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LOWER EXTREMITY > Hip - ANATOMY AND KINESIOLOGY part 2 > Flashcards

Hip - ANATOMY AND KINESIOLOGY part 2 Flashcards

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1
Q

Center-edge angle
- indicate how much of the fem head is covered
“Angle of Wiberg”
- reference ( vertical)
- lateral aspect of the
acetabulum

ABN:
<____deg= ____
>____deg= ____(pincer)

A

“Angle of Wiberg”
- reference ( vertical)
- lateral aspect of the
acetabulum

ABN:
<25 deg= dysplasia
>39 deg= FAI (pincer)

FAI- Femoral Acetab impingement

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2
Q

Acetabular Anteversion angle

Ref: ____

> ____ degrees (Ant) = instability/
dislocation

< ____degrees (Post) = excessive
coverage

Normal acetabular anteversion angle is ____

A

Ref: post acetabulum & post and ant
acetabulum

> 20 degrees (Ant) = instability/
dislocation

< 15 degrees (Post) = excessive
coverage

Normal acetabular anteversion angle is 15° to 20°.

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3
Q

Femoral Head epiphysis

Young: ____

Adult: ____

Fx fem neck : ____ interruption of blood supply

A

Young: small branch obturator aa

Adult: med fem circumflex aa

Fx fem neck : interference/ complete interruption of blood supply

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4
Q

Angle of Anteversion

Inc anteversion= ____

Retroversion= ____

A

Inc anteversion= shaft femur rotate medially

Retroversion= shaft of femur rotate laterally

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5
Q

Angle of Torsion of Femur

  • Angle made by the femoral
    neck with the femoral
    condyle

Normal = ____°
* At birth, the mean angle is approximately ____°
* In the adult, the mean
angle is ____° to ____°

A
  • Angle made by the femoral
    neck with the femoral
    condyle

Normal = 13-15°
* At birth, the mean angle is
approximately 30°
* In the adult, the mean
angle is 8° to 15°

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6
Q

Angle of Anteversion

Angle >15°
what happens to the shaft of femur?

A

◦Shaft of the
femur rotated
medially

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7
Q

Angle of Anteversion

Excessive anteversion

Related Posture?

Possible Compensatory

Postures?

A

Related Posture:
Toeing in
Subtalar pronation
Lateral patellar subluxation
Medial tibial torsion
Medial femoral torsion

Possible Compensatory
Postures:
Lateral tibial torsion
Lateral rotation at knee
Lateral rotation of tibia,
femur, and/or pelvis
Lumbar rotation on same side

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8
Q

Angle of Anteversion

Angle <13°

what happens to the shaft of femur?

A

◦Shaft of the
femur rotated
laterally

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9
Q

Angle of Anteversion
Excessive
retroversion

Related Posture?

Possible Compensatory Postures?

A

Related Posture
Toeing out
Subtalar supination
Lateral tibial torsion
Lateral femoral torsion

Possible Compensatory Postures
Medial rotation at knee
Medial rotation of tibia,
femur, and/or pelvis
Lumbar rotation on opposite
side

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10
Q

Craig’s test/ Ryder method

Test for Anteversion

Procedure:
(+):
Indication:

A
  • Prone with the knee flexed
    to 90°
  • Palpates greater trochanter
  • Passive IR and ER until
    greater troch is parallel to
    table or most lateral position.
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11
Q

Neck Shaft Angle

Normal?
Coxa Valga degrees?
Coxa Vara?

A

Normal - 120°-135°
Coxa Valga - >135°
Coxa Vara - <120°

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12
Q

Neck Shaft Angle

<drive>
</drive>

A
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13
Q

HIP JOINT

  • Multiaxial ball-and-socket joint
  • Synovial joint
  • Very stable joint
  • Femoral head is ____
  • Acetabulum is ____
A
  • Multiaxial ball-and-socket joint
  • Synovial joint
  • Very stable joint
  • Femoral head is convex
  • Acetabulum is concave
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14
Q

Coxa Valga: Longer
- limb ____
- hip ____
- Inc/dec? leverage abductor

A

Coxa Valga: Longer
- limb lengthening
- hip instab
- dec leverage abductor

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15
Q

Coxa Vara: Shorter
- limb ____
- increase ____
- Arthritic changes

A

Coxa Vara: Shorter
- limb shortening
- increase tensile forces- fem neck fx
- Arthritic changes

