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Orthopedic Diagnosis > The Hip > Flashcards

The Hip Flashcards

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1
Q

The hip joint is classified as

A

ball and socket joint

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2
Q

How many planes of motion does the hip joint move in?

A

3
Sagittal (flexion/extension)
Frontal (abduction/adduction)
transverse (internal/external rotation)

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3
Q

All three axes of hip motion pass through

A

the center of the femoral head

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4
Q

Os Coxa is made up of

A

three individual bones

ilium, ischium, pubis

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5
Q

Acetabulum

A

site where the ilium, ischium, and pubis fuse together

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6
Q

A majority of acetabular development is completed by

A

the age of 8

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7
Q

Acetabular rim

A

aka labrum

deepens the acetabulum thereby increasing the stability of the hip joint

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8
Q

The whole of the acetabulum is covered with hyaline cartilage except

A

the fovea capitis

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9
Q

The pelvic girdle is composed of which three joints

A

hip (acetabularfemoral)
sacroiliac
public symphysis

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10
Q

Iliac crest contusion

A

contusion to the site of or an avulsion of the quadratus lumborum and or abdominal muscles from the crest
very painful/disabling if periosteum is involved

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11
Q

With an iliac crest contusion, Patient experiences:

A

pain when laterally flexing away from the side of injury

pain with abduction of both legs together in side-lying position

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12
Q

Bucket handle fracture

A

superior and inferior public rami fractures with a separation or fracture of the contralateral SI joint

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13
Q

Sprung Pelvis

A

separation of the pubic symphysis and both SI joints

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14
Q

Straddle Fracture

A

bilateral superior pubic rami and ischopubic fractures

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15
Q

Most common areas for pelvis avulsion fractures

A

ASIS
AIIS
Ischial Tuberosity

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16
Q

Femur

A

Strongest and longest bone in the body

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17
Q

two thirds of the femoral head is covered in

A

a smooth layer of cartilage except for the fovea capitis

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18
Q

The fovea capitis is the attachment for what?

A

ligamentum teres

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19
Q

Inclination angle

A

angle between the femoral shaft and neck

approximately 125- 130 degrees

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20
Q

The inclination angle in a tall person is

A

valga

larger

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21
Q

The inclination andle in a short person is

A

vara

smaller

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22
Q

Femoral Head dislocation

A

dashboard injury to the knee will cause a posterior hip dislocation if the hip is adducted at the time of injury

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23
Q

the greater trochanter

A

serves as the insertion site for several muscles that act on the hip joint

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24
Q

the lesser trochanter

A

located on the posterior-medial junction of the neck and shaft of the femur
created from the pull of the iliopsoas muscle

