Clinical Anatomy: Hips don't lie

Multiple Choice

Muscles, their tendons, and their attachments to the bone are classified as what type of tissue?

• Cartilagenous

• Contractile

• Inert

• Synovial

Multiple Choice

Which of the following describes osteokinematic movement?

• Movement between two bony segments

• Movement between two articular surfaces

Multiple Choice

Which of the following would be classified as a grade 1 tenderness on the Wolfe Scale?

• Withdrawal prior to pressure

• No tenderness

• Reports with grimace &/or flinchReports tenderness

• Reports tenderness

Multiple Choice

Which of the following symptoms is NOT associated with inflammation?

• Tumor

• Dolor

• Calor

• Pallor

Multiple Choice

What three bones fuse together to form the os coxa (pelvis)?

• ilium, ischium, & pubis

• ilium, ischium, & sacrum

• femur, acetabulum, & sacrum

• ischium, femur, & acetabulum

Multiple Choice

What movement occurs upon a frontal AXIS?

• rotation

• lateral flexion

• extension

• abduction

​X AXIS= Frontal/Coronal Axis

​Y AXIS= Vertical/Longitudinal Axis

​Z AXIS= Sagittal/AP Axis

Multiple Choice

The diameter of the acetabulum is larger or smaller than the head of the femur?

• Larger

• Smaller

Multiple Choice

Which of the following is NOT a function of the acetabular labrum?

• Stability

• Cushion/Shock Absorption

• Mobility

• Proprioception

Multiple Choice

What motion should be avoided with an acetabulum labrum tear?

• hip flexion

• hip medial rotation

• hip extension

• hip adduction

​Rectus femoris can have an indirect attachment to the labrum

Multiple Choice

The articular capsule of the hip is taut in full_____.

• Flexion

• Extension

• Medial Rotation

• Lateral Rotation

Multiple Choice

What is proximally attached to the edge of the acetabulum & distally to the neck of the femur?

• Ischiofemoral Ligament

• Labrum

• Rectus Femoris

• Articular Capsule

Multiple Choice

Which of the following is not an intra articular ligament of the hip?

• Ischiofemoral

• Pubofemoral

• Pelvifemoral

• liofemoral

Multiple Choice

Pubofemoral ligament limits all of the following EXCEPT

• Medial Rotation

• Lateral Rotation

• Abduction

• Extension

Multiple Choice

Which intra articular hip ligament is the strongest?

• Pubofemoral

• Iliofemoral

• Ischiofemoral

• Ligamentum Teres

Multiple Choice

Which intra articular hip ligament is the weakest?

• Pubofemoral

• Iliofemoral

• Ischiofemoral

Multiple Choice

Resisted isometric muscle testing of glute max will elicit pain with inflammation of which bursae?

• trochanteric

• ischial

• iliopectineal

• subpubic

Multiple Choice

Resisted isometric muscle testing of the hamstrings will elicit pain with inflammation of which bursae?

• Tronchanteric

• Iliopectinal

• Subpubic

• Ischial

Multiple Choice

Resisted isometric muscle testing of the hip flexors will elicit pain with inflammation of which bursae?

• Trochanteric

• Ischial

• Iliopectineal

• Sububic

Multiple Choice

Where do most hip labrum tears occur?

• 6:00-7:00

• 3:00-5:00

• 1:00-2:00

• 9:00-12:00

Multiple Choice

Which muscle does not participate in hip extension?

• Short head of biceps femoris

• Adductor Magnus

• Semimembranosis

• Glute max

​BICEPS FEMORIS

​Origin: Long Head-Ischial Tuberosity

​ Short Head- Linea aspera & Lateral supracondylar line

​Insertion: Head of the fibula

​Innervation: Long Head- Tibial

​ Short Head- Common Peroneal

​Action: Long Head- Hip Extension & Knee Flexion

​ Short Head- Knee Flexion

​

​*Can extend trunk when thigh & leg are flexed*

Multiple Choice

Which of the following muscles does not participate in hip flexion?

• Tensor fascia latta 

• Adductor brevis 

• Sartorius

• Vastus Lateralis

​VASTUS LATERALIS

​Origin: Greater trochanter & linea aspera

​Insertion: Base of patella & tibial tuberosity via patellar ligament

​Innervation: Femoral (L2-L4)

​Action: Knee Extension

Multiple Choice

Which muscle does not participate in hip adduction?

• Pectineus

• Piriformis

• Adductor Magnus

• Gracilis 

​PIRIFORMIS

​Origin: Anterior surface of sacrum & sacrotuberous ligament

​Insertion: Greater trochanter

​Innervation: Nerve to Piriformis

​Action: External Rotation

​Anterior

​Posterior

Multiple Choice

Which muscle is a medial rotator of the hip?

