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Kinesiology 2 > Hip > Flashcards

Hip Flashcards

1
Q

What type of articulation is the hip?

A

Femoral-acetabular articulation

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2
Q

What is another name for the hip?

A

Coxofemoral joint

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3
Q

Which bones make up the hip joint?

A

Head of the femur and acetabulum of the pelvis

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4
Q

What type of joint is it?

A

A diarthrodial ball and socket joint

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5
Q

What is another name for this type of joint?

A

Enarthrodial

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6
Q

What is a diarthrodial or enarthrodial joint?

A

Multiaxial with three degrees of freedom

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7
Q

What is the hip joint designed for?

A

Maximal stability while providing considerable mobility

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8
Q

Which joint is more mobile shoulder or hip?

A

Shoulder, because the hip has a deeper socket arrangement

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9
Q

What are the primary function of the hip?

A

Weight bearing of the upper body during static and dynamic upright postures
Force transmission pathway for ground reaction forces

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10
Q

From what other pathologies can pain in the hip come from?

A

Lumbo-sacral region

Knee

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11
Q

Where can the hip pathologies refer pain?

A 
Groin
Anterior-medial-lateral thigh
Knee
Buttock
(Foot /ankle)
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12
Q

When can hip pathologies be seen?

A

During gait

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13
Q

What is the resting position of the hip?

A

30 degrees Flexion
30 degrees abduction
0 degrees or slight ER

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14
Q

What is the closed packed position of the hip and what phase of gait does it occur?

A

Extension
Internal Rotation
Abduction
During Terminal Stance

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15
Q

What is the capsular pattern of the hip and what angle is it in?

A

When the capsule is tight due to the ligaments
Flexion
Abduction
Medial (internal) rotation

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16
Q

What type of pattern does the acetabular bone have?

A

Concave pattern

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17
Q

What is the acetabulum’s orientation?

A

Lateral
Anterior
Inferior

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18
Q

What type of articular surface the acetabulum have and what is it covered with?

A

Horseshoes-shape articular surface

Covered in hyaline cartilage

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19
Q

What finishes the horseshoes articulation of the acetabulum?

A

Deep acetabular fossa that contains a synovial covered fibroelastic fat pad

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20
Q

What deepens the socket increasing the concavity?

A

Acetabular labrum
A wedge shaped fibro-cartilage
Inferior to transverse acetabular ligament

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21
Q

What pattern does the femoral head make?

A

Distal convex articular pattern

2/3 of a sphere

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22
Q

What is the femoral head fully lined with?

A

Hyaline cartilage except for the fovea capitus

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23
Q

What is the common orientation of the femur?

A

Medial
Anterior
Superior

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24
Q

What is the capsule of the hip?

A

Strong and Dense

Contributes to joint stability

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25
Q

Where does the capsule of the hip attach?

A

Proximally to entire rim of the acetabulum and distally to the base of the femoral neck

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26
Q

What does the capsule of the hip form?

A 
Zona Orbicularis (orbital zone)
Due to multilayering
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27
Q

Where is the capsule thick and thin?

A

Thick-Anteriosuperiorly

Thin-Loosely attached Posterioinferioly

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28
Q

What does the capsule of the hip restrict?

A

Joint distraction

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29
Q

What is the capsule of the hip reinforced by?

A

Strong ligaments

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30
Q

What is the capsule considered as?

A

Extensive synovial lining

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31
Q

What do the ligaments of the hip do?

A

Contribute to stability

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32
Q

Where are the ligaments located?

A

2 anterior

1 posterior

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33
Q

What are the primary ligaments of the hip?

A

Iliofemoral (y ligament of bigelow)
Ischialfemoral
Pubofemoral

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34
Q

What are the additional ligaments of the hip?

A

Ligament of the head of the femur (ligamentum teres)

Transverse acetabular ligament

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35
Q

When are the ligaments strong?

A

When pulled fast

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36
Q

Where are the iliofemoral ligament attachments?

A

Proximal-Lower portion of ASIS. Area on ilium proximal to superior and posteriosuperior rim of Acetabulum
Distal-Intertrochanteric line
Lateral-anterior aspect of greater trochanter
Medial-Anterior portion of the lesser trochanter

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37
Q

What does the iliofemoral ligament primarily do?

