Study Hip (PTA) Flash Cards

 
Pile Management Card
Hip (PTA)

loading
True/False

Extracapsular fractures will cause a vascular disruption to the head of the femur?
FALSE

INTRACAPSULAR WILL CAUSE A DISRUPTION, BUT NONUNION MAY OCCUR WITH EXTRACAPSULAR AS THE RESULT OF FIXATION FAILURE
Recommendatins vary from partial weight bearing for at least 6 weeks to wbat immediately after surgery?
CEMENTLESS AND HYBRID
Immediate postoperative weight bearing as tolerated?
CEMENTED
What is the rationale for a minimally invasive THA?
USE OF SMALLER INCISIONS POTENTIALLY LESSONS SOFT TISSUE TRAUMA DURING SURGERY AND THEREFORE SHOULD IMPROVE AND ACCELERATE A PATIENT'S POSTOPERATIVE RECOVERY
What form of THA offers the best stability?
ANTEROLATERAL APPROACH
This for of THA can give a positive trandelenberg sign. Why?
DIRECT LATERAL APPROACH
-DISRUPTION OF THE ABDUCTOR MECHANISM IS ASSOCIATED WITH POSTOPERATIVE WEAKNESS AND GAIT ABNORMALITIES.
Cementless fixation is typically used for?
PATIENTS UNDER AGE 60 AND ARE PHYSICALLY ACTIVE AND GOOD BONE QUALITY
Cement fixation is typically used for?
PATIENTS WITH OSTEOPOROSIS AND POOR BONE STOCK AND TYPICALLY WITH ELDERLY PATIENTS
Characteristics of a flat back posture?
-DECREASED LUMBOSACRAL ANGLE
-DECREASED LUMBAR LORDOSIS
-HIP EXTESION
-POSTERIOR PELVIC TILT
This procedure replaces the damaged femoral head with a bipolar prosthesis?
HEMIARTHROPLASTY
What does a hemiarthroplasty require?
A NORMAL ACETABULAR SURFACE (RARELY USED FOR ARTHRITIS)
What are the mobility impairments of a sway back?
IN THE UPPER ABDONMIANS
-RECTUS FEMORIS AND OBLIQUES
-INTERNAL INTERCOSTAL
-HIP EXTENSOR
-LOWER LUMBAR EXTENSOR