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25
angle of Anteversion
the angle that the femoral neck makes with the acetabulum
26
normal angle of anteversion
8-15 degrees
27
Femoral Anteversion
aka medial femoral torsion | the angle between femoral neck and the transcondylar axis is greater than 15 degrees
28
What type of gait do you see with femoral anteversion
toe-in gait
29
Increased medial femoral torsion leads to
``` OA dysplasia of the acetabulum susceptibility to anterior femoral dislocation knee joint misalignment problems patellar dislocations excessive lumbar lordosis external tibia rotation foot pronation ```
30
Femoral retroversion
aka lateral femoral torsion | the angle between the femoral neck and the transcondylar axis is less than 15 degrees
31
why type of gait fo you see with femoral retroversion
toe out
32
lateral femoral head torsion may lead to
low back/SI pathologies internal rotation of the tibia supination of the feet
33
Legg-calve-perthes disease
avn of the femoral capital epiphysis before closure of the growth plate
34
Who predominately experiences legg-calve-perthes diseaes
males (5:1) | ages 3-12
35
Four stages of Legg-Clave-Perthes disease
avascularization revascularization repair deformity
36
Primary causes of Legg-Calve-Perthes
trauma hereditary nutritional circulatory
37
which test will be positive with Legg-Calve- Perthes?
trendelenberg
38
Legg-Calve Perthes is bilateral in what percentage of cases?
10
39
How do the odds of experiencing Legg-Calve-Perthes change with a smoker's household?
change of experiencing this pathology increases from 1 in 1200 to 1 in 100
40
Three extra-articular ligaments in the hip
iliofemoral ligament of Bertin/Bigelow Pubofemoral Ligament Ischiofemoral ligament
41
Iliofemoral Ligament
made up of two parts: inferior(medial) portion and a superior(lateral) portion strongest ligament in the body
42
Which muscle does the iliofemoral ligament blend with
iliopsoas
43
Pubofemoral Ligament
blends with the inferior band of the iliofemoral and pectineus muscle
44
Ischiofemoral ligament
winds posteriorly around the femur and attaches anteriorly, strengthening the capsule
45
What hip ligament in most commonly injured?
ischiofemoral
46
All extra-articular hip ligaments tighten with:
hip extension
47
the lateral band of the iliofemoral ligament limits:
adduction
48
the medial band of the iliofemoral ligament limits:
external rotation
49
the pubofemoral ligament limits
abduction
50
the ischiofemoral ligament limits:
internal rotation
51
Iliopsoas
the most powerful of the hip flexors
52
iliopsoas is made up of:
iliacus and psoas major
53
Pectineus
adducts, flexes, and internally rotates the hip
54
Rectus femoris
combines the movements of hip flexion and knee extension
55
Tensor fascia latae
assists in flexing, abductiong, and internally rotating the hip
56
Sartorius
the longest muscle in the body | responsible for flexion, abduction, and external rotation of the hip as well as some degree of knee flexion
57
Gluteus maximus
largest and most important extensor and external rotator of the hip
58
gluteus medius
main abductor of the hip
59
anterior portion of gluteus medius
flexes, abducts and internally rotates the hip
60
the posterior portion of gluteus medius
extends and externally rotates the hip
61
Gluteus minimus
the major internal rotator of the femur
62
Some causes of weak gluteus medius muscles?
``` fracture of the greater trochanter slipped capital femoral epiphysis congenital hip dislocation poliomyelitis meningomyelocele L5 nerve root lesion ```
63
Slipped femoral capital epiphysis
slipping of the neck of the femoral head as the head remains in the acetabulum
64
Who most commonly experiences a Slipped femoral capital epiphysis
``` tendency to be with overweight adolescents adolescents 10-15 more males than females more black than white left hip more then right ```
65
who would you see a bilateral Slipped femoral capital epiphysis in?
females
66
What is the common etiology with a Slipped femoral capital epiphysis
trauma 50% of the time
67
What will you see on xray with a Slipped femoral capital epiphysis
an alteration in klein's line
68
Piriformis
an external rotator of the hip at less than 60 deg | at 90 deg of hip flexion, piriformis reverses its action and becomes an internal rotator/abductor of the hip
69
Small external rotators
obturator externus and internus superior and inferior gemelli quadratus femoris
70
Hamstrings
made up of biceps femoris, semimembranosus, and semitendinosus
71
Action of biceps femoris
extends the hip, flexes the knee, and externally rotates the tibia
72
action of semimembranosus and semitendinosus
extends the hip, flexes the knee, and internally rotates the tibia
73
Hip adductors
adductor magnus, longus, and brevis, and the gracilis
74
Iliopsoas bursa
aka iliopectineal located under the inguinal ligament, between the iliopsoas tendon and the iliopectineal eminence of teh superior pubic ramus
75
What commonly causes inflammation of the psoas bursa?
O/A of the hip
76
Where is the subtrochanteric bursa?
between the greater trochanter and the TFL
77
Borders of the femoral triangle
the inguinal ligament, adductor longus, and the sartorius
78
the floor of the femoral triangle is formed by
portions of the iliopsoas and pectineus
79
The posterior gluteal region receives innervation by way of:
the subcostal, iliohypogastric nerves and the dorsal rami of L1 L2 and L3 and the cluneal nerves of S1 S2 and S3
80
Normally the sciatic nerve passes
inferior to the piriformis muscle (88% of people)
81
The external iliac artery becomes the femoral artery as it passes underneath
the inguinal ligament
82
the branches of the femoral artery
lateral femoral circumflex artery | medial femoral circumflex artery
83
The lateral circumflex artery supplies
anterior portion of the of the femoral neck and the anterior hip joint capsule
84
the medial femoral circumflex artery supplies
perforates and supplies the posterior hip joint capsule and synovium

Orthopedic Diagnosis (10 decks)

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