Hip/pelvis Flashcards
(164 cards)
1
Q
hip articulation is formed by what
A
femural heal and acetabulum
2
Q
hip transmits what types of loads
A
tensile and compressive
3
Q
what type of joint is the hip?
A
ball and socket
4
Q
what is another name for ball and socket
A
spheriodal
5
Q
how many planes of movement does the his go through
A
3- sagittal, frontal, transvers
6
Q
sagittal plane of hip movement
A
flexion extension around transverse axis
7
Q
frontal plane of hip movement
A
abduction and adduction around ant/post axis
8
Q
transverse plane of hip movement
A
internal/external rotation around vertical axis
9
Q
os coxa is made up of
A
ilium, pubis, ischium
10
Q
ilium forms which portion of os coxa
A
superior 2/5
11
Q
ischium forms which portion os coxa
A
posterior 2/5 acetabulum and ramus
12
Q
ischium + ramus=
A
ischial tuberosity
13
Q
pubis for which portion os coxa
A
anterior 1/5 acetabulus.
14
Q
smallest bone of os coxa
A
pubis
15
Q
what are the parts of the pubis bone
A
body, inf and sup rami
16
Q
by what age is acetabular development complete?
A
age 8
17
Q
what of the acetabulum changes at puberty?
A
acetabular depth
18
Q
why does the acetabulum increase depth?
A
development of three secondary ossification centers
19
Q
which way is the acetabulum angled
A
lateral, inf, ant
20
Q
what increases joint stability of the acetabulum?
A
acetabular rim–> labrum
21
Q
what lines the acetabulum
A
hyaline cartilage (articular cartilage)
22
Q
what part of the acetabulum is not covered with cartilage?
A
fovea capitis
23
Q
what three joints make up the pelvic girdle
A
acetabulofemoral
sacroiliac
pubic symphysis
24
Q
what is the most stable joint in the body
A
acetabulofemoral
25
what is pelvic obliquity
pelvic leveling
26
excess lordosis in lumbar spine possibly what
weak abs
27
what tests confirm weak abdominals?
Milgrams test
28
if milgrams does not confirm weak abs what other tests?
could be space occupying lesion or disc path
valsalva
bechterew
anterior innominate- mazion- advancement sign
SLR
29
what is an iliac contusion
contusion/avulsion to site of quadratus lumborum or abdominal muscles from the iliac crests. VERY painful. disabling is periosteum is involved
30
what is an avulsion
pulling of the tendon from the periosteum
31
what will elicit pain in iliac contusion
lateral flexing away from side of inj and abduction when laying on side
32
etiology of iliac contusion
trauma- football, lax, hockey
33
pubic tubercles should be level with what in the inspection
grater trochanters
34
what could heal wrong causing misalignment?
congenital hip dislocations/ fracture
35
superior/ inferior pubic rami fractures with separation/ fracture of contralateral SI joint
Bucket handle fracture
36
separation of the pubic symphysis and both SI joints
sprung pelvis
37
bilateral superior pubic rami and ischiopubic fracture
straddle fracture
38
MOI landing hard on butt, falling from a height, horseback riding
straddle fracture
39
MOI bad infection, appendicitis, trauma, buildup of pressure
sprung pelvis
40
most common areas of pelvis for avulsion fractures
ASIS, AIIS, ischial tub
41
avulsion from iliac crest is usually
abdominal muscles
42
avulsion from ASIS
sartorius
43
avulsion from AIIS
rectus femoris
44
avulsion from lesser trochanter
iliopsoas
45
avulsion from pubic symphysis
adductor group
46
avulsion from ischial tub
hamstrings
47
avulsion from greater trochanter
gluteal muscles
48
strongest and longest bone in the body
femur
49
portion not covered in smooth layer of cartilage
fovea capitis, ligamentum teres
50
angle between femoral shaft and neck
inclination angle
51
average inclination angle
120-130 degrees
52
how does the inclination angle change with body type
taller person more valgus larger angle
| shorter person more varus smaller angle
53
MOI for femoral head dislocation
dashboard injury
54
force to knee if hip is adducted may cause
posterior hip dislocation
55
muscles that insert into greater trochanter
```
adductor brevis
gemelli (inf/sup)
gluteus medius
gluteus minimus
obturator internus
piriformis
```
56
muscles that insert into lesser trochanter
iliacus
pectineus
psoas major
57
how is the lesser trochanter created?
pulling of the iliopsoas
58
what type of bone is in the femoral neck?
trabecular bone
59
what is it designed to withstand?
