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kinesiology > Structures of the Hip Joint > Flashcards

Structures of the Hip Joint Flashcards

week 8 (65 cards)

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1
Q

ligaments and joint capsule

the hip joint capsule is tight in what direction and more relaxed in what direction?

A

tight in extension
more relaxed in flexion

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2
Q

ligaments and joint capsule

the strongest ligament in the body is the iliofemoral ligament - what motion does it prevent?

A

hyperextension

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3
Q

ligaments and joint capsule

pubofemoral lies anteroinferiorly and prevents excess _____- and _______

A

abduction and extension

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4
Q

ligaments and joint capsule

which ligament is the weaknest of the hip joint capsular ligaments?

A

ischiofemoral

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5
Q

ligaments and joint capsule

which ligament consists of a triangular band of fibers that forms the posterior hip joint capsule?

A

ischiofemoral

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6
Q

the ischiofemoral ligament prevents excess ________?

A

hip flexion and internal rotation

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7
Q

ligaments and joint capsule

the ligamentum teres is located intracapsular and attaches the apex of the cotyloid notch to the fovea of the femoral head. this serves as a carrier for what artery?

A

foveal artery (posterior division of the obturator artery)

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8
Q

labrum

the labrum of the hip has three surfaces - what are they?

A
  1. internal articular surface (adjacent to the joint-avascular)
  2. external articular surface (contacting joint capsule - vascular)
  3. basal surface - attached to the acetabular bone and ligaments
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9
Q

ligaments and joint capsules

what ligament(s) surrounds the hip and helps hold it in place while moving?

A

transverse ligaments

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10
Q

labum

what arteries supply the outer third of the labrum of the hip?

A

obturator, superior gluteal and inferior gluteal arteries

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11
Q

labrum

what are the functions ofthe acetabular labrum?

A
  1. joint stability - ↑ containment of the femoral head - deepening the joint by 21%. thus allowing a wider area of force distribution and resisting lateral and vertical motion within the acetabulum
  2. sensitive shock absorber
  3. joint lubricator (synovial fluid in contact with articular cartilage)
  4. pressure distributor
  5. ↓ contact stress between the acetabular and the femoral cartilage
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12
Q

muscles

muscles of the hip joint can be grouped based upon their functions relative to the movemetns of the hip
what are the flexors?

A
  • psoas major
  • psoas minor
  • iliacus
  • pectineus
  • rectus femoris
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13
Q

muscles

what are the extensor muscles of the hip joint?

A

gluteus maximus
semitendinosus
semimembranosus
biceps femoris (long head)

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14
Q

muscles

what are the adductor muscles of the hip joint?

A

adductor magnus
adductor longus
adductor brevis
gracilis
pectineus

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15
Q

muscles

what are the abductors of the hip joint

A

gluteus medius
TFL

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16
Q

muscles

what are the internal rotators of the hip joint?

A

TFL
gluteus minimus

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17
Q

muscles

what are the external rotators of the hip joint?

7 muscles

A

gluteus maximus
gemellus superior
gemellus inferior
obturator externus
obturatorinternus
quadratus femoris
piriformis

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18
Q

CPP and OPP

what is the Close Packed Position for the hip joint?

why?

A

full extension

  • because this position draws the strong ligaments of the joint tight resulting in stability
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19
Q

CPP and OPP

what is the open packed position for the hip joint?
why?

A

the hip joint is one of the only joints where the position of optimal articular contact is combined flexion, abduction and external rotation

since flexion and external rotation tend to uncoil the ligametns and make them slack

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20
Q
A
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21
Q

labrum

what distributes force evenly through labral tissue?

A

hydrostatic pressure

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22
Q

labrum

what is hydrostatic pressure of the hip labrum?

A

it is similiar to lung or wall clings
its a closed vaccuum- the synovial fluid suctiosn the hip in

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23
Q

what is center edge angle?

A

angle between:
- vertical line from the center of the femoral head
- line connecting the center of the femoral head and the lateral rim of the acetabulum

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24
Q

what creates a bigger center edge angle? what creates a smaller one?

why?

