Hip (Lecture and Lab)

Question 1

The hip is considered what type of joint with how many degrees of freedom?

Answer 1

Diarthrodial ball and socket; 3 DoF

Question 2

T/F: The hip has more stability and less ROM than the shoulder.

Answer 2

True

Question 3

Give the closed pack position of the hip.

Answer 3

Max extension, IR, and ABD: Terminal Stance

Question 4

What is the hip capsular pattern?

Answer 4

Flexion>ABD>IR

Question 5

What is the angle of inclination? What is normal for the hip?

Answer 5

Angle between the neck and shaft in the frontal plane. Newborn: 150 degrees, Adult: 125 degrees

Question 6

Give the definition and value for coxa valga.

Answer 6

Excessive angle of inclination; >135 degrees

Question 7

Explain coxa vara.

Answer 7

Decreased angle of inclination; <120 degrees

Question 8

The line from the ASIS through the patella to the tibial tuberosity is the what?

Answer 8

Q- angle

Question 9

What is the normal Q- angle for men and women?

Answer 9

Men: ~12
Women: ~18-20

Question 10

Anteversion is what?

Answer 10

An increase in the angulation created in the transverse plane between the neck and shaft of the femur.

Question 11

Give the characteristics of the LE with ante version.

Answer 11

1) Toed in gait
2) Increased Q Angle caused by increased external tibial torsion
3) pronated feet
4) May also see increased lumbar lordosis

Question 12

What could be the cause if it the patient appears to have a leg length discrepancy due to foot pronation?

Answer 12

Anteversion may be unilateral

Question 13

Internal rotation dramatically increases to what with anteversion?

Answer 13

60- 90

Question 14

What is decreased with anteversion?

Answer 14

ER ROM with stretch weakness of ER’s

Question 15

What is the decrease in angulation created in the transverse plane between the neck and shaft of the femur?

Answer 15

Retroversion

Question 16

What clinical findings would you have with retroversion?

Answer 16

1) Toed out gait
2) Increased internal tibial torsion
3) Supination of the foot
4) Decreased Q angle
5) Increased ER with stretch weakness of IR’s
6) Genu varum and outward patellas

Question 17

The Medial Circumflex Femoral Artery passes between what muscles to feed what general area?

Answer 17

Between Iliopsoas and pectinous to feed the back of the thigh, head and neck of femur.

Question 18

The Lateral Circumflex Femoral Artery passes where to feed what general area?

Answer 18

Laterally deep to sartorius and rectus femoris to feed lateral side of the thigh and head of the femur.

Question 19

What are the normal values for flexion and extension of the hip?

Answer 19

Flexion: 110-120
Extension: 10-15

Question 20

Give the normal values of ABD and ADD of the hip.

Answer 20

ABD: 30-50
ADD: 30

Question 21

What is the normal value for both IR and ER of the hip?

Answer 21

~45

Question 22

ROM will diminish generally with age, but what motion is lost most?

Answer 22

Extension

Question 23

Give the 5 reasons that the hip is stable.

Answer 23

1) Deep acetabulum with tight fitting femoral head
2) Vacuum effect of the ball & socket that resists distraction
3) A thick capsule and ligaments
4) Balance of adjacent muscles around the hip
5) WB produces stability of the hip joint

Question 24

What muscles give the hip balance in the frontal plane?

Answer 24

ABD and ADD work each side of the hip. If the legs are even then the muscles are under equal tension.

Question 25

If the ABD and ADD balance is off how will it appear?

Answer 25

Shows up as increased side to side motion of the hips

Question 26

Discuss the muscular balance of the saigttal plane.

Answer 26

Balance of the hip flexors and extensors.

Question 27

What causes an anterior tilt of the pelvis and also increase the anterior shear forces on L4/L5 & L5/S1?

Answer 27

A contracture of the hip flexors.

Question 28

The transverse plane muscular balance is between the IR and ER muscles. What will overly powerful ER cause?

Answer 28

Toeing out

Question 29

A unilateral contracture of the ER will cause?

Answer 29

Increase posterior rotation of the pelvis which causes an increase in ant/post motion in the other hip.

Question 30

T/F: You test the ligaments of the hip separately with specific tests.

Answer 30

False; they don't have specific tests, but you do test with ROM.

Question 31

Where does the Iliofemoral ligament run?

Answer 31

From the AIIS to the intertrochanteric line

Question 32

The pubofemoral ligament originates at the Iliopubic eminence and inserts where?

Answer 32

Near the lesser trochanter

Question 33

The Ischiofemoral ligament inserts at the back of the femoral neck and originates where?

Answer 33

posteriorly from the the ischium below the acetabulum

Question 34

The Iliofemoral and pubofemoral ligaments are ____ in extension and ____ in flexion.

Answer 34

Taut; lax

Question 35

What is on slack during ABD? What is tight?

Answer 35

Slack: Upper Iliofemoral Taut: Pubofemoral

Question 36

The _________ ligament is taut in ADD and the _________ ligament is slack.

Answer 36

Iliofemoral ligament | Pubofemoral ligament

Question 37

All anterior ligaments are taut in ____ and slack in _____.

Answer 37

ER;IR

Question 38

What ligament is suspected to be tight in IR and extension?

Answer 38

Ischiofemoral Ligament

Question 39

Give the 3 functions of articular cartilage.

Answer 39

1) Reduce Friction 2) Absorb compressive forces 3) Maintains jt height (provides stability)

Question 40

What phase of joint lubrication occurs during swing through?

Answer 40

Hydrodynamic

Question 41

What are the two joint surfaces doing during hydrodynamic phase?

Answer 41

Gliding and rolling past each other.

Question 42

Which direction does the synovial fluid move during hydrodynamic?

Answer 42

The move past each other in the opposite direction

Question 43

The second phase of joint lubrication is referred to as _________ and begins where?

Answer 43

Hydroelastic; begins at heel strike

Question 44

What helps the femoral head to keep its shape even through compressive forces in the hip joint?

Answer 44

Cartilage in the superior femoral head and the posterior acetabulum.

Question 45

What helps with force dissipation in the femur?

Answer 45

Trabecular formation

Question 46

What happens with the synovial fluid as the WB continues through the stance phase?

Answer 46

Synovial fluid is pushed out

Question 47

What is the Boundary Stage and why is it important?

Answer 47

Boundary Stage: Single layer of synovial fluid is providing lubrication. Occurs during the Squeeze Film Phase

Question 48

After toe off the hip goes into the close packed position. What is the name of the stage and why is it important?

Answer 48

Close Pack Phase; important because this is the point of max congruence between the two surfaces