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16
Q

Compensatory: Valga
A. ipsi Valga- ____

B. C/L unaffected - ____

A

Compensatory: Valga
A. ipsi Valga- shorten the longer valga side
B. C/L unaffected - lengthen

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17
Q

Compensation: Vara
A. Ipsi Vara: ____

B. C/L : ____

A

Compensation: Vara
A. Ipsi Vara: to lengthen
B. C/L : shorten

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18
Q

PJM to Increase

Hip flexion

A

Posterior

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19
Q

PJM to Increase

Hip extension

A

Anterior

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20
Q

PJM to Increase

Hip internal rotation

A

Posterior

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21
Q

PJM to Increase

Hip external rotation

A

Anterior

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22
Q

PJM to Increase

Hip abduction

A

Inferior

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23
Q

PJM to Increase

Hip adduction

A

Superior

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24
Q

HIP Resting position

A

30° flexion, 30° abduction, slight ER

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25
HIP Close pack position
Extension, abduction, IR
26
HIP Capsular pattern
Flexion, abduction, and IR
27
HIP Capsular pattern
Flexion, abduction, and IR
28
HIP ROM Flexion Extension Abduction Adduction Lateral rotation Medial rotation
Flexion - 110°-120° Extension - 10°-15° Abduction - 30°-50° Adduction - 30° Lateral rotation - 40°-60° Medial rotation - 30°-40°
29
HIP JOINT Average Range of Motion Necessary Shoe tying Sitting (average seat height) Stooping Squatting Ascending stairs (average stair height) Descending stairs (average stair height) Putting foot on opposite thigh Putting on trousers
Shoe tying - 120° of flexion Sitting (average seat height) - 112° of flexion Stooping - 125° of flexion Squatting - 115° of flexion, 20° abduction, 20° of medial rotation Ascending stairs (average stair height) - 67° of flexion Descending stairs (average stair height) - 36° of flexion Putting foot on opposite thigh - 120° of flexion, 20° of abduction, 20° of lateral rotation Putting on trousers - 90° of flexion
30
Forces on the Hip
Forces on the Hip
31
LIGAMENTS OF THE HIP 1. ______femoral 2. ______femoral 3. ______femoral
1. Iliofemoral 2. Pubofemoral 3. Ischiofemoral
32
Iliofemoral Ligament * Strongest ligament * Inverted Y-shaped ligament * Superior band limits: ______ * Inferior band limits: ______ * Prevents ______ during standing
* Strongest ligament * Inverted Y-shaped ligament * Superior band limits: adduction, extension * Inferior band limits: abduction, extension * Prevents overextension during standing
33
Pubofemoral Ligament * Triangular shaped * Limits: ______ * Ipsi/Conra? pelvic tilt
* Triangular shaped * Limits: extension, abduction and ER * Ipsilateral pelvic tilt
34
LIGAMENTS OF THE HIP * Spiral shaped * Limits: ______
* Spiral shaped * Limits: extension, abduction and IR
35
FEMORAL TRIANGLE
FEMORAL TRIANGLE
36
ADDUCTOR TRIANGLE
37
MUSCLES OF THE HIP Flexors 1. I 2. P 3. S 4. TFL 5. RF 6. P
Flexors 1. Iliacus 2. Psoas major 3. Sartorius 4. Tensor fascia lata 5. Rectus Femoris 6. Pectineus
38
Iliacus Nerve? Action?
Nerve supply: Femoral (L1-L4) A: Hip flexion, APT
39
Psoas major Nerve? Action?
Nerve supply: Lumbar plexus ( L1-L3) A: Hip flexion, APT
40
THOMAS TEST Procedure: (+): Indication:
- Prone, PT flexes knee - Pt holds position (+) leg rises off the table * Tested leg pushed down= inc lordosis = Hip flexion contracture (+) J sign/stroke- Abd = Tight ITB
41
Sartorius Nerve? Action?
Nerve supply: femoral ( L2-L3) A: Flexion, abduction, external rotation of the hip
42
Tensor Fascia Lata Nerve? Action?
Nerve supply: SGN (L4-S1) A: Flexion and abduction of the hip, IR
43
OBER’S TEST Procedure: (+): Indication: Knee flexed? Inc stress on what structure?
