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Semester 2 PM Exam 7 > Hip Exam and Eval > Flashcards

Hip Exam and Eval Flashcards

1
Q

The big 4

A

Observation, gait, ROM, palpation

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2
Q

Large percentage of hip complaints stem from

A

lumbar spine/pelvis

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3
Q

Hx should include

A

Mechanism, severity, onset, area, type of pain, 24 hour pain, weightbearing, agg and rel positions, numbness/tingling, hx of low back problems, diagnositc imaging, surgery, changes in ADL, red flag questions

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4
Q

Purpose of history

A

Develops a diff dx
Gives us red flags or specific concerns
Assists with determining if pt fits into scope of PT
Determine pt goals

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5
Q

Diff Dx - SI or lumbar spine

A

Previous hx of back pain

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6
Q

Diff Dx - Mm strain

A

Onset of symptoms, area of pain

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7
Q

Diff Dx - Mm tear

A

onset of symptoms, area of pain

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8
Q

Diff Dx - Tendonitis

A

Onset of symptoms, area of pain

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9
Q

Diff Dx - Avulsion

A

Onset of symptoms, area of pain

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10
Q

Diff Dx - Bursitis

A

Ilipsoas, Iliopectineal, ischial tubercle, greater troch, area of pain and onset

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11
Q

Diff Dx - DJD

A

Onset, x-ray, age, groin pain, radiating to knee, morning stiffness, OA in other joints, pain with prolonged ambulation

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12
Q

Diff Dx - Stress fracture

A

onset, xrays, rule out other pathology, osteoporotic, athlete

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13
Q

Diff Dx - synovitis

A

onset, intensity of pain

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14
Q

Diff Dx - Labral Tear

A

Athlete, trauma, clicking

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15
Q

Diff Dx - avascular necrosis

A

previous trauma, congenital hip dislocation, Legg Calve perthes, slipped capital femoral, steroid use, deep aching throb in hip

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16
Q

Diff Dx - Pubic symphysis dysfunction

A

Previous history of back pain, trauma

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17
Q

Diff Dx - Lower abdominal strain

A

area of pain

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18
Q

Dff Dx - Entrapment of nerves

A

femoral, obturator, iliohypogastric, numbness/weakness in leg

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19
Q

Diff Dx - Leg Calve Perthes

A

Age, positioning of limb

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20
Q

Diff Dx - Slipped capital femoral epiphysis

A

Age, leg position

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21
Q

Diff Dx Osteoid osteoma

A

Onset of sx, night sweats, loss of weight, rule out musculoskeletal/neuro path

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22
Q

Diff Dx Meralgia paresthetica

A

Abnormal sensation in testing lateral femoral cutaneous

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23
Q

Diff Dx Inguinal/femoral hernia

A

onset of sx, bulging at site

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24
Q

Diff Dx - Muscle calcification

A

previous muscle contusion

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25
Q

Diff Dx - tumor

A

night sweats, rule out musculoskeletal/neuro

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26
Q

Diff Dx - inflammatory synovitis

A

history of it, systemic issues versus single joint

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27
Q

Diff Dx - subluxation

A

trauma

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28
Q

Diff Dx - Dislocation

A

Trauma

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29
Q

Diff Dx - Infection

A

fever, acute pain

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30
Q

Diff Dx - Inflamed lymph nodes

A

palpation will reveal, need to rule out musculo/neuro

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31
Q

Diff Dx - Referred visceral pain

A

Rule out musculo/neuro

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32
Q

Diff Dx - thrombosis of femoral artery, great saphenous vein, gluteal arteries

A

pulses, are of pain

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33
Q

Diff Dx - bladder infection

A

fever, pain with urination

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34
Q

Diff Dx - congenital hip dislocation

A

age

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35
Q

Diff Dx - septic arthritis

A

Fever, history of infection

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36
Q

Lumbar scan

A

Observation/palpation
Gait
AROM and overpressure
If needed - PA spring, neural, dermatomes, myotomes, reflexes

37
Q

Lumbar scarn observation/palpation

A

Lumbar spine and hip
Anteversion or Retroversion
Knee and foot position
LE sx can radiate up to hip and vica versa

38
Q

Lumbar Scan - Gait

A

observe lumbar spine and LE
Determin pain level with WB
ROM with gait
Trendelenburg or any other muscle weakness

39
Q

Lumbar Scan - Neuro

A

Slump, SLR, derm, myo, reflexes

40
Q

How to clear joint below

A

Knee

AROM and overpressure

41
Q

Hip tests and measures

A 
Observation
Gait
AROM and overpressure
Palpation
Muscle contraction
Joint mob
Flexibility
Special tests
Functional tests
Outcome measures
42
Q

