S2_L1: Hip Conditions Flashcards by MindMed Official

TRUE OR FALSE: The Ilium forms the superior 2/5 of the acetabulum. The Pubis forms the posterior 2/5 of the acetabulum

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

C. Only the 1st statement is true

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The following statements are true about the femur, EXCEPT:

A. strongest and longest bone in the body
B. head is angled medially, superiorly and anteriorly
C. 2/3 of femoral head is covered with articular cartilage
D. Neck-shaft angle: 120 degrees
E. None of the above

D. Neck-shaft angle: 120 degrees

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Match the following ligament to its corresponding description.

strongest ligament in the body
tighten in extension and abduction
Y- ligament of Bigelow
limits hip extension
more commonly injured among the 3 ligaments

A. Iliofemoral
B. Pubofemoral
C. Ischio-femoral

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TRUE OR FALSE: All capsular thickenings/ ligaments are taut in flexion. All are relaxed in extension.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

B. Both statements are false

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The orientation of the acetabulum: (1)_______ (2)_______, (3)_____

anterior
lateral
inferior

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Match the following muscles to its description or function.

Counteracts the backward pull of the gluteus maximus on the ITB
deltoid of the hip
largest and most important hip extensor and external rotator

A. Gluteus maximus
B. Gluteus medius
C. Gluteus minimus
D. Piriformis
E. None of the above

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Match the following muscles to its description or function.

major internal rotator of the femur
at 90 degrees hip flexion, becomes an internal rotator and abductor
critical for balancing the pelvis during single leg stance

A. Tensor Fasciae Latae
B. Gluteus medius
C. Gluteus minimus
D. Piriformis
E. None of the above

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This is the longest muscle in the body

Sartorius

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Enumerate the os coxae

ilium, ischium, pubis

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The PSIS is approximately at level of?

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This is formed by fusion of ilium, ischium and pubis

Acetabulum

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This is the point of weakness in the trabecular pattern of the femur and a common site of osteoporotic fractures.

Ward’s Triangle

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The Ward’s Triangle is bewteen the (1)_____ and the (2)_____

neck
greater and lesser trochanters

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When the angle of inclination is more than 130 degrees, it is termed as?

Coxa valga

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How many degrees is the normal range for femoral anteversion?

15 degrees

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The Joint Capsule is
thicker (1)______ (where maximal stress and weight bearing occurs) and thinnest (2)_____

anterosuperiorly
posteroinferiorly

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The joint capsule is laterally attached to (1)______ anteriorly and posteriorly to the lateral 1/3 of the (2)_____

intertrochanteric line
femoral neck

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This ligament blends with the inferior band of the iliofemoral ligament and pectineus muscle

Pubofemoral ligament

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This is also known as the capitis femoris ligament.

Ligamentum Teres

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The Acetabular Labrum is ______ shaped, with its two ends connected by the (2)_____

Horseshoe
transverse acetabular ligament

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This is an idiopathic form of osteonecrosis in children. It is also known as coxa plana. What is this condition?

Legg-Calve-Perthes disease

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The following statements are true about Legg-Calve-Perthes disease, EXCEPT:

A. previously thought to be tuberculosis of the hip
B. Boys (80%) > Girls
C. Bilateral (85%) > Unilateral
D. Age: 3-12 years old
E. None of the above

C. Bilateral (85%) > Unilateral

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What is the most constant sign of Legg-Calve-Perthes disease?

Limping

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Determine the following condition.

Decrease in angle of inclination
Signs and symptoms of underlying condition
Shortening of extremity
Congenital or acquired
(+) Trendelenburg’s sign

A. Coxa Vara
B. Coxa Valga

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Determine the following condition. 1. May result in osteoarthritis 2. Persists in children who are unable to stand due to chronic disability 3. Limited abduction and IR 4. Normal in infants 5. Angle less than 120 degrees A. Coxa Vara B. Coxa Valga

1. B 2. B 3. A 4. B 5. A

TRUE OR FALSE: Muscles provide tri-planar movement and stability. Due to wide range of motion of hip, a muscle’s line of pull may be altered with changing hip position. A. Both statements are true B. Both statements are false C. Only the 1st statement is true D. Only the 2nd statement is true

A. Both statements are true

This is the most powerful hip flexor, who also acts as a trunk flexor.

