ____
out
29
Obturator N segments
L2, L3, L4
30
Femoral N segments
L2, L3, L4
31
sciatic N segments
L4, L5
| S1-S3
32
Lateral cutaneous to thigh N segments
L2-L3 (no motor function for lat cut to thigh N)
33
femoral hypo mobility syndrome is associated with what pathologies
deg disease
decreased joint space
OA
34
sx of femoral hypomobility syndrome
```
deep groin or deep hip px
referred px to medial knee
px with wt bearing or px with sit to stand
stiffness in the morn
sx after the age of 55
```
35
often times, those with femoral hypo mobility syndrome will have what kind of gait
trendelenberg gait
36
what posture will be associated with femoral hypomobility syndrome
ant pelvic tilt
37
Legg calve perth disease, px is where
medial knee
38
Legg calve perth disease, these motions are limited
mainly ext and ABD
39
SCFE stands for
slipped capital femoral epiphysis
40
px for SCFE is where
referred to knee or thigh
41
motions limited by SCFE
mainly IR and ABD and flexion (IR MAINLY)
42
2 tests that should be pos with snapping hip or ITB syndrome
obers and GT bursitis tests
43
px with AVN is usually described as
dull, achy, throbby
44
constant low back/buttocks px with same sided groin px for a person over 55 would make you want to look into
OA
45
lateral thigh px that increases with sit to stand, think
GT bursitis
46
SHARP px in ant sup groin area, look into
FAI
47
You also have to look into sx review with groin/hip px, list some possiblities
hernia, female issues, GI probs
48
how to find iliopsoas
1/3 way btwn umbilicus and ASIS
49
normal hip flexion is
120
50
normal hip ext is
20
51
CRAIGS test is for
retro/anteversion
52
explain CRAIGS
prone, feel at GT as you IR and ER . at the "pop out" point you measure the tibial crest and perp to floor angle
53
normal CRAIGS should be
8-15
54
which type of ____version usually goes along with squinting patella
anteversion
55
the patellar/pubic percussion test has very hight
sens and spec
56
True LL is measured from ___ to ____
ASIS to lat mall
57
hamstring strain is most often felt at
ischial tub (attachment)
58
glut med strain is most often felt at
GT
59
is snapping hip px ful at rest (usually)
no
60
px at the sup, ant hip, look into
FAI
61
what 2 motions really hurt with ITB syndrome
adduction and flexion
62
if pt had trauma 2-4 weeks ago and there is still px and bruising at the site, with palpable hard bumps at site, look into
myositis ossificans (refer out)
63
if you suspect myositis ossificans, you NEVER do what
stretch
64
PRICEMEM
protect, rest, ice, compress, elevate, manual therapy, early motion
65
hamstrings trains often occur bc what muscle imbalance
the pt usually uses the hams for the primary hip flexor instead of glut max
66
distinguishing diff adductors - which one is pos with leg straigth (for px)
gracilis
67
distinguishing diff adductors - which one is pos with hip at 45 deg (for px)
add longus or brevis
68
if hip is at 90 degress and there is px with adduction
pectineus
69
bursitis is common with what other pathologies
arthritic
70
why is piriformis syndrome prevalent
20 % of pop actually has their sciatic pierce through that muscle
71
piriformis syndrome will usually yield a pos ___test
fadir
72
age range for AVN
30-50
73
how can a displaced femoral neck fx lead to AVN
lack of blood supply
74
what motions cause px with AVN
ALL
75
is there a loss of ROM with labral tears (usually)
no
76
reporting a feeling of giving out or clicking/popping =
labral tear (possible)
77
what is C sign
putting a C around your hip, this is common px pattern with OA
78
which movement sx impairment dx is hip OA
femoral hypomobility syndrome
79
steriods, alchohol, trauma or chemo can be related with what pathology
AVN
80
where is most common spot for labral tear
ant/sup
81
weakest part of the hip
inf/post
82
what motions aggravate labral tears
compression, adduction and any rotation
83
type of impingment when the femoral head is larger than the acetabulum
cam
84
type of impingement when the acetabulum overcovers the femoral head
pincer
85
main test for FAI
scour/FADIR (scour can also be used for labral tear)
86
anteverted people have very little
ER
87
anteverted pple are toe _
in
88
Retroverted pple lack ___
IR
89
boney open packed position of the hip
30⁰ flexion, 30⁰ abduction, slight ER
90
boney closed pack of hip
Maximum extension, IR, slight abduction
91
Inf glides help with what motions
ABD (main one)
flexion
and IR when hip is at 90
92
post glides help with
flexion (main one)
IR
and add when hip is at 90
POST = FID
93
Ant glides help with
EXT **
ER
abd when hip is at 90
ANT = XEB
94
lateral glides help with
IR
ADD
overall px
95
femoral accessory hypermobility syndrome is associated with what pathologies
* Labral tear
| * Early DJD
96
Femoral anterior glide syndrome (movement sx impairment) is associated with what pathologis
* Femoral-acetabular impingement
* Iliopsoas tendinopathy
* Iliopsoas bursitis
97
hip extension and knee ext dysfunction (movement sx impairment) is assct with what pathologies? also, explain this dysfunction
* Sciatica
* Hamstrings strain
* Piriformis syndrome
* Ischiogluteal bursitis
hip extension is the primary movement dysfunction, associated with a dominance of the hamstring muscles over the gluteus maximus.