high loads
60
where is the lesser trochanter located
posterior medial junction of the neck and shaft of femur
61
angle that the femoral neck makes with the acetabulum
angle of anteversion
62
what is normal anteversion
8-15 degrees
63
angle between femoral neck and transcondylar axis is greater than 15 degrees
medial femoral torsion
64
what type of gait is associated with medial femoral torsion
toe in
65
increased femoral head torsion result in
```
OA
dysplasia or acetabulum
susceptibility to anterior femoral dislocation
knee joint misalignment
patellar dislocations
excessive lumbar lordosis
external rotation of tibia
pronation of feet
```
66
angle between femoral neck and transcondylar axis is less than 15 degrees
femoral retroversion
67
femoral retroversion causes what type of gait
toe out
68
decreased femoral head torsion may result in
LB SI path
internal rotation of tibia
supination of feet
69
LCP
legg calve perthes disease
70
avascular necrosis of the femoral capital epiphysis before the closure of the growth plate
legg calve perthes disease
71
LCP prominance in which genders and ages
5:1 male, ages 3-12
72
what history should be indicators for LCP
painful limp reduced mobility and muscle atrophy
73
an aka for femoral anteversion
medial femoral torsion
74
what test is positive with legg calve perthes
trendelenberg
75
MOI for LCP
trauma
heredity
nutritional
circulatory
76
four stages of LCP during ages
2-8
77
what are the four stages of LCP
avascularization
revascularization
repair
deformity
78
when is the peak influence of LCP
5 years (range is 2-14)
79
is LCP ever bilateral?
in 10% of cases
80
first sign of LCP
effusion as shown by lateral displacement of femoral head
81
what population is LCP more prevelant
children who experience second hand smoke frequently
| 1:100
82
what is the possible reason causing LCP
nicotine constricting blood vessels in the hip during development
83
what are the three extra articular ligaments that provide stability in the hip joint
iliofemoral ligament (bertin/bigelow)
pubofemoral
ischiofemoral
84
how many parts does the iliofemoral ligament have
2: inferior (medial) and superior (lateral)
85
what is the strongest ligament in the body
iliofemoral ligament
86
how is iliofemoral oriented
superior laterally
87
what muscle does the iliofemoral ligament blend with
iliopsoas
88
what is the orientation of the pubofemoral ligament
inferior-medial
89
what does the pubofemoral ligament blend with
inferior band or iliofemoral and pectineus muscle
90
what is the orientation of the ischiofemoral ligament
winds posteriorly around femur, attaches anteriorly
91
what ligament in the hip is most commonly injured
ischiofemoral
92
what happens with the three stabilizers when the hip is put into extention
they all tighten
93
what part of iliofemoral ligament limits adduction
lateral
94
what part of the iliofemoral ligament limits external rotation
medial band
95
what does the pubofemoral limit
abduction
96
what does the ischiofemoral ligament limit
internal rotation
97
what is the most power hip flexor
iliopsoas
98
what makes up the iliopsoas
iliacus and psoas
99
what adducts, flexes, and internally rotates the hip
pectineus
100
what muscle combines flexion of the hip and extension at the knee
rectus femoris
101
what is the longest muscle in the body
sartorius
102
TFL
tensor fascia latae
103
the TFL does what at the hip
abduct, flex, internally rotate
104
sartorius responsible for what movement at the hip
flexion, abduction, external rotation and some knee flexion
105
what is the largest and most important hip extensor and external rotator
gluteus maximus
106
what is the main abductor of the hip
gluteus medius
107
weakness of the gluteus medius can be tested with
trendelenburg test
108
the anterior portion of glute med does what
flex, abduct, internally rot hip
109
the posterior portion of the glute med does what
extends, externally rotates hip
110
what is the major internal rotator of the femur
gluteus minimus
111
what cause weak gluteus muscles
```
fracture of greater trochanter
slipped capital femoral epiphysis
congenital hip dislocation
poliomyelitis (polio)
meningomyelocele
```
112
trendelenburg test positive
high iliac crest on supported side and low iliac crest on side of lifted leg
113
trendelenburg test indicator
weak glute med muscles on supported side
114
what is slipped femoral capital epiphysis
slipping of the neck on the femoral head as the head remains in the acetabulum
115
what is the age range for slipped femoral capital epiphysis
10-15
116
slipped femoral capital epiphysis is more predominant in
males more than females
117
slipped femoral capital epiphysis is more common in what race
blacks more than white
118
etiology of slipped femoral capital epiphysis is trauma
50% of the time
119
the positive on xrays is what for slipped femoral capital epiphysis
kleins line
120
what action is the piriformis responsible for
external hip rotator at less than 60 degrees.