Iliopsoas

The following is true about the biceps femoris, EXCEPT: A. only the long head acts on the hip B. most commonly strained hamstring muscle C. has a dual innervation D. has a tri-articular function E. none

E. None

TRUE OR FALSE: All hamstring muscles extend the hip.

False. The short head of biceps femoris does not.

This is the most powerful adductor that is active in all motions except abduction

Adductor magnus

This is the most commonly strained adductor muscle

Adductor longus

This is the most superficial and medial hip adductor. It is also the longest of the hip adductors

Gracilis

This is the largest and most constant bursa around the hip

Iliopsoas bursa

The ischiogluteal bursa lies between the (1)______ and (2)______ muscle and acts as a cushion that prevents (3)_____ when you sit

1. ischium 2. gluteus maximus 3. friction

Ischial bursitis is also known as?

weaver’s bottom

TRUE OR FALSE: Osteonecrosis of the femoral head may be idiopathic in nature.

True

How does Osteonecrosis of the femoral head occur?

d/t trauma or a blockage/impairment in circulation

This is the process of removal of dead bone and replacement of new bone

Creeping substitution

What are the first manifestations of osteonecrosis of the femoral head?

limp and slight spasm of the hip

What special test is used to check and support the diagnosis of osteonecrosis of the femoral head?

FABER’s test

Legg-calve-perthes disease leads to a (1)_____ and (2)_____ femoral neck

1. broad 2. short

Determine which radiographic is being described in Legg-calve-perthes disease. 1. begins when the capital femoral epiphysis is completely reossified 2. segmental collapse (resorption) of the capital femoral epiphysis 3. sclerotic, smaller proximal femoral ossific nucleus 4. necrotic bone is resorbed with subsequent reossification of the capital femoral epiphysis A. Initial stage B. Fragmentation stage C. Reparative stage D. Remodeling stage

1. D 2. B 3. A 4. C

This sign shows of a defect or lytic area at the lateral border of the epiphysis with underlying metaphyseal resorption.

Gage’s sign

The following is true about congenital coxa vara, EXCEPT: A. (+) Trendelenburg test B. Detected at birth and becomes evident as the child begins to walk C. Prominent greater trochanter on palpation D. Leg length shortening of 2-4cm E. None

B. detected at birth and becomes evident as the child begins to walk NOTE: It is usually not detected

The following is true about Ligamentum Teres, EXCEPT: A. Attaches from the fovea to the acetabulum B. contains artery from external iliac artery or femoral artery C. significant source of blood to femoral head in infants and children D. If damaged, can result to arthritis E. None

B. contains artery from external iliac artery or femoral artery

The following are the functions of the Acetabular Labrum: A. enhances joint (1)_______ B. (2)_______ forces transmitted to articular cartilage C. (3)_______ feedback

1. stability 2. decrease 3. proprioceptive

TRUE OR FALSE: Abnormal muscle performance alter distribution of forces across the hip joint articular surfaces and potentially predisposes to degenerative changes

True

During single leg stance, how much of the bodyweight is transmitted to the hip?

What are the actions of the anterior gluteus medius?

flexion, abduction, and internal rotation

When the hip is <60 degrees of flexion, what is the action of the piriformis?

external rotation

TRUE OR FALSE: The Quadratus femoris does not externally rotate the hip.

False

This muscle is able to internally rotate the hip. A. Pectineus B. Sartorius C. Both D. Neither

A. Pectineus

This muscle is able to extend the hip. A. Pectineus B. Sartorius C. Both D. Neither

D. Neither

This muscle is able to abduct the hip. A. Pectineus B. Sartorius C. Both D. Neither

B. Sartorius

This muscle is able to flex the hip. A. Pectineus B. Sartorius C. Both D. Neither

C. Both

What portion of the adductor magnus is considered functionally as a hamstring due to its anatomic alignment?

posterior portion

This bursa prevents friction between gluteus medius and greater trochanter and also between gluteus medius and minimus

Subgluteus medius bursa

This bursa is situated between the greater trochanter and gluteus maximus and TFL muscles

Subgluteus maximus bursa

This is the main vascular source of the femoral head throughout life, but is the only source in young children. It arises from the medial circumflex artery. Which artery is this?

