Station 4: The Hip and Pelvis

Question 1

What is normal Hip flexion ROM?

Answer 1

100-135 degrees

Question 2

What are some reasons for variation in hip flexion ROM?

Answer 2

History of injury
Connective tissue tightness

Question 3

Why do we measure hip flexion ROM with knee bent?

Answer 3

Removes hamstrings from measurement

Question 4

What is normal Hip Hyperextension ROM?

Answer 4

10-30 degrees

Question 5

How can you cheat a hip hyperextension ROM measurement?

Answer 5

Arch back

Question 6

What does a narrow stance squat suggest about the acetabulum?

Answer 6

Shallow acetabulum

Question 7

What does a wide stance squat suggest about the acetabulum?

Answer 7

More bone coverage of acetabulum

Question 8

What two angles/structures relate to the angle of the acetabulum?

Answer 8

Centre-edge angle (Angle of Wiberg)
Acetabular anteversion angle

Question 9

What two angles/structures relate to the angle of the femur?

Answer 9

Angle of inclination
Torsion Angle

Question 10

What structures surround the acetabulum

Answer 10

Acetabulum labrum
Ligamentum teres
Transverse ligament

Question 11

What is the optimal centre edge angle (angle of Wiberg)

Answer 11

35-40 degrees

Question 12

What is the Centre-edge angle?

Answer 12

How much roof of the acetabulum is there over the femur (35-40 degs)

Question 13

What plane is the centre edge angle in?

Answer 13

Frontal plane

Question 14

What does a smaller centre edge angle mean?

Answer 14

It means there is less of a roof over the femur. This means you can see more into the socket
Less stability but more mobility. Greater risk of injury

Question 15

What is the optimal acetabular anteversion angle?

Answer 15

20 degrees

Question 16

What is the acetabular anteversion angle?

Answer 16

How much the acetabulum comes round the front of the femur (20 degs)

Question 17

What plane is the acetabular anteversion angle in?

Answer 17

Transverse

Question 18

What does a greater acetabular anteversion angle mean?

Answer 18

Less bone comes round the front of femur
Can see more into acetabulum socket

Question 19

What is the optimal angle of inclination?

Answer 19

125 degrees

Question 20

What is the angle of inclination?

Answer 20

The angle between the shaft and neck of the femur (125 degrees)

Question 21

What are the different deformities from higher or lower than optimal angles of inclination?

Answer 21

Coxa vara (<125 degs)
Coxa valga (>125 degs)

Question 22

What is Coxa Vara?

Answer 22

Coxa Vara is where the angle of inclination is <125 degrees. (More like a right angle R for right angle in vara). Femoral neck is flat and really stable but less mobile.
Lots of shear force through hip as a result

Question 23

What is Coxa Valga?

Answer 23

Coxa Valga is where the angle of inclination is >125 degrees. Femoral neck is steep and really mobile but less stable.
Less shear force through hip as a result
Seen in people with cerebral palsy

Question 24

What is the optimal torsion angle?

Answer 24

15 degrees

Question 25

What is the torsion angle?

Answer 25

Orientation of neck and femur. It sits 15 degrees forward (anteversion)

Question 26

What is retroversion?

Answer 26

Neck and femur sits <15 degrees forward. Sits straight into side or backwards Feet twist out

Question 27

What is excessive anteversion?

Answer 27

Neck sit excessively forward Feet twist in to compensate (pigeon toe)

Question 28

What is the acetabulum labrum made of and what does it do?

Answer 28

It is made of fibrocartilage and is horseshoe shaped, found in the socket (intrinsic) Deepens socket, suctions head of femur into socket Shock absorption and cushion for load bearing

Question 29

What is the ligamentum teres?

Answer 29

Runs through inside of joint - connecting bone to bone Fovea capitus into acetabulum Either delivers blood flow and nerve supply OR is completely redundant

Question 30

What is the transverse ligament?

Answer 30

Connects acetabulum at bottom of socket Completes the rounded shape Prevents inferior dislocation (uncommon)

Question 31

What are the three ligaments of the hip and what do they do?

Answer 31

Iliofemoral Pubofemoral Ischiofemoral All extrinsic and screw head of femur into socket

Question 32

What is the thinnest hip ligament?

Answer 32

Ischiofemoral

Question 33

The front hip ligaments are loosest in what motion?

Answer 33

Hip flexion

Question 34

When do hip ligaments pull tightest?

Answer 34

Hip extension and Internal rotation

Question 35

When do hip ligaments pull loosest?

Answer 35

Hip flexion and External rotation

Question 36

What is true leg length discrepancy, what does it cause and how do you find it?

Answer 36

It is the actual difference in leg length Causes tilt in pelvis and secondary compensation of spinal column Find ASIS and medial malleolus and measure difference between two bony landmarks

Question 38

What is apparent leg length discrepancy, what does it cause and how do you find it?

Answer 38

Determines whether leg length differences are due to pelvic rotation, sacroiliac dysfunction, foot pronation/supination or postural abnormalities Find umbilicus and medial malleolus and measure difference between two bony landmarks