121
at 90 degrees of hip flexion what does the piriformis do
reverses its muscle action becoming an internal rotator and abductor.
122
what are the small external rotators of the hip
obturator externus/internus, inferior gemelli and quadratus femoris
123
what make up the hamstrings
biceps femoris, semitendinosus, semimembranosus
124
which hamstring extends the hip flexes the knee and externally rotates the tibia
biceps femoris
125
which hamstring extend the hip flex the knee and internally rotate the tibia
semimembranosis and semitendinosus
126
which hip adductor is most frequently injured
adductor longus (groin pull)
127
what muscles adduct the hip
adductor magnus, longus and the gracillis
128
how many total bursa are in the hip region?
12
129
other names for the iliopsoas bursa
iliopectineal, iliac, iliofemoral, subpsoas bursa
130
largest bursa of the hip
iliopsoas
131
where is IPB located
deep to iliopsoas tendon cushions tendon from structures anterior aspect of hip jt
132
what is the most common cause of an inflamed and distended IPB
RA
133
sub trochanteric bursa is located where
between greater trochanter and TFL
134
what can cause bursitis of trochanteric bursa
adaptively shortened TFL
135
what are the borders of the femoral triangle
superiorly > inguinal ligament
medially > adductor longus
laterally > sartorius
floor > parts of iliopsoas(lateral) and pectineus(medial)
136
inguinal ligament is located between
pubic tubercle and anterior iliac spine
137
laterally to medially how are the nerves and vascular vessels arranged
Nerve, Artery, Vein
138
which of the three found in the femoral triangle are not palpable
femoral vein
139
what provides cutaneous innervation in the posterior gluteal region
subcostal N, dorsal rami of L1-3 and dorsal primary rami (cluneal N) of S1-3
140
anterior hip region cutaneous N supply superior to inguinal ligament
iliohypogastric N
141
anterior hip region cutaneous N supply inferior to inguinal ligament
subcostal N and femoral branch of genitofemoral N and iliolingual N
142
sciatic N is located between
ischial tuberosity and greater trochanter
143
what may cause tenderness of the sciatic N
disc pathology or trauma
144
what kind of issue may sciatic N have with piriformis muscle
congenital
145
what percentage of people have normal location of sciatic N in relation to piriformis
88% Sciatic N passes inferiorly to piriformis
146
11% of population has what happen with sciatic N and piriformis
common peroneal division goes through the piriformis
147
0.9% of population has what happen with sciatic N and piriformis
common peroneal division passes superior to piriformis (superficial)
148
0.1% of population has what happen with sciatic N and piriformis
both divisions pass through piriformis
149
what occurs during the acute phase of intervention
PRICE (protection, rest, ice, compression, elevation)
150
goals of acute phase of intervention
restore pain free ROM in entire kinetic chain
decrease pain/inflammation
retard muscle atrophy
min effects of immobilization and activity restriction
maintain gen fitness
patient indep with home exercise program
151
functional phase of intervention
```
full ROM
normal jt kinematics
muscle strength
neuromuscular control
normal muscle force couple relationships
```
152
test for fracture of long bone or hip jt pathology
anvil test
153
test to determine short leg or femoral neck angle
leg length discrepancy
154
pediatric test differentiating between congenital hip dislocation or anatomical short leg and contralat anatomical short leg
allis sign
155
test depicting contracture of hip flexors typically iliopsoas
thomas test
156
strict test for hip joint patholody
patrick/fabere sign
157
a test confirming hip joint pathology but also depicting mechanical problem in S-I jt
Laguerre test
158
what test stresses S-I joints into extension and indicates general sacroiliac joint lesion, anterior sacroiliac ligament sprain, or inflammation of the S-I joint
Gaenslen and Lewin-Gaenslen
159
test where tester stands side opposite and flexes knee and internally rotates the thigh. the positive: pain in the hip region= hip jt pathology. pain the in buttock/pelvis= S-I jot lesion
Hibb test
160
test indicating contraction of the IT band or tensor fascia lata usually secondary to synovitis of hip secondary to trauma of the glute med or min
ober test
161
In this test Dr slight flex in the knee abducts the hip and extends hip lets go of the knee and it should drop. the drop is secondary to trauma of the glute med/min
ober test
162
pain in either S-I indicating an S-I lesion
pelvic rock/ iliac compression
163
the test done as a part of the other tests in the process of flexing the knee to the butt
ely sign
164
deep S-I jt pain. sprain of anterior S-I jt
yeoman test