IMPAIRED MUSCLE PERFORMANCE DUE TO STRETCHED AND WEAK LOWER ABDOMINAL MUSCLES
What is the result of a sway back?
AN INCREASED LORDOSIS AND INCREASES KYPHOSIS IN THE THORACIC REGION, AND A FORWARD HEAD
The relaxed or slouched posture is AKA?
SWAY BACK
When are patients typically discharged from therapy?
8-12 WEEKS
When are soft tissues normally healed by?
6 WEEKS
What are the goals for the initial phase of postoperative rehabilitation?
-PREVENT VASCULAR AND PULMONARY COMPLICATIONS
-IMPROVE STRENGTH IN THE UPPER AND SOUND LOWER EXTREMITIES
-PREVENT POSTOPERATIVE REFLEX INHIBITION OF HIP AND KNEE MUSCULATURE
-RESTORE ACTIVE MOBILITY AND DYNAMIC CONTROL OF THE INVOLVED HIP AND ADJACENT JOINTS
Low intensity resistance exercises of the operated hip often are delayed for how long postoperatively?
4-6 WEEKS
After hip surgery it is expected to see _____ to _____ of active hip flexion (with knee flexed) by _____ to _____ weeks postop.
80-90 DEGREES
2-4 WEEKS
When do exercises begin after hip surgery?
THE FIRST POSTOPERATIVE DAY TO PREVENT POSTOPERATIVE COMPLICATIONS AND TO RESTORE A PATIENT'S CONTROL OF THE OPERATED HIP DURING FUNCTIONAL ACTIVITIES
What are some signs and symptoms of possible failure of the internal fixation mechansim?
-SEVERE, PERSISTENT GROIN, THIGH, OR KNEE PAIN THAT INCREASES WITH LIMB MOVEMENT OR WEIGHT BEARING.
-PROGRESSIVE LIMB LENGTH INEQUALITY (SHORTENING OF THE INVOLVED LOWER EXTREMITY) THAT WAS NOT PRESENT IMMEDIATELY AFTER SURGERY
-PERSISTENT ER OF THE OPERATED LIMB
-A POSITIVE TRENDELENBURG SIGN DURING WB ON THE INVOLVED LIMB THAT DOES NOT RESOLVE WITH STRENGTHENING EXERCISES
What are some considerations to consider for wb status aften hip fx surgery?
-PATIENT'S AGE
-BONE QUALITY
-FX LOCATION
-TYPE OF FIXATION
-DEGREE OF INTRAOPERATIVE STABILITY ACHIEVED
What is an important thing to do immediately after hip surgery?
GET THE PATIENT UP AND MOVING AS QUICKLY AS POSSIBLE TO PREVENT OR MINIMIZE THE ADVERSE EFFECTS OF PROLONGED BED REST, INCLUDING THROMBOEMBOLI AND PULMONARY COMPLICATIONS WHICH PROTECTING THE FX SITE.
What is bad about femoral neck fractures?
THERE IS A HIGH RISK OF DISRUPTION OF THE VASCULAR SUPPLY TO THE HEAD OF THE FEMUR.
When is surgery indicated after a hip fx?
24-48 HOURS AFTER INJURY
What is the goal of surgery after a hip fx?
ACHIEVE MAXIMUM STABILITY AND RESTORE ALIGNMENT OF BONY STRUCTURES OF THE HIP
Where is pain felt for ischiogluteal bursitis?
AROUND THE ISCHIAL TUBEROSITIES
Ischiogluteal bursitis is AKA?A
TAILOR'S OR WEAVERS BOTTOM
Where is pain felt for a psoas bursitis?
PAIN IN THE GROIN OR ANTERIOR THIGH AND POSSIBLY INTO THE PATELLAR AREA

(AGGRAVATED DURING ACTIVITIES OF EXCESSIVE HIP FLEXION)
A patient with an anterverted hip with have?
EXCESSIVE IR AND DECREASED ER
True/False

A patient with a coxa vera will have more abduction than adduction?
FALSE

MORE ADDUCTION
A patient with a coxa vara will have what kind of contracture?
HIP ADDUCTOR CONTRACTURE
Femoral nerve injuries will affect what muscle group?
QUADS
Obturator nerve injuries will affect what muscle group?
ADDUCTOR GROUP
Sciatic nerve injuries will affect what muscle group?
HAMSTRINGS
Hip end feels?
FLEXION: SOFT

