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movement science final!!!!! > the hip complex > Flashcards

the hip complex Flashcards

1
Q

what type of joint is the hip

A

synovial/ diarthrodial ball and socket

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2
Q

how many DOF does the hip have

A

3
flex/ext
add/abd
IR/ER

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3
Q

the acetablum is contributes by the fusion of what 3 pelvic bones

A

ilium, ishium and pubis

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4
Q

the acetablum articulates with the ____ ____ and is covered with what type of cartilage

A

femoral head
hyaline

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5
Q

what creates a tunnel allowing fibroelastic fat tunnel carrying blood vessels deep into acetabulum

A

Acetabular notch + transverse acetabular ligament

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6
Q

what part of the acetablum is the deepest portion ?
does it articulate with the femoral head ?

A

acetabluar fossa
no

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7
Q

what is the normal acetabulum positioning

A

~50° inferior and ~20° anterior (little anteversion)

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8
Q

what are 4 abnormalities of the acetabulum

A

acetabular dysplasia
coxa profunda
anteversion
retroversion

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9
Q

what abnormality of the acetabulum is shallow acetabulum, decreased coverage, instability

A

acetabular dysplasia

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10
Q

what abnormality if the acetabulum is over coverage leading to impingement

A

coxa profunda

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11
Q

what is the different between anteversion and retroversion

A

anteversion is more anterior leading to instability and retroversion is more posteriorly leading to over coverage

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12
Q

if the acetablum is angles >20 what is considered

A

anteversion

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13
Q

if the acetablum is angles <20 what is considered

A

retroversion

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14
Q

what is the typical center edge angle

A

22-50°

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15
Q

if the center edge angle is <22-50° what does that indicate

A

acetabular dysplasia

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16
Q

if the center edge angle is > 22-50° what does that indicate

A

pincer type of impingement

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17
Q

what is the angle that connects the lateral rim and center of femoral head and is the coverage of the femoral head

A

center edge angle

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18
Q

what is the typical acetabular inclination

A

32-45°

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19
Q

what does the acetabular inclination measure

A

acetabular depth

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20
Q

the acetabular inclination is measured from what to what on an xray

A

line parallel to the teardrops to lateral acetablum

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21
Q

if the acetabular inclination is > 32-45° what can that indicate

A

acetabular dysplasia

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22
Q

what is the function of the acetabular labrum

A

depends the socket and increases concavity and maintains negative pressure to add stability

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23
Q

the nerve ending of the acetabular labrum provided what

A

proprioceptive and pain sensitivity feedback

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24
Q

what ligament does the acetabular labrum blend what

A

transverse acetabular ligament

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25
Q

the femoral head is rounded with what type of cartilage

A

hyaline

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26
Q

what ligament is attached to the fovea

A

ligamentum teres

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27
Q

is the fovea overhead with hyaline cartilage

A

no

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28
Q

what way does the femoral head face

A

medially , superiority and anteriorly with respect to the femoral shaft and condyle

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29
Q

what plane do you measure the angle of inclination in

A

frontal plane

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30
Q

what is the normal angle of inclination of the femoral angle

A

~125°

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31
Q

the angle of inclination is greater during ___ and smaller in ____

A

childhood
women

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32
Q

what are the 2 abnormalities with angle of inclination

A

coxa valga and vara

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33
Q

what is coxa valga

A

increased angle of inclination

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34
Q

is someone has coxa valga there is a ___ shear on the neck and ____ MA for abductors

A

decreased 2x

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35
Q

someone with coxa valga will have a ___ coverage leading to instability , femoracetabular impingement

A

decreased

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36
Q

coxa valga is associated structurally with what

A

genu varum ( knees go out)

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37
Q

what is coxa vara

A

decreased angle of inclination

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38
Q

someone with coxa vara will have ___ stability , ___ MA abductors and ___ bending/shear

A

increased 3x

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39
Q

someone with coxa vara has increased chance of what

A

slipped capita femoral epiphysis

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40
Q

coxa vara is structurally associated with what

A

genu valgum (knee in)

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41
Q

why will Kids with CP tend to have Coxa Valga and will often present with genu valgum when walking/standing

A

spasticity

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42
Q

what plane is the angle of torsion taken in

A

transverse plane

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43
Q

the angle of torsion is the axis thru what

A

femoral head/neck and femoral condyle

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44
Q

what is the normal angle of torsion of the head and neck ?