A
  • deep acetabulum =bigger
  • shallow acetabulum = smaller

the deeper the femoral head sits in the acetabulum the further the line connecting the center of the femoral head and lateral rim of the acetabulum will be from each other resulting in a bigger angle and vice versa for a smaller angle

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25
# center edge angle what degree range categorizes definite dysplasia of the hip?
<16°
26
# center edge angle what degree category constitutes possible dysplasia of the hip?
16°-25°
27
# center edge angle what degree category constitutes a normal hip and no dysplasia?
>25°
28
# center edge angle what degree category constitutes possible excessive acetabular coverage (coxa profunda or protrusio acetabuli)?
>40°
29
# angle of inclination what is the approximate degree of the angle of inclination of the hip? between what degrees can be considered normal?
approx 125° between 110°-140° can be normal
30
# angle of inclination where are the lines draw on the femur to create the angle of inclination?
line through neck and line through shaft of femur
31
what kind of angle of inclination do people have when they are born? what occurs as we go through puberty?
higher angle when born ~150°. Gravity and weightbearing will bring the angle down during puberty and bone will stop growing post puberty
32
# angle of inclination what is coxa valga? ## Footnote of femur
increased angle of inclination ≥140°
33
# angle of inclination what are the issues with coxa valga of the femur?
- all compressive load - changes length/tension relationship of muscles - changes moment arm - increases moment arm --> < in hip adductor strength - ↑ compressive load through femur = arthritic changes earlier in life and increased risk of fracture
34
# angle of inclination what is coxa vara? ## Footnote of femur
decreased angle of inclination ≤105°-110°
35
# angle of inclination what are the complications of coxa vara of the femur?
- > moment arm of hip adductors - more vertical load through head of femur - more shearing force through epiphysial plate or slipped head of femur - more bending force through neck = neck fractures
36
# angle of torsion what is the normal degree of angle of torsion for the femur?
10°-20°
37
# angle of torsion what is anteversion of the femur?
35° the acetabulum cup faces slightly anterior
38
# angle of torsion what is retroversion of the femur?
less than 15-20° acetabular cup faces posteriorly
39
# angle of torsion what are some complications of anteversion? retroversion? why?
think girl thinkkkk
40
# acetabular labrum what is one of the main goals of the hip labrum?
increase surface area
41
# labrum what type of labral tear is more come in the US and europe?
anterior labral tear
42
# labrum what are 3 common mechanisms of labral tears in the hip?
- direct trauma - sports with frequent external rotations or hyperextension (ballet, soccer, hockey, etc) - twisting movements, hyper abduction, hyper extension, hyper extension with external rotation
43
# labrum what are 5 symptoms of hip labral tears?
- often anterior groin pain, can be trochanteric and buttock region - constant dull pain, periods of sharp pain, pain worsens in activity. can be nighttime pain (sleep position in end range positions) - aggravated by walking, pivoting, prolonged sitting and impact activities - clicking, locking or catching or giving away can be reported (not considered significant but is common) - ROM not restricted BUT CAN BE PAINFUL AT END ROM ## Footnote mri arthrograph can diagnose but expensive
44
what is the leading cause of disability worldwide?
osteoarthritis !!!!
45
what are some characteristics of osteoarthrtis (OA)?
- degeneration of articular cartilage in synovial joints - disease of the whole joint - most common in the knee and the hip - cartialge cannot be regenerated - comorbidities are common (obesity, DM2, etc)
46
# hip osteoarthritis hip internal rotation _____ (passive rom) hip flexion _____ age ______ or hip internal rotation ____ (passive rom) pain with duration of morning stiffness of the hip ≤ to ______ age ______
- IR <15° - flexion ≤ 115° - age > 50 years OR - IR ≥15° - pain with hip IR - 60 minutes - >50 years | rememer we dont diagnose ppl with OA ! ## Footnote *passive ROM's doesn't really matter if its active or passive