A

Checks extension and internal rotation

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38
Q

Where does the ischiofemoral ligament attach?

A

Proximal-Area on ischium, posterior and inferior to rim of acetabulum
Distal- Posterior superior aspect of the neck of femur near greater trochanter

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39
Q

Which way do the ischiofemoral fibers run?

A

Upward and laterally

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40
Q

What does the Ishciofemoral ligament do?

A

Pulls tight on extension and internal rotation

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41
Q

Where does the pubofemoral ligament attach?

A

Proximal-Pubic bone near acetabulum

Distal-Onto femur anterior to lesser trochanter

42
Q

What does the pubofemoral ligament do?

A

Tightens primarily on abduction, extension, and internal rotation

43
Q

What does the ligamentum teres contain?

A

Branch of obturator artery

Provides blood supply to the top of femoral head

44
Q

What is Bursa?

A

Small fluid filled sacks that act to decrease friction and provide cushion between the structures they sit between

45
Q

What are the four bursas of the hip?

A

Trochanteric
Iliopectineal
Iliopsoas
Ischiogluteal

46
Q

What is the trochantric bursa?

A

Most extensive,
Posteriorlateral to greater trochanter
Decreases friction between ITB, Glut min, and Greater trochanter
Tight ITB can lead to trochantric bursitis

47
Q

What is the iliopectineal bursa?

A

Continuous with joint capsule anteriorly
Between iliopsoas and iliopectineal eminence of bone
Superior acetabular rim
Presents as deep groin pain when injured

48
Q

What is the iliopsoas bursa?

A

Often overlooked
Close to the insertion of the muscle
Between ischial tuberosity and hamstring tendon
Common in people who sit on hard surfaces

49
Q

What is the ischiogluteal bursa?

A

Weavers bottom

Axial of ischial tuberosity

50
Q

What are the two pathways for the vascular structures?

A

Ligamentum teres

neck of femur

51
Q

What can cause loss of circulation?

A

Fracture,
Capsular tension
Constriction

52
Q

What are the medial and lateral circulflex arteries?

A

Derived from femoral and deep femoral arteries

Supply the intra and extracapsular arterial rings ascending the neck of the femur

53
Q

What does the obturator artery provide?

A

Braching that migrates to the femoral head by way of the ligamentum teres

54
Q

What nerve roots innervate the hip?

A

L2 to S1
Primary L3
Significant potential referral pattern of pain to and from the hip

55
Q

Where does the femoral nerve innervate

A

Quadriceps

56
Q

What nerve roots are with femoral nerve?

A

L2-4

57
Q

What is the path of the femoral nerve?

A

Descends through psoas major
Passes between the iliacus and iliac fascia
Runs beneath the inguinal ligament into the thigh

58
Q

What injury could injury femoral nerve?

A

Fracture of ASIS

59
Q

What does the sciatic nerve innervate?

A

Hamstrings

60
Q

What are the nerve roots of the sciatic nerve?

A

L4-S3

61
Q

What is the path of the sciatic nerve?

A

Exits below piriformis and above gemellus

70% below piriformis

62
Q

What pathology could occur with sciatic nerve?

A

Sciatica

63
Q

What does the obturator nerve innervate?

A

Adductors

64
Q

What nerve roots are with obturator nerve?

A

L2-4

65
Q

What is the obturator nerve path?

A

Through psoas major
Emerge through brim of pelvis
Enters thigh through obturator canal

66
Q

What must be considered with the hip muscles?

A

2 joint muscles
Multiple actions
Position of the hip

67
Q

What muscles produce flexion of hip?

A

psoas major/minor

Iliacus

68
Q

What muscles produce extension of the hip?

A

Glut max

Hamstring

69
Q

What muscles produce abduction of hip?

A

glut med.

70
Q

What muscles produce adduction of hip?

A

adductors

Gracilis

71
Q

What muscles produce medial rotation of hip?

A

glut min

TFL

72
Q

What muscle produce lateral rotation of hip?

A

External rotators

73
Q

What is the ratio for quads and hamstrings?

A

60% rule

74
Q

What occurs with flexion contracture?

A

Rotate with posterior rotation through SI joint instead

75
Q

What is an adductor gait?

A

Scissor gait

76
Q

Is there joint play in the hip?

A

Yes, passively

Not often used

77
Q

How can true distraction or traction occur in the hip joint?

