Pathologies Related to Pelvis and Hip I Flashcards by Siva Pye

Pathological hip fracture overview:

________ femur fx; particularly the _____ due to what?

proximal

neck

disease

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Pathological hip fracture

Etiology: Conditions with compromised ______

Osteoporosis and _________
_________ _______ : congenital and inherited brittle bone disease
________ disease- chronic bone disorder with abnormal bone turnover that results in bigger but softer bones

May or may not involve a _______

bone

osteomalacia

Osteogenesis imperfecta

Paget’s

fall

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Risk factors for Pathological hip fracture: _____ based on etiologies

vary

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Incidence/Prevalence with pathological hip fracture:

mostly ______

_____ Americans

older

European

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Pathogenesis of Pathological hip fracture: ______ _____ of bone resulting in fx

gradual weakening

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Pathological hip fracture

S&S:

Painful ____ and possible _____ way
_____ and possibly _______ thigh P! and to the knee and lateral ______

Increased pain in ________ and decreased in _______ WB

snap; giving

Groin; anteromedial

hip

WB; non

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With a Pathological hip fracture, you may observe…

_______ and excessively ______ rotated LE due to displacement and pull of ER’s

_______ and _______ gait

Shortened; externally

antalgic; asymmetrical

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With a Pathological hip fracture, ROM will be in ______ directions but specifically _____

several; IR

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With a Pathological hip fracture, what special test will be positive?

Patellar-pubic percussion

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With a Pathological hip fracture, there could be a sign of the _______

buttock

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The sign of the buttock is a collection of _____ indicating a ______ pathology

signs; serious

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What is the etiology for sign of the buttock? (4)

Fx
Tumor
Infection
Hematoma

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S&S for sign of the buttock

Hx- possible ______, infection, or ______ S&S

cancer
fracture

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What would you observe with sign of the buttock?

gluteal swelling

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ROM S&S with the sign of the buttock:

Hip _____ limitation the same no matter the ______ position with _____ end feels

Same degree of trunk ______ limitation in relation to the _____ and trunk position

FLX
knee
empty

flexion
femur

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With sign of the buttock resisted/MMT: they will have _____ and ______ glutes

weak; painful

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Sign of the buttock referral?

Urgent referral to MD but emergent if there is fx present

*due to possible displacement and vascular compromise

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With a pathological hip fracture:

PT Implications- significant _____, _____, and health ______ arise from resulting sedentary situation

Ensure patients with risk factors of Osteoporosis had a ______ scan

morbidity; mortality; issues

DEXA (DXA)

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Age group for DEXA scan:

Biological women at ____ years old

Biological men at _____ years old

65
70

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Pathological hip fracture is a “Do Not Want To Miss” condition

You want to ______ with _______ referral due to possible displacement and potential vascular compromise

immobilize; emergent

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________ is aka avascular necrosis or AVN of the femoral head

Osteonecrosis

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With osteonecrosis incidence/prevalence:

May be ______ in _____% of cases

______> younger individuals

bilateral; 60

older

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With osteonecrosis etiology and risk factors:

Insufficient _______ supply to _______ head

arterial; femoral

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Two risk factors associated with trauma and osteonecrosis?

Fx/dislocation
Slipped femoral epiphysis or growth plate

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With osteonecrosis etilogy which ligament is involved?

ligamentum teres- intracapsular ligament

Pertaining to osteonecrosis: The ligamentum teres attaches proximally in the ________ is distally in the _______ of the femoral head

acetabulum; fovea

Pertaining to osteonecrosis: The ligamentum teres contains the _____ _____ artery to supply the head of the femur Also plays a ________ role

medial epiphyseal supportive

With osteonecrosis, the femoral head is also supplied by the _____ and ______ circumflex aa.

medial; lateral

Osteonecrosis etology and risk factors: Insufficient ______ supply to ______ head

arterial; femoral

Osteonecrosis etology and risk factors: Gradual onset with... _______ abnomalities ________ (ex. radiation, smoking, alcoholism) _____ ______ disease with a shortage of healthy carrying oxygen RBCs Chronic _______ and oral _________ use Bone _______ pathology _______ syndrome

Vascular Toxicity Sickle cell corticosteroid; contraceptive Marrow Metabolic

Osteonecrosis pathogenesis: ______ leading to death of bony tissue Rapid progression to ____-_____ _____ _____ May involve ______ tears

Ischemia age-related joint changes labral

Osteonecrosis S&S: Hx of... _____ and possibly _______ thigh P! and to the knee _______ but worsening with _______ and unknown Even occuring at rest due to ______

Groin; anteromedial Intermittent; gradual ischemia

With osteonecrosis, you may observe ______ and ______ gait

antalgic; asymmetrical

With osteonecrosis their ROM may be limited with _____, ______, and _______ due to greater contact

IR/ABD/FLX

With osteonecrosis, there could S&S with what condition that involves changes?

