Hip and Thigh Test

For the majority of hip dislocations, what position would you expect the lower extremity of the involved side be in if this injury were to occur?

flexion, adduction, and internal rotation

A positive Patrick's test may indicate all of the following conditions except:

hip abductor tightness

What injury is a contusion to the iliac crest, anywhere from the anterior superior iliac spine to the posterior superior iliac spine?

hip pointer

Originates on the inner surface of the ilium and inserts on the lesser trochanter of the femur and shaft just below

iliacus

Originates on the lower borders of the transverse processes of L1-L5, the sides of the bodies of T12-L5, and the intervertebral fibrocartilages, and the base of the sacrum and inserts on the lesser trochanter of the femur and shaft just below, pectineal line of pubis and iliopectineal eminence

iliopsoas Group

Internal Snapping hip syndrome involves which muscle tendon

iliopsoas tendon

Ishiofemoral Ligament description

located posteriorly and limits hip abduction

Originates on the anterior inferior iliac spine of the ilium and groove (posterior) above the acetabulum and inserts on the superior aspect of the patella and patella tendon to the tibial tuberosity

rectus femoris

Originates on the anterior superior iliac spine and notch just below and inserts on the anterior medial surface of the tibia just below the condyle

sartorius

Originates on the ischial tuberosity and inserts on the posteromedial surface of the medial tibial condyle

semimembranosus

Originates on the ischial tuberosity and inserts on the upper anterior medial surface of the tibia just below the condyle

semitendinosus

Pubofemoral Ligament description

tight in hip extension and limits hip abduction

The mechanism of injury in a hip sprain most commonly is _______.

trauma?

The most common affected bursa in the hip is the _____.

trochanteric

Originates on the front of the inferior pubic ramus just below the origin of the adductor longus and inserts on the lower 2/3 of the pectineal line of the femur and the upper half of the medial lip of the linea aspera

Adductor brevis

Originates on the anterior pubis just below the crest and inserts on the middle 1/3 of the linea aspera

Adductor longus

A weakening of the muscles or tendons of the lower abdominal wall can cause what?

Athletic Pubalgia

Originates on the ischial tuberosity, lower half of the linea aspera, and lateral condyloid ridge and inserts on the head of the fibula and lateral condyle of the tibia

Bicep femoris

Which of these special tests measures a patient's femoral anteversion, or forward torsion of the femoral neck?

Craig's test

List 2 common causes for Greater Trochanteric Bursitis.

Direct blow, chronic friction

Slipped capital femoral epiphysis usually occurs in boys with what particular body type?

Endomorphic

The adductor muscles during hip flexion tend to also cause _______.

External rotate

What is femoral angulation and what is a normal angle? How are the conditions coxa valga and coxa vara characterized?

Femoral angulation is the degree of angulation of the femoral neck relative to the femoral shaft. A normal angle is 120-135 degrees. Coxa Valga is characterized by an angle of greater than 135 degrees and coxa vara is characterized by an angle of less than 120 degrees.

The _____ test is performed by grasping the knee & applying a posterolateral force through hip as femur is passively flexed, adducted, & internally rotated then abducted & externally rotated in acetabulum.

Freiburg test

Originates on the posterior ¼ of the crest of the ilium, posterior surface of the sacrum and coccyx near the ilium, and fascia of the lumbar area and inserts on the oblique ridge on the lateral surface of the greater trochanter and the iliotibial band of the tensor fascia latae

Gluteus Maximus

The sciatic nerve runs directly deep to which of the following muscles in the hip region?

Gluteus Maximus

Originates on the lateral surface of the ilium just below the crest and inserts on the posterior and middle surfaces of the greater trochanter of the femur

Gluteus Medius

Originates on the lateral surface of the ilium just below the origin of the gluteus medius and inserts on the anterior surface of the greater trochanter of the femur

Gluteus minimus

Originates on the anteromedial edge of the descending ramus of the pubis and inserts on the anterior medial surface of the tibia below the condyle

Gracilis

What injury could potentially lead to avascular necrosis of the femoral head if the emergency care is not properly provided?