A

anteriorly 10-20°

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45
Q

what angle of torsion is considered anteversion

A

> 15-20 °

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46
Q

someone with anteversion will have ____ medial rotation , ___ lateral rotation and ___ stability

A

increased
decreased 2x

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47
Q

what degrees of the angle of torsion is considered retroversion

A

< 10-15 °

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48
Q

someone with retroversion will have ___ lateral rotation and ___ medial rotation

A

increased
decreased

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49
Q

what has more articular surface the head of the femur or the acetabulum

A

head of femur

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50
Q

how is the femoral head exposed in standing

A

anteriorly/superiorly

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51
Q

when does most joint congruence of the hip occur during

A

flexion , abduction and slight lateral rotation (ER)
(frog legged position)

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52
Q

acetabular dysplasia may be found in ___-

A

infancy

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53
Q

how many capsular ligaments does the joint capsule of the hip have

A

3

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54
Q

the joint capsule of the hip is thickest where and thinnest where

A

thickest : anterior -superorily
thinnest: posterior - inferiorly

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55
Q

what fibers of the joint capsule carry blood vessels that provide nutrition to the femoral head/neck

A

retinacular fibers

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56
Q

the femoral neck is _____ of the joint capsule

A

intracapsular (with in)

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57
Q

what is extra capsular of the joint capsule

A

greater and lesser trochanters

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58
Q

what is the lateral hip bursae called

A

trochanteric

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59
Q

the lateral bursae reduces friction b/w what

A

posterior facet, glute max , ITB and GT

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60
Q

what are the 2 anterior bursae’s

A

glute med and iliopsoas

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61
Q

what is the posterior bursae called

A

ishiogluteal

62
Q

what is the ligament of the head of the femur

A

ligamentum teres

63
Q

in the ligaments teres intra or extra articular ? is it extra or intra synovial

A

intra ]
extra

64
Q

where does the ligamentum teres attach to

A

acetabular notch , under transverse acetabular ligaments to the fovea

65
Q

what ligament is secondary blood supply to the femoral head

A

ligamentum teres

66
Q

what does the ligament teres provide restraint for

A

hip medial/lateral rotation when in > 90 ° of hip flexion

67
Q

if there is no blood supple to the head of the femur what can that lead to

A

a vascular necrosis

68
Q

what ligament is considered the Y ligament

A

iliofemoral lig

69
Q

the iliofemorla is fan shaped form what to what

A

AIIS to intertrochanteric line

70
Q

what is the primary stabilizing component of the anterior hip

A

iliofemoral ligament

71
Q

what does the iliofmeoral ligament resist

A

excessive lateral rotation , especially when the hip is in neutral or in flexion

72
Q

what ligament is from the pubic portion of the acetabular tim to the iliopectineal eminence

A

pubofemoral lig

73
Q

the pubofemoral lig forms a sling that support what and connect fibers between what

A

supports inferior femoral neck and connects fibers between iliofemoral and ischiofemoral

74
Q

what does the pubofemoral ligament resist

A

lateral rotation when hip in EXT

75
Q

what ligament attaches to the posteior surface of acetabular rim and labrum

A

ischiofemoral lig

76
Q

what is the function of the ischiofemoral ligament

A

primary restraint to medial rotation

77
Q

the capsuloligamentous tension in closed pack position is what

A

extension + slight abduction + medial rotation but most congruence is different … flex , abd and ER

