The Hip Complex

Question 1

Acetabulum contains 3 fused pelvic bones. What are they?

Answer 1

Ilium, ischium, pubis

Question 2

Acetabular positioning?

Answer 2

50 degrees inferior and 20 degrees anterior

Question 3

What is coxa profunda?

Answer 3

Over coverage leading to impingement

Question 4

What is the center edge angle?
Typical angle? > and < is?

Answer 4

Coverage of femoral head, connects lateral rim and center of femoral head

22-50 degrees
> is indicative of acetabular dysplasia
< is indicative of pincer type impingement

Question 5

What is acetabular inclination?
What is normal? Increase?

Answer 5

Measurement of acetabular depth measurement from line parallel to teardrop to lateral acetabulum

32-45 degrees
> can be indicative of acetabular dysplasia

Question 6

The femoral head is rounded with? The ligamentum teres is attached to the ___. The ___ is NOT covered with ____
Faces what 3 directions?

Answer 6

Hyaline cartilage
Fovea
Hyaline cartilage

Medically, superiority, and anteriorly

Question 7

Most joint congruence occurs during?

Answer 7

Flexion, abduction, abduction, and slight lateral rotation

Question 8

The joint capsule is thickest and thinnest?
The femoral neck is?
The greater and lesser troch are?

Answer 8

Thick- anterior superior
Thing- posterior inferior

Femoral neck is intracapsular
Greater lesser troch are extra capsular

Question 9

Hip bursae in what 3 directions?

Answer 9

Lateral, anterior, posterior

Question 10

Ligamentum Teres restraint for what motion?

Answer 10

Hip medial/lateral rotation when in >90 degrees of hip flexion

Question 11

What does the iliofemoral ligament resist? (Y ligament of bigelow)

Answer 11

Excessive lateral rotation, esp when hip is in neutral or flexion

Question 12

What does the pubofemoral ligament resist?

Answer 12

Resists lateral rotation when hip is in extension

Question 13

What does the ischiofemoral ligament resist?

Answer 13

Medial rotation

Question 14

Close Packed position of the hip?
However most congruent is?

Answer 14

Extension plus slight abduction plus medial rotation
Flexion abduction plus external rotation

Question 15

What is loose packed position?
Joint capsule and ligaments support how much of body weight?

Answer 15

Midrange flexion, plus slight abduction plus mid rotation
2/3

Question 16

The line of gravity falls what to hip creating what moment?
Hip most vulnerable to dislocation in what positions?

Answer 16

Posterior to hip creating extension moment

Flexion and adduction

Question 17

Femoral head transfers forces to shaft creates a bending moment across femoral neck resulting in….
Superior___
Inferior___

Answer 17

Superior tensile forces
Inferior compression forces

Question 18

What kind of force is being created between HAT and GRF?

Answer 18

Shear forces

Question 19

Medial trabecular system vs lateral tracebular system?

Answer 19

Medial - resists vertical compressive forces through femoral head

Lateral- resists shear forces if body weight of Hat and grf

Question 20

Normal gait on level ground requires at least:
Flexion
Extension
Abd/Add
Med/Lat rot

Answer 20

Flexion - 30 degrees
Extension- 10 degrees
Abd/add- 5 degrees
5 degrees of med and lay rotation

Question 21

The primary weight bearing area of the femoral head is ____

Answer 21

Superiorly, degenerative changes include loss of ball shape, flattening of superior portion

Question 22

Pelvis motions on femur
APT
PPT
Lateral pelvic tilt (bilateral stance)

Answer 22

APT- hip flx
ppt- hip ext
Lateral pelvic tilt produces abd or add if opp side of pelvic hikes, stance side abd
If opposite side drops, stance side add

In bilateral stance Add on shift side, abd on opposite side

Question 23

Forward and backward rotation of pelvis on femur?

Answer 23

Forward- non wb pelvis moves anteriorly, produces medial rotation if wb hip

Backward- non wb pelvis moves posterior lay, wb hip produces lateral rotation

Question 24

Adductors can be?
Piriformis can ?

Answer 24

Flexors or extensors
Piriformis can laterally rotate in extension or medically rotate in flexion

Question 25

Function of hip flexors? Primary muscles?

Answer 25

Bring swing limb forward during gait, resist hip extension forces Iliopsoas, recuts femoris biggest contribution to hip flexion when knee is flexed), TFL, sartorious

Question 26

Function of hip adductors? Primary muscles?

Answer 26

Stabilize hip in standing, can help flex hip from extension, extend from flexed position Pettiness, adductor Brevis, Longus, magnus, gracilis- can help flex hip if knee is extended

Question 27

Hip Extensors muscles?

Answer 27

Glute max- longest MA for extension when hip is flexed at u0 degrees Hamstrings- if knee is flexed above 90 degrees, lose ability to extend hip

Question 28

Primary muscles for hip abduction

Answer 28

Glute med: abduction in all hip position Glute min: abd and flexion

Question 29

Hip lateral rotators?

Answer 29

Obturator internus and external- OI decreased MA with hip flexion Obturator externus and quad fem are effective lateral rotators regardless of hip flexion

Question 30

Are there any primary hip medial rotators?

Answer 30

No primary medial rotators

Question 31

Growth plate closures Femoral head/neck Greater troch Lesser troch Distal femur

Answer 31

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