Retinacular arteries

TEUE OR FALSE: The femoral head first gets infarcted before it gets necrotized.

True

Fix the sequencing of the stages of osteonecrosis of the femoral head. 1. Osteoclastic resorption of dead trabeculae and osteoblastic repair with new bone occurs 2. Degeneration and disappearance of osteocytes from their lacunae is seen in the bone trabeculae 3. Osteoclastic resorption of dead trabeculae and osteoblastic repair with new bone occurs 4. Invasion of the infarcted area by new blood vessels and young connective tissue

2431

This sign results from a subchondral fracture due to osteoclastic activity. It is due to the collapse of the entire head and leads to the flattening of the femoral head

Crescent sign

The following is FALSE about LCPD, EXCEPT: A. Established etiology is a hi dislocation in early childhood, between 2-10 years old B. Self limiting over a period of 2-3 years, but can heal within these years C. Is hereditary and occasionally affects 2 or 3 family members D. Limited hip adduction and external rotation E. None

B. Self limiting over a period of 2-3 years, but can heal within these years NOTE: There is not a clearly established etiology. There is no genetic predisposition. Hip ABD and IR is limited.

What is a late complication in Legg-Calve Perthes Disease

Osteoarthritis NOTE: This often happens when the pt becomes an adult.

Based on Catterall's Staging on Legg-Calve Perthes Disease, in what group will a total head involvement be?

Grp IV

Based on Catterall's Staging on Legg-Calve Perthes Disease, in what group will it be classified as when only the anterior part of the head is involved?

Group I

Based on Catterall's Staging on Legg-Calve Perthes Disease, in what group will it be classified as when collapse of central portion happens?

Group II

The following indicates a good prognosticating factor for Legg-Calve Perthes Disease, EXCEPT: A. Boys B. Slender children C. Femoral head is contained within the acetabulum during the period of softening D. Catterall Group I E. None

E. None

What is the most important factor in preventing hip deformity in Legg-Calve Perthes Disease?

Containment of the femoral head within the acetabulum

The following is true about a Slipped Capital Femoral Epiphysis, EXCEPT: A. More common in tall and thin children B. Boys > Girls C. Unilateral D. Has a history of trivial trauma or strain E. None

A. More common in tall and thin children

In Slipped Capital Femoral Epiphysis, what structure thins out during adolescence and yields to shear forces?

periosteum

One etiology of a Slipped Capital Femoral Epiphysis is because the head slips from the neck at the epiphyseal plate due to disruption of what zone?

hypertrophic zone

In Slipped Capital Femoral Epiphysis, to what direction does the head slip?

downward and backward

In Slipped Capital Femoral Epiphysis, diagnosis should be suspected in any adolescent with (1)______ accompanied by hip or knee discomfort with restriction of (2)_____

1. limp 2. internal rotation

TRUE OR FALSE: In Slipped Capital Femoral Epiphysis, the degree of slippage determine the prognosis.

True

In Slipped Capital Femoral Epiphysis, an X-ray shows of >1/2 displacement. What will this be classified as? A. Pre-slipping B. Mild slip C. Moderate slip D. Severe slip

D. Severe slip

In Slipped Capital Femoral Epiphysis, an X-ray shows of widening only of the physis. What will this be classified as? A. Pre-slipping B. Mild slip C. Moderate slip D. Severe slip

A. Pre-slipping

In Slipped Capital Femoral Epiphysis, an X-ray shows of displacement 1/3 to 1/2 diameter of the neck . What will this be classified as? A. Pre-slipping B. Mild slip C. Moderate slip D. Severe slip

C. Moderate slip

Match the following kinds of bursitis. 1. tenderness over anterior hip at the middle of inguinal ligament 2. tenderness behind greater trochanter 3. extending, adducting and IR the hip elicits pain A. Iliopectineal / Iliopsoas bursitis B. Deep trochanteric bursitis C. Superficial trochanteric bursitis D. Ischiogluteal bursa E. None

