Hip Flashcards by Armi B

Hip is ——axial joint with ——-degrees of freedom

triaxial

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flexion/extension

sagittal plane

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abduction/adduction

frontal plane

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internal/external rotation

transverse plane

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what is circumduction motion?

combination of motions occurring in all 3 planes simultaneously
seen in stroke patients

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in the case of the hip, circumduction will cause the foot to be moving

in a circular pattern, and the lower ex will be moving in a cone with apex of the cone at the hip

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what is the primary function of the hip?

support the weight of the head, arms and trunk in both static and dynamic weight-bearing

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what are some other functions of the hip?

provide a pathway of forces between the pelvis and the lower ex
functions primarily in a closed kinetic chain system in which the head is considered the fixed point.

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hip functions primarily in

Closed-Kinetic Chain system

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what is the fixed point in CKC system?

head

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hip flexion is an example of

CKC

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The forces applied in static stance w/o muscle contraction: Each femoral head bears about —–of the body weight above the hips

1/2

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The forces applied in static stance w/o muscle contraction:Each lower extremity is about ——-body weight

1/6

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The forces applied in static stance w/o muscle contraction:Each hip bears about ——–of the body weight

1/3

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Forces applied to the hip, with muscle contraction:

3X body weight if standing on one leg

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Forces applied to the hip, with muscle contraction: stance phase of gait

up to 6 times body weight during stance phase of walking cycle

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increase in velocity of gait causes

the increase in force at the hip

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The acetabulum faces

laterally
inferiorly
anteriorly

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greater trochanter is important for

muscle attachment

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neck of the femur is important for

injuries

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In an extended position of the hip ( which is a neutral position in sagittal plane)

considerable amount of femoral head is uncovered - not the greatest head coverage

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swaddling of the infant puts hip in what position?

Extended

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swaddling of infants causes

congenital hip dislocation

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swaddling forces the hip into

less congruent position

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when the infant is carried on the mother's hip at a very young age

the incidence of hip dislocation is less than normal

when the infant is carried on the mother's hip at a very young age

this abducted, flexed, externally rotated position correlates to a position of greater coverage of the femoral head within acetabulum, providing protection to the hip joint

only a ----------shaped portion of the periphery is covered with hyaline cartilage

horseshoe

over time horseshoe shaped cartilage thins and you have direct contact of femoral head with acetabulum fossa and you get

hip arthritis lack of shock absorbance lower back pain

the acetabular fossa is

non articular

femoral head ---------contact acetabular fossa

DOES NOT | this articular confuguration allows hip joint to have a cushion effect

if the femoral head were in complete contact with the acetabular fossa

then all shock passing up through the femur would then be transferred to the pelvis

now that the femoral head is not in complete contact with the acetabular fossa

the shock is transferred to the articular cartilage which then compresses to help dissipate the shock.

in radiograph if you dont see any joint space that means there is

No cartilage

The entire acetabulum is deepened by

acetabular labrum

The labrum helps

- deepen the socket | - increase relative concavity of acetabulum

hip joint is one of the

most stable joint in the body

hip capsular ligaments

screw down the femoral head into acetabulum as you get into hip extension

As the hip extends the hip capsular ligaments

coil and tighten making hip extension the "closed-packed" position or neutral position

As the hip moves into hyperextension

the ligament act to provide resistance

in hip joint the closed packed or neutral position

is not the position of maximum congruity

what is the most congruent position of the hip

flexed to 90º abducted externally rotated the "quadruped"position

the least stable hip position

flexed adducted (there is decreased congruity, and the joint is loose-packed)

what is the strongest ligament of the body?

iliofemoral ligamnet aka the Y ligament of Bigelow

superior fibers of the iliofemoral ligament are

tensed with adduction

Inferior fibers of the iliofemoral ligament are

tensed with abduction

the pubofemoral ligament is taut with

extension | hip abduction

the ischiofemoral ligaments are located

posteriorly

the fibers of ischiofemoral are ---------oriented

spirally

the spiral fibers tighten with --------------and loosedn or unwind during----------

hip extension | flexion

Forces passing through bony architecture are often represented by

trabecular patterns

in the hip, the trabecular patterns

the weight bearing forces passing through both femur and pelvis

most of trabecular patterns in the pelvis pass through

acetabulum

There is no significant trabeculae patterns to protect

the neck of the femur ...therefore more susceptible to fracture

elderly women tend to get hip fracture

due to osteopenia

The trabeculae act to provide

- reinforcement along weight bearing lines | - prevent the femoral head from being sheared off

An area of increased subchondral bone density exists

in the superior acetabulum

Area of subchondral bone density corresponds to

the area of greatest weight-bearing within the acetabulum

The zone in the hip which has less trabecular reinforcement is called

a zone of weakness

women are more susceptible to hip fracture due to

increased angulations which increases area of weakness

Hip range of motion vary widely in opinions of normal value due to

pelvic tilt

Do we see motions of the femur on pelvis during ckc?

What do we see during CKC motion of the hip?

we see pelvis tilting anteriorly for hip flexion and posteriorly for hip extension or lateral pelvic tilt in case of abduction and adduction of the hip

Regardless of the direction of the pelvic tilt, in CKC what will occur?

compensation in the lumbar spine

What is Lumbar Pelvic Rhythm?

in OKC, the hip, pelvis and lumbar all work together to provide increased range of motion.

What is normal value for frontal plane hip range of motion?

45º abduction and 45º addction | most people do not seem to have this much range of motion

what is the more realistic value for frontal plane hip range of motion?

30º abduction and 25º adduction

what is the minimum range of motion required for normal daily activities?

20º abduction

Greatest amount of range of motion is in ------plane

Sagittal

Hip flexion with knee extended

70º-90º | limited by hamstrings

Hip flexion with knee flexed

Greater than 120º | limited by bony architecture or by abdominal girth

How do you evaluate Hip range of motion?

put middle finger under lower back all the way to spine to make sure we aren't getting hip or spine motion.- when you feel pressure, stop lifting the leg

hip hyperextension is limited by

capsular ligaments particularly the iliofemoral ligament

hip extension with the knee extended may be limited by

the medial thigh muscle group

Hip extension with the knee flexed to 90º may be limited

by the quadriceps femoris

Transverse plane hip range of motion varies depending on

the position of the knee and the hip

what is the benefit of measuring hip range of motion with the knee flexed ?

muscle limitations to transverse plane hip motion have been minimized

What is the benefit of measuring hip range of motion with the hip flexed?

ligamentous limitation has been minimized

What are the theoretical normal values for transverse plane hip range of motion?

45º External rotation | 45º internal rotation

What is the minimum hip ranges of motion required for normal gait in sagittal plane?

30º flexion | 10º hyperextension

What is the minimum hip ranges of motion required for normal gait in frontal plane?

5º abduction/adduction

What is the minimum hip ranges of motion required for normal gait in Transverse plane

5º internal/external rotation

climbing stairs, sitting, crossing legs all increase

hip ranges of motions

during gait, as you go through pre-swing you get

rapid hip flexion

Hip Flashcards

(83 cards)