78
Q

what is the loose packed position for capsuloligamentous tension

A

midrange flexion + slight abduction and mid rotation

79
Q

capsules and ligaments are ___ in hyperextension

A

taut

80
Q

what support 2/3 of body weight without muscular assistance

A

joint capsule and ligaments

81
Q

where does the LOG fall? and what does it create

A

posterior to hip and creates an external moment

82
Q

when is the hip most vulnerable to dislocation and what type does it result in

A

flex and add (dashboard innjury)
posterior dislocation

83
Q

most weight bearing stresses in the pelvis passed from what to what

A

SI to acetabulum

84
Q

√ Femoral head transfers forces to shaft – creates a bending moment across the femoral neck resulting in:

A

superior tensile forces and inferior compressive forces

85
Q

what kind of force is being created between the head, arms , and trunk and GRF

A

shear

86
Q

what does the medial trabecular system resist

A

vertical compressive forces thru femoral head

87
Q

what does lateral trabecular system resist

A

shear forces of body weight of HAT and GRF

88
Q

what can happen at the zone of weakness

A

fx

89
Q

Peak contact pressures during unilateral stance are located near ___ aspect of acetabulum dome

A

superior

90
Q

women tend to have a ___ contact area and ___ peak stress

A

smaller
higher

91
Q

what shows greatness prevalence of degeneration in the hip

A

dome

92
Q

Primary weight bearing area of the femoral head is___

A

superiorly

93
Q

pertaining to the motion of the femur on the acetabulum the ___ femoral head is on the ____ acetabulum … what way will the head slide and roll

A

convex
concave
head will slide/glide anf spin/roll in opposite direction bc convex on concave

94
Q

pertaining to the femur moving on the acetabulum in open chain what way does it spin during open chain flexion and extension

A

flex: femoral head spine posterior on acetabulum
ext: femoral head spins anterior on acetabulum

95
Q

pertaining to the femur moving on the acetabulum in open chain what happens during open chain abduction and adduction of the hip

A

abd: femoral head will roll superiorly and glide inferiorly
add: femoral head will roll inferiorly and glide superiorly

96
Q

pertaining to the femur moving on the acetabulum in open chain what happens during open chain medial and lateral rotation or the hip

A

medial rotation/IR : femoral head will roll anterior and glide posterior

lateral rotation/ ER: femoral head will roll posteriorly and glide anteriorly

97
Q

normal gait on ground level requires :
Flexion-
extension-
abduction/ adduction -
medial/lateral rotation-

A

Flexion- 30°
extension- 10°
abduction/ adduction -5°
medial/lateral rotation- 5°

98
Q

during hip flexion what kind of pelvic tilt will there be ? what about hip extension ?

A

anterior
posteior

99
Q

what does lateral pelvic tilt produce

A

abduction or adduction

100
Q

if opposite side of pelvis hikes then it is stance hip ___

A

abduction

101
Q

if opposite side of pelvis drops then it is stance hip ___

A

adduction

102
Q

in lateral pelvic shift in bilateral stance there is ___ on the shifted side and ___ on opposite

A

add
abd

103
Q

the pelvis motion on femur occurs in which stance

A

unilateral

104
Q

forward rotation of non weight bearing pelvis moves ___

A

anteriorly

105
Q

forward rotation of weight bearing hip produces ___ rotation

A

medial rotation

106
Q

during backward rotation the non weight bearing pelvis moves ____

A

posteriorly

107
Q

backwards rotation of weight bearing hip produces ___ rotation

A

lateral

108
Q

what is the order of forward bending

A

spinal flex
anterior pelvic tilt
hip flexion

109
Q

what can forward bending be limited by

A

tight mm

110
Q

what is the order of sidelying leg lift

A

hip abd
lateral pelvic tilt
lumbar side bend

111
Q

the LOG creates and ___ moment that is counterbalance by ____ and ____ tension

A

extensor
ligaments and iliopsoas

112
Q

if muscles contract in bilateral stance there will be an ___ force in joint

A

added

113
Q

the stance hips in unilateral stance must support what

A

compression from HAT and opposite legs , compression of abductor mm that counteract the ADD moment

