Term
|
Definition
| provide stability for lower limb support; allow mobility for walking/sitting/etc; transfer forces from HAT to lower limbs; balance |
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Term
|
Definition
| head, arms, trunk = everything above pelvis |
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Term
| what makes up the acetabulum |
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Definition
|
|
Term
| what are the articular surfaces of hip |
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Definition
|
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Term
| which way does acetabulum face? |
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Definition
| anterior, lateral, inferior |
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Term
|
Definition
| deepens socket, secures femoral head |
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Term
| where is articular cartilage thickest |
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Definition
| superior-anterior on both femoral head and acetabulum (they match); this is where most force is transmitted through |
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|
Term
| what is the acetabular anteversion angle? |
|
Definition
| 25 deg angle medial to sagittal plane |
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Term
| what is the acetabular center-edge angle? |
|
Definition
| 35 deg angle lateral to frontal plane |
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Term
| describe bony protection of acetabulum |
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Definition
| little bony protection anteriorly; good protection superiorly |
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Term
| purpose of acetabular alignment |
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Definition
| help ensure femur fits inside acetabulum and stays where it should |
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Term
|
Definition
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Term
|
Definition
| no cartilage; ligamentum teres |
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Term
|
Definition
| no articular cartilage; keeps femoral shaft from impinging on ischium |
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Term
| describe the projection/direction of the femur |
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Definition
| projects medially to bring knees and feet closer to midline |
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Term
| what part of femur is convex? |
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Definition
|
|
Term
| what part of femur is concave? |
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Definition
|
|
Term
| how does concave/convex shape of femur affect compression/tension? |
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Definition
| tension on anterior surface, compression on posterior surface |
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|
Term
| what is the normal angle of inclination of the femur? |
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Definition
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|
Term
| if someone has coxa vara is their angle of inclination greater or less than 125? |
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Definition
|
|
Term
| how does hip abductor force chance for someone with coxa vara? |
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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 |
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|
Term
| if someone has coxa valga is their angle of inclination greater or less than 125? |
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Definition
|
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Term
| how does the abductor force change for someone with coxa valga? |
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Definition
| abductor force is less for someone with coxa valga bc the moment arm for the abductor force is shortened. |
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Term
| describe dislocation vs fracture potential for someone with coxa valga |
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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. |
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|
Term
| which has greater bending moment: coxa vara or coxa valga? |
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Definition
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|
Term
| in coxa vara, is the femur adducted or abducted? |
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Definition
|
|
Term
| in coxa vara, is the knee more likely to be genu varum or genu vaglum? |
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Definition
|
|
Term
| in coxa vaglus, is the femur abducted or adducted? |
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Definition
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|
Term
| in coxa valga, are the knees more likely to be genu valgum or genu varum? |
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Definition
|
|
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 |
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|
Term
| does coxa vara or coxa valga make the leg look shorter? |
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Definition
|
|
Term
|
Definition
| angle of the femoral head in the transverse plane |
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|
Term
| what is our normal torsion angle? |
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Definition
|
|
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 |
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Term
| why does someone with excessive anteversion toe in while walking? |
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Definition
|
|
Term
| what is a person with excessive retroversion prone to? |
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Definition
|
|
Term
| if a person has excessive anteversion, where do they lose ROM? |
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Definition
|
|
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 |
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|
Term
| what happens to the hip with poor alignment? |
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Definition
| not a lot of congruence, causes increased stress = force/smaller area |
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Term
| what is the positioning of the femur in the ortolani maneuver? |
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Definition
| abduction, flexion, external rotation: listen for click of relocation of femoral head over posterior acetabular rim |
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|
Term
| how many dof in hip joint? |
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Definition
|
|
Term
| what are the movements of the hip joint? |
|
Definition
| flexion/extension, abduction/adduction, internal/external rotation |
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|
Term
| what maintains stability of the hip joint? |
|
Definition
| capsule, ligaments, negative intra-articular pressure, muscles, weight bearing compression |
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|
Term
| what is the hip joint contact force during stance phase of walking |
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Definition
|
|
Term
| what lines hip joint capsule? |
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Definition
|
|
Term
| is femoral neck in the hip joint capsule? |
