Shared Flashcard Set

Details

Hip
Hip Kinesiology UNC PT DPT
145
Anatomy
Graduate
12/10/2011

Additional Anatomy Flashcards

 


 

Cards

Term
hip functions
Definition
provide stability for lower limb support; allow mobility for walking/sitting/etc; transfer forces from HAT to lower limbs; balance
Term
what is HAT
Definition
head, arms, trunk = everything above pelvis
Term
what makes up the acetabulum
Definition
ilium, ischium, pubis
Term
what are the articular surfaces of hip
Definition
acetabulum, femoral head
Term
which way does acetabulum face?
Definition
anterior, lateral, inferior
Term
purpose of labrum
Definition
deepens socket, secures femoral head
Term
where is articular cartilage thickest
Definition
superior-anterior on both femoral head and acetabulum (they match); this is where most force is transmitted through
Term
what is the acetabular anteversion angle?
Definition
25 deg angle medial to sagittal plane
Term
what is the acetabular center-edge angle?
Definition
35 deg angle lateral to frontal plane
Term
describe bony protection of acetabulum
Definition
little bony protection anteriorly; good protection superiorly
Term
purpose of acetabular alignment
Definition
help ensure femur fits inside acetabulum and stays where it should
Term
shape of femoral head
Definition
2/3 of a perfect sphere
Term
features of fovea
Definition
no cartilage; ligamentum teres
Term
describe femoral neck
Definition
no articular cartilage; keeps femoral shaft from impinging on ischium
Term
describe the projection/direction of the femur
Definition
projects medially to bring knees and feet closer to midline
Term
what part of femur is convex?
Definition
anterior
Term
what part of femur is concave?
Definition
posterior
Term
how does concave/convex shape of femur affect compression/tension?
Definition
tension on anterior surface, compression on posterior surface
Term
what is the normal angle of inclination of the femur?
Definition
125 deg
Term
if someone has coxa vara is their angle of inclination greater or less than 125?
Definition
less
Term
how does hip abductor force chance for someone with coxa vara?
Definition
hip abductor force is greater for someone with coxa vara bc the moment arm for the abductor force is lengthened. Bc of this, person is less likely to dislocate an dmore likely to fracture
Term
if someone has coxa valga is their angle of inclination greater or less than 125?
Definition
greater
Term
how does the abductor force change for someone with coxa valga?
Definition
abductor force is less for someone with coxa valga bc the moment arm for the abductor force is shortened.
Term
describe dislocation vs fracture potential for someone with coxa valga
Definition
abductors not as efficient, so force coming up through femur makes hip more likely to dislocate. Less tension at femoral neck bc it's straighter, so femoral neck less likely to dislocate.
Term
which has greater bending moment: coxa vara or coxa valga?
Definition
coxa vara
Term
in coxa vara, is the femur adducted or abducted?
Definition
adducted
Term
in coxa vara, is the knee more likely to be genu varum or genu vaglum?
Definition
genu valgum
Term
in coxa vaglus, is the femur abducted or adducted?
Definition
abducted
Term
in coxa valga, are the knees more likely to be genu valgum or genu varum?
Definition
genu varum
Term
why do people with coxa vara adduct and why do people with coxa vagla abduct their femurs?
Definition
to have good contact area, maximum congruency, most stabilized hip
Term
does coxa vara or coxa valga make the leg look shorter?
Definition
coxa vara
Term
what is torsion angle?
Definition
angle of the femoral head in the transverse plane
Term
what is our normal torsion angle?
Definition
15 deg anteversion
Term
what happens if someone has excessive anteversion?
Definition
prone to congenital anterior dislocation, less femoral head in acetabulum, joint incongruence, increased wear on articular cartilage, toeing in during walking
Term
why does someone with excessive anteversion toe in while walking?
Definition
hip internal rotation
Term
what is a person with excessive retroversion prone to?
Definition
posterior dislocation
Term
if a person has excessive anteversion, where do they lose ROM?
Definition
external rotation
Term
if a person has excessive retroversion, what do they do to compensate and where do they lose ROM?
Definition
they externally rotate, point toes out, lose internal rotation
Term
what happens to the hip with poor alignment?
Definition
not a lot of congruence, causes increased stress = force/smaller area
Term
what is the positioning of the femur in the ortolani maneuver?
Definition
abduction, flexion, external rotation: listen for click of relocation of femoral head over posterior acetabular rim
Term
how many dof in hip joint?
Definition
3
Term
what are the movements of the hip joint?
Definition
flexion/extension, abduction/adduction, internal/external rotation
Term
what maintains stability of the hip joint?
Definition
capsule, ligaments, negative intra-articular pressure, muscles, weight bearing compression
Term
what is the hip joint contact force during stance phase of walking
Definition
up to 3x body weight
Term
what lines hip joint capsule?
Definition
synovial
Term
is femoral neck in the hip joint capsule?
Definition
yes
Term