A

Inferior-lateral direction

78
Q

What glides occur in Flexion, abduction, and Medial/lateral rotation?

A

Flexion-PI glide
Abduction-I glide
Lateral-A glide
Medial-P glide

79
Q

What is the angle of inclination?

A

Frontal Plane reference angulation of the femur

Femoral Neck shaft angle

80
Q

What is the angle of torsion?

A

Transverse plane referenced angulation of femur

Refered as anteversion or retroversion

81
Q

What is the normal angle of inclination of the hip?

A

120-130 degrees

82
Q

What is an increase in the angle of inclination of the hip?

A

Coxa Valga

Inside angle gets bigger

83
Q

What are the aspects of coxa valga of the hip?

A

Increased leg length
Increased compression forces
Abnormal location of joint contact points
Mechanical disadvantage of hip abductors (shorter lever arm)

84
Q

What is a decrease in the angle of inclination of the hip?

A

Coxa Varum

Inside angle gets smaller

85
Q

What are the aspects of coxa varum of the hip?

A

Decreased leg length
Increased shearing forces
Abnormal location of joint contact points
Mechanical advantage for hip abductors (longer lever arm)

86
Q

What is an increase in the angle of torsion?

A

Femoral anteversion

87
Q

How does femoral anteversion present?

A

Excessive medial roation
Decreased lateral rotation
Squinting patella-knees point in (pronators)

88
Q

What is a decrease in the angle of torsion?

A

Femoral retroversion

89
Q

How does femoral retroversion present?

A

Excessive lateral rotation
Decreased medial rotation
Frog eyes patella-patellas point out

90
Q

What are the aspects of hip stability in bilateral stance?

A

LOG falls posterior to hip joint
Extension moment torque
Posterior pelvic tilt on femoral heads
Kept in check by capsuloligamentous structures

91
Q

What accounts for 2/3 of body weight?

A

head
Trunk
Arms

92
Q

How much weight is distributed in each hip joint?

A

1/3 body weight

93
Q

What are the aspects of hip stability in unilateral stance?

A

Frontal plane disruption of hip
5/6 of body weight on single limb
Additional compression forces due to the contraction of hip musculature

94
Q

How much body weight is adjusted in unilateral standing compared to bilateral in quiet standing, stance phase of gait, and stair climbing?

A

Quiet standing-2.5-3 times
Stance phase-3-4 times
Stair-7 times

95
Q

What two forms of gait occur with abductor muscle weakness?

A 
Gluteus medius gait (compensated)-Trunk lean to reduce weight arm and increased mechanical advantage
Pelvic drop (uncompensated)
96
Q

What can help reduce the compressive forces?

A

Decreased weight- one point reduction decreases forces by 2.5-7 pounds
Assistive devices ipsilateral-reduce force but cause other problems
Assistive devices contralateral-reduce 40% of forces

97
Q

What are the pelvic, hip and lumbar motions?

A

Anterior tilt-flexion-extension
Posterior tilt-extension-flexion
Pelvic drop-R adduction-R lateral flexion
Hip hike-R abduction-L lateral flexion
Forward rotation-Internal rotation-L rotation
backward rotation-external rotation-r rotation

98
Q

Not quiz-

What are the other neuromuscular causes of hip pain?

A 
Low back pain- S1 pain
peripheral nerve entrapment
Femoral hernia
Stress fractures
Fasciatis
Knee OA
99
Q

Not Quiz-

What ar ethe systemic causes of hip pain?

A 
Cancer/bone mets
Bone tumors
Cardiovascular arterial insufficiency
urological or renal disorders
Inflammatory disease like reiters, crohn's disease, abdominal or peritoneal inflammation, ankylosing spondylitis
100
Q

Not quiz-

What are hints of systemic pain?

A 
Aids/TB/Sickle cell anemia/hemophilia
Hip/groin pain with gastro symptoms
Hip pain worse at night and alleviated with activity
enlargement of lymph nodes
Men age 18-24 hip groin pain
Rebound tenderness
101
Q

Not quiz-

What are referred patterns of hip pain?

A 
Femoral nerve distribution
Obturator nerve distribution
Ilioinguinal nerve
Genitofemoral nerve
Lateral cutaneous nerve

Kinesiology 2 (12 decks)

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