CHS 371- Exam 2 (Hip)

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CHS 371- Exam 2 (Hip)
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2013-03-03 22:14:42
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Hip
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  1. List the hip bones
    • Pelvis
    • Femur
    • Sacrum
    • Ilium bone
    • Pubic Bone
    • Ischium
  2. Describe the Pelvis
    made of 3 bones: Ilium, Ischium, and Pubis

    Separate boes at birth and during growth and development

    Fused at maturity
  3. Describe the Femur
    Classification: long bone

    Function: lever

    longest bone in the body
  4. Describe the Sacrum
    It is the extension of the spinal cord

    5 fused vertebrae

    posteriorly between the 2 pelvic bones

    SI joint is formed by the pelvis and sacrum
  5. Describe the Ilium Bone
    classification: flat bone

    function: protection
  6. Describe the pubic bone
    "PUBIS"

    Classification: irregular bone

    Function: protection
  7. Describe the Ischium
    Classification: irregular bone

    function: protection
  8. Hip Joint
    Large Stable Joint

    consists of: head of femur and acetabulum of Pelvis  (ball and socket)

    • Structure: synovial joint
    • Function: ball and socket joint
    • Provides: stability, mobility,shock absorption, and protection

    • 3 degrees of freedom:
    • Frontal, saggital and transverse
  9. Describe the Femoral Head
    • "ball"
    • spherical
    • smooth surface

    covered by articular cartilage (hyaline cartilage)

    Function: shock absorption, joint nutrition
  10. Describe the acetabulum
    • "socket"
    • Latin = little vinegar cup

    • lined by articular hyaline cartilage
    • supports entire body weight
  11. Describe the Acetabular Labrum
    Latin = lip

    • Fibrocartilage
    • deepens the socket
    • provides stability and proprioception (body awareness)
  12. List the hip ligaments
    • Femoroacetabular ligament consists of 3 main ligaments :
    • Illiofemoral ligament
    • Ischiofemoral ligament
    • Pubofemoral Ligament
  13. Describe the Iliofemoral ligament
    ilium to femur

    anterior to hip joint

    prevents abduction and external rotation
  14. Describe the ischiofemoral ligament
    ischium to femur

    triangular band of strong fibers

    posterior side of hip joint

    limits medial rotation
  15. Describe the Pubofemoral Ligament
    pubis to femur

    anterior to hip joint

    limits abduction
  16. List the Hip Movements
    • flexion
    • extension
    • abduction
    • adduction
    • internal rotation
    • external rotation
  17. Describe Hip flexion
    movement of the femur anteriorly toward the pelvis

    Normal ROM: 0-130*

    saggital plane motion
  18. Describe hip extension
    Movement of the femur straight posteriorly away from the pelvis

    Normal ROM: 0-30*

    saggital plane motion
  19. describe hip abduction
    Movement of the femur laterally to the side away from midline

    normal ROM: 0-45*

    Frontal plane motion
  20. describe hip adduction
    movement of the femur medially towards the midline

    normal ROM: 0-30*

    frontal plane motion
  21. describe hip internal rotation "medial rotation"
    rotary movement of the femur medially around its longitudinal axis toward the midline

    normal ROM: 0-45*

    Transverse plane motion
  22. describe hip external rotation "lateral rotation"
    Rotary movement of the femur laterally around its longitudinal axis away from the midline

    Normal ROM: 0-50*

    Transverse plane motion
  23. Hip Flexor muscles
    • psoas (major and minor)
    • Illiacus
    • Rectus Femoris
    • Sartorius
    • Tensor Fascia Latae (TFL)
    • Adductor Longus
  24. Psoas (major and minor)
    O: T-12 to L-5 vertebrae

    I: Lesser trochanter of femur

    A: Hip Flexion
  25. Illiacus
    O: inner part of illium

    I: lesser trochanter of femur

    A: Hip flexion
  26. Rectus Femoris
    O: Iliac spine

    I: Tibial tuberosity

    • A: hip flexion
    •     knee extension
  27. Sartorius
    O: anterior illium

    I: upper medial tibia

    A: hip flexion
  28. Tensor Fascia Latae (TFL)
    O: Anterior iliac crest

    I: IT band

    • A: hip flexion
    •     hip abduction
  29. Adductor longus
    O: Anterior Pubis

    I: Proximal medial femur

    • A: Hip addiction
    •     hip flexion
  30. Hip extensor muscles
    • Gluteus maximus
    • semimebranosis
    • semitendinosis
    • biceps femoris
  31. gluteus maximus
    O: Psterior ilium and sacrum

    I: greater trochanter of femur and IT band

    • A: hip extension
    •     external rotation
  32. semimembranosis
    O: ischial tuberosity

    I: proximal medial tibia

    • A: hip extension
    •     knee flexion
  33. semitendinosis
    O: ischial tuberosity

    I: proximal and medial tibia

    • A: hip extension
    •     knee flexion
  34. biceps femoris
    O: ischial tuberosity