98
with ant pelvic tilt, what is tight and what is weak
- Tight hip flexors
- Weak abdominals
- Weak gluts
99
tx options for ant pelvic tilt (things to correct)
```
Tx options:
Strengthen hamstrings
Strengthen gluts
Strengthing abs
Strengthen calves
Stretch hip flexors
Stretch quads
```
100
before doing your resisted motion test, pt should be in ____ position
resting (30 deg flexion and abd and slight ER)
101
hold trendelenburg stance for ___ sec
30
102
explain the GT bursitis test (motions you put their hip in)
they are sidelying with knee flexed, you pull them into hip ext, then drop their leg in hip adduction, then hip flexion
103
explain the side lying (straight abd only) hip muscle imbalance test
Patient in sidelying (affected side up) with knee extended. Have patient abduct hip. stabalize at their hip, Observe their movement pattern. If the leg moves into hip flexion or internal rotation, suspect hip flexor/TFL dominance.
104
explain the side lying (abd with ER) hip muscle imbalance test
o Place the leg into an abducted, extended, externally rotated position. Ask them to actively hold the leg in that position. If the leg internally rotates or flexes again, suspect hip flexor/TFL dominance.
105
What are you looking for with the SLR test (where you feel their GT as they raise their leg in supine)
feeling for movement of the GT
Positive: if the axis moves anteriorly > ½” , suspect muscle imbalance around hip, possible posterior hip joint capsular tightness
106
scour test follows the same patten as
FADIR
107
the WOMAC outcome measure is used to test for
OA (higher score is worse)
108
for what assessment or mobs do you need a towel under the sacrum
for post assessement and mob
| for the "quick and dirty" ant assessment
109
when doing a post mob, your motion should go
down and out
110
when doing prone ant mob, your motion should go
down and in
111
when doing an inf mob (that is similar to the distraction technique) you pull ___
straight down
112
when doing distraction, you pull
down and out a little
113
good parameters for distraction
30-60 sec holds, 3-5 times
114
most pple have more ____ motion in hip than ____
more ant than post (so post mobs are more used usually)
115
what typically happens with a lateral femoral cutaneous N injury
it gets trapped under the inguianal lig
116
stable vs non stable pelvic fxs
stable - no separation at pubic symphysis
| unstable - there is separation and probably WB restrictions
117
plates and screws are used with what type of fixation
ORIF (open reduction)
118
list the post hip precautions
flexion, IR, add
119
list ant hip precautions
ext, abd, ER
120
hip precautions time frame usually
6 mos to a year
121
surgical reshaping of bone
osteomy
122
anterior displacement of the femoral neck due to the most superior part of the femoral head slipping (happens alot with obese children)
SFCE
| slipped femoral capital epiphysis
123
childhood condition where there is lack of blood supply to femoral head, causing it to flatten and limp is usually noted
Legg Calve Perths disease
124
most common cause of hip px in kids
synovitis
125
which type of femoral fx has an increased rate of AVN and non union
displaced femoral neck
126
special test for FAI
FADIRR
127
special test for labral tear
scour
128
special test for piriformis syndrome
FADDIR
129
naturally, the acetabulum faces what directions
ant
lat
inf
130
dislocations usually occur in what direction
post
131
list the grading scale to assess joint motion
0-6 (0 is nothing, 6 is unstable)
| 3 is normal
132
If IT band is tight, what is probably weak
glut med (all gluts really) bc that means IT band is doing most of the work
133
what pathology often has an MOI related to twisting or torsion
labral tear
134
what pathology can have associations with alcohol use, or sterioids
AVN
135
what is the capsular pattern
flexion
abd
IR
136
femoral hypomobility syndrome is associated with what pathologies
DJD (early on)
137
what direction does the ilium move in hip flexion
post
138
normal femoral acetabular angle should be
125
| Less than is coxa vara, more than is coxa valga
139
sup gluteal N innervates
TFL
glut med
glut min
140
segments to sup gluteal N
L4, L5, S1
141
what peripheral N are both sensory and motor (10)
```
obturator
femoral
sciatic
pudendal
tibial
common fib
medial plantar
lat plantar
deep fibular
superficial fibular
```
142
N to fibularis longus and brevis
superficial fibular
143
N to fibuarlis tertius
deep fibular
144
extensors of lower leg are what N
deep fibular
145
segments to deep fibular N
L4, L5, S1
146
the cutaneous N are ____ only
sensory
147
Inf gluteal N segments
L5, S1, S2
