PTRS 745 Exam 2 > Hip > Flashcards

Hip Flashcards

(53 cards)

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1
Q

Q: Describe the transfer of forces in the hip.

A

From sacrum to pelvis to femur

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2
Q

Diagram: Articular Structures of the Hip (2)

A

Labrum, and synovial fluid act like shock absorber

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3
Q

Diagram: Ligament Structures of the Hip

A

Iliofemoral ligament = one of strongest in the body (with the help of the labrum)

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4
Q

Diagram: Posterior Musculature of the Hip (6)

A

Large muscles used for movement (walking)

Deep muscles:

  • mimic RC
  • hold you in extension to keep femoral head in socket
  • Can cause a posterior tilt
  • ER that act as extensors when contract together
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5
Q

Diagram: Anterior Musculature of the Hip (2)

A

All the adductors (which also do IR)

Constantly contracted, can effect posture - anterior tilt

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6
Q

Q: Which set of muscule balance the hip?

A

ER and IR

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7
Q

Content: External Rotators (6)

A
  1. Piriformis (< 60 degrees)
  2. Superior/inferior gemellus
  3. Obturator internus/externus
  4. Quadratus femoris
  5. Gluteus maximus
  6. Gluteus medius/minimus (flexed)
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8
Q

Q: Which ER might become tight and then weak and cause posterior tilt? (5)

A
  1. Superior gemellus
  2. Obturator internus
  3. Inferior gemellus
  4. Obturator externus
  5. Quadratus femoris
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9
Q

Content: Internal Rotators (8)

A
  1. Piriformis (at 90)
  2. Semitendinosus
  3. Semimembranosus
  4. Adductors
  5. Pectineus
  6. Tensor fasica latae
  7. Gluteus medius (extended)
  8. Gluteus minimus (extended)
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10
Q

Diagram: Bursae of the Hip (2)

A

Ischial and Iliopsoas

Ischial = can be inflammed with prolonged sitting/trauma

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11
Q

Q: How much flexion can be appreciated at the hip?

A

110-120 degrees

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12
Q

Q: How much extension can be appreciated at the hip?

A

10-15 degrees

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13
Q

Q: How much abduction can be appreciated at the hip?

A

30-50 degrees

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14
Q

Q: How much adduction can be appreciated at the hip?

A

30

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15
Q

Q: How much external rotation can be appreciated at the hip?

A

40-60 degrees

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16
Q

Q: How much internal rotation can be appreciated at the hip?

A

30-40 degrees

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17
Q

Q: Describe the roll and glide with hip flexion.

A

R = anterior

G = posterior

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18
Q

Q: Describe the roll and glide with hip extension.

A

R = posterior

G = anterior

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19
Q

Q: Describe the roll and glide with hip abduction

A

R = lateral (superior)

G = inferior

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20
Q

Q: Describe the roll and glide with hip adduction

A

R = medial (inferior)

G = superior

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21
Q

Q: Describe the roll and glide with hip IR.

A

R = medial (anterior)

G = posterior

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22
Q

Q: Describe the roll and glide with hip ER.

Study These Flashcards
A

R = lateral (posterior)

G = anterior

23
Q

Q: Which hip motions have an end feel of tissue approximation (or stretch)? (2)

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A
  1. Flexion
  2. Adduction
24
Q

Q: Which hip motions have an end feel of tissue stretch? (4)

Study These Flashcards
A
  1. Extension
  2. Abduction
  3. IR
  4. ER
25
Q: What functional range is required for shoe tying?
120 of flexion
26
Q: What functional range is required for sitting (average seat height)?
112 of flexion
27
Q: What functional range is required for stooping?
125 of flexion
28
Q: What functional range is required for squatting?
115 of flexion 20 of abduction 20 of IR
29
Q: What functional range is required for ascending stairs (average stair height)
67 of flexion
30
Q: What functional range is required for descending stairs (average stair height)?
36 of flexion
31
Q: What functional range is required for putting foot on opposite thigh?
120 of flexion 20 of abduction 20 of ER
32
Q: What functional range is required for putting on pants?
90 of flexion
33
Content: 3 types of femoral head orentation
1. Coxa valgus 2. Coxa varus 3. Anteversion
34
Content: Coxa valgus (4)
1. Increase joint reaction force 2. Muscles in mechanical disadvantage 3. Modify angle at knee joint 4. ~170 (greater than norm of 125)
35
Content: Coxa varus (4)
1. Decrease joint reaction force 2. Increase the shear forces on the femoral head/neck 3. Damage at the epiphyseal plate 4. ~ 100 (less than norm of 125)
36
Diagram: Coxa valugs and varus
37
Q: What is normal femoral anteversion?
8-15 degrees
38
Diagram: Hip Anteversion/Retroversion (2)
Anterversion = Increasing medial femoral torsion Retroversion = Increasing lateral femoral torsion
39
Q: What test is used to measure femoral anteversion?
Craig's test
40
Content: SE (for Hip) (4)
1. Profile 2. Location/distribution pain (body chart) 3. Behavior of symptoms (agg./easing) 4. Hx (injury/insidious)
41
Content: OE (for Hip) (6)
1. Observation 2. Palpation 3. AROM/PROM 4. Length 5. Strength 6. Special tests
42
Q: What are the degenerative changes seen in OA? (3)
1. Articular cartilage break down/loss 2. Capsular fibrosis 3. Osteophyte formation on the joint margins
43
Term: The shortest distance between the femoral head margin and the acetabulum
Minimal joint space
44
Q: What is normal and hip OA joint space (in mm)?
Norm = ~4.5 Hip OA = \< or equal to 2.5
45
Content: Kellgren and Lawrence scale for Osteoarthritis (4)
Grade 1 = Doubtful narrowing of joint space and possible osteophytic lipping Grade 2 = Definite osteophytes, definite narrowing of joint space Grade 3 = Multiple moderate osteophyites, definites joint space narrowing, some sclerosis and possible deformity of contour Grae 4 = Large osteophytes, marked joint space narrowing, severe sclerosis, and definited deformity of bone contour
46
Diagram: Nonpharmacologic recommendations for the management of hip osteoarthritis (from the american college of RA)
Recommend: aerobic exercise, weight loss Conditionally recommended: self manage, manual therapy, supervised exercise, thermal agents, walking aids Not recommended: balance + strength, tai chi, manual therapy alone
47
T/F: The optimal OA treatment program should consist of both medications and non-drug treatments.
True
48
Content: Non-drug treatments for OA (11 - general idea)
1. Education and self-management 2. Reulgar telephone contact (promotting self-care) 3. Physical therapy 4. Aerobic, muscle strengthening and water-based exercises 5. Weight loss 6. Walking aids 7. Footwear and insoles 8. Knee braces (in case of OA) 9. Heat and cold 10. TENS 11. Acupuncture
49
T/F: Patients often see one health care provider and then receive a definitive diagnosis of a labral tear.
False: Seen by multiple health care providers before obtaining a definitive diangosis (can take 2 years)
50
Content: Facts on Atraumatic Labral Tear (7) 1. Gender 2. Age 3. Hx 4. Pain 5. Limp 6. Dr's seen 7. Previous Dx
1. 71% female 2. Mean age = 38 3. Typically no hx of trauma 4. 86% in mod-severe pain 5. 39% were limping 6. On average has seen 3.3 practitioners over 21 mos 7. Usually had diagnosis of "soft tissue injury"
51
Content: OE for Labral Tears (5)
1. Standing alignment: Posterior pelvic tilt and knee hyperextension 2. Precision of both active/passive hip flexion 3. In prone, pattern of hip extension (indicates relative participation of hmas and glute max) 4. Muscle strength: hip ABD, glute max, iliopsoas, deep ER when not painful 5. Gait with hyperEXT and ER 5. Increased accessory/joint motion
52
Content: Provocative Hip Tests (4)
lol "provocative" 1. FABER test 2. Scour test 3. Resisted SLR (hip in 30 flexion) 4. Flex-Add-IR (most appropriate for interior lesion = pain and clicking)
53
Q: What is the normal angle of inclination of the femoral head?
125 degrees
PTRS 745 Exam 2
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