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(CN) The Hip

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Front
Back
Which muscles flex the hip? (4)   Iliopsoas, Sartorius, Rectus femoris, Pectineus  
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What muscles extend the hip? (5)   Glut max & med, Hamstrings (Semitendinosus, Semimebranosus, Biceps Femoris)  
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What muscles abduct the hip? (4)   Glut med & min, Piriformis, Obturator internus  
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What muscles adduct the hip? (4)   Adductor magnus, longus & brevis, Gracilis  
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What muscles medially rotate the hip? (5)   TFL, Glut med & min, Pectineus, Adductor longus  
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What muscles laterally rotate the hip? (7)   Glut max, Obturator internus & externus, Piriformis, Gemelli Twins, Sartorius  
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What is Ely's test used for? Describe it.   Positive test indicates rectus femoris contracture. Place pt in prone and passively flex their knee. Positive test: Spontaneous hip flexion with the knee flexion.  
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What is Ober's test used for? Describe it.   Positive test indicates TFL tightness. Place pt in sidelying with lower leg flexed at hip and knee. Passively move test leg into extension and adduct it. Positive test: Leg is unable to adduct to the table behind the lower leg.  
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What is the Thomas test used for? Describe it.   Indicates hip flexion contracture. Pt place in supine w/ legs full extended, and brings one knee to the chest. Positive test: Straight leg raises up from the table.  
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What is the tripod sign? What does it indicate?   Positive test: When placed in a sitting position, one knee is passively extended, the pt extends the trunk in order to limit the effect of the tight hamstrings. If you hadn't guessed it, a positive test indicates tight hamstrings!  
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What is Craig's test used for? Describe it.   Evaluates anteversion. Place pt prone with test knee flexed to 90. Palpate posterior aspect of the greather trochanter and rotate the hip M&L until trochanter is // with the table. Anteversion = angle of lower leg w/ perpendicular axis of the table.  
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What is a normal amount of anteversion in an adult?   8-15 degrees.  
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What is Patrick's(Faber's) test used for? Describe it?   Postive test may indicate ilipsoas, SI or hip joint problems. Place pt in supine w/ the ankle of test leg resting on contralateral knee. (Figure of 4) Slowly lower the test knee toward the table. Positive test: failure of test leg to abduct to the table.  
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What are the two types of total hip replacement? Describe each.   Cemented: Immediate WBAT, May require more bone tissue removal, May experience loosening. Noncemented: TTWB for up to 6 wks, Lasts longer than cemented, Leaves more bone intact, Allows for continued tissue growth.  
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What are the general post-op precautions after THR w/ posterolateral approach? (8)   Avoid adduction, medial rotation and flexion past 90. Do not: sit on low surfaces, bend over toward ground, lean to get up from chair, cross legs. Maintain abduction w/ a pillow.  
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What does early PT intervention consist of post-THR?   Maintaining WB status, ambulation and mobility training w/ precautions, Isometric strengthening, Gentle stretches w/ precautions.  
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What is the Q angle?   The degreee of angluation between the ASIS, midpatella and tibial tubercle.  
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What is a normal Q angle when measured in supine? What could an excessive Q angle lead to?   Males: 13degrees, Females 18 Degrees. Excessive Q angle can lead to pathology and abnormal patellar tracking.  
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Streight Leg Raise   evaluate lower back pain and unilateral disfunction of the SIJ  
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pain with 0-30 degree w SLR   Hip pathology or severly inflamed nerve root  
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pain in 30-50 SLR   sciatic N. involvement  
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pain w 50-70 SLR   tight hamstrings  
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pain in 70-90 SLR   SIJ stressed  
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Prone knee bend   femoral nerve stretch L1-L3 N. involvement  
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