Hip dislocation

Which is the best method to manually muscle test the biceps femoris muscle?

Knee flexion

How you do you perform the Patrick's (FABER) or Figure Four test?

Lay the patient supine and place the foot of the injured extremity on the knee of the uninvolved leg so that the test leg is in flexion, abduction, and external rotation.

A hematoma that ossifies into bony deposits which may or may not be attached to the femur is known as a (an) ____.

Myositis Ossificans

What pathology is Ober's test sensitive for and how do you perform it correctly?

Ober's test is sensitive for tensor fascia latae tightness. The patient is side lying on the uninjuried side. Then the examiner abducts the thigh, stabilizes the pelvis, and extends the the flexed knee. If the leg stays abducted it is positive.

An inflammation of the pubic symphysis and surrounding muscle insertions is known as what?

Osteitis pubis

All of the following is true of the Allis Maneuver except...

Patient supine on ground with hip extended and knee bent at 20 degrees

Originates on a 1-inch wide space on the front of the pubis just above the crest and inserts on a rough line leading from the lesser trochanter down to the linea aspera

Pectineus

The _______________ are used to accelerate when running and the __________________ are used to decelerate.

Quads, hamstrings

Teres Ligament description

Surrounded by a sleeve of synovial membrane and connects into the femoral head. It becomes taut in adduction and flexion

Originates on the anterior iliac crest and surface of the ilium just below the crest and inserts on ¼ of the way down the thigh into the iliotibial tract, which in turn inserts into Gerdy's tubercle of the anterolateral tibial condyle

Tensor Fasciae Latae

How do you correctly perform the Thomas Kendall Test and what does it primarily test for?

The Thomas Kendall test is sensitive for tightness of the rectus femoris and the psoas major. The patient is lying supine on the table with their distal thighs off the table so that the calves do not touch the table edge. The patient takes uninvolved knee to the chest while the examiner is observing the involved leg looking for the knee to extend for rectus femoris tightness and the thigh to lift up off the table for psoas tightness

Explain in detail how to test for piriformis syndrome or piriformis tightness.

The examiner places the patient sidelying on the uninvolved side. The patient flexes the involved hip to about 90 degrees with the flexed and hanging off the table. The examiner stabilizes the pelvis and places a downward force on the knee to see if tightness is present in the piriformis by limited hip adduction in the hip flexed position. If pain is produced posteriorly consistent with piriformis syndrome.

What is Myositis Ossificans and what is it commonly caused by ?

You develop myositis ossificans from repeared direct blows to an already contused area. Myositis Ossificans is a hematoma that ossifies into boney deposits which may or may not be attached to the femur.

The fibrocartilaginous rim that reinforces the socket of the hip joint is referred to as the _______.

acetabulum?

Originates on the edge of the entire pubic ramus and the ischium and ischial tuberosity and inserts on the whole length of the linea aspera, medial condyloid ridge and adductor tubercle

adductor magnus

Femoral ______________ results in toe-in gait.

anteversion

The mechanism of injury in a posterior hip dislocation most commonly is a _______.

dashboard

A femoral shaft fracture may be checked for by performing the _____ test.

fulcrum test?

Name the muscles that function as medial rotators of the hip.

gluteus minimus, gluteus medius, tensor fascia latae

Iliofemoral Ligament description

prevents extensive hip extension and trunk hyperextension

The ____ test, when positive, may indicate hip joint pathology, sacroiliac joint pathology, or iliopsoas spasm, or adductor tightness.

Trendelenburg sign?

In snapping hip syndrome, what muscle is involved and what bony landmark is the muscle snapping over when you can see it?

When you can see the hip snap, the tensor fasciae latae snaps over the greater trochanter