The Hip Overview Flashcards by Jawric Cuyzon

How many degrees of freedom is in the hip?

3 degrees of freedom with 6 osteokinematic movements

Flexion, Extension, Abduction, Adduction, IR, ER

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What is a capsular pattern?

A joint specific pattern of restriction of PROM which indicates capsular tightness

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What is the position of capsular restriction?

flexion
abduction
medial rotation (IR)

If stabiize the pelvic bone (?) more extension and medial rotation

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What is the closed pack position of the hip?

Extension
Medial rotation
Abduction-adduction (?)

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What is the open pack position of the hip?

Flexion
External rotation
- max surface contact

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What is the anatomical characterisitics of the hip?

Has 4 bones that makes it symbiotic with innominate

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What type of joint is the hip?

congruent joint - ball and socket
- making it a slide and glide movements

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What is the function of the hip?

Mobility and stability
Transmission of forces between the pelvis and LE

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How much force is needed to dislocate the hip?

400 newton pounds :0

That’s ALOT BROTHER

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What are the primary blood supply of the femoral head?

ligamentum teres
circumflex arteries
superior and inferior gluteal arteries

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What is the function of the labrum?

a fibrocartilaginous tissue that is meant for:
- cushion
- slide and glide

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What are the anterior ligaments?

Iliofemoral (Y)
Pubofemoral

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What are the posterior ligaments?

Ischiofemoral
Ligametum teres

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What does the ligamentum teres assist with?

90 degree flexion that helps with IR/ER

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What are the two types of muscles in the body?

Stabilizers and movers

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What are the primary stabilizers

Hip rotators and psoas

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What are the flexors of the hip?

Iliacus
TFL
Rec fem
Sartorius
adductor longus
pectineus

Assistance from:
- gracilis
- adductor brevis
- anterior glute min

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What are the extensors of the hip?

Glute max
Hammies
Posterior adductor magnus

Assistance from:
- glute med

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What are muscles of abduction?

Glute med
TFL
Superior glute max
Glute min

Assistance from:
- sartorius
- rec fem
- piriformis at 90 deg

What are the muscles of adductors?

Adductor group
pectineus
gracilis
pectineus

Assistance from:
- obturator externus

What are the muscles of medial rotators?

NO PURE ROTATORS
but
TFL
Glute min
Anterior fibers of glutee med
Adductor group
Semimembranosus/tendinosus

What are the muscles of lateral rotators?

Obturator interior/exterior
Gemeli
Quad fem
piriformis
glute max
posterior fibers of glute med
bicep femoris

Bolded = stabilizers

What is the flexion ROM and end-feel?

ROM = 110-120

End feel: tissue approximation/tissue stretch

What is the extension ROM and end-feel?

ROM: 10-15

End-feel: Tissue stretch

What is the **abduction** ROM and end-feel?

ROM: 30-50 End-feel: tissue stretch

What is the **adduction** ROM and end-feel?

ROM: 25-30 End-feel: tissue approximation and tissue stretch

What is the **ER** ROM and end-feel?

ROM: 40-60 End-feel: tissue stretch

What is the **IR** ROM and end-feel?

ROM: 30-40 End-feel: tissue stretch

What are some of the functional ROM at the hip?

What is the angle of inclination?

the angle between the shaft and neck

What are the normal angle of inclination?

125 degrees ## Footnote taller person = larger angle shorter person = smaller angle

What is coxa valga?

increase angle causes femoral head to be directed more superiorly in the acetabelum

What is the effects of coxa valga to the hip?

* Changes the orientation of the joint reaction force * mechanical disadvantage * increased overall length of UE

How does coxa valga **change the orientation of the joint reaction force**?

From vertical direction -> almost parallel to shaft = increased stress across the joint (not specialized to take that force)

What is the **mechanical disadvantage** of coxa valga?

Moment arm of hip abduction is short = contaction is more vigorous to stabilize the pelvis ## Footnote produces another increase in joint reaction force

What is the cause of an overall length for coxa valga?

Decreases physiological angle of the knee - more stress on medial aspect of the knee joint - more likely to impinge the hip FAI

# Coxa Vara What is the orientation?

More horizontal orientation of femoral neck

# Coxa Vara Where is the direction of force?

Increased downward shear forces

# Coxa Vara What is an important change regarding angle of pull?

Increases the effective angle of pull and lever arm of hip abduction

# Coxa Vara What is reduced?

Compressive forces BUT increased shear and torsional forces @ fem head/neck junction

# Coxa Vara How is the knee affected?

causes lateral compressive forces at the knee - medial tensile

What is the most likely outcome of coxa vara?

More likely to fracture

What are the anteversion?

anterior orientation of the neck = more hip IR

What kind of gait is associated with anteversion?

In-toeing gait

What is retroversion?

Increased femoral ER

What kind of gait is associated with retroversion?

Out-toeing gait