ALL OTHER END FEELS ARE FIRM
Capsular pattern of the hip?
FLEXION>ABD>IR
Actual differences exists between the length of a patient's two lower limbs?
TRUE LLG
The actual length of the patient's two lower limbs is identical, but other factors such as joint or muscle contractures cause one of the limbs to function or appear as if it were shorter or longer than the other?
FUNCTIONAL/APPARENT LLG
Functional is synonimous with?
APPARENT
Signs and symptoms of rheumatoid arthritis?
-CHRONIC SWELLING
-PAIN
-DEFORMITY OF THE JOINTS
Autoimmune degeneraive condition?
RHEUMATOID ARTHRITIS
Primary causes of osteoarthritis?
-AGING
-MECHANICAL
-CHEMICAL (STEROID INJECTIONS)
-STRUCTURAL
-GENETIC
-SECONDARY (KNEE PROBLEMS)
-REFERRED PAIN
Wear and tear?
OSTEOARTHRITIS
Avascular necrosis of the hip is associated with?
-FEMORAL NECK FX
-HIP DISLOCATIONS
-SLIPPED CAPITAL EPIFITHES
-LUPUS
-ERYTHEMATOSUS
-ALCOHLISM
-PROLONGED USE OF CATABOLIC STEROIDS
Many options are available when treating hip fractures which are?
-PATIENT'S AGE
-LOCATION OF FX
-QUALITY OF BONE
-SEVERITY OF FX (SIMPLE VS. DISPLACED)
-ACTIVITY LEVEL OF PT
-ASSOCIATED SOFT TISSUE INJURIES
-SPECIFIC GOALS FOR THE PATIENTS RETURN TO ACTIVITY
Causes of iliopectineal bursitis?
-CONTRACTURE OF ILIOPSOAS SECONDARY TO DJD
Causes of ischial bursitis?
-SITTING FOR LONG PERIODS OF TIME
-FALL
Causes of a greater trochanter bursitis?
-SHORTENED ITB
-LEG LENGTH DISCREPENCY
-BANKED SURFACES
-ANTERVERSION
The most common contusion affecting the hip and pelvis involves the ____________ ___________ of the iliac crest and is commonly termed a _____ _________?
-SUBCUTANEOUS TISSUES
-HIP POINTER
An adductor muscle strain usually involves what muscle?
ADDUCTOR LONGUS
Most acute injuries affecting the hip are?
MUSCULOTENDINOUS STRAINS OF
-HAMSTRINGS
-ILIOPSOAS
-ADDUCTORS
-RECTUS FEMORIS
Characterized by either local tenderness over the iliopsoas muscle and tendon or diffuse radiating pain into the anterior thigh?
ILIOPECTINEAL BURSITIS
An ischial bursitis can exhibit what kind of injury?
HAMSTRING STRAIN
This will result from a direct contusion of the ischial tuberosity or extended periods of sitting?
ISCHIAL BURSITIS
Bursitis' commonly affecting the hip?
-TROCHANTERIC BURSITIS
-ISCHIAL BURSITIS
-ILIOPECTINEAL BURSITIS
What modalities may be helpful in the acute phase of a greater trochanter bursitis?
-ULTRASOUND
-HYDROTHERAPY
Tx of greater trochanteric bursitis?
-CENTERED ON RELIEVING PAIN AND INFLAMMATION
-ADDRESSING THE UNDERLYING CAUSE OF THE CONDITION
What is the tx for soft tissue disorders of the hip?
-CORRECT MALALIGNMENT
-STRETCHING AND STRENGTHENING
How do you diagnose a soft tissue disorder of the hip?
ACTIVE CONTRACTIONS/PASSIVE STRETCHING SHOULD REPRODUCE SYMPTOMS
What muscles are typically involved with soft tissue disorders of the hip?
-RECTUS FEMORIS
-TFL/IT BAND
-HIP ER
A femoral neck fx is an example of what kind of hip fx?
INTRACAPSULAR
An intertrochanteric hip fx is an example of what kind of hip fx?
EXTRACAPSULAR OR TROCHANTERIC
What are the classifications of hip fx's?
-INTRACAPSULAR
-EXTRACAPSULAR
What are the risk factors of hip fx's?
-ELDERLY
-FEMALE
-WHITE
-SEDENTARY
-HX OF PRIOR FX
-PSYCHOTROPIC DRUGS (PROZAC) WEAKENS BONES
-ALCOHOLISM
-DEMENTIA
What is likely to occur from a posterior hip dislocation?
OSTERNECROSIS
What is the most common type of hip dislocation?
POSTERIORLY (80%)
High energy Fx's and are normally seen in young patients?
-FEMORAL SHAFT FX
-HIP DISLOCATIONS
Tx of a femoral shaft fx?
INTRAMEDULLARY ROD