Observation - Posture

A

Anteversion/Retroversion
Coxa vara/valga
Leg length differences

43
Q

If patient has lordotic posture…

A

weak RA, tight iliopsoas

44
Q

If patient has sway back

A

weak iliopsoas, tight ES, tight hams, weak glut max

45
Q

If patient has asymmetrical iliac crests

A

tight hip abductors, tight quadratus lumborum

46
Q

Balance/Gait - One leg stand

A

Trendelenburg
Balance
PF strength

47
Q

Balance/Gait - Gait

A

Affect of posture on gait
Balance
Pain with gait

48
Q

AROM

A 
Flexion
Extension
Abduction
Adduction
IR 
ER
49
Q

Hip Flexion -

A

Sitting or supine (Usually supine)

50
Q

Hip Extension -

A

Supine - doesnt asses extensors unless PT adds resistance
Prone - only tests a limited range
Sidelying - resistance can be applied to imitate gravity, pelvis has to be stabilized

51
Q

Hip Abduction

A

Supne

52
Q

Hip Adduction

A

Supine

53
Q

Hip IR

A

Supine - hip 90 degrees

54
Q

Hip ER

A

Supine, hip 90 degrees

55
Q

Hip OA cluster

A

Hip IR less than 15
Hip flexion less than or equal to 115
Age greater than 50

56
Q

Hip OA cluster 2

A

Hip IR greater than or equal to 15
Pain with hip IR
Morning stiffness of hip for up to 60 min
Age greater than 50

57
Q

End Feels for hip in normal

A

should all be tissue resistance (springy/muscular)

58
Q

Muscle testing

A

Myotomal testing
GMT
MMT
Resisted contraction of muscle

59
Q

GMT

A

helps you determine general strength

60
Q

MMT

A

for specific muscles that are weak

61
Q

Resisted Contraction

A

used to determine if greater muscle contraction will cause pain
Isolates to a muscle or tendon problem
Resisting muscle in lengthened position is a good way used for subtle lesions that midrange contraction may not pick up

62
Q

Strong and painless Resisted COntraction

A

Normal or very isolated minor pathology

63
Q

Strong and painful Resisted contraction

A

Minor/moderate pathology of mm, tendon, bursa

64
Q

Weak and painful resisted contraction

A

more acute or major pathology of mm, tendon, fracure

65
Q

Weak and painless resisted contraction

A

serious pathology, nervous system, tumor

66
Q

Joint mobility assessment

A

Resting (open packed) position
Close packed position
Capsular pattern

67
Q

Resting (open packed) position

A

Flexed 30 degrees, abd 30 deg, slight lateral rotation

68
Q

Close packed position

A

max ext, medial rotation and abduction

69
Q

Capsular pattern

A

medial rotation, flexion, abduction = extension

70
Q

in treatment when contractile tissues are lengthened…

A

follow with lengthening non contractile tissue and vice versa

71
Q

Joint Mobility Assessment

A

Lateral distraction
Longitudinal Distraction
Anterior Posterior
Posterior Anterior

72
Q

Flexibility

A 
Thomas
Modified Thomas
Elys
Ober
Modified Ober
Hamstring
Piriformis
73
Q

Below 60 degrees of hip flexion, piriformis is

A

an external rotator

74
Q

Above 60 degrees of hip flexion, piriformis is

A

a medial rotator and horizontal abductor

75
Q

Special Tests

A

Scour

FABERE

76
Q

Scour test

A

nonspecific for medial - anterior lesions and when done in abduction for posterior-lateral lesions

77
Q

FABERE test

A

non specific for screening hip pathology if pain is in hip

78
Q

Labral Tests

A

Internal rotation, compression = high Sn, poor Sp

MRA is best

79
Q

Craigs Test

A

Used to assess anteversion/retroversion

Determine the point where GT is most lateral

80
Q

Leg Length Test

A

x ray is gold standard

81
Q

Activity limitations and participation restrictions

A 
One leg balance
Sit to stand
Single leg squat
Step ups
Step downs
Isolated sport activity 
6 min walk test
TUG
82
Q

Outcome Measures - Lower Extremity Functional Scale

A

Intended for clients with musculoskeltal condition of LE
Low score = 0, high = 80
Discriminating btw acute and chronic, surgery/ no surgery and clients recieving or not recieving home care

83
Q

For individual patient to evaluate true change with LE functional scale../

A

minimally important differece = 9 points

84
Q

Outcome Measures - Patient Specific Functional Scale

A

Clients identify up to 5 activities with which they have difficulty
Clients rate 0-10 of current level of difficulty

85
Q

Minimally detectable change for Patient specific functional scale

A

2.5 points

86
Q

WOMAC - outcome measures

A

3 scales, pain stiffness and physical function

Mainly for OA

87
Q

Harris Hip Score - outcome measures

A

Used by physicians for total hip replacement

Surgery deemed successful if score inc 20 points plus radiology looks stable

88
Q

Final Eval

A 
Tx dx
Prognosis
Goals
Plan
Intervention

Semester 2 PM Exam 7 (8 decks)

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