1. A 2. B 3. A

Match the following kinds of bursitis. 1. AKA weaver’s bottom 2. Pain radiates down the posterior thigh mimicking a herniated disc 3. Pain on extreme adduction of the hip A. Iliopectineal / Iliopsoas bursitis B. Deep trochanteric bursitis C. Superficial trochanteric bursitis D. Ischiogluteal bursa E. None

1. D 2. D 3. C

Match the following kinds of bursitis. 1. LE held in abducted and ER position to relax the tension from gluteus maximus and bursa 2. Between GT and skin and subcutaneous tissue 3. Between iliopsoas and iliopectineal eminence A. Iliopectineal / Iliopsoas bursitis B. Deep trochanteric bursitis C. Superficial trochanteric bursitis D. Ischiogluteal bursa E. None

1. B 2. C 3. A

Match the following kinds of bursitis. 1. Pain may radiate to back of thigh 2. Behind greater trochanter and in front of tendinous portion of gluteus maximus 3. Differential diagnosis - femoral hernia, psoas abscess, synovitis and septic arthritis A. Iliopectineal / Iliopsoas bursitis B. Deep trochanteric bursitis C. Superficial trochanteric bursitis D. Ischiogluteal bursa E. None

1. B 2. B 3. A

A 8 months old infant presents with limitation of motion on the (L) hip. There is apparent limb shortening. As a PT, you flexed the pt's hip to 90 degrees and observe that one side of the knee is lower than the other. What special test was done? A. Allis test B. Barlow test C. Ortolani test

A. Allis test NOTE: A. Allis test is also known as Galeazzi test

A 8 months old infant presents with limitation of motion on the (L) hip. There is apparent limb shortening. As a PT, you flexed the pt's hip to 90 degrees and observe that one side of the knee is lower than the other. What is the patient's condition? A. Congenital Hip Dysplasia B. Hip Dislocation C. Hip Pointer

A. Congenital Hip Dysplasia

Determine the following conditions. 1. always accompanies other congenital anomalies or neuromuscular conditions 2. pain over iliac crest and during ambulation and active abduction 3. most common disorder of the hip in children 4. pseudoacetabulum usually is present 5. direct trauma to the iliac crest A. Congenital Hip Dysplasia B. Hip Dislocation C. Hip Pointer

1. A 2. C 3. A 4. A 5. C

Determine the following conditions. 1. left hip is more commonly involved 2. risk factors are females and firstborns, and with breech presentation 3. a complication of this is sciatic nerve palsy 4. uses Ultrasound (UTZ) diagnosing and documenting reducibility and stability 5. this is common in sports and falls A. Congenital Hip Dysplasia B. Hip Dislocation C. Hip Pointer

1. A 2. A 3. B 4. A 5. C

The following is true about Congenital Hip Dysplasia, EXCPET: A. commonly associated with intrauterine “packaging” problems B. restricted motion is seen on neonates C. waddling gait is seen in toddlers D. in the first 4 months of life, plain radiographic evaluation is unreliable because the femoral epiphysis has not yet ossified E. None

B. restricted motion is seen on neonates

How is the Barlow test performed?

PT gives a posterolateral force to the extremity with the hip in a flexed and adducted position.

How is the Ortolani test performed?

PT abducts the hip and lifts of the proximal femur anteriorly to relocate it

Match the following. 1. drawn perpendicular to the Hilgenreiner line at the lateral edge of the acetabulum 2. continuous arch drawn along the medial border of the femoral neck and superior border of the obturator foramen 3. line drawn horizontally through each triradiate cartilage of the pelvis A. Hilgenreiner line B. Perkin line C. Shenton line

1. B 2. C 3. A

This is an angle formed by an oblique line (through the outer edge of the acetabulum and triradiate cartilage) and the Hilgenreiner line

Acetabular index

If shenton’s line was disrupted, what condition is said to be positive?

(+) hip dysplasia

What is the normal degrees of the acetabular index?

30 degrees

In the newborn, a normal value in the acetabular index averages to (1)______. By 24 months of age, the acetabular index decreases to ______.

