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Hip Anatomy
Question | Answer |
---|---|
What are the intra-articular structures of the hip? | Synovium, articular-cartilage, ligamentum teres, acetabular labrum |
What area of the articular cartilage is thickest in the hip? | Anterio-superiorly = primary weight bearing area |
What bones make up the innominate bone of the acetabulum? | ilium, ishium, & pubis |
The acetabulum is covered by what type of cartilage? What specific part is not covered by this specific cartilage? | Hyaline cartilage, fovea capitis |
The fovea capitis contains what ligament? What artery supplies this area? | Ligamentum teres, obturator artery |
What is the wedge-shaped fibrocartilage and connective tissue ring that rims the periphery of the acetabulum? | Acetabular labrum |
To allow for extension, the labrum is thinner in what direction? | anterior |
Is the labrum thought to be vascular or avascular? | avascular |
What is the function of the acetabulum? | 1. deepens the acetabulum 2. reduces contact stress or force per unit area by increasing contact area and distributing load 3. provide proprioceptive feedback and enhances joint stability (negative-intra-articular pressure)labrum "grasps" the femoral he |
What bone is the strongest and longest? | femur |
What fraction of the femoral head articulates with acetabulum? | 2/3 |
What plane does hip flexion/extension occur in? | sagittal |
Hip flexion ROM? | 0 - 140 |
Hip extension ROM ? | 0-45 |
Arthrokinematics of hip flexion? | spin with posterior glide of femoral glide head on acetabulum |
Arthrokinematics of hip extension? | spin with anterior glide |
What plane does hip abduction occur in? | frontal plane |
Hip abd ROM? | 0-40 |
Arthrokinematics of hip abd? | inferior glide |
what plane does hip IR and ER occur in? | transverse |
Hip IR ROM? | 0-40 |
Hip ER ROM? | 0-45 |
Arthrokinematics of hip IR? | posterior glide |
Arthrokinematics of hip ER? | anterior glide |
Is the angle of inclination more or less in a newborn? | More, 140-150 degrees |
What is the angle of inclination in a normal adult male? | 125 degrees |
What is the angle of inclination in a normal adult female? | 110-115 |
Definition of coxa valga? | angle of inclination is greater than 125 degrees |
Does coxa valga or coxa vara predispose you to hip OA? | coxa valga |
what promotes hip dislocation and lengthens the limb (coxa valga or vara)? | coxa valga |
Does the normal joint reaction force have a medial or lateral bias at the hip? | medial bias |
Coxa valga causes the hip to have a _______ bias at the hip? | lateral |
What are the 3 related postures you will see in someone with coxa valga | 1. ipsilateral genu varus (knee) 2. longer ipsilateral leg 3. posterior pevlic rotation |
What are the possible compensations of coxa valga? | 1. ipsilateral pronation 2. contralateral supination 3. contralateral plantarflexion 4. ipsilateral recurvatum 5. ipsilateral anterior pelvic rotation |
Definition of coxa vara? | angle is less than 125 degrees |
What increases stability, shortens the limb and causes a greater incidence of femoral neck fractures (coxa valga or vara)? | Coxa vara |
What are the 3 related postures of coxa vara? | 1. ipsilateral genu valgus (knee) 2. shortened ipsilateral leg 3. anterior pelvic rotation |
What are the possible compensations with coxa vara? | 1. ipsilateral supination 2. contralateral pronation 3. ipsilateral plantarflexion 4. contralateral recurvatum (hyperextension of knee) 5. ipsilateral posterior pelvic rotation |
what is the normal angle of torsion in the femoral shaft? | 15 degrees of anteversion |
Anteversion is an increase or decrease in the angle of torsion? | increase (more than 15 degrees) |
Anteversion or Retroversion is associated with a decrease in joint stability and an increased tendency for anterior dislocation of the femoral head? | anteversion |
Anteversion is characterized by excessive _________ rotation and loss of ______________ rotation? | medial rotation, lateral rotation |
What are the three related postures for femoral anteversion? | 1. in-toeing 2. excess subtalar pronation 3. lateral patellar subluxations |
what are the possible compensations for femoral anteversion? | 1. excess external tibial torsion 2. ER of tibia 3. ipsilateral lumbar spine rotation |
Retroversion involves an increase or decrease in anterior torsion? | decrease |
Anteversion or Retroversion promotes stability and is associated with lateral rotation of the femur? | Retroversion |
Retorversion or Anteversion: will see a medial tibia rotation as compensation? | retroversion |
What are the 2 related postures for retroversion? | 1. out-toeing 2. excess subtalar supination |
What are the possibile compensations of retroversion? | 1. excess internal tibial torsion 2. IR of tibia 3. comtralateral lumbar spine rotation |
What test is the gold standard for measuring anteversion and retroversion? | CT scan |
What law states: "Bone is deposited and reabsorbed in accordance with the stress placed upon it?" | Wolff's Law |
You would use an assistive device on the opposite or same side to create a longer moment arm to keep the pelvis level? | opposite side |
What is the purpose of the synovial membrane in the hip? | lubrication |
What is the capsular pattern of the hip? | IR > flexion, abduction |
The ligamentum teres arises from the __________ and inserts into the __________? | acetabular notch, fovea capitis |
What is the purpose of the ligamentum teres? | protects the posterior branch of the obturator artery that supplies the head of the femur |
The ligamentum teres is most tense with ? | adduction & distraction |
The pubofemoral ligament blends medially with the _____________ muscle and attaches into the _______________? | pectineus muscle, trochanteric fossa |
the pubofemoral ligament prevents excessive __________, __________, and ___________? | Abduction, extension, lateral rotation |
What ligament is also known as the Y ligament of Bigelow? | iliofemoral ligament |
what is the strongest ligament in the body? | iliofemoral ligament |
What ligament plays a significant role in upright posture? | iliofemoral ligament |
the iliofemoral ligament prevents excessive ____________, ___________ and ___________? | extension, adduction& lateral rotation |
what is the weakest ligament of the hip? | ischiofemoral ligament |
The ischiofemoral ligament arises from the ________ and attaches to the ___________? | posterior acetabular rim, trochanteric fossa |
The ischiofemoral ligament helps stabilize the hip in _________? | extension |
The ischiofemoral ligament resists __________, _________ and __________? | abduction, medial rotation & extension |
What muscles flex the hip? | 1. iliopsoas 2. rectus femoris 3. sartorius |
What muscles extend the hip? | 1. gluteus maximus 2. posterior aspect of glut med 3. hamstrings |
What muscles adduct the hip? | 1. add brevis 2. add longus 3. add magnus 4. gracilis 5. pectineus |
What muscles abduct the hip? | 1. glut med 2. glut min 3. TFL |
What muscles ER the hip? | 1. PGOGOQ 2. sartorius |
What muscles IR the hip? | 1. add longus 2. add brevis 3. add magnus 4. anterior part of glut med 5. anterior part of glut min 6. pectineus 7. gracilis |