MF Hip Word Scramble
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Question | Answer |
What type of joint is the hip? | Multiaxial ball & socket joint |
What forms the acetabulum? | Fusion of the ilium, ischium & pubis. Deepened by the labrum. |
Compare the hip & shoulder | Hip is more stable & dynamic, less ROM; hip ligaments stronger |
What comprises the innominate? | Ilium + Ischium + Pubis |
Which directions does the acetabulum open? | Inferiorly, Anteriorly, Laterally |
Which directions does the femoral head open? | Anteriorly, Medially, Superiorly |
What is the "degree above the frontal plane that the femoral neck faces" & what is it's normal measure? | Anteversion. Normally b/t 8-15 degrees |
More hip anteversion causes what? | Toeing in (hip IR) |
Hip retroversion causes? | Toeing out (hip ER) |
What ligament is the strongest of the hip? | Iliofemoral (Y ligament of Bigelow) |
What motions does the iliofemoral ligament prevent? | Excessive extension. Also maintains upright hip posture. |
Which hip ligament is the weakest? | Ischiofemoral |
Which motions does the ischiofemoral ligament prevent? | Winds tightly on extension |
Which motions does the pubofemoral ligament prevent? | Excessive abduction of the femur; also limits extension |
All 3 ligaments limit what? | Internal Rotation |
Resting Position of the Hip | 30 deg flexion & abduction; Slight ER |
Closed Packed Position of the Hip | Extension, IR, Abduction |
Capsular Pattern of the Hip | Flexion, abduction, IR > Extension, Adduction, ER |
Hip Dysplasia occurs more often in whom? | Girls, Infants |
Legg-Calve-Perthes occurs more often in whom? | 3-12 yo boys |
Hip OA & femoral neck fx occur more often in whom? | Older population, women, usu 2ndary to osteoporosis |
If pain is in the anterior hip, what could it be? | OA, hip flexor strain, impingement, iliopsoas bursitis, hip fx, stress fx, arthritis, acetabular labral tear, AVN of femoral head |
Lateral hip pain is indicative of.... | IT band, meralgia paresthetica, lumbar n root pain, trochanteric bursitis |
Posterior Hip pain is indicative of... | referred pain from L-spine; SI jt dysfxn; Hip extensorrotator m. strain |
Clicking is common with what type of injury? | Labral Tears |
Internal Snapping Hip | Iliopsoas tendon over lesser trochanter/anterior acetabulum; Iliofemoral ligament over femoral head; Iliopsoas bursal or capsular thickening |
External Snapping Hip | Tight IT band; Glut max over greater trochanter; Trochanteric bursitis |
Intra-articular Snapping Hip | Labral/ligamentum teras; loose bodies; capsular instability (laxity in hip) |
Unremitting, long duration pain in the hip is | Possible yellow/red flag, esp if close to lower back or large nerve distribution area |
What nerve pierces the piriformis in 12% of the population? | Sciatic N. |
Posture Observations | Pelvic obliquity (unequal leg length, mm contractures, scoliosis); Watch spine & hip during AROM/PROM; Does pt stand equally on both legs?; Iliopsoas tightness- deviation of spine to same side |
Balance observations | Balance on single leg (eyes open, then closed) |
Traumatic Posterior hip dislocation | Limb is shortened, adducted, medially rotated; greater trochanter is prominent |
Anterior hip dislocation | Limb is abducted, laterally rotated; May be cyanotic or swollen |
Intertrochanteric fractures | Limb is shortened & laterally rotated |
Shortening of a leg... | Spinal scoliosis if present on only 1 lower limb; Shortening may be structural or functional |
Anterior View | Abnormal bony contour difficult to detect; Swelling hard to see |
Lateral View | Contour of buttock observed; Hip flexion deformity observed |
Posterior View | Position of the hip & effect of this position on the spine; Hip flexion contracture may lead to increased lumbar lordosis |
Exam- Active Movements | Flexion; Extension; Abduction; Adduction; IR; ER |
End feel of Passive Movements | Flexion; Extension; Abduction; Adductoin; IR; ER--All have tissue approximation/stretch end feel! |
Resisted Isometric Mvmts | Flexion/extension, Abd/Add, IR/ER of hip; Flexion/Extension of the knee |
Patrick's Test aka Faber aka Figure-4 test | FABER= flexion, abduction, ER. Position = inability to lower leg; Possible SI involvement |
Trendelenberg's Sign | Stability of hip abduction; Drop in OPPOSITE pelvis |
Craig's Test for femoral anteversion | Birth- 30 deg; Adult- 8-15 deg; Pt lies prone & flexes knee |
True Leg Length | ASIS to Medial Malleolus |
Apparent Leg Length | Belly button to Medial Malleolus |
Thomas Test | Supine, knee to chest, flatten L-spine; Rise in other leg at hip &/or knee extension &/or hip abduction |
Ober's Test | IT band tightness; Stabilize hip while loweirng leg |
Piriformis Test (FAIR test) | Flexion, Adduction, IR; sidelying, flex hip to 60 deg, knee flexed; Lower leg to increase symptoms |
Peripheral Nerve Injury- Sciatic Nerve | L4-S3- Piriformis Syndrome |
Peripheral Nerve Injury- Superior Gluteal N | L4-S1- Acute gluteal pain |
Peripheral Nerve Injury- Femoral N. | L2-L4 |
Peripheral Nerve Injury- Obturator N. | L2-L4 |
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