- S/L - Passively Abd + ext c knee ext/ flexed to 90 - PT slowly lowers leg (+) Does not fall on table = ITB contracture flexed knee: stress on Fem nn
44
Rectus Femoris Nerve? Action? Active : ______ passive insufficiency: ______
Nerve supply: Femoral (L2-L4) A: Hip flexion, Extends knee Active : too shortened passive insufficiency: too elongated "Rectus Femely"
45
KENDALL TEST - aka RF contracture test - Patient does KTC and holds Procedure: (+): Indication:
- aka RF contracture test - Patient does KTC and holds N: angle of test knee should remain at 90 deg (+) knee extends
46
ELY’S TEST Nerve? Action?
- PT flexes knee (+) Hip flexion on same side = RF tightness
47
Pectineus Nerve? Action?
Nerve supply: Femoral ( L2- L4) A: Flexion, adduction, IR of the hip
48
Adductors 1. Adductor longus 2. Adductor brevis 3. Adductor magnus 4. Gracilis 5. Pectineus Adductors: Hip neutral: ______ Hip already flexed: ______
1. Adductor longus 2. Adductor brevis 3. Adductor magnus 4. Gracilis 5. Pectineus Hip neutral: Hip flexor Hip already flexed: assist in hip extension
49
Adductor longus Nerve? Action? Add longus ______in extension ______in other position
Nerve supply: Obturator (L3-L4) A: Adduction and flexion Add longus: ER in extension IR in other position
50
Adductor brevis Nerve? Action?
Nerve supply: Obturator ( L3- L4) A: Adduction
51
Adductor Magnus Nerve? Action?
Nerve supply: - Adductor portion: Obturator nn (L2- L4) - Hamstring portion: Sciatic nn (L4-S3) A: Adduction
52
Gracilis Nerve? Action?
Nerve supply: Obturator ( L2-L3) A: Adduction of hip and flexion of knee "Phelps Gracilis"
53
PHELP’S TEST Procedure: (+): Indication:
- Prone c knees extended -> Abd leg - Knees flexed 90 deg -> abd further (+) abd increases = Gracilis tightness
54
Extensors 1. Gluteus maximus 2. Hamstrings a) Biceps femoris b) Semimembranosus c) Semitendinosus 3. Adductor magnus
Extensors 1. Gluteus maximus 2. Hamstrings a) Biceps femoris b) Semimembranosus c) Semitendinosus 3. Adductor magnus
55
Gluteus Maximus Nerve? Action? MMT: G max - ______ - ______ - Pt will ______ - PT will ______ - further flexion of knee = greater use of hamstrings
Nerve supply: IGN (L5-S2) A: Extension of hip, lateral rotation, PPT MMT: G max - prone - hip straight c knee flexed to 90 - Pt will extend hip - PT will put ant force on the post thigh - further flexion of knee = greater use of hamstrings
56
Biceps Femoris Nerve? Action?
Nerve supply: - Long head: Tibial portion of the sciatic - Short head: Common peroneal of sciatic A: Extension of the hip, flexion and lateral rotation of the knee
57
TAKING OFF THE SHOE TEST Procedure: (+): Indication:
- Take off the shoes of test side - Place the heel at med longitudinal arch of opp leg - (+) sharp pain at biceps fem - 1st or 2nd degree mm strain
58
Abductors 1. Gluteus medius 2. Gluteus minimus 3. Tensor fascia lata
Abductors 1. Gluteus medius 2. Gluteus minimus 3. Tensor fascia lata
59
Gluteus med Nerve? Action? Anterior: ______ Post: ______ - as a whole: ______
Nerve supply: SGN ( L4-S1) A: Abduction of the hip Anterior: flexor and IR Post: extensor and ER - as a whole: abducts hip
60
Semitendinosus and Semimembranosus Nerve? Action?
Nerve supply: tibial portion of Sciatic nn ( L4-S2) A: Extension of the hip, flexion and medial rotation of the knee
61
Gluteus Minimus Nerve? Action?
Nerve supply: SGN ( L4- S1) A: Abduction and internal rotation of the hip
62
Tensor Fascia Lata Nerve? Action?
Nerve supply: SGN (L4-S1) A: Flexion and abduction of the hip, IR
63
External Rotators 1. Gluteus maximus 2. Sartorius 3. Piriformis 4. Gemellus superior 5. Gemellus inferior 6. Obturator internus 7. Obturator externus 8. Quadratus femoris
64
Piriformis Nerve? Action?
Nerve supply: 1st and 2nd sacral nn (L5-S2) A: Internal and external rotation of the hip
65

LOWER EXTREMITY (3 decks)

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