114
Q

how much body weight in unilateral stance alone

A

2-3x

115
Q

lateral lean of trunk toward stance legs ___ MA of head , arms ,trunk and lower limb

A

decreases

116
Q

if someone is walking with a lateral trunk lean to the stand leg the use of cane ___ can transfer some BW force to cane

A

ipsilaterally

117
Q

Use of cane ____ relieves some of bodyweight force and assist the abductors by providing counter torque theoretically by using what mm

A

contralaterally

latissimus dorsi

118
Q

femoroacetabular impingement is a dysfunctional abutment of the what

A

proximal femur and acetabulum

119
Q

what type of impingement is pistol grip deformity of the femoral neck which pushes on anterior/superior labrum and cartilage

A

cam

120
Q

describe the pincer impingement

A

increased overcoverage of the acetabulum compression the superior labrum between he acetabulum and the femur

121
Q

if a patient presents with
• Groin pain, hip, or low back
• Pain may be dull/aching
• Sharp pain with turning, twisting, squatting • Hip joint stiffness

what can we suspect

A

femoroacetabular impingement

122
Q

what other hip pathology often occurs with FAI

A

labral tear

123
Q

someone with a labral tear will have….

A

decreased center edge angle
acetabular retroversion
coxa vara

124
Q

what is the MOI of labral tears

A

traumatic tears or cumulative microtrauma

125
Q

someone will a labral tear will have increased stresses with what 2 motion

A

abduction and ER

126
Q

if a patient presents with

• Sharp pain in front of hip
• Clicking, locking or feeling of “giving way”
• Stiffness or difficulty moving hip
• Microtrauma - running, ballet, golf, hockey, etc
• Traumatic - fall, MVA, high impact sports
• Normal wear and tear
• h/o developmental hip condition(s): hip dysplasia, FAI, Legg-Calve
Perthes, Slipped Capital Femoral Epiphysis

what can we suspect

A

labral tear

127
Q

FAI can also lead to what

A

OA

128
Q

a form of arthrosis is what

A

legg calve perthes

129
Q

bending forces across the femoral neck in those over 40 will cause what hip path

A

fx

130
Q

hip fx are associated with what

A

decreased bone density

131
Q

in coxa valga the weight bearing line is closer to what

A

shaft of femur

132
Q

what is coxa valga associated with

A

genu varum

133
Q

coxa valga decreases___ and risk of ___

A

stability
dislocation

134
Q

coxa vara ____ stability

A

increased

135
Q

there is an increased __ force to femoral neck of coxa vara patients

A

shear

136
Q

anteversion is associated with toe __

A

in

137
Q

retroversion is associated with toe ___

A

out

138
Q

slipped capital femoral epiphysis is an intracapsular ____ and ___ slippage of the ___ femoral epiphysis on the metaphysis

A

posteiror and inferior
proximal

139
Q

what do u look at on xray from SCFE

A

klein line

140
Q

what is drehmann sign for SCFE

A

hip flexion with ER

141
Q

someone with swayback posture will have what mm paralysis

A

glute max

142
Q

someone with sway back will have what kind of pelvis tilt and what at the hip

A

posterior
hip extension

143
Q

swayback posture will have compensatory ….

A

thoracic kyphosis

144
Q

where does LOG fall for swayback

A

behind the GT

145
Q

what type of muscular imbalance does someone have with anterior pelvic tilt

A

glute max

146
Q

anterior pelvic tilt is associated with what in the hip

A

increased hip flexion

147
Q

anterior pelvic tilt has compensatory …

A

increased lumbar lordosis

148
Q

where is the log of anterior pelvic tilt

A

posteiror to hip

149
Q

when does the distal femur growth plate close ?

A

20

150
Q

when does the growth plate for femoral head/neck, GT and LT close

A

18

movement science final!!!!! (9 decks)

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