Age-Related Joint Changes

Osteonecrosis is a _______ referral to MD if _______ onset

urgent; gradual

With osteonecrosis, if referred for PT proceed with ________ Should focus on _______ training with an _______ device to help protect the femur PT directed primarily at ______ motion, improving ______, and for _____/______ integrity; like age-realted joint changes Rx

caution gait; assistive protection; circulation; bone; cartilage

With osteonecrosis, the patient may end up having a ____-_______ or possibly a _____

Hemi- arthroplasty THA

______-_____-______ is aka as coxa plana or flat hip

Legg-Calve-Perthes

Legg-Calve-Perthes is the AVN of the femoral head in _______

children

Etiology for Legg-Calve-Perthes: _______ Exposure to ______ ______ ______ _______ factors (ex. genetics, endocrine, nutritional, or socioeconomic conditions) ________ dysfunction of bone and vasculature

trauma 2nd hand smoke Prenatal Developmental

With Legg-Calve-Perthes incidence/prevalence: it is MOST common in ____-_____ year old caucasian biological ______

5; 8 boys

With Legg-Calve-Perthes pathogenesis- there is impaired vascular supply to ________ (med/lat _______ aa.) that changes the shape of the femoral _____ and ________

epiphyses; circumflex; head; acetabulum

Legg-Calve-Perthes S&S: Vary in _______ _______ and ______ onset primarily If p!ful, ____ and possible ________ thigh p! and to the knee

magnitude gradual; unknown groin; anteromedial

With Legg-Calve-Perthes S&S: If p!ful, groin and possible anteromedial thigh p! and to the knee it could _____ with activity decrease with ______

increase rest

What might you observe with Legg-Calve-Perthes? _______ and _______ gait Muscle _______ if ______ standing

antalgic; asymmetrical atrophy; long

With Legg-Calve-Perthes, ROM will be limited with ______ and ______ due to greater bony contact

IR; ABD

Legg-Calve-Perthes is a ____-_____ problem

long term

Legg-Calve-Perthes is a _______ referral to MD if gradual; ______ referral to MD if trauma

urgent emergent

With Legg-Calve-Perthes, if referred for PT proceed with caution: Should focus on _______ training with an _______ device to help protect the femur PT directed primarily at ______ motion, improving ______, and for _____/______ integrity

gait; assistive protected; circulation; bone; cartilage

With Legg-Calve-Perthes, they present to the clinic periodically in a _______, ______, or ____ in a slight abducted position

splinted braced casted

With Legg-Calve-Perthes, they present to the clinic periodically in a splinted, braced, or casted in a slight abducted position: It allows better _______ head contact with acetabulum Maintain and help better ______ femoral head in the acetabulum as ______ can occur Complication: prone to _______

femoral form contractures

With Legg-Calve-Perthes, possible age-related _____ changes in early _____ and ____% will develop age-related ______ disease before 50 yrs. old

joint; adulthood; 50; joint

With Legg-Calve-Perthes, MOST will need ______ surgery and or early ______

corrective; THA

With Legg-Calve-Perthes, there could be earlier ______ and _____ P! development in life due to ______ dysfunction *kids tend to keep _____ *adults tend to _____ activity

LBP; knee gait moving reduce

_____ ______ ______ is the anterior displacement of femoral neck on femoral head

Slipped capital epiphysis

Slipped capital epiphysis is aka as adolescent ____ ______

coxa vara

_______ _______ ______ is the MOST significant epiphyseal plate disorder of the LE

Slipped capital epiphysis

What is the etiology of slipped capital epiphysis? Mostly _______ Association with _____ and _______ disorders and _____ _______

idiopathic endocrine; renal Down Syndrome

What is the MOST common etiology for slipped capital epiphysis?

Hypothyroidism

With slipped capital epiphysis, risk factors create increased _____ force across the _______ plate

shear; epiphyseal

The single MOST common risk factor for slipped capital epiphysis is?

obesity

Risk factors for slipped capital epiphysis: Biological _____ Rapid _______ ______ therapy Femoral ______

males growth radiation torsion

With slipped capital epiphysis: Incidence/prevalence MOST common in early _______ ______ Americans and biological _____ Typically higher _____ in 75% of cases Bilateral in up to ___/___ of patients

adolescence African; boys BMI 1/3

The pathogenesis of _______ _______ _______- progressive displacement of femoral neck relative to the head through the growth plate due to shear forces and/or weakened epiphyseal plate

Slipped capital epiphysis

Slipped capital epiphysis S&S More likely ______ and ______ onset than trauma but could be sudden with ______ activity like rolling in bed _______ and possibly _______ thigh P! and to the knee

gradual; unknown benign Groin; anteromedial

With slipped capital epiphysis, you may observe it to be ______ and _________, ______ rotated hip, and muscle ______ if long standing

antalgic; asymmetrical externally atrophy

With slipped capital epiphysis: ROM may be limited with ______/______/and ________ due to greater bony contact Obligatory ______ during flexion Possible sign of ______

IR/ABD/FLX ER buttock

With slipped capital epiphysis: PT implications- should always be considered in ___-_______ with atraumatic ____ pain; particularly if associated with _____ gait

peri-adolescent hip antalgic

Slipped capital epiphysis is a ______ referral to MD

urgent

PT implications of slipped capital epiphysis: If referred for PT proceed with caution- If slip is __ 1 cm. ~ Splinted in an _____ position with non-WBing

< ABDUCTED

PT implications of slipped capital epiphysis: Post-splinting Should focus on _______ training with an _______ device to help protect the femur PT directed primarily at ______ motion, improving ______, and for _____/______ integrity

gait; assistive protected; circulation; bone; cartilage

With slipped capital epiphysis: Surgery is required if slip is ___ 1 cm.

With slipped capital epiphysis: you need to avoid _____ or _______ (rapid loss of articular cartilage)

AVN; chondrolysis

Vascular insufficiency S&S _______ _______ or ______ discoloration ________ pulses Impaired ______ refill with nail bed recovery ____ skin ____ loss

COLDNESS blueish; pale diminished capillary shiny hair

With vascular insufficiency: it is at least an ______ but possibly ______ referral depending on severity and if _______

urgent; emergent; traumatic

Pathologies Related to Pelvis and Hip I Flashcards

(76 cards)