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Definition
|
|
Term
| what are the 2 types of fibers of the hip joint capsule? |
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Definition
|
|
Term
| where are the longitudinal fibers of the hip joint capsule most extensive? |
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Definition
|
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Term
| what do circular fibers of hip joint capsule do? |
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Definition
| inner layer of fibers form ring around base of femoral neck |
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Term
| what are the ligaments that thicken the hip joint capsule? |
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Definition
| iliofemoral, pubofemoral, ischiofemoral |
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|
Term
| when are the hip joint capsule ligaments tight? |
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Definition
|
|
Term
| what are the anterior ligaments of the hip joint capsule? |
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Definition
|
|
Term
| describe the iliofemoral ligament |
|
Definition
| Y shaped; very thick and strong; has medial and lateral bundles |
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Term
| when is the iliofemoral ligament tight |
|
Definition
| hip extension, full external rotatoin |
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|
Term
| what do the pubofemoral ligament fibers blend with? |
|
Definition
| medial fascicles of iliofemoral ligament |
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|
Term
| when is the pubofemoral ligament tight? |
|
Definition
| hip extension, hip abduction |
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|
Term
| what is the posterior ligament of the hip? |
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Definition
|
|
Term
| when are the superficial ischiofemoral ligament fibers tight? |
|
Definition
| hip extension, full internal rotation |
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|
Term
| when are the superior fibers of the ischiofemoral ligament tight? |
|
Definition
|
|
Term
| when are the inferior fibers of the ischiofemoral ligament tight? |
|
Definition
|
|
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 |
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|
Term
| function of intracapsular pressure |
|
Definition
| creates sunction in joint to increase stability |
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|
Term
| how does intracapsular pressure change |
|
Definition
| with increased fluid/swelling AND with ROM |
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|
Term
| when is intracapsular pressure lowest |
|
Definition
| midrange (flexion of 30-100_ |
|
|
Term
| what is the normal ROM of the hip? |
|
Definition
|
|
Term
| if a person has swelling/pain, what position will they want to be in to reduce pressure/pain? |
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Definition
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|
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 |
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|
Term
| in the hip, is the position of maximum congruency the same as the close packed position? |
|
Definition
|
|
Term
| what is the hip's closed packed position? |
|
Definition
| full extension, slight internal rotation, abduction |
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|
Term
| what is the position of maximum congruency of the hip? |
|
Definition
| 90 deg flexion, moderate abduction, external rotation |
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|
Term
| what is the catcher positoin? |
|
Definition
| postion of maximum congruency |
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|
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
|
|
Term
| hip movement of posterior pelvic tilt |
|
Definition
|
|
Term
| what is the movement of hip hiking |
|
Definition
|
|
Term
| what is the movement of dropping a pelvis (opposite of hip hiking) |
|
Definition
|
|
Term
| what is an example of moving pelvis on femur? |
|
Definition
|
|
Term
|
Definition
| moving pelvis on femur: abduct standing leg, drop pelvis = adducting lifted leg |
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|
Term
| what is the open chain hip movement |
|
Definition
|
|
Term
| closed chain internal rotation of hip |
|
Definition
| stand on one leg, move pelvis toward that leg |
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|
Term
| what is the arthrokinematics of hip flexion/extension |
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Definition
|
|
Term
| why is there barely any translation at the hip joint? |
|
Definition
|
|
Term
| relationship of hip/pelvic movement for anterior pelvic tilt |
|
Definition
| hip flexion, lumbar lordosis |
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|
Term
| relationship of hip/pelvic movement for posterior pelvic tilt |
|
Definition
| hip extension, lumbar flattening |
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|
Term
| how can unilateral/bilateral pelvic motion influence leg length? |
|
Definition
| length looks different in sit/stand |
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|
Term
| what are the hip flexor muscles? |
|
Definition
| iliopsoas, tensor fascia lata, sartorius, rectus femoris |
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|
Term
| why is the iliopsoas an important hip flexor? |
|
Definition
| produces large flexor torque |
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|
Term
|
Definition
| 2 joint muscle; produces greater knee extension than hip flexion |
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Term
|
Definition
|
|
Term
|
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
|
|
Term
| which hip extensors are affected by knee position? |
|
Definition
|
|
Term
| the hip extensors have a large PCSA, which means that they generate a lot of _________? |
|
Definition
|
|
Term
| how can you maximally lengthen hamstrings? |
|
Definition
|
|
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
|
|
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
|
|
Term
| if L gmedius is weak, which way will a person lean |
|
Definition
|
|
Term
| what force does Gmedius do besides internal adduction? |
|
Definition
|
|
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
|
|
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
|
|
Term
| who gets slipped capital femoral epiphysis? |
|
Definition
|
|
Term
| what is an indication of slipped capital femoral epiphysis |
|
Definition
|
|
Term
|
Definition
|
|
Term
| what is the primary cause of disability in the elderly |
|
Definition
|
|
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
|
|
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
|
|
Term
| conventionally, what are prosthetic acetabular sockets made of? |
|
Definition
|
|
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
|
|
Term
| what does posteriorolateral approach increase |
|
Definition
| risk of posterior dislocation |
|
|
Term
| what does posteriolateral approach compromise |
|
Definition
|
|
Term
| what does posteriolateral approach spare |
|
Definition
|
|
Term
| what is the risk fo anteriolateral approaches |
|
Definition
| greater risk of anterior dislocation |
|
|
Term
| what does the anteriolateral approach compromise |
|
Definition
|
|
Term
| what is weakened after anteriolateral THA? |
|
Definition
|
|
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 |
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