LECTURE 5A: HIP ANATOMY

Question 1

hip joint resting position

Answer 1

30 degrees flexion
30 degrees abduction
slight ER

Question 2

closed pack position of hip joint

Answer 2

full ER, IR, ABD

Question 3

hip joint has ___ degrees of freedom

Answer 3

3 degrees

Question 4

hip joint is a ____ joint

Answer 4

synovial joint
convEX FEMUR on concave acetabulum

Question 5

the head of the femur is ____ than the acetabulum

Answer 5

larger
*medially, superiorly, anteriorly

Question 6

James Cyriax capsular pattern of the hip joint

Answer 6

1. flexion
2. abduction
3. IR (in some cases, IR limited most)

*hip is bread and butter for capsular pattern!

Question 7

If I want SIJ manipulation, what position is hip joint?

Answer 7

closed packed
*full extension, IR, abduction

Question 8

osteoarthritis of the hip (JOINT) likely presents with…

Answer 8

capsular pattern
*lose flexion first (you have the most ROM to lose) , then abduction, then IR

Question 9

sometimes, hip dysfunction (capsular pattern) will not follow normal capsular pattern but will lose ___ ROM first

Answer 9

INTERNAL ROTATION

Question 10

If you see loss of ___ and they are not naturally ___, be suspicious of capsular pattern

Answer 10

lose IR
not naturally retroverted

Question 11

What is the hip joint designed for?

Answer 11

STABILITY (transmit force between pelvis and LE)
*stability>mobility

Question 12

undercoverage of femoral head by acetabulum

Answer 12

Hip dysplasia

Question 13

excessive bony development/over coverage of femoral head by acetabulum

Answer 13

Femoro-acetabular impingement (FAI)

Question 14

what is integral to successfully evaluating/treating hip dysfunction?

Answer 14

regional interdependence
*(treat back first if involved)

Question 15

acetabulum is made of what three bones?

Answer 15

ilium, ischium, pubis

Question 16

labral tear does what?

Answer 16

loss of negative pressure (passive stability) so MUSCLES PICK UP SLACK (fatigue)

Question 17

The acetabulum faces ___, ___, ____ and is covered by ___

Answer 17

anterior, lateral, inferior
CONCAVE
covered by articular cartilage.

Question 18

acetabular fossa is filled with ___

Answer 18

fat pad-important for shock absorption and proprioception

Question 19

angle of inclination for femur in infants

Answer 19

150 (larger)

Question 19

angulation of the femur (inclination) of the femoral neck/shaft NORMAL ADULTS

Answer 19

125-139 degrees

Question 20

angle of inclination in elderly of femur

Answer 20

120

Question 21

coxa valga is femur angle over ___

Answer 21

139 degrees

Question 22

coxa vara is femur angle below ____

Answer 22

125

Question 23

___ will cause shorter limb, STRUCTURAL LLD

Answer 23

coxa vara (more table top angle/sharper)

Question 24

normal angle of torsion of femur (anteversion) for adults

Answer 24

10-15 degrees

Question 25

normal angle of torsion of femur for infants

Answer 25

30 degrees

Question 26

excessive anteversion is greater than ___ degrees

Answer 26

15 degrees

Question 27

excessive anteversion causes

Answer 27

toe in, hip IR

Question 28

excessive anteversion predisposes people to ____ and ___

Answer 28

OA and excessive anterior glide

Question 29

relative retroversion (less than 10) AND absolute retroversion (less than 0)

Answer 29

cause TOE OUT AND HIP ER

Question 30

most common way to dislocate hip

Answer 30

POSTERIOR! *thin/loose posterior and inferior

Question 31

The joint capsule is thick ____

Answer 31

anterior and superior (more predisposed to shorten/restriction)

Question 32

acetabular labrum

Answer 32

fibrocartilage, attaches to acetabular margin increases articulation congruency disperses load

Question 33

only muscle that flexes hip at END RANGE HIP FLEXION

Answer 33

iliospsoas

Question 34

RECTUS FEMORIS

Question 35

TFL

Question 36

SARTORIUS

Question 37

GLUTE MED POSTERIOR FIBERS

Answer 37

EXTEND, Abduction, ER hip *commonly weak

Question 38

___ fibers of glute med are most commonly weak

Answer 38

posterior fibers (extend, abduct, ER)

Question 39

glute med and min anterior fibers

Answer 39

flex abduct IR hip

Question 40

glute max does ____

Answer 40

extension, ER of hip superior fibers: hip ABD inferior fibers: hip ADD

Question 41

glute max is commonly atrophied in patients with

Answer 41

sway back spine DJD hip DJD

Question 42

What is potential site of sciatic entrapment?

Answer 42

pirformis

Question 43

medial hamstrings do what

Answer 43

Semimembranosus and semitendinosus Extend and IR the hip Flex and IR the knee

Question 44

Lateral hamstrings do what

Answer 44

Biceps femoris Long head crosses 2 joints Extends and ER the hip Flexes and ER the knee

Question 45

What muscle most commonly strained in adductors?

Answer 45

adductor longus (adducts, flexes hip

Question 46

pectineus

Answer 46

ADDucts, IR and flexes the hip

Question 47

gracilis

Answer 47

ADDucts the hip IR and flexes the knee

Question 48

adductor longus/brevis

Answer 48

ADDucts and flexes the hip

Question 49

adductor magnus

Answer 49

ADDucts the hip Anterior fibers flex the hip Posterior fibers extend the hip

Question 50

which bursa are most clinically important?

Answer 50

iliopsoas trochanteric bursa ischiogluteal bursa

Question 51

Superior border: inguinal ligamental triangle

Answer 51

inguinal ligament

Question 52

Medial border: femoral triangle

Answer 52

adductor longus

Question 53

lateral border: femoral triangle

Answer 53

sartorius

Question 54

floor of femoral triangle

Answer 54

iliopsoas on lateral side pectineus on medial side

Question 55

NERVES of muscles that cross the hip joint also supply the ____

Answer 55

joint capsule and the joint *pain can be referred from hip to thigh, leg or foot! NERVE

Question 56

supply to the femoral head is from

Answer 56

ligamentum teres artery *hip dislocation has chance of KILLING BLOOD SUPPLY

Question 57

flexion hip AROM

Answer 57

110-120

Question 58

hip extension AROM

Answer 58

10-15 degrees

Question 59

abduction hip AROM

Answer 59

30-50

Question 60

adduction hip ROM

Answer 60

25-30

Question 61

hip IR ROM

Answer 61

30-40

Question 62

hip ER ROM

Answer 62

40-60

Question 63

hip flexion arthrokinematics

Answer 63

spin posterior glide

Question 64

hip extension arthrokinematics

Answer 64

Spin, anterior glide

Question 65

hip abduction arthrokinematics

Answer 65

inferior/medial glide

Question 66

hip adduction arthrokinematics

Answer 66

superior/lateral glide

Question 67

hip IR arthrokinematics

Answer 67

posterior glide

Question 68

hip ER arthrokinematics

Answer 68

anterior glide

Question 69

___% of the ____mm inserts into ITB

Answer 69

80% of GLUTE MAX inserts into ITB