    • I: lateral condyle of tibia 
    •    head of fibula

    • A: hip extension
    •     knee flexion
  35. Hip abductor muscles
    • Gluteus medius
    • Gluteus minimus
    • Tensor Fascia Latae (TFL)
  36. Gluteus medius
    O: Lateral ilium

    I: greater trochanter

    • A: hip abduction
    •     internal rotation
    •     external rotation
  37. gluteus minimus
    O: lateral ilium (below gluteus medius)

    I: greater tochanter

    • A: hip abduction
    •     internal rotation
    •     external rotation
  38. TFL
    O: anterior iliac crest

    I: IT band

    • A: hip abduction
    •     hip flexion
  39. hip adductor muscles
    • Adductor longus
    • adductor brevis
    • adductor magnus
    • pectinius
    • gracilis
  40. adductor longus
    O: anterior pubis

    I: proximal medial femur

    • A: hip adduction
    •     hip flexion
  41. adductor brevis
    • O: anterioinferior pubis
    •   
    • I: Proximal medial femur

    A: hip adduction
  42. adductor magnus
    • O: pubis
    •      ischium
    •      ischial tuberosity

    I: posterior and medial femur

    A: hip adduction
  43. pectineus
    O: pubis

    I: upper medial femur

    • A: hip flexion
    •     hip adduction
    •     hip internal rotation
  44. Gracilis
    O: pubis

    I: medial tibia

    • A: hip adduction
    •     hip internal rotation
  45. hip internal rotator muscles
    • Gracilis
    • pectinius
    • gluteus medius (anterior fibers)
    • gluteus minimus (anterior fibers)
    • TFL
  46. Hip external rotator muscles
    • Gluteus medius (posterior fibers)
    • Gluteus minimus (posterior fibers)
    • Gluteus Maximus
  47. 6 deep external rotators
    • Piriformis
    • superior gemellus
    • inferior gemellus
    • quadratus femoris
    • obturator internus
    • obturator externus

    O: sacrum and ischium

    I: greater trochanter

    A: Hip external rotation
  48. Why are hip injuries less common?
    very movable

    great stability

    supported by strong ligaments
  49. Hip joint injuries are usually?
    groin pain
  50. Joint Injury: Avascular Necrosis
    Disruption of the blood supply

    • truama
    • steroid use
    •     asthma
    • Alcoholism
    •      fatty deposits in bloodstream

    • Pain in groin
    • range of motion loss

    Treatment: activity modification, surgery
  51. Injury: slipped capital epiphysis
    Epiphysis = area at end of long bone that is separated from main part of  bone by a growth plate.

    • common after onset of puberty
    • males> females
    • common in obese children

    • cause: unknown
    • may be caused by weak growth plate
    •       trauma
    •       inflammation
    •       change in hormone levels

    treatment: surgery (pins or screws)
  52. Injury: Hip fracture
    usually to the femoral neck of the femur

    • Cause: trauma
    •               falls
    •               accidents
    •              usually over 65
    •               women at higher risk


    • pain in groin
    • unable to bear weight
    • swelling and bruising

    treatment: surgery
  53. Injury: Lateral hip soft tissue lesion
    most common affected tissue

    • gluteus medius tendon
    • trochanteric bursa (hip bursitis)

    • pain over the greater trochanter
    • pain with walking, climbing)
    • pain when sleeping on side affected
  54. Injury: IT band
    • test: stretching IT band
    •         contracting med or TFL
    •         normal xrays, possible calcification in        glut med tendon or bursa
    •         referred pain in the back

    15% in women 66.6% in men

    acute trauma (falls, impact) increased activity/exercise rubbing of tight IT band

    Ice, rest, cortisone shot, stretch IT band, restore hip, strengthen glut med and TFL
  55. Injury: Hip pointer
    • Bruise to the ilium
    • pain above groin
    • treat: ice, padding, rest
  56. Injury: Stress fractures
    • cause: overuse
    • runners
    • military
    • poor biomechanics
    • occurs at femoral neck

    • pain in groin
    • while running often no pain while walking or sitting

    treatment: rest, pool running, bioimechanics, training modification
  57. Injury: Adductor (groin) strain
    pain in adductors (adductor longus)

    excessive motion (soccer, hockey)

    treatment: rest, ice, regain motion, eccentric loading
  58. Injury: hip impingement
    "femeroacetabular impingement"
  59. Injury: Acetabular Labral Tear
    Tear of fibrocartilage labrum

    cause: trauma, excessive motion (hockey, golf, gymnastics)

    • might not have symptoms
    • groin pain
    • catching or popping
    • pain with twisting
    • motion loss

    • treatment: non surgical
    •                       motion restoration
    •                       neuromuscular control
    •                 surgical
    •                       repair
    •                       debridement
  60. Hip Replacement
    pain in groin due to severe osteoarthritis or trauma

    protective cartilage of the hip erodes (articular cartilage protects ends of bones)

    replaces the ball and socket


    • end stage operation
    • nothing else helped
    • patient can't walk, function, sleep

    • good outcomes but high risk
    •       infection
    •       blood clots
    •       death

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