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Orthopedic Diagnosis > Lecture: The Hip > Flashcards

Lecture: The Hip Flashcards

1
Q

the hip articulation is formed b/w the head of the __ and the __ of the pelvic bone.

A
  • femur

- acetabulum

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2
Q

hip joint transmits truly impressive loads, both __ & __.

also provides a wide range of __ __ movement.

A
  • tensile
  • & compressive
  • lower limb
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3
Q

hip joint is classified as a __ & __ joint.
permits motion in 3 planes:
all 3 of these axes pass thru the center of the __ __.

A
  • ball & socket
  • (1)sagittal (flex/ext around a transverse axis)
  • (2)frontal (abd/add around an ant.-post. axis)
  • (3)transverse (int/ext rot. around a vertical axis)
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4
Q

os coxa (hip bone), initially begins as 3 ind. bones:

A
  • ilium
  • ischium
  • pubis
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5
Q

the body of the ilium forms the __ 2/5ths of the acetabulum.
the ischium is a __ that contributes to the acetabulum & __, forming the __ 2/5th’s of the acetabulum.
ischium + ramus form the __ tuberosity.

A
  • superior
  • body; rams
  • posterior
  • ischial
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6
Q

pubis is the smallest of the hip bones.
consisting of a __ and __ & __ rami.
it forms the __ 1/5th of the acetabulum.

A
  • body
  • inferior & superior
  • anterior
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7
Q

the majority of acetabular development is completed by age?

and the __ increases thru puberty

A
  • eight

- depth

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8
Q 
the acetabulum is angled laterally, \_\_ & \_\_.
acetabular rim (labrum) fxn:
the whole of the acetabulum is covered with \_\_ cartilage, except the fovea capitis, b/c?
A
  • inferiorly & anteriorly
  • (deeps the acetab.) increasing its stability of the hip jt.
  • hyaline
  • serves as an attachment site for ligaments
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9
Q

pelvic girdle is composed of 3 joints:

A
  • sacroiliac
  • hip joint (acetabularfemoral)
  • pubic symphysis
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10
Q

ASIS should be in same horizontal plane, if not= __ __.

which test?

A
  • pelvic obliquity

- leg length discrepancy

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11
Q

the __ tubercle marks the __ point on the iliac crests.

A
  • iliac

- widest

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12
Q

iliac crest contusion:
aka?
contusion at site or an avulsion of the __ __ and/or __ muscles from the crest.
very painful, even disabling if __ is involved.
pt. experiences pain when __ bending __ from the side of injury.
etiology?

A
  • hip pointer
  • quadratus lumborum and/or abdominal
  • periosteum
  • side; away
  • trauma
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13
Q

greater trochanters are to be level with?

congenital hip dislocation or hip __ could heal improper and make the levels unequal; which test?

A
  • pubic tubercles
  • fracture
  • Allis Sign
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14
Q

Bucket Handle Fracture: __ & __ pubic rami frxs w/ a separation or frx of the __-__ SIJ.
MOI?

A
  • superior & inferior
  • contra-lateral
  • high speed falls (motorcycle, bicycle)
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15
Q

Sprung Pelvis: separation of the __ symphysis & __ SIJ’s.

MOI?

A
  • pubic
  • both
  • genitourinary injuries, severe constipation (organ rupture), possibly from multiple births.
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16
Q

Straddle Fracture: __lateral __ pubic rami, & ischiopubic fractures.
MOI?

A
  • bilateral
  • superior
  • falling on butt from high place or w/ great force, or from long time sustained micro trauma (i.e. riding a tractor for years)
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17
Q

most common areas of the pelvis for avulsion fractures are:

A
  • ASIS
  • AIIS
  • ischial tuberosity
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18
Q

approximately _/_rds of the femoral head is covered with a smooth layer of __, except __ __, (attachment site of __ __)

A
  • 2/3
  • cartilage
  • fovea capitis
  • ligamentum teres
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19
Q

the angle b/w the femoral shaft and the neck is called?
average degree of angle? (varies b/c of diff. body types)
in a tall person the angle is __ (aka __).
the opposite is true with shorter individuals, __.

A
  • inclination angle
  • 125-130
  • larger; valga
  • vara
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20
Q

dashboard injury to the knee will cause __ hip dislocation if the hip is __ at the time of injury.

A
  • posterior

- adducted

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21
Q

the trabecular bone in the femoral neck and head is specifically designed to withstand __ __.
and incorporates both primary & secondary __ & __ patterns.

A
  • high loads

- compressive & tensile

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22
Q

greater trochanter serves as the __ site for several muscles that act on the __ joint.
the lesser trochanter is created from the pull of the __ muscle.

A
  • insertion
  • hip
  • iliopsoas
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23
Q

the angle the femoral neck makes with the acetabulum is called the angle of __.
normal is?

A
  • anteversion

- 8-15deg.

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24
Q

femoral ANTeversion is when the angle is >__.
= a toe __ gait.
this increased femoral head torsion may result in:

A
  • > 15deg.
  • in
  • osteoarthritis
  • susceptible to ant. femoral dislocation
  • knee joint misalignment problems
  • patellar dislocations
  • excessive lumbar lordosis
  • external rotation of the tibia
  • pronation of the feet
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25
femoral RETROversion is when the angle is <__. =a toe __ gait. this decreased femoral head torsion may result in:
- <15deg. - out - low back or SI pathologies - internal rotation of the tibia - supination of the feet
26
``` Legg-Calve-Perthes Disease: __ necrosis of the femoral capital __ b4 closure of the __ plate. __ = 5:1 predominance ages: __-__, peaking at __ years old. bilateral in __ %. history of: positive in which test? primary causes: 4 stages: ```
-avascular; epiphysis; growth -male -2-14; 5 -10 -painful limp, reduced mobility & muscle atrophy -trendelenberg test -trauma, hereditary, nutritional, circulatory (happens in 1 in 1200, smoking increases that to 1 in 100) -1=avascularization, 2=revascularization, 3=repair, 4=deformity
27
3 extra-articular ligaments help provide stability at the hip joint: (tighten with hip ext.!)
- iliofemoral ligament - pubofemoral ligament - ischiofemoral ligament
28
``` the iliofemoral ligament consists of __ parts: it is the __ ligament in the body. oriented superior & __. blends with the __ muscle. limits what movement? ```
- 2 (inf/med. & sup/lat.) - strongest - lateral - iliopsoas - lat=adduction & med=ext. rot.
29
pubofemoral ligament is oriented inferior & __. blends with the inferior band of the __ & the __ muscle. limits what movement?
- medial - iliofemoral & pectineus - abduction
30
ischiofemoral ligament winds __ around the femur, and attaches __, strengthening the capsule. this ligament is more commonly __ that the other hip ligs. limits what movement?
- posteriorly - anteriorly - injured - internal rotation of the hip
31
iliopsoas muscle comprised of 2 parts: innervated by: the most __ of the hip flexors. what tests?
- iliacus & psoas major - femoral nerve - powerful - thomas & ely sign
32
pectineus muscle: action: innervated by:
- adductor - flexor - & internal rotator of the hip - femoral nerve
33
``` rectus femoris muscle: combines movements of: main __ muscle. innervated by: what test? ```
- flexion at the hip - & extension at the knee - quad. - femoral nerve - ely sign +
34
tensor fascia latae (TFL) assists in: innervated by: what test?
- flexing - abducting - & internally rotating the hip - superior gluteal nerve - ober +
35
sartorius responsible for: __ muscle in the body. innervated by:
- flexion - abduction - & ext. rot. of the hip - & some deg. of knee flex. - longest - femoral nerve
36
gluteus maximus __ & most __ hip extensor & external rotator of the hip. innervated by? tested in which nerve root?
- largest; important - inferior gluteal nerve - S1
37
``` gluteus medius main __ of the hip. weakness of this M. is + on what test? anterior portion action: posterior portion action: innervated by? tested in which nerve root? ```
- abductor - trendelenburg - flexes, abducts & internally rotates hip - extends & externally rotates hip - superior gluteal nerve - L5
38
gluteus minimus the major __ __ of the FEMUR innervated by? tested in which nerve root?
- internal rotator - superior gluteal nerve - L5
39
what are causes for a weak gluteus muscle?
- fractures of the greater trochanter - slipped capital femoral epiphysis - congenital hip dislocation (allis sign) - poliomyelitis - meningomyelocele - nerve root lesion
40
slipped femoral capital epiphysis: slipping of the __ on the femoral head, as the head remains in the __. adolescent ages: tends to be more in which gender? tends to be more in which race? tends to be more in which hip? bilateral is more common in __? has a tendency to be more common in __ adolescents. onset of limp with __ pain referred to the __. etiology is __ 50% of the time. alteration in __ line (normal 120).