148
N to quad femoris and gemellus Inf segments (these are motor only)
L5, S1, S2
149
tibial N segments
L4, L5, S1, S2, S3
150
N to post calf is
tibial N
151
ischiofemoral lig limits what motions
IR
152
common MOI for labral tears
compression or rotational forces (golf is an ex of rotational)
153
arthrokinematics for hip flexion
femoral head rolls anteriorly and glides posteriorly on acetabulum
154
hip extensors
primary - glut max
| secondary - glut med and hamstrings
155
hip abductors
Gluteus Minimus
Gluteus Medius
Tensor Fascia Latae
Gluteus Maximus
156
hip IR (list)
```
Gluteus Minimus (anterior fibers)
Gluteus Medius (anterior fibers)
Tensor Fascia Latae
Adductor Longus
Pectineus
Gracilis
```
157
hip ER (list)
```
Gluteus Maximus
Gluteus Medius
Piriformis
Gemellus Superior/Inferior
Obturator Internus/Externus
Quadratus Femoris
```
158
the aggravating factor for the 2 pediatric conditions
walking - causes an antalgic gait
159
what would be a common hx for a strain
overdominance of the muscle
160
adductor strain would be what mvmt dx
hypomobility
161
list the movement dx categories for hip
```
hypomobility
hypermobility
femoral ant glide syndrome
hip ext with knee ext
hip ext with medial rotation
hip adduction (with or without medial rotation)
lateral rotation syndrome
```
162
hypermobility is what pathologies
labrum tear and early DJD
163
femoral ant glide syndrome is what pathologies
* Femoral-acetabular impingement
* Iliopsoas tendinopathy
* Iliopsoas bursitis
164
hip ext/knee ext is what pathologies
* Sciatica
* Hamstrings strain
* Piriformis syndrome
* Ischiogluteal bursitis
165
hip ext with medial rotation is what pathologies
* Hamstrings strain
* Lengthened piriformis syndrome
* Sciatica
166
hip adduction syndrome is what pathologies
```
Pathology
• Trochanteric bursitis
• Snapping hip syndrome
• Sciatica
• ITB faciitis
```
167
lateral rotation syndrome is what pathologies
* Hamstring muscle strain
* Piriformis syndrome
* Sciatica
168
main mvmt dx associated with piriformis syndrome
lateral rotation syndrome
169
In this movement dysfunction, there is insufficient posterior glide of the femur during hip flexion. It is associated with stiffness of the hip extensors and posterior hip joint structures and excessive flexibility of anterior hip joint structures which create a path of least resistance of anterior glide.
femoral ant glide
170
how might you differentiate GT bursitis from glut med strain
often times bursitis has a squishy feel on palpation
171
femoral hypermobility px would be with
WB - compression (bc of dx in this category)
172
list the mvmt dx for hip
```
hypomobility
hypermobility
Adduction
Ant glide
LR
ext with IR
ext and ext
```
173
what pathologies are associated with femoral ant glide
```
impingement
iliopsoas pathology (bursitis or tendon pathology)
```
174
pathologies with ext ext
sciatica
hamstring strain
piriformis syndrome
ischiogluteal bursitis
175
the only thing different about pathologies for ext with IR is
no ischiogluteal bursitis (others are same as ext ext)
176
pathologies for hip adduction syndrome, everything is on the ___lateral
ITB
GT bursitis
Snapping hip
177
both LR and ext with IR have what pathologies
hamstring strain
sciatica
piriformis
178
areas for bursitis
iliopectineal
ishial gluteal
GT
179
Constant low back/buttock pain and same-side groin pain, what might you think
OA
180
Lateral thigh pain exacerbated when moving from sitting to standing, irritation when sleeping on one side....what might you think
GT bursitis
181
sharp px in ant groin area
sharp - impingment
182
FABER is for
OA
183
scour is for
OA, labral tear
184
what is craigs test
checks for ante/retroversion
feel when GT "pops" out the most
measure perp to floor against tibial crest when they are prone (8-15 normal)
185
patellar pubic percussion test has very high
sens and spec
186
true leg length is from ___ to ___
asis to lateral malleolus
187
list segmental leg length markers and what they mean
* Iliac crest -> greater trochanter (suggesting coxa vara or coxa valgus)
* Greater trochanter -> lateral knee joint line (suggesting femoral shortening)
* Medial knee joint line -> medial malleolus (suggesting tibial shortening)
188
with LEFS ___ score is worse
lower
189
increased femoral adduction during a mini squat may indicate weak
glut med
190
which has a larger angle, anteversion or retro
anteversion
191
labral tears typically have no restriction in
ROM
192
observational test for adduction syndrome
good one is single leg stance (watch if they adduct)
193
ischial bursitis is what movment pattern
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