what are the 2 types of fibers of the hip joint capsule?
Definition
longitudinal, circular
Term
where are the longitudinal fibers of the hip joint capsule most extensive?
Definition
anteriorly
Term
what do circular fibers of hip joint capsule do?
Definition
inner layer of fibers form ring around base of femoral neck
Term
what are the ligaments that thicken the hip joint capsule?
Definition
iliofemoral, pubofemoral, ischiofemoral
Term
when are the hip joint capsule ligaments tight?
Definition
hip extension
Term
what are the anterior ligaments of the hip joint capsule?
Definition
iliofemoral, pubofemoral
Term
describe the iliofemoral ligament
Definition
Y shaped; very thick and strong; has medial and lateral bundles
Term
when is the iliofemoral ligament tight
Definition
hip extension, full external rotatoin
Term
what do the pubofemoral ligament fibers blend with?
Definition
medial fascicles of iliofemoral ligament
Term
when is the pubofemoral ligament tight?
Definition
hip extension, hip abduction
Term
what is the posterior ligament of the hip?
Definition
ischiofemoral ligament
Term
when are the superficial ischiofemoral ligament fibers tight?
Definition
hip extension, full internal rotation
Term
when are the superior fibers of the ischiofemoral ligament tight?
Definition
full adduction
Term
when are the inferior fibers of the ischiofemoral ligament tight?
Definition
flexion
Term
how can a paraplegic stand?
Definition
keep COG behind hip axis to maintain extensor moment using gravity. Anterior ligaments will tighten and keep person standing. All 3 ligaments resist extension
Term
function of intracapsular pressure
Definition
creates sunction in joint to increase stability
Term
how does intracapsular pressure change
Definition
with increased fluid/swelling AND with ROM
Term
when is intracapsular pressure lowest
Definition
midrange (flexion of 30-100_
Term
what is the normal ROM of the hip?
Definition
15-0-120
Term
if a person has swelling/pain, what position will they want to be in to reduce pressure/pain?
Definition
midrange
Term
what is the problem with putting someone who has just had hip surgery into hip flexion
Definition
shortens hip flexors = pelvis rotates anteriorly, spine goes into lordosis, neural foramen close
Term
in the hip, is the position of maximum congruency the same as the close packed position?
Definition
no
Term
what is the hip's closed packed position?
Definition
full extension, slight internal rotation, abduction
Term
what is the position of maximum congruency of the hip?
Definition
90 deg flexion, moderate abduction, external rotation
Term
what is the catcher positoin?
Definition
postion of maximum congruency
Term
why does the catcher use the positoin of max congruency?
Definition
to have less pressure through joints
Term
what is the hip movement of anterior pelvic tilt?
Definition
hip flexion
Term
hip movement of posterior pelvic tilt
Definition
hip extension
Term
what is the movement of hip hiking
Definition
abducting standing leg
Term
what is the movement of dropping a pelvis (opposite of hip hiking)
Definition
adducting standing leg
Term
what is an example of moving pelvis on femur?
Definition
hip hike
Term
describe hip hike
Definition
moving pelvis on femur: abduct standing leg, drop pelvis = adducting lifted leg
Term
what is the open chain hip movement
Definition
moving femur on pelvis
Term
closed chain internal rotation of hip
Definition
stand on one leg, move pelvis toward that leg
Term
what is the arthrokinematics of hip flexion/extension
Definition
spin
Term
why is there barely any translation at the hip joint?
Definition
high congruency
Term
relationship of hip/pelvic movement for anterior pelvic tilt
Definition
hip flexion, lumbar lordosis
Term
relationship of hip/pelvic movement for posterior pelvic tilt
Definition
hip extension, lumbar flattening
Term
how can unilateral/bilateral pelvic motion influence leg length?
Definition
length looks different in sit/stand
Term
what are the hip flexor muscles?
Definition
iliopsoas, tensor fascia lata, sartorius, rectus femoris
Term
why is the iliopsoas an important hip flexor?
Definition
produces large flexor torque
Term
describe rectus femoris
Definition
2 joint muscle; produces greater knee extension than hip flexion
Term
describe sartorius
Definition
long muscle
Term
describe TFL
Definition
IT band slides over greater trochanter
Term
why does knee position effect hip flexor muscles?
Definition
if you're in a lot of knee flexion, rectus, sartorius, TFL will be stretched
Term
how do people accommodate tight hip flexors?
Definition
increased anterior pelvic tilt, increased lumbar lordosis => increased posterior lumbar joint compression
Term
what are the hip extensor muscles?
Definition
gluteus maximus, semitendinosus, semimembranosus, biceps femoris, posterior fibers of adductor magnus
Term
what are the actions of the gluteus maximus?
Definition
extension, external rotatoin
Term
what are the actions of the long head of the biceps femoris?
Definition
extension, external rotation
Term
what are the actions of the semitendinosus and semimembranosus?
Definition
extension, internal rotation
Term
which fibers of adductor magnus extend the hip?
Definition
posterior
Term
which hip extensors are affected by knee position?
Definition
hamstrings
Term
the hip extensors have a large PCSA, which means that they generate a lot of _________?
Definition
force
Term
how can you maximally lengthen hamstrings?
Definition
flex hip, extend knee
Term
when are hamstrings actively insufficient?
Definition
max length: flex hip, extend knee; max short: extend hip, flex knee
Term
if I want to test glute strength without hamstring contribution, what should I do?
Definition
flex the knee to lengthen hamstrings
Term
what are the hip abductor muscles?
Definition
gluteus medius, gluteus minimus, tensor fascia lata, piriformis
Term
what are the hip adductor muscles?
Definition
adductor magnus, adductor longus, adductor brevis, gracilis, pectineus
Term
what are the hip external rotators?
Definition
gluteus maximus, obturator internus, obturator externus, superior gemelli, inferior gemelli, quadratus femoris, piriformi
Term
what are the hip internal rotators?
Definition
TFL, Gmedius, adductors
Term
what forces create bending moment at the femur?
Definition
gravity = weight of HAT AND gravity = ground reaction force
Term
why do ground reaction force and weight of HAT create bending moment at femur
Definition
bc femur is not a straight line
Term
what part of femoral neck is compressed, what part gets tension?
Definition
compressive forces at inferior neck; tensile forces at superior neck
Term
what kind of moment does HAT produce in a single leg stance?
Definition
adduction bc COG is medial
Term
what opposes adduction from gravity in a single leg stance?
Definition
internal abduction moment from gluteus medius
Term
what happens if Gmedius is weak?
Definition
leg drops into adduction moment
Term
which leg drops when GM is weak?
Definition
leg opposite weak Gmedius
Term
what do people do to compensate for weak Gmedius?
Definition
lean trunk over weak side to move COG medially, shorten COG moment arm, and reduce amount of internal adduction needed
Term
if L gmedius is weak, which hip will drop?
Definition
R
Term
if L gmedius is weak, which way will a person lean
Definition
over L
Term
what force does Gmedius do besides internal adduction?
Definition
compression
Term
what will a person do to reduce compression if they have OA in a hip?
Definition
lean over the painful side to shift COG laterally, reduce COG moment arm, reduce amount of internal adduciton to overcome external gravity abduction => reduce compression
Term
what kind of force does a cane produce?
Definition
upward reaction force
Term
what is the overall direction of a cane reaction force?
Definition
clockwise: same direction as adduction force from Gmedius on opposite leg
Term
why do you want the cane on the opposite leg?
Definition
so that its clockwise reaction force will be in same direction as adduction of Gmedius from opposite leg
Term
what happens in congenital hip dislocation?
Definition
head is dislocated from acetabulum; shallow acetabulum
Term
what is slipped capital femoral epiphysis?
Definition
separation of ball of femur from femur at epiphysis
Term
where is pain felt with slipped capital femoral epiphysis?
Definition
thigh and knee
Term
who gets slipped capital femoral epiphysis?
Definition
children 10-15
Term
what is an indication of slipped capital femoral epiphysis
Definition
antalgic gait
Term
what is antalgic gait
Definition
limp
Term
what is the primary cause of disability in the elderly
Definition
arthritis
Term
what happens in arthritis
Definition
joint space narrowing, osteophytes, subchondral sclerosis
Term
in x-rays, what do we expect to see between bones at joints
Definition
radiolucent (black) space
Term
what does it mean if joints/bones don't have radiolucent space between them
Definition
cartilage is worn down
Term
what is replaced in total hip arthroplasty
Definition
acetabular and femoral components
Term
conventionally, what is the femoral component of hip prostheses made of?
Definition
metal
Term
conventionally, what are prosthetic acetabular sockets made of?
Definition
polyethylene
Term
what are 3 recent types of hip proesthetics?
Definition
highly polished ceramic heads AND acetabular components; highly polished metal heads AND acetabular components; highly cross-linked polyethylene heads AND acetabular components
Term
what is the most common total hip arthroplasty technique?
Definition
posteriorolateral
Term
what does posteriorolateral approach increase
Definition
risk of posterior dislocation
Term
what does posteriolateral approach compromise
Definition
external rotators of hip
Term
what does posteriolateral approach spare
Definition
hip abductors
Term
what is the risk fo anteriolateral approaches
Definition
greater risk of anterior dislocation
Term
what does the anteriolateral approach compromise
Definition
gluteus medius
Term
what is weakened after anteriolateral THA?
Definition
hip abductors
Term
what are the steps of THA?
Definition
1. hip is dislocated and femoral head is removed. 2. acetabulum is enlarged in preparation of prosthesis. 3. acetabular prosthesis is put in place with 2 screws. 4. femoral prosthesis is placed
Term
how long do prosthetics last?
Definition
20 years in an inactive person
Term
what positions should be avoided to prevent dislocating hip
Definition
hip flexion past 90, adduction past neutral, internal rotation past neutral
Supporting users have an ad free experience!