- neck; acetabulum - 10-15 - males - blacks - left - females - overweight - hip; knee - trauma - Klein's
41
Piriformis: an __ rotator of the hip at LESS than __ degrees of hip FLEXion. at __ degrees of hip flexion, the piriformis reverses muscle action becoming an __ rotator & __ of the hip.
- external - 60 - 90 - internal & abductor
42
small external rotators of the hip:
- obturator externus & internus - superior & inferior gemelli - & quadratus femoris
43
hamstrings made up of: (3)
- biceps femoris - semimembranosus - semitendinosus
44
biceps femoris action: innervation?
- extends the hip - flexes the knee - & INT. rot. the tibia - fibular branch of sciatic n. (tibial nerve)
45
semimembranosus & semitendinosus action: innervation?
- extends the hip - flexes the knee - & INT. rotates the tibia
46
hip adductors: (4)
- adductor magnus - adductor longus - adductor brevis - gracilis
47
adductor longus is frequently __ during strenuous activity. if pulled, called? most __ adductor. innervation:
- pulled - groin pull (strain) - prominent - post. division of obturator nerve
48
there are more than a __ bursae in the hip region. the iliopsoas (iliopectineal) bursa is located under the __ ligament, b/w the iliopsoas __ and the iliopectineal __ of the superior pubic rams. osteoarthritis (OA) of the hip commonly causes __ of the __ bursae. the __ bursae is located between the greater trochanter & __.
- dozen - inguinal - tendon - eminence - inflammation - psoas - subtrochanteric; TFL
49
``` femoral triangle aka? superior border? medial border? lateral border? the floor is formed by: ```
- scarpa's triangle - inguinal ligament - adductor longus - sartorius - portions of the iliopsoas on the lateral side - & pectineus on the medial side
50
inguinal ligament is located b/w __ & the __ __. | unusual __ along the ligament could indicate an inguinal __.
- ASIS & pelvic tubercle - bulges - hernia
51
femoral artery is normally quite __.
-strong
52
femoral nerve lies __ to the femoral artery. aka? __ branch of lumbar plexus. formed by branches of ventral rami, from __-__ spinal N.
- lateral - saphenous n. - largest - L2-L4
53
femoral vein is __ palpable.
-not
54
apex-inf. = adductor canal | aka?
-hunter's canal
55
sciatic nerve is located b/w __ __ & __ __. tenderness may be due to a disc __ or __. problem w/sciatic n. may be due to its relationship w/__ M. it is the __ & __ nerve in the body.
- greater trochanter & ischial tuberosity - pathology or trauma - piriformis - largest & longest
56
normally the sciatic nerve passes __ to the piriformis m. __%. OR the common peroneal division of the sciatic n. will pass either: __ the piriformis (__%) __ to the piriformis (__%) OR both divisions pass __ the piriformis m. (__%)
- inferior; 88% - thru; 11% - superior; 9% - thru; .1%
57
the external __ artery becomes the femoral artery as it passes __ the inguinal ligament.
- iliac | - underneath
58
the anterior portion of the femoral neck & the anterior portion of the capsule of the hip joint are supplied by:
-lateral femoral circumflex artery
59
the medial femoral circumflex artery perforates & supplies:
- the posterior hip joint capsule | - & synovium
60
the hip is a common area of __ & __ pain.
- local | - & referred
61
weight loss, fatigue, fever & loss of appetite should be sought out b/c they are clues to a: other examples include:
- systemic illness - insidious onset of symptoms, evidence of radiculopathy, blower and/or bladder changes, night pain unrelated to movement and severe pain.
62
use P.R.I.C.E. during what phase? | and what does 'price' stand for?
- acute | - protection, rest, ice, compression & elevation
63
osteoarthritis: (__ common for of arthritis) aka? primarily a disorder of __ cartilage & __ bone. men & women __ affected. after age? deep, __ joint pain, after __ or weight bearing, relieved by? __ may be present on movement. seen on x-rays as __ of joint space, __ bony deposits in joint space, or joint deformity due to __ or articular damage. non-inflammatory usually involving __ to a __ joints.
- most - degenerative joint disease - hyaline; subchondral - equally - 40 - aching; exercise; rest - crepitation - narrowing; cyst-like - degeneration - one; few

Orthopedic Diagnosis (20 decks)

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