1. 27.5° 2. 21°

This is an angle formed by a vertical line through the center of the femoral head and perpendicular to the Hilgenreiner line and an oblique line through the outer edge of the acetabulum and center of the femoral head

Center-edge angle of Wiberg

How is the hip dislocated anteriorly?

Hip is flexed, abducted and externally rotated at the moment of injury

How is the hip dislocated posteriorly?

Hip is flexed, adducted and internally rotated at moment of injury

Which type of dislocation is most common?

Posterior dislocation

This type of dislocation happens when direct impact on the lateral aspect of the greater trochanter forces the head into the acetabulum.

Central dislocation

This is a common procedure performed in cases of severe joint damage caused by arthritis, displaced femoral neck fractures, and avascular necrosis

Arthroplasty

This condition is common in osteoporotic elderly patients, but may occur in younger individuals after high energy injuries. The involved extremity in this injury is usually shortened and externally rotated. Pt often reports of inability to ambulate or ambulates with a limp. Tenderness with percussion of the greater trochanter is palpable? What condition is being referred? A. Femoral Head Fracture B. Femoral Neck Fracture C. Acetabular Fracture D. Pelvic Fracture

B. Femoral Neck Fracture

This condition is usually due to vehicular accidents, fall from height, avulsion fracture, or osteoporosis. A massive flank or buttock contusion with hematoma may be seen, together with a leg length discrepancy. What condition is being referred? A. Femoral Head Fracture B. Femoral Neck Fracture C. Acetabular Fracture D. Pelvic Fracture

D. Pelvic Fracture

This injury usually occurs with dislocations of the hip. It's complications are avascular necrosis or post-traumatic arthritis. This uses Pipkin's classification. What condition is being referred? A. Femoral Head Fracture B. Femoral Neck Fracture C. Acetabular Fracture D. Pelvic Fracture

A. Femoral Head Fracture

Match the following condition. 1. AKA Coxa sultans 2. (+) Ober's Test 3. Snapping as iliotibial band passes over the greater trochanter 4. Snap noted over the prominence of the greater trochanter during hip flexion and extension or rotation 5. Snap felt at groin during extension of hip A. ILIOTIBIAL BAND SYNDROME B. SNAPPING HIP

1. B 2. A 3. A 4. B 5. B

A cemented type of fixation uses (1)_____ or (2)_____ for fixation

1. bone cement 2. polymethylmethacrylate (PMMA)

What are the specific movements that are greatly discouraged after an arthroplasty procedure?

1. No flexion beyond 90 degrees 2. No abduction beyond 45 degrees 3. No adduction beyond midline 4. No rotation

This type of arthroplasty has one or both joint surfaces are replaced by a prosthesis/implant made of metal, plastic or a combination

Replacement Arthroplasty

This type of arthroplasty involves the insertion of a substance like fascia, skin, plastic or metal between the two reconstructed joint surfaces

Interpositional arthroplasty

This type of arthroplasty involves the removal of a segment of bone from one or both surfaces of the joint

Resectional Arthroplasty

What classification is used to distinguish the type of femoral neck fracture? A. Pipkin classification B. Gustilo-Anderson classification C. Evans Classification D. Garden classification

D. Garden classification

What classification is used to distinguish the type of intertrochanteric fracture? A. Pipkin classification B. Gustilo-Anderson classification C. Evans Classification D. Garden classification

C. Evans Classification

What tool is used to diagnose a snapping hip?

Ultrasound

What is the most common complication of an acetabular fracture?

Sciatic nerve palsy

A femoral head fracture is classified as what type of the fracture occurred bellow the fovea?

Type I

A femoral head fracture is classified as what type if it is associated with a femoral neck fx?

Type III

Based on Garden's Classification on Femoral Neck Fractures, what does a type 3 fx mean?

complete fracture with partial displacement

Based on Garden's Classification on Femoral Neck Fractures, what does a type 2 fx mean?

complete but undisplaced fracture

This kind of hemiarthroplasty is done by the replacement of the head and the neck with an additional acetabular cup that is not attached to the pelvis

Bipolar

This kind of hemiarthroplasty is used in less active and older patients unlikely to outlive the hip implant

Unipolar

S2_L1: Hip Conditions Flashcards

(119 cards)