47
# hamstring strain what is a type 1 hamstring strain?
- high speed running - usually involve the long head of the BICEPS FEMORIS, most commonly at the proximal muscle-tendon junction ## Footnote strain = muscle/tendon
48
# hamstring strain what is a type II hamstring strain?
- excessive lengthening of the hamstring in hip flexion with knee extension (kicking, sliding tackle, forward split) - typically located close to the ischial tuberosity and involve the proximal free tendon of SEMIMEMBRANOSUS | known as the "stretching type" ## Footnote * tendon is the tissue due to exessive lengthening
49
# hamstring strain symptoms of hamstring strains
- localized tenderness and swelling at the site of injury - ecchymosis (frequently) - restricted kne extension and straight leg raising - palpable divot in the injured hamstring (more severe injuries -fibers torn) - positive tripoid sign (ppt or bend backwards = + test) ## Footnote ecchymosis = brusing - can travel down leg due to gravity
50
# hamstring strain what is the tripod sign
- seated - knees 90° flexed off treatment bed - passively extend 1 knee - return knee to start and compare to other side - (+) if patient tries to lean back or slumping in lumbr spine to relief tension
51
# dysfunction of the tendon what are mechanisms of a high hamstring tendinopathy?
- runners, athletes in sports with frequent cahnge of direction - non athletes - gradual onset
52
# dysfunction of the tendon what are symptoms of a high hamstring tendinopathy?
- deep ache in the gluteal area can radiate down - pain worse during or after repetitive activity - provoked by deeper hip flexion activities (squats, lunging) - provoked by long periods of sitting (especially hard surfaces) - excessive stretching ## Footnote things that stretch the tendon or direct pressure on tendon sitting in APT can exasturbate this as well
53
# dysfunction of the tendon what is a treatment progression for high hamstring tendinopathy?
first focus on: - prximal stability - motor control (muscular including hamstrings) then focus on: - hamstring strength - speed and power
54
# femoral neck stress fracture compression-sided fractures (inferior-medial neck) what are signs/symptoms?
- hip/groin pain - edema (swelling) - pain worse with weight bearing and IR (ER too but mostly IR) - point tnederness on palpation - painful and limited active and passive hip flexion, IR, extension - pain increase during activity - antalgic gain (limping, not wanting to load) ## Footnote *what are we concerned with when someone has this fracture?
55
# femoral neck stress fracture what population do we see these fractures?
- repetitive high load, chronic overload - runners, gynmasts
56
# hip fracture what is an acute hip fracture?
severe groin and anterior thigh pain and tenderness, sometimes trochanteric osteoporosis more in females cnacer population -> when it spreads to bone
57
# hip fracture what are symptoms of an acute hip fracture?
- pain (both passive & acute -> unable to walk) - limited mobility (almost nill --> fulcrum is not intact) - possible bruising after a day or two - hip might look twisted or rotated (or foot)
58
# hip fractures what are the 2 most common types of hip fractures?
intertrochanteric and femoral neck ## Footnote * what did the doc do? - nails - hemi arthroplasty - full hip replacement
59
# FAIS femoroacetabular impingement syndrome is an important cause of pain in what population?
hip pain in young and middle aged adults
60
# FAIS FAIS is a precursor to what?
idiopathic hip OA
61
what is a cam morphology? what are 2 types of cam morphologies?
excessive bony growth at neck/head of femur - pincer and pistol are 2 types
62
# FAIS cam morphology talk about it
- "pistol grip" morphology is a change in structure - male predominance (4:1) - athletes have a higher prevalence than nonathletes - poor clearance of the femur, especially with flexion and abduction
63
64
# FAIS symptoms of FAIS?
- sharp anterior hip/groin or trochanteric pain - pain with activites such as walking, pivoting and recreational exercise - clicking, catching, locking, stiffness, restricted ROM or giving way - limited hip FLEXION, ABDUCTION and INTERNAL ROTATION rom (FAI) ## Footnote cam can cause FAIS but one ≠ the other
65

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