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The Hip
(CN) The Hip
Front | Back |
---|---|
Which muscles flex the hip? (4) | Iliopsoas, Sartorius, Rectus femoris, Pectineus |
What muscles extend the hip? (5) | Glut max & med, Hamstrings (Semitendinosus, Semimebranosus, Biceps Femoris) |
What muscles abduct the hip? (4) | Glut med & min, Piriformis, Obturator internus |
What muscles adduct the hip? (4) | Adductor magnus, longus & brevis, Gracilis |
What muscles medially rotate the hip? (5) | TFL, Glut med & min, Pectineus, Adductor longus |
What muscles laterally rotate the hip? (7) | Glut max, Obturator internus & externus, Piriformis, Gemelli Twins, Sartorius |
What is Ely's test used for? Describe it. | Positive test indicates rectus femoris contracture. Place pt in prone and passively flex their knee. Positive test: Spontaneous hip flexion with the knee flexion. |
What is Ober's test used for? Describe it. | Positive test indicates TFL tightness. Place pt in sidelying with lower leg flexed at hip and knee. Passively move test leg into extension and adduct it. Positive test: Leg is unable to adduct to the table behind the lower leg. |
What is the Thomas test used for? Describe it. | Indicates hip flexion contracture. Pt place in supine w/ legs full extended, and brings one knee to the chest. Positive test: Straight leg raises up from the table. |
What is the tripod sign? What does it indicate? | Positive test: When placed in a sitting position, one knee is passively extended, the pt extends the trunk in order to limit the effect of the tight hamstrings. If you hadn't guessed it, a positive test indicates tight hamstrings! |
What is Craig's test used for? Describe it. | Evaluates anteversion. Place pt prone with test knee flexed to 90. Palpate posterior aspect of the greather trochanter and rotate the hip M&L until trochanter is // with the table. Anteversion = angle of lower leg w/ perpendicular axis of the table. |
What is a normal amount of anteversion in an adult? | 8-15 degrees. |
What is Patrick's(Faber's) test used for? Describe it? | Postive test may indicate ilipsoas, SI or hip joint problems. Place pt in supine w/ the ankle of test leg resting on contralateral knee. (Figure of 4) Slowly lower the test knee toward the table. Positive test: failure of test leg to abduct to the table. |
What are the two types of total hip replacement? Describe each. | Cemented: Immediate WBAT, May require more bone tissue removal, May experience loosening. Noncemented: TTWB for up to 6 wks, Lasts longer than cemented, Leaves more bone intact, Allows for continued tissue growth. |
What are the general post-op precautions after THR w/ posterolateral approach? (8) | Avoid adduction, medial rotation and flexion past 90. Do not: sit on low surfaces, bend over toward ground, lean to get up from chair, cross legs. Maintain abduction w/ a pillow. |
What does early PT intervention consist of post-THR? | Maintaining WB status, ambulation and mobility training w/ precautions, Isometric strengthening, Gentle stretches w/ precautions. |
What is the Q angle? | The degreee of angluation between the ASIS, midpatella and tibial tubercle. |
What is a normal Q angle when measured in supine? What could an excessive Q angle lead to? | Males: 13degrees, Females 18 Degrees. Excessive Q angle can lead to pathology and abnormal patellar tracking. |
Streight Leg Raise | evaluate lower back pain and unilateral disfunction of the SIJ |
pain with 0-30 degree w SLR | Hip pathology or severly inflamed nerve root |
pain in 30-50 SLR | sciatic N. involvement |
pain w 50-70 SLR | tight hamstrings |
pain in 70-90 SLR | SIJ stressed |
Prone knee bend | femoral nerve stretch L1-L3 N. involvement |