MS 1 hip palpation

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Author:
shmvii
ID:
174143
Filename:
MS 1 hip palpation
Updated:
2012-09-28 17:39:49
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MS hip palpation
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Description:
MS 1 hip palpation
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  1. angle of anteversion/torsion/declination
    • angle of hip joint w frontal plane
    • angle between a line running through the femoral condyles and a line through the center of the femoral head and neck
    • norm: 8-15 degrees (some sources say up to 25)
  2. the defs and presentations of anteversion and of retroversion
    • anteversion: angle of anteversion/torsion/declination > 15 degrees, --> toe in / pigeon toe
    • retroversion: angle < 8 --> toe out
  3. angle of inclination def, norm
    • angle btwn femoral head/neck and femoral shaft
    • norm 125 degrees
  4. name for angle of inclination > 125 degrees
    coxa valga
  5. name for angle of inclination < 125 degrees
    coxa vara (more common in women)
  6. how to palpate the iliac crest
    • pt standing or supine
    • it's lat and sup to naval
    • "rest" hands on top of it
  7. how to palpate iliac tubercle
    • pt standing or supine
    • move ant and sup to widest part of rim
    • should be able to id contour of bone
  8. how to palpate greater trochanter
    • pt standing or supine
    • drop down latteraly from the crest and "sit" on top of trochanter
    • use fingers to fel contours of bone
    • confirm via IR/ER
    • it's roughly in line w pubic tubercles and coccyx
  9. how to palpate ASIS
    • pt standing or supine
    • follow curve of pelvis from iliac tubercle and continue inf.
    • rest thumbs UNDER to assess pelvic symmetry
  10. how to palpate pubic tubercles
    • pt standing or supine
    • place middle finer on umbilicus
    • rest heel of hand on top of pubic symph
    • use 2 index fingers to find the top of the pubic tubercles
  11. borders of femoral triangle
    • sup: inguinal ligament (which is btwn the pubic symph and ASIS)
    • med: adductor longus (have pt adduct to find this)
    • lat: sartorius (resist the pt in ER)
    • floor: iliopsoas laterally and pectineus medially
  12. how to find inguinal lig
    • runs btwn ASIS and pubic symph
    • feels like a rope or cord
    • it's the sup border of the femoral triangle
  13. how to palpate femoral artery, its rel to psoas
    • in femoral triangle, felt inf to the middle of the inguinal lig,
    • the psoas is lat to it
  14. how to palpate PSIS
    • pt standing or prone
    • start at iliac crests
    • move post. inf. until unable to feel ridge
    • move inf and med 45 degrees
    • palpate by softly moving skin inf and sup until you can "hook" under the PSISs
  15. how to palpate SI joint
    • pt standing or prone
    • from PSISs move med and inf
    • should feel and indentation over the joint (joint will be much deeper)
  16. how to palpate ischial tuberosities (ITs)
    • under the butt
    • rest thumb pads on the ITs
  17. how to palpate the sciatic nerve
    • pt prone or sidelying
    • flex knee against resistance to find head of hamstrings (medial and inf to IT)
    • as pt relaxes, sink thru soft tissue btwn muscles and feel the nerve - cordlike
    • also: found half way btwn PSIS and greater trochanter (it runs perpendicular to this line)
  18. how to find the piriformis
    • pt sidelying or prone
    • btwn lateral sacrum area (PSIS and coccyx) and sup post greater troch
    • difficult to feel if not inflamed
    • inserts at area of the trochanteric bursa, so bursits and piriformis syndrome may be misdiagnosed
  19. how to palpate trochanteric bursa
    • (not palpable unless inflamed)
    • rests on the greater trochanter

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