• Glute med

• Gemelli

• Glute max

• Gracilis

​GLUETUS MEDIUS

​Origin: Gluteal surface of ilium between anterior & posterior gluteal lines

​Insertion: Greater trochanter

​Innervation: Superior Gluteal

​Action: Abduction, Internal Rotation (anterior fibers), & External Rotation (posterior fibers)

​

​*keeps pelvis level when leg is raised*

FLEXION

​Iliopsoas, sartorius, TFL, rectus femoris, pectineus, adductor longus, adductor brevis, adductor magnus (ant), & gracilis

​EXTENSION

​Semitendinosus,semimembranosus, long head of biceps femoris, adductor magnus (post), & glute max

​ADDUCTION

​Adductor longus, adductor brevis, adductor magnus, gracilis, pectineus, & obturator externus

​ABDUCTION & MEDIAL ROTATION

​Glute med, glute min, TFL

​LATERAL ROTATION

​Obturator internus & externus, gemelli, piriformis, quadratus femoris, & glute max

Multiple Choice

What muscle comprises the lateral portion of the floor of the femoral triangle?

• Pectineus

• Sartorius

• Iliopsoas

• Adductor Longus

​Lateral Floor: Iliopsoas

​Medial Floor: Pectineus

​Lateral Border: Adductor Longus

​Medial Border: Sartorius

​Superior Border: Inguinal Ligament

​Contents: femoral nerve, femoral artery, femoral vein, empty space for lymphatics

Multiple Choice

Legg-perthes disease is the result of occlusion of which artery?

• Medial femoral circumflex

• Femoral

• Lateral femoral circumflex

• Ligamentum teres

Multiple Choice

Which artery provides the main blood supply to the head & neck of the femur?

• Medial femoral circumflex 

• Femoral

• Lateral femoral circumflex 

• Ligamen

Multiple Choice

Which of the following muscles has a dual innervation?

​ADDUCTOR MAGNUS

​Origin: Adductor Portion- Inferior ramus of pubis, ramus of ischium

​ Hamstring Portion- Ischial tuberosity

​Insertion: Adductor Portion- Gluteal tuberosity, linea aspera, medial supracondylar line

​ Hamstring Portion- Adductor tubercle

​Innervation: Adductor Portion- Obturator (L2-L4)

​ Hamstring Portion- Sciatic

​Action: Adductor Portion- Hip Adduction

​ Hamstring Portion- Hip Extension

​Anterior

​Posterior

Multiple Choice

What action does this muscle perform?

• Adduction

• Medial Rotation

• Knee Flexion

• Hip Extension

​SARTORIUS

​Origin: ASIS

​Insertion: Pes Anserinus (superior part of medial surface of tibia)

​Innervation: Femoral (L2-L4)

​Action: Hip Flexion, External Rotation, Abduction, & Knee Flexion

Multiple Choice

What is the innervation of the muscle that inserts onto the iliotibial tract and internally rotates the hip?

• Obturator

• Sciatic

• Superior Gluteal

• Inferior Gluteal

​TENSOR FASCIAE LATAE

​Origin: ASIS, Anterior Iliac Crest

​Insertion: Iliotibial Tract (band) attaching to Gerdy's tubercle

​Innervation: Superior Gluteal

​Action: Hip Flexion, Hip Abduction, & Internal Rotation

​Anterior

​Lateral

Multiple Choice

The muscle that originates on the superior ramus of the pubis and inserts on the pectineal line of femur performs which action?

• medial rotation

• lateral rotation

• hip abduction

• hip adduction

​PECTINEUS

​Origin: Superior ramus of pubis

​Insertion: Pectineal line of femur

​Innervation: Femoral (L2-L4)

​Action: Hip Adduction

​Anterior

​Posterior

Multiple Choice

Patient with a history of osteoporosis experiences a fall. Patient complains of sharp groin pain and presents with an antalgic gait. What is your Dx?

• Torn adductor magnus

• Hip osteoarthritis

• Femoral neck fracture

• Trochanteric bursitis

Multiple Choice

Patient comes to your clinic with a complaint of hip pain. The patient experiences stiffness in the morning that typically lasts less than an hour. Upon exam internal rotation is limited and painful. What is your Dx?

• Hip osteoarthritis 

• Tight glute med

• Femoral neck fracture

• Trochanteric bursitis

Multiple Choice

Which portion of iliopsoas is innervated by the femoral nerve?

• Psoas Minor

• Psoas Major

• Ishialis

• Iliacus

​ILIACUS

​Origin: Iliac crest, Iliac fossa, Ala of sacrum, Anterior SI ligaments

​Insertion: Tendon of psoas major to lesser trochanter

​Innervation: Femoral (L2-L4)

​Action: Hip Flexion, External Rotation