Nonsurgical tx of the acetabulum or pelvis, when is wb permitted?
9 WEEKS
Surgical tx of a fx pelvis or acetabulum involves how many weeks of a protected wb?
8-10
What is the most significant clinical feature associated with pelvic fx's?
THE POTENTIALLY LIFE-THREATENING COMPLICATIONS
Because of the fragile hemodynamic nature of the significant pelvic fx, wb of any kind is deferred for how long?
8 WEEKS OR LONGER
How can unstable pelvic fx's be defined?
-ROTATIONALLY UNSTABLE BUT VERTICALLY STABLE
-ROTATIONALLY AND VERTICALLY UNSTABLE
How are stable fx's of the pelvis treated?
-NONSURGICALLY
-PROTECTION
-BED REST (2-3 WEEKS)
-PROGRESSIVE MOTION AND EXERCISE ONCE STABLE BONE UNION HAS BEEN CONFIRMED
When can strengthening exercises be added after a hip avulsion fx?
WHEN THE PHYSICAN CONFIRMS RADIOGRAPHIC EVIDENCE OF SECURE UNION OF THE AVULSION
How can avulsion fx's of the pelvis be treated?
-CONSERVATIVELY WITH REST
-PROTECTED WB
-CRUTCHES
-AVOIDANCE OF PREMATURE STRETCHING AND RESISTIVE EXERCISES.
The most basic classification of pelvic fx's refers to the injury as either?
STABLE/UNSTABLE
Acetabular fractures?
-HIGH-VELOCITY INJURY
-YOUNG ADULTS
-MAYBE ASSOCIATED WITH HIP DISLOCATION
-ABDOMINAL VISCERA AND SCIATIC NERVE INJURY
-USUALLY REQUIRES ORIF
Treatment of SCFE?
SURGERY
MOI of SCFE?
SUDDEN TRAUMA OR ATRAUMATIC AND SLOW
SCFE affects what gender/age?
BOYS (10-16)
Shearing forces displace the head of the femur inferiorly and posteriorly relative to the neck of the femur
SLIPPED CAPITAL FEMORAL EPIPHYSIS
What is the treatment for LCP?
BRACING IN ABD & IR
What are the signs and symptoms of LCP?
-LIMP
-IPSILATERAL MEDIAL THIGH PAIN
-LIMITED IR AND ABD
What is the etiology (cause) of LCP?
UNKNOWN
LCP typically involves?
MALES 3-12 YEARS OF AGE
What is the treatment for excessive femoral anterversion?
FOOT ORTHODICS
What are the signs and symptoms of excessive femoral anterversion?
-EXHIBIT A TOE IN GAIT
-MALALIGNMENT OF THE LOWER LIMB
-EXHIBITS GREATER IR ROM OF THE HIP
With anterversion, the ipsilateral lower limb will be in what position?
IR
Angle between the femoral neck and femoral shaft on the transverse plane is ________ in adults?
15 DEGREES
Anterversion will often result in what?
-GENU VALGUM
-PES PLANUS
Retroversion?
-A DECREASE IN THE TORSION OF THE FEMORAL NECK
-CAUSES THE SHAFT OF THE FEMUR TO BE ROTATED LATERALLY
A decrease in the torsion of the femoral neck is called?
RETROVERSION
Anterversion?
-AN INCREASE IN THE FEMORAL NECK
-CAUSES THE SHAFT OF THE FEMUR TO BE ROTATED MEDIALLY
An increase in the torsion of the femoral neck is called?
ANTERVERSION
What is the primary focus of LCP?
-MAINTAINING THE FEMORAL HEAD WITHING THE ACETABULUM
-REGAINING MOTION
-REDUCING PAIN AND DYSFUNCTION
What is the cause of LCP?
AVN
How is LCP characterized?
NONINFLAMMATORY, SELF LIMITING (CAN HEAL SPONTANEOUSLY WITH OR WITHOUT SPECIFIC TX), SYNDROME IN WHICH THE FEMORAL HEAD FLATTENED AT THE WEIGHT BEARING SURFACE.
Legg-Calve-Perthes disease is AKA?
COXA PLANA
Usually affects children between 4-8 years old?
LEGG-CALVE-PERTHES DISEASE (LCP)
Diseases that can lead to degenerative changes in the hip joint?
-OSTEOARTHRITIS (DJD)
-RHEUMATOID ARTHRISIS
-CONGENITAL DEOFOMITIES
This is the most common arthritic disease of the hip joint?
OSTEOARTHRITIS
What is the function of the hip abductors during gait?
CONTROL THE LATERAL PELVIC TILT DURING SWINGING OF THE OPPOSITE LEG
How will someone compensate if they have tight hip flexors?
INCREASED LUMBAR LORDOSIS OR WALKS WITH THE TRUNK BENT FORWARD
Place this card into pile: