Summary LIst of Hip Conditions

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Questions and Answers

What area of the body does ankylosing spondylitis primarily cause stiffness and pain?

The gluteals.

When is the pain typically worst for patients with ankylosing spondylitis?

In the morning.

What activity is known to relieve symptoms of ankylosing spondylitis?

Exercise.

What are the two spinal regions where central stenosis is commonly observed?

Cervical and lumbar. Signup and view all the answers

What type of reflexes are typically observed in patients with central stenosis?

Hyperreflexive DTR. Signup and view all the answers

What is the main symptom differentiating foraminal stenosis from central stenosis?

DTR being hypo reflexive. Signup and view all the answers

Which patient age group is at greater risk for developing central stenosis?

Individuals over 50 years. Signup and view all the answers

What position generally provides relief for symptoms associated with central stenosis?

Seated or in a flexed position. Signup and view all the answers

Differentiate between vascular and neurological pain symptoms in thoracic outlet syndrome (TOS).

Vascular pain is characterized by throbbing, swelling, and often distal symptoms like pallor, while neurological pain presents as burning, sharp, and radiating sensations. Signup and view all the answers

What role does rest play in alleviating symptoms associated with thoracic outlet syndrome?

Rest, along with shoulder or arm support, can significantly reduce pain and discomfort in patients with TOS. Signup and view all the answers

Identify two observable signs that suggest vascular complications in TOS.

Pallor or cyanosis and diminished pulse are two signs indicating vascular compromise in TOS. Signup and view all the answers

Explain the significance of Erb's point in neurodynamic testing for thoracic outlet syndrome.

Erb's point is significant because it is where the brachial plexus is most superficial, making it essential for evaluating nerve compression. Signup and view all the answers

What is the primary assessment method for confirming scoliosis presence?

Observation of spinal alignment, particularly the alignment of the spinous processes, is the primary assessment for scoliosis. Signup and view all the answers

What is the best test among vascular tests for diagnosing thoracic outlet syndrome?

The Roos test is regarded as the best among the vascular tests for diagnosing TOS. Signup and view all the answers

How does muscle spasm affect breathing assessments in patients with scoliosis?

Muscle spasms can lead to asymmetrical breathing patterns and reduced thoracic expansion, complicating the assessment. Signup and view all the answers

Describe the relevance of true leg length discrepancy in the context of scoliosis assessment.

True leg length discrepancy helps identify structural imbalances that may complicate scoliosis, influencing treatment approaches. Signup and view all the answers

List two symptoms that suggest compression of nerves in thoracic outlet syndrome.

Tingling and numbness are two symptoms indicating potential nerve compression in TOS. Signup and view all the answers

What impact does shoulder positioning have on thoracic outlet syndrome symptoms?

Shoulder positioning can exacerbate symptoms by increasing compression in the thoracic outlet area. Signup and view all the answers

What connection is established between forward head posture and thoracic outlet syndrome?

Forward head posture is often observed in TOS patients, contributing to muscle tightness and vascular compromise. Signup and view all the answers

How might decreased range of motion relate to causal factors in thoracic outlet syndrome?

Decreased range of motion may result from muscle spasms or tightness in specific areas, indicating the underlying cause of TOS symptoms. Signup and view all the answers

Identify the two primary interventions recommended for structural scoliosis.

A heel wedge and a lift are the two main interventions for addressing structural scoliosis. Signup and view all the answers

What are the five contraindications represented by the acronym PSycH in testing?

Psychological influences, severe pain, severe progressive excessive neuro deficits, highly unstable condition, and legal problems. Signup and view all the answers

List the three precautions indicated by the acronym SSS that should be taken before testing.

Continuous and/or night pain, symptoms easily provoked with movement, and symptoms that do not settle easily. Signup and view all the answers

Why is technique particularly important in testing for patients with neurological issues?

Because it's easy to malposition or misperform the test, which could lead to inaccurate results. Signup and view all the answers

During passive tests, what should symptoms not exceed in intensity?

Symptoms should not exceed 3-4/10 during the test. Signup and view all the answers

What should a patient do before performing an active movement test?

Practice doing the movement prior to the test. Signup and view all the answers

Name the three golden tests associated with the condition discussed.

Slump, ULTTs (Upper Limb Tension Tests), and SLR (Straight Leg Raise). Signup and view all the answers

What two types of incidents are most typically associated with vertebrobasilar insufficiency?

Motor vehicle accidents (MVAs) and whiplash. Signup and view all the answers

What demographic is at greater risk for experiencing symptoms related to vertebrobasilar insufficiency?

Individuals aged 50 to 70 years old. Signup and view all the answers

List the five primary signs and symptoms reported most commonly using the acronym VHLGUM.

Visual disturbances, headache, loss of consciousness, gait disturbances, and upper extremity paresthesia. Signup and view all the answers

What anatomical structures surround the thoracic outlet?

Clavicle, 1st rib, and superior border of scapula. Signup and view all the answers

What two structures passing through the thoracic outlet are critical for upper extremity function?

Axillary artery and axillary vein. Signup and view all the answers

What is the more common form of thoracic outlet syndrome, acute or chronic?

Chronic. Signup and view all the answers

What factors can make individuals more susceptible to developing thoracic outlet syndrome?

Poor posture, repetitive overhead positions, and specific occupations like desk jobs. Signup and view all the answers

What condition, present statistically in 0.2-1% of the population, could lead to thoracic outlet syndrome symptoms?

Cervical rib. Signup and view all the answers

What does a hypomobility finding in joint play at the ribs indicate?

It indicates a dysfunction in the absence of trauma. Signup and view all the answers

What might hypermobility with joint play at the ribs signify?

It may signify a sprain. Signup and view all the answers

What movements should be approached with caution in rib joint dysfunction?

C side glides and T rib mobility. Signup and view all the answers

What does the term PAIVM refer to, and is rib motion typically classified as one?

PAIVM refers to passive accessory intervertebral movement; rib motion is not classified as PAIVM. Signup and view all the answers

List two aggravating activities commonly associated with rib joint dysfunction.

Rotation and side bending. Signup and view all the answers

What is a key consideration when performing PPIVMs and accessory movements?

Consider whether performing these movements will excessively aggravate the injury. Signup and view all the answers

What may be indicative of negativity in muscle dynamics associated with adverse neurodynamics?

Weak muscles and muscle atrophy in affected nerve distributions. Signup and view all the answers

What could the presence of muscle spasm indicate in patients with rib joint dysfunction?

It indicates the body's response to pain and instability in the joint area. Signup and view all the answers

How does habitual poor posture relate to rib joint dysfunction?

Habitual poor posture can lead to muscle imbalances and contribute to rib dysfunction. Signup and view all the answers

What does often painful and reduced mobility in rib joint assessments suggest?

It suggests that the nerves may not be very mobile, leading to restrictions. Signup and view all the answers

What is the expected pain quality described in rib joint dysfunction?

The pain is typically sharp and stabbing. Signup and view all the answers

What is the impact of inhaling and exhaling in patients with rib joint issues?

These actions can aggravate the pain in rib joint dysfunction. Signup and view all the answers

What special test considerations are crucial for assessing adverse neurodynamics?

Understanding that normal nerves may hurt under excessive tension is crucial. Signup and view all the answers

In what instance may a normal neurodynamic test be insufficient for an athlete?

When it does not apply enough stress on the tissue to determine progressive adverse neurodynamics. Signup and view all the answers

How may smoking and specific occupations relate to rib joint dysfunction?

These factors can increase the risk of developing rib joint issues. Signup and view all the answers

What differentiates spondylolisthesis from spondylolysis?

Spondylolisthesis features vertebral instability, while spondylolysis is a unilateral or bilateral fracture of the pars interarticularis. Signup and view all the answers

What is the significance of knowing whether a patient has stenosis or disc pathology?

It is important because disc pathologies can be treated conservatively, whereas stenosis often requires surgical intervention. Signup and view all the answers

Which spinal region is predominantly affected by spondylolisthesis?

The lumbar region, specifically at the L5 vertebra. Signup and view all the answers

What are the typical symptoms associated with spondylolisthesis?

Typical symptoms include lumbar pain aggravated by extension and possible radicular symptoms due to nerve impingement. Signup and view all the answers

What is a DEXA scan used for in relation to osteoporosis?

A DEXA scan is used for measuring bone density and diagnosing osteoporosis. Signup and view all the answers

Name one observation that might be present in a patient with osteoporosis.

Increased kyphosis or a forward head posture. Signup and view all the answers

What is the primary risk factor for osteoporosis in terms of gender and age?

Females over the age of 50 are at greater risk for developing osteoporosis. Signup and view all the answers

What movement is typically most aggravating for patients experiencing facet joint dysfunction?

Extension, side bending, and rotation are movements that typically aggravate the pain. Signup and view all the answers

How does spondylolysis predispose a patient to spondylolisthesis?

Bilateral spondylolysis creates a risk for spondylolisthesis due to resulting vertebral instability. Signup and view all the answers

What specific condition is suggested by the term 'retrolisthesis'?

Retrolisthesis refers to the backward slippage of a vertebra over the one beneath it. Signup and view all the answers

What does the term 'Gower's sign' indicate in a clinical assessment?

Gower's sign indicates instability as a person uses their hands to walk up their thighs when transitioning from flexion to extension. Signup and view all the answers

What are two potential consequences of osteoporosis in daily life?

Increased risk of fragility fractures and limitations in physical function due to pain and reduced mobility. Signup and view all the answers

In which activity would tightness in the hamstrings commonly be palpated?

Tightness in the hamstrings may commonly be associated with lumbar spine conditions, especially in cases of instability. Signup and view all the answers

What role does corticosteroid use play in the risk of osteoporosis?

Corticosteroid use can increase the risk of developing osteoporosis, especially in postmenopausal women. Signup and view all the answers

What measurement difference typically indicates the necessity for intervention in leg-length discrepancies?

A measurement difference of more than 1 cm is often used to determine the need for intervention. Signup and view all the answers

Why is it recommended to proceed with caution when addressing a 1 cm leg-length discrepancy?

Sudden changes could exacerbate existing problems and adversely affect pain and function. Signup and view all the answers

What two points are commonly used for measuring leg-length discrepancies?

Measurements are usually taken from the ASIS to the medial malleolus or from the ASIS to the lateral malleolus. Signup and view all the answers

What maneuver is performed before checking for functional leg-length discrepancies and why?

The Weber-Barstow maneuver is performed to level the pelvis, which aids in accurate measurement. Signup and view all the answers

What can be concluded if true leg-length is normal yet measurements show a discrepancy?

The condition can be classified as a functional leg-length discrepancy. Signup and view all the answers

Which two primary muscular structures are affected by an iliac crest contusion?

The abdominal wall and gluteus medius are primarily affected. Signup and view all the answers

What condition is associated with an iliac crest contusion?

Meralgia paraesthetica, caused by compression of the lateral femoral cutaneous nerve, is associated. Signup and view all the answers

What is a potential consequence of an avulsion fracture at the hip?

Avulsion fractures can result in significant pain due to tearing of ligamentous or tendinous attachments. Signup and view all the answers

In which sports are iliac crest contusions most frequently observed?

Iliac crest contusions are most commonly seen in sports like diving and volleyball. Signup and view all the answers

What role does the bulk of the quadriceps play in measuring leg-length discrepancies?

The quadriceps' bulk can affect the measurement by altering the distance to the malleoli. Signup and view all the answers

What differentiates a structural leg-length discrepancy from a functional one?

Structural discrepancies are due to bone length differences, while functional discrepancies arise from postural adaptations. Signup and view all the answers

How can significant pain in a diving-related injury be described?

Pain can be disproportionate due to the high innervation of the bone, causing severe discomfort. Signup and view all the answers

What is the common measurement procedure for assessing leg-length discrepancies?

Measurements are taken with the patient supine, legs at 90 degrees from the pelvis and parallel. Signup and view all the answers

What impact can a sudden change in leg-length discrepancy have on a patient?

It can lead to significant impacts on function and pain levels, especially after many years of adaptation. Signup and view all the answers

What is a secondary predictor for presenting with FAI, and how does it differ from the main predictor?

A secondary predictor is a posterior pelvic tilt, which differs from anterior pelvic rotation by having less early onset. Signup and view all the answers

What are the two factors associated with the developmental form of FAI?

Pelvic positioning and posture. Signup and view all the answers

Can FAI be asymptomatic, and what does this imply?

Yes, FAI can be asymptomatic, indicating that individuals may not exhibit noticeable symptoms despite the condition. Signup and view all the answers

What is a key consideration regarding asymptomatic FAI?

The potential impact on the knee, sacroiliac joint, lumbar spine, etc. Signup and view all the answers

What is a hallmark sign of hip osteoarthritis?

Decreased internal rotation and flexion. Signup and view all the answers

How does FAI typically differ from OA in terms of lesion characteristics?

FAI lesions are localized, unlike the more generalized condition of OA. Signup and view all the answers

What happens to bone structure in both arthritis and spondylosis?

Bone starts to wear on bone, leading to a compensatory increase in new bone formation. Signup and view all the answers

What types of pathologies would an intra-articular test be unable to differentiate?

It cannot determine the specific type of intra-articular pathology present. Signup and view all the answers

What common sensations are experienced with a labral tear in the hip?

Clicking, catching, popping, and instability. Signup and view all the answers

What is the most typical movement restriction observed with a labral tear?

Movement from flexion to extension is usually the most painful and restrictive. Signup and view all the answers

What aspect of the labrum is most injury-prone?

The anterior portion of the labrum. Signup and view all the answers

What defines the end feel in FAI during assessments like the scower test?

The end feel is typically bone-to-bone. Signup and view all the answers

What are the five main risk factors associated with osteoarthritis?

Age, sex (females), weight, activity level, and family history. Signup and view all the answers

Would surgical intervention be appropriate for a 35-40 year old with hip osteoarthritis?

No, surgical intervention is not typically ruled out for individuals in this age group. Signup and view all the answers

How does the mechanism of injury (MOI) for avulsion fractures differ among skeletally immature individuals compared to adults?

In skeletally immature individuals, the tendon remains intact and pulls off a piece of bone due to the weaker bone structure, whereas in adults, the tendon may rupture instead. Signup and view all the answers

Explain the nature of pain associated with apophysitis and its relationship to physical activity.

Apophysitis typically presents as a dull, aching pain that may be aggravated by activity, particularly during growth spurts. Signup and view all the answers

What key factors differentiate apophysitis from an avulsion fracture?

The key factors are the mechanism of injury (traumatic vs. gradual) and the nature of the injury itself. Signup and view all the answers

In which population is osteitis pubis most commonly found, and what activities are associated with it?

Osteitis pubis is most commonly found in skeletally mature males and is often associated with ice sports like hockey and kicking sports like soccer. Signup and view all the answers

What distinguishing features help differentiate osteitis pubis from an adductor strain?

Osteitis pubis has chronic symptoms and tenderness at the symphyseal area, while an adductor strain typically has acute onset and localized tenderness. Signup and view all the answers

What type of population is most at risk for femoral neck stress fractures, and what are the pain characteristics?

Endurance athletes, especially females with lean body mass, are most at risk for femoral neck stress fractures, presenting as deep, aching pain. Signup and view all the answers

How does the time of day affect the pain experienced from a stress fracture?

Pain from a stress fracture is typically more bothersome at night because the bone repair process is most active during rest. Signup and view all the answers

What are the three types of femoroacetabular impingement (FAI), and which is considered the most problematic?

The three types of FAI are Cam, Pincer, and Mixed; the Mixed type is considered the most problematic. Signup and view all the answers

What indicates the necessity for imaging to confirm the presence of FAI?

Imaging is necessary when there is a suspicion of FAI in individuals with longstanding groin pain. Signup and view all the answers

What is a common symptom that indicates a possible stress fracture in athletes?

Common symptoms include localized pain that is exacerbated by increased activity or training loads. Signup and view all the answers

Describe the typical characteristics of point tenderness in avulsion fractures.

Point tenderness in avulsion fractures is typically very pronounced, particularly at the site of the injury. Signup and view all the answers

What specifics should be noted during palpation of an avulsion fracture?

During palpation, one should expect significant pain and tenderness in the affected area, which limits pain assessment. Signup and view all the answers

How do the symptoms of apophysitis present over time, especially in relation to activity levels?

The symptoms of apophysitis can start as mild and become more pronounced with increased activity or rapid growth spurts. Signup and view all the answers

What complications can arise from femoral acetabular impingement if left untreated?

Untreated femoral acetabular impingement can lead to chronic pain, labral tears, and eventually osteoarthritis. Signup and view all the answers

What are the two activities that are most aggravated with a hip sprain?

Running and cutting. Signup and view all the answers

What is the difference between acute and chronic mechanisms of injury for muscular pathology of the hip?

Acute injuries are caused by sudden movements or compressive forces, while chronic injuries result from habitual postural misalignments. Signup and view all the answers

What are the four symptoms commonly associated with hip muscular pathology?

Dull, aching, stiff, and tight. Signup and view all the answers

What time of day is a hip pathology most likely to be stiffer?

In the morning. Signup and view all the answers

What does SHARD stand for in the context of hip muscular pathology?

Swelling, Heat, Altered function, Redness, and Deep tissue pain. Signup and view all the answers

Would pain typically radiate with a hip muscular pathology, and why?

Not typically, but it could occur with piriformis pathology due to sciatic nerve involvement. Signup and view all the answers

What two factors does the amount of SHARD present with a hip muscular pathology depend on?

The severity of the injury and the location of the given muscle. Signup and view all the answers

What special test is associated with a piriformis pathology?

Piriformis length test. Signup and view all the answers

When assessing hip AROM, which step is frequently overlooked?

Observing for any compensation or asymmetry. Signup and view all the answers

What are the three tests most relevant for assessing adverse neurodynamic issues?

Slump test, SLR (Straight Leg Raise), and Prone knee bend. Signup and view all the answers

What is a common reaction of strength in the presence of a hip/pelvic musculature injury?

Strength may be strong and painful, weak and painful, or weak and pain-free. Signup and view all the answers

What two hip movements are most aggravated with a hip sprain?

Hip extension and hip rotation. Signup and view all the answers

Which position is best for honing in on what specific hip muscle is affected during assessment?

Palpation. Signup and view all the answers

What observation might indicate a rectus femoris or iliopsoas strain?

Lordosis in standing versus kneeling. Signup and view all the answers

What structures should definitely be palpated when assessing hip pathology?

At a minimum, palpate the hip joint, surrounding muscles, and the greater trochanter. Signup and view all the answers

What position is contraindicated for palpating the hip, and why?

Supine is contraindicated because some patients may experience discomfort during palpation. Signup and view all the answers

Prior to hip palpation, what two actions should be conducted?

Explain what you are doing and seek permission from the patient. Signup and view all the answers

Which anatomical structures are likely affected in piriformis syndrome?

The piriformis muscle and the sciatic nerve. Signup and view all the answers

How does the relation of the sciatic nerve to the piriformis typically present anatomically?

The sciatic nerve normally passes anterior and deep to the piriformis. Signup and view all the answers

What two hip range of motion movements are impacted when the sciatic nerve pierces the piriformis?

Internal rotation and external rotation are affected. Signup and view all the answers

What is the main cause of pseudo sciatica?

A hypertrophied piriformis is the primary cause of pseudo sciatica. Signup and view all the answers

Name two types of sciatica and differentiate them.

Pseudo sciatica is due to non-disc related issues, while true sciatica stems from lumbar disc pathology. Signup and view all the answers

What are the three primary mechanisms of injury for ischial bursitis?

Mechanical, chemical, and septic causes. Signup and view all the answers

Which type of bursitis is primarily discussed in this course?

Mechanical bursitis is the main focus of this course. Signup and view all the answers

Identify the most common acute mechanism of injury associated with ischial bursitis.

The most common acute mechanism is falling on the ischial tuberosity. Signup and view all the answers

What is unique about the pain associated with septic bursitis?

Septic bursitis is often accompanied by redness due to infection. Signup and view all the answers

What may be present when a person with trochanteric bursitis moves their hip?

Crepitus may be present during hip movement. Signup and view all the answers

What special test may be conducted if irritations typically aggravated with trochanteric bursitis are suspected?

Ober's test is commonly used to assess this condition. Signup and view all the answers

What are the four structures affected in internal snapping hip syndrome, represented by the acronym HIII?

Hamstring syndrome, Iliopsoas tendon, Iliofemoral ligament, Iliopsoas bursal/capsular thickening. Signup and view all the answers

What movement and position primarily exacerbate the snapping of the iliofemoral ligament over the femoral head?

The movement from FLEX to EXT at an angle of 45 degrees, worsened when the hip is ABD and ER. Signup and view all the answers

What is the 'C sign' and with which condition is it associated?

The 'C sign' is a deep pain sign associated with intra-articular snapping hip syndrome. Signup and view all the answers

How do you differentiate between snapping hip syndrome caused by a loose body versus a labral tear?

By the end feel; a loose body presents with bone-on-bone, while a labral tear presents as a springy block. Signup and view all the answers

What are the three most common areas where pain is referred for intra-articular hip syndrome?

Groin, anterior hip, and anterior thigh. Signup and view all the answers

What is the main goal when targeting the sources of internal and external snapping hip syndrome?

To address basic mechanics. Signup and view all the answers

Why are special tests associated with snapping hip syndrome likely to be positive?

Because there would be associated mobility restrictions with those tests. Signup and view all the answers

What imaging may be needed to rule out intra-articular issues and internal bursa?

Imaging like MRI or X-ray. Signup and view all the answers

What structural changes are typically observed in ankylosing spondylitis due to joint fusion?

Loss of lumbar lordosis and an increase in thoracic kyphosis. Signup and view all the answers

How does the position of the body affect symptoms in central stenosis?

Symptoms worsen with walking and standing, but improve when seated or in a flexed position. Signup and view all the answers

Identify a key difference between symptoms of foraminal stenosis and central stenosis.

Foraminal stenosis primarily presents with radicular pain, while central stenosis may show bilateral symptoms. Signup and view all the answers

What is the typical age demographic at increased risk for central stenosis?

Individuals aged 50 years and older. Signup and view all the answers

In central stenosis, what typical reflex findings are observed?

Hyperreflexive deep tendon reflexes (DTR), potentially reaching grade 3 or 4. Signup and view all the answers

What type of movements are particularly challenging for individuals with central stenosis?

Extension and axial compression movements are particularly painful. Signup and view all the answers

What is typically observed during the pain provocation testing of the sacroiliac joint (SIJ) in ankylosing spondylitis?

Pain may be provoked, indicating potential inflammation or dysfunction in the SIJ. Signup and view all the answers

List two common secondary causes of central stenosis.

Facet arthritis and disc degeneration. Signup and view all the answers

What active movement should a patient practice prior to an active test?

They should practice doing the movement. Signup and view all the answers

What is the key risk associated with performing tests on elderly populations?

They may have highly unstable conditions. Signup and view all the answers

Why should the intensity of symptoms not exceed 3-4/10 during testing?

Exceeding this threshold may indicate worsening of the patient's condition. Signup and view all the answers

Identify two primary signs of vascular complications in thoracic outlet syndrome?

Pallor and decreased pulse in the affected limb. Signup and view all the answers

What condition could be linked with cervical instability that often affects upper cervical motion?

Rheumatoid arthritis. Signup and view all the answers

In general, which demographic is at a higher risk for vertebrobasilar insufficiency?

Males aged 50-70 years. Signup and view all the answers

What major factor relates to increased risk of developing thoracic outlet syndrome?

Repetitive overhead motions. Signup and view all the answers

Which cranial nerve symptom could indicate neurological compromise in a patient?

Diplopia. Signup and view all the answers

What precaution should be taken if a patient experiences symptoms easily provoked with movement?

Limit their range of motion during the test. Signup and view all the answers

Which sign is most commonly reported with vertebrobasilar insufficiency?

Dizziness. Signup and view all the answers

What structure is NOT typically compressed in thoracic outlet syndrome?

The spinal cord. Signup and view all the answers

What assessment method is crucial for evaluating thoracic outlet syndrome?

Physical examination for posture and range of motion. Signup and view all the answers

What should a healthcare provider ask for during testing, as a form of feedback from the patient?

Verbal feedback on their symptoms. Signup and view all the answers

Identify one secondary symptom that might accompany vertebrobasilar insufficiency.

Nystagmus. Signup and view all the answers

What is the significance of differentiating between stenosis and disc pathology?

Stenosis cannot be changed while disc pathology can be treated. This distinction informs the chosen interventions. Signup and view all the answers

What age and gender demographic is most at risk for transitioning from spondylolysis to spondylolisthesis?

Typically, females between the ages of 10 to 25 years are at higher risk. This may also increase in older populations. Signup and view all the answers

What are the two main types of vertebral slippage identified in spondylolisthesis?

Anterolisthesis, where a vertebra slips forward, and retrolisthesis, where it slips backward. Signup and view all the answers

What are two potential symptoms observed with lumbar spondylolisthesis?

Pain in the lumbar region and potential radicular symptoms due to nerve impingement. Signup and view all the answers

Identify the primary objective measuring tool for diagnosing osteoporosis.

DEXA scanning is the primary tool for assessing bone density. Signup and view all the answers

What are typical postural observations associated with osteoporosis?

Increased kyphosis, Dowager's hump, and a forward head posture. Signup and view all the answers

What lifestyle factors are noted to increase the risk of developing osteoporosis?

A sedentary lifestyle, smoking, and excessive alcohol consumption significantly increase risk. Signup and view all the answers

What intervention should not be considered until leg-length discrepancy is addressed?

A heel lift or wedge. Signup and view all the answers

What type of pain location is common in facet joint dysfunction?

Pain is typically located posterolateral, unilateral, and localized. Signup and view all the answers

How is congenital maldevelopment measured?

With a radiograph, clinically, and using fixed points. Signup and view all the answers

Why is caution advised when correcting a 1 cm leg-length discrepancy?

Rapid changes may lead to significant impacts on pain and function. Signup and view all the answers

What does the acronym HIS DiP stand for in relation to osteoporosis observations?

Head forward posture, Increased kyphosis, Scoliosis, Dowager's hump, and Protuberant abdomen. Signup and view all the answers

Which movements are generally avoided during range of motion assessments in patients with osteoporosis?

ROM assessments are generally not performed due to the risk of fractures. Signup and view all the answers

What measurement points are used for determining leg-length discrepancy?

ASIS to medial malleolus or ASIS to lateral malleolus. Signup and view all the answers

What potential effects does spinal osteophyte development have?

Osteophyte development can lead to nerve impingement and radiating pain. Signup and view all the answers

In measuring leg-length discrepancies, why is the Weber-Barstow maneuver performed?

To level the pelvis before taking measurements. Signup and view all the answers

Can individuals with FAI be asymptomatic, and to what extent?

Yes, individuals with FAI can be asymptomatic, often unaware of their condition. Signup and view all the answers

What characterizes the observation findings in spondylolisthesis?

Increased lordosis, step deformity, and muscle spasm. Signup and view all the answers

What is the significance of a 1.5 cm leg-length discrepancy?

It is still considered normal, but can lead to problems. Signup and view all the answers

Which type of pathology is associated with functional leg-length discrepancies?

Iliosacral pathology. Signup and view all the answers

What does a positive Gower's sign indicate?

It indicates difficulty returning from flexion to extension, suggesting instability. Signup and view all the answers

What important consideration should be made regarding asymptomatic FAI?

Its potential impact on other joints like the knee, sacroiliac joint, and lumbar spine. Signup and view all the answers

What might indicate functional leg-length discrepancies during physical assessment?

Normal true leg-length measurements with differing functional measurements. Signup and view all the answers

What can exacerbate symptoms of spondylolisthesis?

Symptoms can be aggravated by extension movements and sustained standing. Signup and view all the answers

What are the hallmark signs of hip osteoarthritis?

Decreased internal rotation and decreased flexion. Signup and view all the answers

What follow-up components are included in the acronym MISs?

Muscle length testing, iliosacral assessment, and scoliosis check. Signup and view all the answers

What are the primary structures affected by an iliac crest contusion?

Musculature in the area, including the abdominal wall and gluteus medius. Signup and view all the answers

What is a major distinction between osteoarthritis and femoral acetabular impingement?

FAI lesions are localized while OA is a more generalized joint condition. Signup and view all the answers

What condition is often associated with iliac crest contusions?

Meralgia paraesthetica. Signup and view all the answers

At which joint does osteoarthritis typically occur at the earliest?

The hip joint. Signup and view all the answers

What is an avulsion fracture?

A tearing away of the bony attachment of a ligament or tendon. Signup and view all the answers

What type of end feel would be present with a labral tear compared to femoral acetabular impingement?

A labral tear presents with a cartilaginous end feel, while FAI presents with a bone-to-bone end feel. Signup and view all the answers

What are the four main sensations associated with a hip labral tear?

Clicking, catching, popping, and instability. Signup and view all the answers

Where does pain typically refer with meralgia paraesthetica?

To the proximal distribution of the lateral femoral cutaneous nerve. Signup and view all the answers

What are the common regions for avulsion fractures?

The hip, particularly at ASIS, AIIS, and lesser trochanter. Signup and view all the answers

What intra-articular test is established for assessing the presence of intra-articular pathologies?

Tests like FABER and FADDIR are used. Signup and view all the answers

In the context of a labral tear, how do structural conditions affect movement restrictions?

Movement restrictions depend on the specific location of the labral tear. Signup and view all the answers

Describe the pain characteristics commonly experienced by those with osteoarthritis.

Pain is often achy or sharp and worsens in the morning or at night. Signup and view all the answers

What aspect of a labrum injury contributes to the feeling of instability?

Abnormal movements due to joint dysfunction cause over-reaction from joint receptors. Signup and view all the answers

What is a common mechanism of injury (MOI) for avulsion fractures in skeletally immature individuals?

A sudden change of direction or forceful rotation. Signup and view all the answers

In what population are avulsion fractures typically more prevalent, and why?

They are more common in skeletally immature individuals due to less ossified bone. Signup and view all the answers

What is the primary structure involved in external snapping hip syndrome?

The iliopsoas tendon. Signup and view all the answers

Which type of snapping hip syndrome is most consistently painful and why?

Internal snapping hip syndrome is most consistently painful because it involves intra-articular structures. Signup and view all the answers

What type of pain is typical for apophysitis, and what phases of activity may it aggravate?

Apophysitis presents as dull, aching pain, often aggravated by activity. Signup and view all the answers

What are two key differentiators between apophysitis and avulsion fractures?

The mechanism of injury (traumatic vs gradual) and the nature of the injury itself. Signup and view all the answers

List the four structures affected in internal snapping hip syndrome utilizing the acronym 'HIII.'

Hamstring syndrome, Iliopsoas tendon, Iliofemoral ligament, Iliopsoas bursal/capsular thickening. Signup and view all the answers

What differentiates the end feel of a loose body from that of a labral tear in intra-articular snapping hip syndrome?

A loose body presents with a bone-on-bone end feel, whereas a labral tear has a springy block end feel. Signup and view all the answers

How does osteitis pubis commonly present, and which population is primarily affected?

Osteitis pubis typically presents as chronic pain at the pubic symphysis, affecting skeletally mature males. Signup and view all the answers

What is the primary symptom that differentiates osteitis pubis from adductor strains?

Osteitis pubis is characterized by chronic pain, while adductor strains are usually acute. Signup and view all the answers

Identify the three most common painful referral locations for patients with intra-articular hip syndrome.

Groin, anterior hip, and anterior thigh. Signup and view all the answers

At what hip position does the iliofemoral ligament primarily snap over the femoral head?

At an angle of 45 degrees, particularly when moving from flexion to extension with hip abduction and external rotation. Signup and view all the answers

What time of day are femoral neck stress fractures most bothersome, and why?

They are most bothersome at night due to increased bone healing processes during rest. Signup and view all the answers

What are the three types of femoral acetabular impingement (FAI)?

<ol> <li>Cam 2. Pincer 3. Mixed.</li> </ol> Signup and view all the answers

What may be necessary to rule out concerning intra-articular pathologies besides snapping hip syndrome?

Imaging may be needed to rule out intra-articular and internal bursa pathologies. Signup and view all the answers

What common movements would most provoke snapping hip syndrome during daily activities?

Pivoting or standing on the affected leg. Signup and view all the answers

What is a common consequence of an increase in training load for endurance athletes?

It can lead to the development of stress fractures, particularly in the femoral neck. Signup and view all the answers

What movement limitations are most likely present with a femoral neck stress fracture?

Limitations and pain are likely at the end ranges of all movements, particularly flexion and extension. Signup and view all the answers

How does palpation contribute to the assessment of an avulsion fracture?

Palpation provides limited insight, as there would be significant pain and tenderness at the site. Signup and view all the answers

What type of pain is typically described in individuals suffering from osteitis pubis?

Deep, aching pain localized at the pubic symphysis. Signup and view all the answers

What activity-related factor aggravates conditions like osteitis pubis?

Aggravation occurs with activity or prolonged periods of sitting. Signup and view all the answers

Why might individuals with apophysitis remain asymptomatic?

Pain may be localized but can diffuse due to extended inflammation, leading to no noticeable symptoms. Signup and view all the answers

What is the hallmark indicator for diagnosing femoral acetabular impingement (FAI)?

Imaging is necessary to confirm the presence of FAI. Signup and view all the answers

What are the two activities most aggravated by a hip sprain?

Running and cutting. Signup and view all the answers

What are the acute mechanisms of injury (MOIs) for muscular pathology of the hip?

Sudden excessive movement and compressive forces. Signup and view all the answers

Which time of day is a hip pathology often stiffer?

In the morning. Signup and view all the answers

What are the four common symptoms associated with hip muscular pathology?

Dull, aching, stiff, and tight. Signup and view all the answers

What special test is typically used to assess a piriformis pathology?

Piriformis length test. Signup and view all the answers

How does smoke impact tissue health concerning hip muscular pathology?

Increases risk, negatively impacting tissue health. Signup and view all the answers

What finding is indicative of altered weight bearing in hip muscular pathology?

Abnormal gait. Signup and view all the answers

What are the two hip movements most aggravated with a hip sprain?

Hip extension and hip rotation. Signup and view all the answers

What does SHARD stand for in terms of hip muscular pathology?

Swelling, Heat, Altered function, Redness, and Deep pressure pain. Signup and view all the answers

What are the three relevant tests for assessing adverse neurodynamics?

Slump, SLR (Straight Leg Raise), and prone knee bend. Signup and view all the answers

During a hip muscular pathology assessment, what position should you prioritize for muscle affected?

Palpation. Signup and view all the answers

What condition does the presence of morning stiffness in hip pathologies typically indicate?

Impaired joint mobility due to inactivity. Signup and view all the answers

What two things aggravate pain associated with a hip muscular pathology?

Active contraction and passive stretching of the affected tissue. Signup and view all the answers

What is the potential range of position difference between contralateral pelvis landmarks in muscular pathology?

20-30 degrees. Signup and view all the answers

What observation sign is associated with a rectus femoris and iliopsoas strain?

Lordosis in standing versus kneeling. Signup and view all the answers

What is the only way to confirm sciatic nerve mispositioning in relation to the piriformis?

Diagnostics/imaging. Signup and view all the answers

Which anatomical anomaly regarding the sciatic nerve can occur with piriformis syndrome?

The sciatic nerve may pierce through the piriformis. Signup and view all the answers

What two hip range of motion movements are affected by the sciatic nerve piercing through the piriformis?

Internal rotation and external rotation. Signup and view all the answers

Identify the two materials that can be used for sensitive area palpation.

Towel and a hand. Signup and view all the answers

What must be explained to the patient before performing hip palpation?

What you’re doing. Signup and view all the answers

In which position should the patient lie down to locate the sciatic nerve between the ischial tuberosity and greater trochanter?

Side lying position. Signup and view all the answers

What symptom is often associated with septic bursitis due to the infection process?

Redness. Signup and view all the answers

Which sign is not reliable for assessing bursitis?

Rebound pain. Signup and view all the answers

What is the expected pain quality for snapping hip syndrome?

Typically superficial. Signup and view all the answers

Identify two kinds of sciatica.

Pseudo sciatica and true sciatica. Signup and view all the answers

Which two movements could be problematic with trochanteric bursitis due to muscle attachments?

Flexion and extension. Signup and view all the answers

What are the three main MOIs associated with trochanteric bursitis?

Running on unbanked tracks, abnormal running mechanics, and wide pelvis with genu valgum. Signup and view all the answers

Describe the pain experienced during acute bursitis.

Usually not very painful. Signup and view all the answers

How do symptoms differ between vascular pain and neurological pain in thoracic outlet syndrome?

Vascular pain tends to present as swelling and heat with distal symptoms, while neurological pain often manifests as burning, sharp, or electrical sensations radiating along nerve distributions. Signup and view all the answers

What role does rest play in the management of thoracic outlet syndrome symptoms?

Rest alleviates symptoms by reducing pressure on the compressed areas, providing shoulder or arm support to relieve discomfort. Signup and view all the answers

Describe the purpose of the Roos test in evaluating thoracic outlet syndrome.

The Roos test helps assess vascular sufficiency and neurological function in patients suspected of having thoracic outlet syndrome. Signup and view all the answers

What indicates a possible vascular complication in a patient with thoracic outlet syndrome during an examination?

Signs such as pallor, cyanosis, decreased skin temperature, and distended veins can indicate vascular complications. Signup and view all the answers

What primary assessments are crucial when evaluating for scoliosis?

Observation of spinal alignment, rib prominence, and pelvic levels are key assessments when evaluating for scoliosis. Signup and view all the answers

How does muscle spasm affect the findings in a breathing assessment for scoliosis?

Muscle spasm may lead to reduced symmetry and expansion in the thorax during a breathing assessment. Signup and view all the answers

What is the significance of observing forward head posture in patients with thoracic outlet syndrome?

Forward head posture often correlates with poor posture and may contribute to the symptoms associated with thoracic outlet syndrome. Signup and view all the answers

What findings are indicative of true leg length discrepancy during an assessment?

A structural discrepancy in the length of the femur and/or tibia, evidenced by differing measurements between the left and right legs, indicates true leg length discrepancy. Signup and view all the answers

Why is the brachial plexus traction test preferred for assessing thoracic outlet syndrome?

The brachial plexus traction test is more specific to thoracic outlet syndrome and can reveal nerve compression more effectively than other assessments. Signup and view all the answers

What are two common symptoms associated with vascular compression in thoracic outlet syndrome?

Common symptoms include heaviness or fatigue in the arm/hand and cramping in the affected extremities. Signup and view all the answers

How can reduced range of motion in the shoulder relate to thoracic outlet syndrome?

Reduced range of motion may correlate with compressive factors, such as tight scalenes in the neck, affecting mobility and pain levels. Signup and view all the answers

What observations are necessary for evaluating muscle length and strength in the context of thoracic outlet syndrome?

Evaluating for point tenderness, muscle spasms, and overall strength in the upper quadrant is important for assessing muscle length and function. Signup and view all the answers

What is a common clinical finding during the assessment for scoliosis related to rib prominence?

Rib prominence may be observed, with one side appearing more prominent than the other when viewed from the anterior aspect. Signup and view all the answers

In the context of an upper extremity assessment, what might a diminished pulse indicate?

A diminished pulse in the upper extremity may suggest compromised vascular function due to thoracic outlet syndrome. Signup and view all the answers

What could indicate an absence of trauma in rib joint assessments?

Hypomobility with joint play at the ribs indicates a dysfunction in the absence of trauma. Signup and view all the answers

When assessing rib joint dysfunction, why should caution be used with certain movements?

Caution is necessary with movements like side glides and thoracic rib mobility as they can aggravate the condition. Signup and view all the answers

Why are neurodynamic tests not definitive for diagnosing disc pathology?

Neurodynamic tests are not diagnostic because they cannot solely identify disc pathology amidst other potential causes. Signup and view all the answers

In the context of adverse neurodynamics, what might muscle atrophy suggest?

Muscle atrophy may indicate malfunctioning nerves associated with several pathologies that include a neurodynamic component. Signup and view all the answers

What does a key consideration during PPIVMs and accessory movements involve?

The key consideration is whether performing these movements will aggravate the injury too much. Signup and view all the answers

What is a critical factor influencing the pain severity in disc pathology?

Pain severity often varies with movement, particularly during actions that open and close the spinal segments. Signup and view all the answers

How does muscle spasm impact patients experiencing rib joint dysfunction?

Muscle spasm is likely present and can lead to increased pain and reduced mobility. Signup and view all the answers

What connection exists between habitual postures and rib joint dysfunction?

Habitual poor posture contributes to rib joint dysfunction by creating imbalances and strains. Signup and view all the answers

What diagnosis can be inferred from localized, sharp, stabbing pain in the ribs?

Localized sharp and stabbing pain typically indicates rib joint dysfunction, often following trauma. Signup and view all the answers

What assessment would you recommend when suspecting adverse neurodynamics?

A scanning exam and motion assessment should be conducted to evaluate potential adverse neurodynamics. Signup and view all the answers

What role does poor muscular flexibility play regarding neurodynamics?

Poor muscular flexibility often coincides with adverse neurodynamics, exacerbating mobility issues. Signup and view all the answers

What is an expected observation in patients with rib joint conditions?

Common observations include head forward posture along with possible chin tilt and habitual poor posture. Signup and view all the answers

What should be considered about symptoms during passive tests?

Symptoms during passive tests should not exceed a certain intensity to avoid misinterpretation of the injury. Signup and view all the answers

What may exacerbate rib joint dysfunction during respiratory actions?

Inhaling and exhaling could exacerbate the dysfunction due to increased rib movement. Signup and view all the answers

What type of imaging is primarily used to confirm conditions like stenosis or a disc pathology?

Radiography or diagnostic imaging. Signup and view all the answers

Why is it crucial to differentiate between spondylolisthesis and disc pathology?

Spondylolisthesis involves vertebral instability, while disc pathology can be treated. Signup and view all the answers

What changes occur to spondylolysis that may indicate a risk for spondylolisthesis?

Bilateral spondylosis may lead to spondylolisthesis. Signup and view all the answers

What are some observable physical signs associated with osteoporosis, using the acronym HIS DiP?

Posture changes, spinal curve, scoliosis, dowager's hump, and protuberant abdomen. Signup and view all the answers

What anatomical region is primarily affected by spondylolisthesis?

The lumbar region, specifically L5. Signup and view all the answers

How does muscle spasm manifest in patients with spinal issues?

Muscle spasm can appear in the erector column, indicating underlying instability. Signup and view all the answers

What is a common symptom that may present with spondylolisthesis due to instability?

Radicular symptoms may occur because of the unstable segment impinging on neurological structures. Signup and view all the answers

What does the term DEXA stand for in the context of osteoporosis assessment?

Dual-Energy X-ray Absorptiometry. Signup and view all the answers

What type of joint dysfunction might result from sudden or unusual movement in the spine?

Facet joint dysfunction. Signup and view all the answers

What is one primary intervention option for patients diagnosed with stenosis?

Surgical intervention is often required for stenosis. Signup and view all the answers

What is the significance of a Gower's sign in spinal assessment?

It indicates a struggle to return from flexion to extension, suggesting possible instability. Signup and view all the answers

What lifestyle factor increases the risk of osteoporosis?

A sedentary lifestyle. Signup and view all the answers

What does a T-score of -2.5 represent in bone density measurements?

It indicates osteoporosis. Signup and view all the answers

What is the primary consequence of osteoporosis in the vertebral column?

Increased risk of fragility fractures. Signup and view all the answers

What type of injury is indicated by muscle spasm in patients with rib joint dysfunction?

A muscle spasm likely indicates an acute injury or sprain. Signup and view all the answers

How does hypomobility in joint play at the ribs relate to injury?

Hypomobility indicates a dysfunction that may arise without trauma. Signup and view all the answers

Which specific movements should be approached with caution in cases of rib joint dysfunction?

Cervical side glides and thoracic rib mobility should be approached with caution. Signup and view all the answers

What does the term 'PAIVM' not apply to in relation to rib motion?

Rib motion, including costovertebral expansion, is not classified as PAIVM. Signup and view all the answers

What may indicate pain in the ribs during motions such as coughing or sneezing?

Pain during such motions suggests possible rib joint dysfunction or irritation. Signup and view all the answers

When discussing rib joint dysfunction, how is the pain quality typically described?

The pain is often sharp and stabbing in rib joint dysfunction cases. Signup and view all the answers

What risk factors should be considered when evaluating a patient for rib joint dysfunction?

Consideration should be given to smoking, occupations, and habitual postures. Signup and view all the answers

What role do habitual poor postures play in rib joint dysfunction?

Poor postures can lead to muscle imbalances that stress rib joints. Signup and view all the answers

How does the presence of pain affect the assessment of joint mobility?

Pain can lead to decreased range of motion and hypomobility in assessments. Signup and view all the answers

What behavior should be noted in patients with insidious rib joint dysfunction?

Patients may display poor muscular flexibility and signs of atrophy. Signup and view all the answers

What common symptom might indicate a patient is experiencing adverse neurodynamics?

Weakness in a muscle may suggest malfunctioning nerve dynamics. Signup and view all the answers

In terms of assessment, how does the timing of pain typically present in disc pathology?

Pain is generally worst during the morning or night. Signup and view all the answers

Why are neurodynamic tests considered non-diagnostic for certain conditions like disc pathology?

Neurodynamic tests cannot definitively diagnose disc-related issues. Signup and view all the answers

What factors affect the interpretation of neurodynamic test results in athletes?

Neurodynamic tests may not apply sufficient stress to identify issues. Signup and view all the answers

What is the primary precaution to consider if a patient experiences continuous pain during testing?

Ensure to monitor their symptoms closely and consider postponing the test. Signup and view all the answers

What does the acronym PSycH represent in terms of contraindications for testing?

Psychological influences, Severe pain, Severe progressive excessive neuro deficits, Highly unstable condition, and Legal problems. Signup and view all the answers

What is the maximum acceptable symptom intensity during passive tests?

Symptoms should not exceed a 3-4/10 intensity. Signup and view all the answers

How should a patient prepare before performing an active movement test?

The patient should practice doing the movement prior to the test. Signup and view all the answers

What role does verbal feedback play during testing procedures?

Patients should provide verbal feedback on their feelings during the test. Signup and view all the answers

Identify two primary risk factors linked to vertebrobasilar insufficiency.

Age (50-70 years old) and male gender. Signup and view all the answers

What are the three most common symptoms reported in patients with vertebrobasilar insufficiency?

Dizziness, visual disturbances, and loss of consciousness. Signup and view all the answers

What two types of incidents are most typically associated with the onset of vertebrobasilar insufficiency?

Motor vehicle accidents (MVAs) and whiplash. Signup and view all the answers

What anatomical space is referred to as the thoracic outlet?

It is the space surrounded by the clavicle, 1st rib, and the superior border of the scapula. Signup and view all the answers

What is one common consequence of a cervical rib present in the population?

It may cause compression of the vascular structures, potentially leading to thoracic outlet syndrome (TOS). Signup and view all the answers

Name one less significant factor that contributes to thoracic outlet syndrome.

Rheumatoid arthritis. Signup and view all the answers

Why is technique essential during the testing of neurological patients?

Incorrect technique can easily lead to misinterpretation of test results. Signup and view all the answers

What symptom is most commonly associated with right posterior artery occlusion?

Right-sided posterior neck pain. Signup and view all the answers

In relation to thoracic outlet syndrome, what might repetitive overhead positions cause?

They can increase the risk of developing compression in the thoracic outlet. Signup and view all the answers

What is the importance of upper cervical stability in the context of cervical health?

Excessive movement between C0/C1 and C1/C2 can cause compression and ischemia. Signup and view all the answers

What two muscle-related symptoms might indicate thoracic outlet syndrome associated with vascular issues?

Heaviness and loss of strength in the arm. Signup and view all the answers

In the context of thoracic outlet syndrome, how does decreased ROM usually present?

It appears as painful and limited movement in areas such as the neck, shoulder, and wrist. Signup and view all the answers

What role does the Roos test play in the diagnosis of thoracic outlet syndrome?

The Roos test is the most effective assessment among vascular tests for TOS. Signup and view all the answers

Which neurological test is specifically performed at Erb’s point?

Tinel's sign testing. Signup and view all the answers

What is the significance of point tenderness in the assessment of thoracic outlet syndrome?

It indicates localized irritation or inflammation at the site of compression. Signup and view all the answers

What common posture issue is often observed in patients with thoracic outlet syndrome?

Forward head posture. Signup and view all the answers

What does decreased skin temperature suggest in the context of vascular TOS?

It indicates reduced blood flow to the affected area. Signup and view all the answers

What observation about rib alignment is crucial when assessing scoliosis?

The alignment of the spinous processes (SPs). Signup and view all the answers

What key assessment technique is used to identify thresholds of symmetry in breathing with scoliosis?

Observation of the upper, middle, and lower thorax during breathing. Signup and view all the answers

Which factors contribute to assessing true leg length discrepancy in patients?

Measurement of femur and tibia length differences between sides. Signup and view all the answers

What is the impact of a muscle spasm on the breathing assessment in scoliosis?

It can hinder the symmetry and full expansion of the thorax. Signup and view all the answers

How does edema relate to vascular changes in thoracic outlet syndrome?

Edema can indicate pooling of blood due to vascular compromise. Signup and view all the answers

What is the primary goal of observing the rib prominence and hip levels in scoliosis assessment?

To determine the severity of spinal curvature and potential structural imbalances. Signup and view all the answers

What can be inferred from symptoms like tingling and numbness in patients with thoracic outlet syndrome?

These symptoms suggest nerve compression and decreased blood flow. Signup and view all the answers

What is the intervention of choice to address a leg-length discrepancy before any heel lift is given?

Correcting the discrepancy itself is the primary intervention of choice. Signup and view all the answers

How is a leg-length discrepancy measured?

It's measured with a radiograph, clinically, using fixed points like ASIS to medial malleolus. Signup and view all the answers

Why might a person not receive a 1 cm heel lift immediately?

A sudden heel lift could create more problems than it resolves due to long-term adaptations. Signup and view all the answers

What are the typical measuring points when assessing for leg-length discrepancies?

Measurements are typically taken from the ASIS to the medial or lateral malleolus. Signup and view all the answers

What does a positive test for leg-length discrepancy indicate?

A positive test indicates a difference of 1 to 1.5 cm is significant and may lead to functional issues. Signup and view all the answers

Before checking for functional leg-length discrepancies, which maneuver should be performed?

The Weber-Barstow maneuver should be performed prior to checking. Signup and view all the answers

What types of posture changes are associated with functional leg-length discrepancies?

They often lead to adaptive or compensatory postures that appear as shortening of one side. Signup and view all the answers

What secondary condition might arise from an iliac crest contusion?

A lateral femoral cutaneous nerve injury, also known as meralgia paraesthetica, may develop. Signup and view all the answers

What is a common sport where iliac crest contusion injuries occur?

Iliac crest contusions are frequently seen in volleyball. Signup and view all the answers

What is the distinction between an iliac crest contusion and an iliac crest fracture?

The presence of crepitus would lean more towards an iliac crest fracture. Signup and view all the answers

What might the presence of notable quad asymmetry suggest during leg length measurement?

It may indicate the necessity to measure from the lateral malleolus instead of the medial malleolus. Signup and view all the answers

What are three components of the follow-up process for assessing discrepancies?

Muscle length testing, iliosacral assessment, and scoliosis check are the three components. Signup and view all the answers

Is it possible to have both structural and functional leg-length discrepancies at once?

Yes, it is possible to have both structural and functional discrepancies simultaneously. Signup and view all the answers

Which two primary structures are affected by an iliac crest contusion?

The musculature in the area, particularly the abdominal wall and gluteus medius, are affected. Signup and view all the answers

What are the two most aggravated activities associated with a hip sprain?

Running and cutting. Signup and view all the answers

What hip movements are primarily aggravated by a hip sprain?

Hip extension and hip rotation. Signup and view all the answers

In what context would you observe a patient with suspected hip muscular pathology?

In weight bearing and gait if they can tolerate it, otherwise in an unloaded position. Signup and view all the answers

What is the role of smoking in relation to hip muscular pathology?

Smoking increases the risk by negatively impacting tissue health. Signup and view all the answers

What signs are commonly associated with hip muscular pathology observation?

SHARD, altered weight bearing, and abnormal gait. Signup and view all the answers

Which time of day is hip pathology typically stiffer?

In the morning. Signup and view all the answers

What two factors determine the amount of SHARD in a hip muscular pathology?

The severity of the injury and the location of the given muscle. Signup and view all the answers

What observation sign is characteristic of a rectus femoris strain?

Lordosis in standing vs kneeling. Signup and view all the answers

What is the typical condition of AROM and PROM in a hip muscular pathology?

Both are painful and reduced. Signup and view all the answers

What are the four symptoms associated with hip muscular pathology?

Dull, aching, stiff, and tight. Signup and view all the answers

What is the special test associated with a piriformis pathology?

Piriformis length test. Signup and view all the answers

What is considered important when performing AROM in an individual with a hip muscular pathology?

Observing for any compensation or asymmetry. Signup and view all the answers

What is the mechanism of injury (MOI) for an avulsion fracture among skeletally immature individuals?

The tendon pulls off at the bone as it's the weakest point, rather than rupturing. Signup and view all the answers

What injury mechanism is synonymous with avulsion fractures?

A tendon or muscle rupture. Signup and view all the answers

Why are avulsion fractures commonly seen in skeletally immature individuals?

Because their bones are not fully ossified or solid like in adults. Signup and view all the answers

What are the pain characteristics associated with avulsion fractures?

Pain can be sharp and constant, especially at night. Signup and view all the answers

What is the most likely common site associated with snapping hip syndrome, and why?

The iliopsoas tendon, because it slips over its attachment at the lesser trochanter or anterior acetabular ring. Signup and view all the answers

What is apophysitis, and where is it most commonly located?

It is an inflammatory condition at a secondary ossification center of a bone, commonly at sites like the ASIS and AIIS. Signup and view all the answers

What are the four structures involved in internal snapping hip syndrome, associated with the acronym HIII?

Hamstring syndrome, Iliopsoas tendon, Iliofemoral ligament, Iliopsoas bursal/capsular thickening. Signup and view all the answers

What differentiates apophysitis from avulsion fractures?

Apophysitis is a gradual onset condition, while avulsion fractures result from a traumatic force. Signup and view all the answers

What type of snapping hip syndrome is likely to be consistently painful?

Internal snapping hip syndrome. Signup and view all the answers

What activity is osteitis pubis commonly associated with in females?

Childbearing. Signup and view all the answers

How can you differentiate between a loose body and a labral tear in terms of intra-articular snapping hip syndrome?

By the end feel; a loose body will present with bone-on-bone, while a labral tear will feel like a springy block. Signup and view all the answers

What is a major challenge in diagnosing a femoral neck stress fracture?

They are hard to locate due to deep tissue covering. Signup and view all the answers

What is the deep pain sign associated with intra-articular snapping hip syndrome called?

The C sign. Signup and view all the answers

What factors can predict a stress fracture over other conditions?

Duration of symptoms, training patterns, and unresponsive tendinopathy. Signup and view all the answers

Which type of femoral acetabular impingement (FAI) is considered extremely problematic?

Mixed FAI, which combines both cam and pincer types. Signup and view all the answers

Which three hip ranges of motion (ROM) are most affected by snapping hip syndrome?

Extension (EXT), adduction (ADD), and external rotation (ER). Signup and view all the answers

How are evaluations for FAI guided?

They should be conducted in any individual experiencing longstanding groin pain. Signup and view all the answers

What angle and movements are primarily associated with the snapping of the iliofemoral ligament over the femoral head?

45 degrees, when moving from flexion (FLEX) to extension (EXT) and worsened in abduction (ABD) and external rotation (ER). Signup and view all the answers

What is the main aspect to target when addressing the sources of internal and external snapping hip syndrome?

Basic mechanics. Signup and view all the answers

What is the primary pain characteristic for a femoral neck stress fracture?

It often presents as a deep aching sensation. Signup and view all the answers

What type of imaging is necessary to confirm the presence of femoral acetabular impingement?

Imaging is required for confirmation. Signup and view all the answers

What population is primarily affected by apophysitis?

Skeletally immature athletes. Signup and view all the answers

What are the common aggravating factors for osteitis pubis?

Activity and prolonged sitting can aggravate the condition. Signup and view all the answers

What is a secondary predictor for presenting with FAI?

A posterior pelvic tilt. Signup and view all the answers

Can FAI be asymptomatic, and if so, what is a critical consideration?

Yes, FAI can be asymptomatic. It's important to consider its impact on surrounding joints like the knee, SI joint, and lumbar spine. Signup and view all the answers

What is the main difference between OA and FAI in terms of lesion presentation?

FAI lesions are more localized, whereas OA presents as a more widespread joint condition. Signup and view all the answers

What is the typical end feel associated with FAI?

Bone to bone. Signup and view all the answers

What sensations are commonly felt with a labral tear of the hip?

Clicking, catching, popping, and instability. Signup and view all the answers

What must be referred to a physician for determining intra-articular pathologies?

An x-ray. Signup and view all the answers

What type of motion is more likely to be restricted with a labral tear?

Movement restriction depends on where the labral tear is located. Signup and view all the answers

What is the primary concern with asymptomatic FAI?

Its potential impact on the knee, SI joint, and lumbar spine. Signup and view all the answers

What is the relationship between bone growth and other arthritis conditions?

Bone wears on bone, leading to compensatory bone growth and joint space narrowing. Signup and view all the answers

How likely is a labral tear to occur alongside a hip dislocation?

It is quite likely. Signup and view all the answers

What structures should be palpated in the hip region for a proper assessment?

The surrounding muscles, tendons, and any bursal structures. Signup and view all the answers

In what position should the patient NOT be when palpating the hip area, and why?

The patient should not be supine because it may cause discomfort during palpation. Signup and view all the answers

What two preparatory actions should a clinician take before palpating the hip?

Explain the procedure and seek the patient's permission. Signup and view all the answers

Name two materials that can be used to assist in palpating sensitive areas.

A towel and a hand. Signup and view all the answers

List any four differential diagnoses for hip muscular pathology.

Tendinopathy, bursitis, snapping hip syndrome, and fracture. Signup and view all the answers

How does the positional relationship between the sciatic nerve and piriformis typically present?

The sciatic nerve should pass anterior and deep to the piriformis. Signup and view all the answers

What two hip range of motion movements are typically affected when the sciatic nerve pierces the piriformis?

Internal rotation and external rotation. Signup and view all the answers

What are the three primary mechanisms of injury (MOIs) associated with ischial bursitis?

Mechanical, chemical, and septic. Signup and view all the answers

What type of bursitis is primarily mechanical in nature?

Ischial bursitis. Signup and view all the answers

Which symptom is often associated with acute bursitis?

Pain. Signup and view all the answers

What condition often accompanies acute bursitis?

Contusions. Signup and view all the answers

What are the main MOIs related to trochanteric bursitis?

Running on flat surfaces, abnormal running mechanics, and anatomical variations like a wide pelvis. Signup and view all the answers

What movements typically aggravate trochanteric bursitis?

Flexion, extension, internal rotation, and external rotation. Signup and view all the answers

What may indicate the loss of lumbar lordosis in a patient with ankylosing spondylitis?

A compensatory increase in thoracic kyphosis and flexion at the hips and knees. Signup and view all the answers

Which activities typically worsen symptoms of central stenosis?

Walking and standing. Signup and view all the answers

What symptom is specifically associated with foraminal stenosis compared to central stenosis?

Hypo-reflexive deep tendon reflexes (DTR). Signup and view all the answers

At what age group is central stenosis particularly prevalent?

Individuals over the age of 50. Signup and view all the answers

How does exercise impact symptoms in a patient with ankylosing spondylitis?

Exercise typically relieves the symptoms. Signup and view all the answers

What type of symptoms are observed in patients with foraminal stenosis?

Radicular pain, weakness, and paresthesia. Signup and view all the answers

Which reflex type is commonly seen in patients with bilateral symptoms due to central stenosis?

Hyper-reflexive deep tendon reflexes (potentially grade 3 or 4). Signup and view all the answers

What is the effect of flexed positions on symptoms associated with central stenosis?

Symptoms typically improve when seated or in a flexed position. Signup and view all the answers

What type of symptoms are typically associated with central stenosis?

Radicular symptoms Signup and view all the answers

Bilateral symptoms are common in central stenosis due to spinal cord involvement.

True Signup and view all the answers

What is the expected role of flexed positions in managing symptoms of central stenosis?

Provide relief Signup and view all the answers

Ankylosing spondylitis primarily leads to _____ loss of lumbar lordosis and increased thoracic kyphosis.

progressive Signup and view all the answers

Match the conditions to their potential causes:

Central Stenosis = Facet arthritis or disc degeneration Foraminal Stenosis = Narrowing of the foraminal space Ankylosing Spondylitis = Fusing of the vertebral joints Both Stenoses = Pressure on nerves Signup and view all the answers

Symptoms of foraminal stenosis are identical to those of central stenosis.

False Signup and view all the answers

What is a common observable posture in individuals with central stenosis?

Forward flexed or side flexed posture Signup and view all the answers

Which demographic is at greater risk for developing ankylosing spondylitis?

Males in their 20s to 40s Signup and view all the answers

Local pain in rib joint dysfunction is typically sharp and stabbing.

True Signup and view all the answers

What might hypomobility indicate in joint play at the ribs?

A dysfunction in the absence of trauma Signup and view all the answers

Pain in rib joint dysfunction is aggravated by __________ and side bending.

rotation Signup and view all the answers

Match the type of injury with its description:

Sprain = Joint capsule/ligament injury associated with trauma Dysfunction = Movement dysfunction without trauma Rib motion = Movement related to rib mechanics Hypomobility = Restricted movement at a joint level Signup and view all the answers

What significantly increases the risk of rib joint dysfunction?

Smoking Signup and view all the answers

Muscle spasms are unlikely to occur in patients with rib joint dysfunction.

False Signup and view all the answers

What is a common outcome observed in patients with malfunctioning nerves?

Muscle atrophy Signup and view all the answers

Other than joint play, __________ movements may indicate adverse neurodynamics.

accessory Signup and view all the answers

What does not typically indicate joint dysfunction in the absence of trauma?

Normal pain-free range of motion Signup and view all the answers

Rib joint dysfunction typically presents with radiating pain.

False Signup and view all the answers

What is often observed in individuals with rib joint dysfunction?

Poor posture or muscle imbalances Signup and view all the answers

Laughing and __________ may aggravate symptoms of rib joint dysfunction.

coughing Signup and view all the answers

What is the expected pain severity in rib joint dysfunction?

Typically high Signup and view all the answers

Rib motion and expansion are considered PAIVMs.

False Signup and view all the answers

Which of the following is NOT a contraindication represented by the acronym PSycH?

Cognitive impairment Signup and view all the answers

Cervical rotation and/or extension are primary aggravators for symptoms related to vertebrobasilar insufficiency.

True Signup and view all the answers

What does the acronym SSS represent in the context of testing precautions?

Continuous and/or night pain, symptoms easily provoked with movement, symptoms that do not settle easily. Signup and view all the answers

The three golden tests for the condition discussed are , , and .

Slump, ULTTs, SLR Signup and view all the answers

Match the primary sign/symptom with its description:

Visual disturbances = Changes to sight, such as blurriness or flashing lights Gait disturbances = Alterations in walking stability or coordination Loss of consciousness = Temporary unresponsiveness or fainting UE paresthesia = Numbness or tingling in the upper extremities Signup and view all the answers

Which of the following factors is NOT considered a significant contributor to thoracic outlet syndrome?

Aging Signup and view all the answers

Dizziness is the most commonly reported symptom associated with vertebrobasilar insufficiency.

True Signup and view all the answers

Name two incidents that are most commonly associated with vertebrobasilar insufficiency.

Motor vehicle accidents (MVAs) and whiplash. Signup and view all the answers

Smaller cervical movement between C0 and C1 and C1 and C2 can lead to ____ of the vertebrobasilar system.

compression Signup and view all the answers

Match the S/S acronym VHLGUM with its corresponding symptom:

V = Visual disturbances H = Headache L = Loss of consciousness G = Gait disturbances U = UE paresthesia M = Most common - dizziness Signup and view all the answers

Which of the following is a common risk factor for thoracic outlet syndrome?

Repetitive overhead work Signup and view all the answers

Old age, particularly individuals between 50-70 years, is at higher risk for vertebrobasilar insufficiency symptoms.

True Signup and view all the answers

What condition is associated with the presence of hyperlipidemia and atherosclerosis as contributing factors?

Vertebrobasilar insufficiency. Signup and view all the answers

What is the primary treatment approach for stenosis?

Surgical intervention Signup and view all the answers

Spondylolisthesis is characterized by vertebral stability.

False Signup and view all the answers

The two structures passing through the thoracic outlet critical for upper extremity function are the and .

Axillary artery, Axillary vein. Signup and view all the answers

A DEXA scan measures __________ to assess osteoporosis.

bone density Signup and view all the answers

Match the following conditions with their definitions:

Spondylolysis = Defect in the pars interarticularis Spondylolisthesis = Slippage of one vertebra over another Anterolisthesis = Forward slippage of vertebra Retrolisthesis = Backward slippage of vertebra Signup and view all the answers

What aggravates pain for individuals with spondylolisthesis?

Extension and sustained standing Signup and view all the answers

Osteoporosis mainly affects males more than females.

False Signup and view all the answers

What is the common observed symptom related to posture in osteoporosis?

Increased kyphosis Signup and view all the answers

Signs of osteopenia might include a T score between __________.

-1 to -2.5 Signup and view all the answers

Which age group is at greater risk of developing osteoporosis?

Adults aged 50 and older Signup and view all the answers

Muscle spasm is typically unlikely in cases of facet joint dysfunction.

True Signup and view all the answers

What is the primary objective of an athletic trainer regarding patients with fragility fractures?

Referral for assessment Signup and view all the answers

The primary cause of a sprain is __________ movement of a joint.

sudden or excessive Signup and view all the answers

What term describes increased segmental mobility with pain?

PAIVM Signup and view all the answers

Facet joint dysfunction can be caused by habitual poor posture.

True Signup and view all the answers

What is the characteristic pain sensation associated with vascular issues?

Throbbing, achy Signup and view all the answers

Radiating pain is more commonly associated with vascular issues than neurological issues.

False Signup and view all the answers

Decreased blood flow can cause sensations such as _ and _.

tingling, numbness Signup and view all the answers

Which of the following symptoms is associated with neurological types of thoracic outlet syndrome?

Numbness in arm/hand Signup and view all the answers

Match the following terms with their descriptions:

Adson's test = Assessing vascular integrity Allen's test = Evaluating blood flow Military brace test = Checking for neurological compromise Roos test = Examining upper extremity endurance Signup and view all the answers

Breathing assessments for patients with scoliosis should be performed while the patient is standing.

False Signup and view all the answers

What anatomical landmarks are used to assess for true leg length discrepancy?

Femur and tibia Signup and view all the answers

The primary assessment for indicating presence of scoliosis is __________.

observation Signup and view all the answers

What assessment is notably useful for thoracic outlet syndrome compared to other neurodynamic-focused tasks?

Brachial plexus traction test Signup and view all the answers

Vascular tests are specific to thoracic outlet syndrome assessment.

True Signup and view all the answers

What does a finding of dilated veins usually indicate?

Severe type of thoracic outlet syndrome Signup and view all the answers

Symptoms of ______________, such as heaviness and loss of strength, are often observed in vascular thoracic outlet syndrome.

fatigue Signup and view all the answers

What specific area is targeted by Tinel's test in neurodynamic assessments?

Supraclavicular area Signup and view all the answers

Match the symptom with its type:

Throbbing pain = Vascular Sharp pain = Neurological Weakness = Vascular Burning sensation = Neurological Signup and view all the answers

What is the primary injury mechanism of injury (MOI) often associated with avulsion fractures in skeletally immature individuals?

Tendon pulling off at the bone Signup and view all the answers

Apophysitis is solely limited to adult athletes.

False Signup and view all the answers

What is the most common painful time for a person with a stress fracture?

Nighttime Signup and view all the answers

Osteitis pubis is commonly associated with ________ in females.

Childbearing Signup and view all the answers

Match the following types of femoral acetabular impingement (FAI) with their definitions:

Cam = Abnormally shaped femoral head Pincer = Bony abnormality in the acetabulum Mixed = Combination of Cam and Pincer Signup and view all the answers

What specific factor indicates an increased likelihood of developing a stress fracture?

Lean body mass Signup and view all the answers

What is the effect of giving a person with a 1 cm leg-length discrepancy a heel lift immediately?

It may create more problems than it solves. Signup and view all the answers

Avulsion fractures and muscle ruptures are treated differently.

False Signup and view all the answers

What are the two main characteristics that differentiate apophysitis and avulsion fractures?

Mechanism of injury and nature of the injury Signup and view all the answers

A Weber-Barstow maneuver is necessary for true leg-length discrepancy measurement.

False Signup and view all the answers

Osgood-Schlatter’s is the most well-known type of apophysitis that occurs at the ________.

Tibia Signup and view all the answers

A hip pointer is commonly associated with __________ injuries.

lateral femoral cutaneous nerve Signup and view all the answers

Which population is more likely to experience an avulsion fracture?

Skeletally immature individuals Signup and view all the answers

Palpation provides significant insight when diagnosing avulsion fractures.

False Signup and view all the answers

What sport is an iliac crest contusion most frequently seen in?

Volleyball Signup and view all the answers

What is the characteristic pain description associated with apophysitis?

Dull, aching Signup and view all the answers

A person can have both a structural and functional leg length discrepancy at the same time.

True Signup and view all the answers

FAI is noted to present as chronic issues and is often aggravated by prolonged ________.

Sitting Signup and view all the answers

What is the best action to take if a true leg-length discrepancy is suspected?

Refer for imaging Signup and view all the answers

Which condition is characterized by inflammation at the pubic symphysis?

Osteitis pubis Signup and view all the answers

To measure leg length discrepancy, the distance is typically measured from the ASIS to the __________.

medial malleolus Signup and view all the answers

Match the following conditions with their primary indicators:

Osgood-Schlatter's = Repetitive strain at tibia Stress fracture = Deep aching pain Osteitis pubis = Tenderness at symphysis Signup and view all the answers

Match the following measurement methods with their purposes:

Radiograph = Visual imaging to assess bone structure Clinical assessment = Physical evaluation to identify discrepancies Fixed points measurement = Standardized reference for leg length assessment Malleoli measurement = Determining limb length by ankle reference Signup and view all the answers

What complication might arise from rapidly correcting a leg-length discrepancy after many years of adaptation?

Increased pain and functional issues Signup and view all the answers

A difference of up to 1 cm in leg length is typically considered significant.

False Signup and view all the answers

What does a positive test result indicate in leg-length measurement?

A discrepancy above 1 to 1.5 cm Signup and view all the answers

Before checking for scoliosis, one must perform the __________ maneuver.

Weber-Barstow Signup and view all the answers

What is the most common area of the body for avulsion fractures?

Hip Signup and view all the answers

Which of the following structures is NOT affected in internal snapping hip syndrome?

Gluteus maximus Signup and view all the answers

Snapping hip syndrome is typically painful.

False Signup and view all the answers

What is the common name for the deep pain sign present with intra-articular snapping hip syndrome?

C sign Signup and view all the answers

Internal snapping hip syndrome typically affects structures represented by the acronym HIII, which stands for _____, Iliopsoas tendon, Iliofemoral ligament, and Iliopsoas bursal/capsular thickening.

Hamstring syndrome Signup and view all the answers

Match the structures with their description in relation to internal snapping hip syndrome:

Hamstring syndrome = Pain on the posterior side of the hip. Iliopsoas tendon = Snaps over the lesser trochanter. Iliofemoral ligament = May cause internal snapping. Iliopsoas bursal = Involves capsular thickening. Signup and view all the answers

What is the most likely common site of snapping hip syndrome?

Iliopsoas tendon Signup and view all the answers

Imaging is generally needed to rule out intra-articular conditions in snapping hip syndrome.

True Signup and view all the answers

What range of motion is most affected when a patient experiences snapping hip syndrome?

Extension, adduction, external rotation Signup and view all the answers

What is a secondary predictor for presenting with Femoroacetabular Impingement (FAI)?

Posterior pelvic tilt Signup and view all the answers

Femoroacetabular Impingement (FAI) can be asymptomatic.

True Signup and view all the answers

The hallmark sign of hip osteoarthritis is decreased __________.

internal rotation (IR) Signup and view all the answers

Which of these options is NOT a risk factor associated with osteoarthritis (OA)?

Dehydration Signup and view all the answers

Match the hip conditions with their associated risk factors for osteoarthritis:

Anteversion = Hip joint alteration Retroversion = Hip joint alteration Coxa vara = Bone structure variation Coxa valga = Bone structure variation Signup and view all the answers

Weight loss is beneficial for individuals with osteoarthritis.

True Signup and view all the answers

What are the three abnormal sensations commonly reported with FAI?

Crepitus, clicking, grinding Signup and view all the answers

For osteoarthritis, pain is most aggravating early in the __________.

morning Signup and view all the answers

What is a common outcome expected with accessory movements in an individual suffering from osteoarthritis?

Decreased mobility Signup and view all the answers

A labral tear in the hip can present similarly to osteoarthritis.

True Signup and view all the answers

What is the anticipated end feel when conducting a Scour test in someone with FAI?

Bone to bone Signup and view all the answers

The main location of injury in a labral tear is the __________ labrum.

anterior Signup and view all the answers

What type of imaging is critical to differentiate between intra-articular pathologies?

X-ray Signup and view all the answers

What structural pathologies are linked with a labral tear?

Anteroversion, retroversion, coxa vara, coxa valga Signup and view all the answers

A feeling of __________ can indicate instability in hip joint pathologies.

instability Signup and view all the answers

Hip sprains are common injuries.

False Signup and view all the answers

What is the typical characteristic of pain associated with a hip muscular pathology?

Dull and aching Signup and view all the answers

The chronic MOI for a muscular pathology of the hip is due to __________ positions out of alignment.

habitual Signup and view all the answers

Which of the following symptoms is NOT typically associated with a hip muscular pathology?

Radiating pain Signup and view all the answers

Match the type of hip pathology with the associated test:

Rectus femoris pathology = Kendall test Iliopsoas pathology = Faber test Adductor pathology = Adduction contracture Hamstring pathology = SLR Signup and view all the answers

Pain from a hip muscular pathology is typically exacerbated by sustained postures.

True Signup and view all the answers

What is the primary chronic risk factor associated with hip muscular pathology due to hormonal changes?

Pregnancy Signup and view all the answers

Joint play with hip muscular pathology is characterized as painful and __________.

hypomobile Signup and view all the answers

Which observation sign indicates a strain of the rectus femoris?

Lordosis in standing vs kneeling Signup and view all the answers

Point tenderness is not associated with hip muscular pathology.

False Signup and view all the answers

What does the degree difference in positioning between contralateral pelvic landmarks indicate for hip muscular pathology?

20-30 degrees Signup and view all the answers

Ice and __________ are crucial for alleviating hip muscular pathology pain.

Heat Signup and view all the answers

What should be done before palpating the hip area?

Both A and B Signup and view all the answers

The patient can be in a supine position when palpating the hip area.

False Signup and view all the answers

What is the primary anatomical structure affected by piriformis syndrome?

Sciatic nerve Signup and view all the answers

Acute bursitis typically presents with ________ and heat.

swelling Signup and view all the answers

Rebound pain is a good sign for assessing bursitis.

False Signup and view all the answers

Name one common acute mechanism of injury associated with ischial bursitis.

Falling on it Signup and view all the answers

The two hip ROM movements affected by a mispositioned sciatic nerve are rotation and rotation.

internal, external Signup and view all the answers

What is considered a red flag in bursal injuries?

Redness Signup and view all the answers

Match the type of bursitis with its characteristic description:

Mechanical = Movement is the provocative cause Septic = Infectious in nature Chemical = Not often discussed Acute = Characterized by pain and swelling Signup and view all the answers

Trochanteric bursitis can cause crepitus during hip movements.

True Signup and view all the answers

What anatomical structures are located between the ischial tuberosity and the greater trochanter?

Sciatic nerve Signup and view all the answers

Piriformis syndrome is mainly caused by a ________ piriformis.

hypertrophied Signup and view all the answers

Which of the following movements would most likely aggravate trochanteric bursitis?

Flexion Signup and view all the answers

Pain with snapping hip syndrome is generally deep.

False Signup and view all the answers

Study Notes

Ankylosing Spondylitis

Affected structures: Gluteal muscles, spinal joints.
Definition: Chronic inflammatory condition affecting the spine and sacroiliac joints, leading to stiffness and pain.
Mechanism of Injury (MOI): Not directly stated but implied as inflammatory.
Symptoms (S/S):
- Morning stiffness, worse in morning.
- Relieved by exercise, increased by rest.
- Pain in gluteal muscles.
- Loss of lumbar lordosis, Increased thoracic kyphosis.
- Compensatory flexion at hips/knees.
- Decreased range of motion (ROM) and accessory movements.
- Positive pain provocation testing of the SI joints.
Risk factors: Males, age range of 20s and 40s.

Central Stenosis

Affected structures: Spinal canal.
Definition: Narrowing of the spinal canal, compressing the spinal cord and/or nerves.
MOI: Narrowing, possibly from facet arthritis, disc degeneration etc.
S/S:
- Pain, radicular.
- Paresthesia.
- Cramping/ weakness.
- DTR: hyperreflexive (grades 3 or 4).
- Pain worse with walking/ standing, better with sitting/ flexion.
- Can be bilateral.
Risk factors: Age 50+.
Possible causes: Facet arthritis, disc degeneration, ligament remodeling/degeneration, tumors, spondylolisthesis.

Foraminal Stenosis

Affected structures: Intervertebral foramen.
Definition: Narrowing of the intervertebral foramen, causing compression of spinal nerve roots.
MOI: Narrowing from bony overgrowth, similar to central stenosis.
S/S: Similar to central stenosis but unilateral (possible bilateral foraminal). Symptoms may be confused for central stenosis. Important to consider which nerve root is affected to differentiate from central stenosis.
Risk factors: High risk depending on location / pathology, similar to central stenosis.
Differentiation from other causes: Confirmation requires imaging; possible interventions for disc pathology can be treated but not bony stenosis.

Spondylolysis/ Spondylolisthesis

Affected Structures: Vertebrae (pars interarticularis), spinal segment
Definition:
- Spondylolysis: fracture or defect in the pars interarticularis of a vertebra, often unilateral.
- Spondylolisthesis: forward or backward slippage of a vertebra.
MOI: Often repetitive extension/ quadrant positions, habitual postures, degenerative/cumulative trauma.
S/S:
- Pain, mainly lumbar.
- Aggravated by extension, sustained standing.
- Possible radicular symptoms (unilateral or bilateral depending on instability and/or nerve root compression)
Risk Factors: Adolescents (10-25y/o) and athletes with repetitive extension/ rotation. Females are more likely to transition from spondylolysis to spondylolisthesis, associated with female athlete triad.
Observations:
- Increased lordosis.
- Step deformity.
- Muscle spasm, aberrant movement (with flexion to extension).
Palpation/ Movements: muscle spasm, hamstring tightness, painful/restricted AROM, instability jog and Gower’s sign, painful/increased segmental mobility (PPIVMs, PAIVMs, RIM).

Osteoporosis

Affected structures: Bone tissue.
Definition: Loss of bone density, increasing risk of fragility fractures.
MOI: Degeneration, possibly related to sedentary lifestyle, excessive force, or age.
Risk factors: Female, Caucasian, Asian, age (50+), sedentary lifestyle, smoking, MVAs, alcohol consumption, corticosteroid use, and decreased body weight.
S/S:
- Posture changes (forward head, kyphosis, scoliosis, Dowager's hump, protruding abdomen).
Diagnostics: DEXA scans (measuring T-scores).
Treatment focus: Referral for fragility fracture assessment/ intervention.

Sprain

Affected structures: Musculature and ligaments.
Definition: Acute injury to ligaments, joint capsule causing pain, stiffness, decreased ROM, and pain upon movement.
MOIs: Sudden, unexpected, or excessive movement; compressive forces.
Risk factors: Occupations/sports requiring repetitive spinal extension or rotation.
S/S: Localized pain, sharp/stabbing pain, pain with movement.
Assessments: Quadrant examination (important).

Disc Pathology

Affected structures: Intervertebral discs.
Definition: Degeneration of the intervertebral discs, common cause of pain and other symptoms.
MOI: Repetitive movement, cumulative trauma, micro trauma, postural imbalances, often aggravated with activities opening up the intervertebral space.
S/S: Viable pain characteristics, often worse in the morning/ evening, pain relieved by supine positioning. Localized or radiating; aggravated with flexion, coughing/sneezing, movements that open/close the joint space.

Spinal Muscular Pathology

Affected structures: Muscles of the spine.
Definition: Condition affecting one or more muscles in the torso area.
MOI: Acute: sudden/unexpected movement, compressive forces. Chronic: habitual postures, lifting, running impacting the injured muscle.
S/S: Dull, aching, stiff, tight pain worsened by movements, especially repetitive movements, sustained postures.

Adverse Neurodynamics

Affected structures: Nerves.
Definition: Injury or irritated nerves potentially from various impairments.
MOI: (SSSIIICTEDP): Scarring, surgery, space-occupying lesions, immobilization, inflammation, injections, compression/ischemia, traction/vibrations, electrical injury, disc pathology , poor posture.
S/S: Mobility often painful and reduced, overt abnormalities may or may not be apparent.
Assessments: Scanning the patient, motion assessment (ex. Slump, UTTs, SLR, Tinel’s, brachial plexus traction testing, 1st T nerve root stretch, Prone knee bend, Bowstring)

Vertebrobasilar Insufficiency

Affected Structures: Vertebral artery, brain stem, nerve, or other vasculature.
Definition: Reduced blood flow to the brain stem/cerebrum due to narrowed or compromised vertebral arteries.
MOI: MVAs, whiplash, repetitive cervical rotation/extension.
Risk Factors: Older age (>50), males, occupations/sports requiring repetitive cervical rotation or extension; smoking, history of CV diseases, (ex. Rheumatoid arthritis).
S/S: Visual disturbances, headache, loss of consciousness, gait disturbances, UE paresthesia, dizziness, slurred speech, nystagmus, diplopia, drop attacks, dysphasia, tinnitus (asymmetric or widespread), facial paresthesia. Worsened by Cervical rotation/extension.

Thoracic Outlet Syndrome

Affected Structures: Nerves and blood vessels passing through the thoracic outlet.
Definition: Compression of the brachial plexus and/or subclavian vessels.
MOI: Acute (clavicle fracture, muscle strain/whiplash); chronic (poor posture, tight muscles, congenital issues).
Risk factors: Female, repetitive overhead positions, sitting in specific positions over a long period (ex desk jobs), MVAs, smoking.
S/S: Pain (anywhere in the upper extremity). Possible unilateral or bilateral. May radiate throughout the nerve distribution (and/or distal, ex. hand), but also can occur from inflammation or compression from the muscles (ex. burning, sharp, electrical). Vascular (more distal and involves skin temperature, pulsation, and/or swelling).

Scoliosis

Affected structures: Spinal column.
Definition: Lateral curvature of the spine.
MOI: Repetitive movements, uneven loads, postural imbalances, muscle imbalances.
Risk factors: Younger patients, often females. Related to asymmetric changes in height and rapid weight changes. May be related to anthropometrics.
S/S: Visual; Asymmetrical spinal processes, shoulder levels, ribs, pelvis. Breathing assessment (symmetry of the thorax).

Leg Length Discrepancies

Affected structures: Femur, tibia, fibula.
Definition: Significant difference in the lengths of the lower limbs, although 1-1.5cm is considered normal.
MOI: Trauma, congenital maldevelopment.
S/S: May not present with obvious pain, but can be functionally present through compensatory posture.
Assessment: Comparing lengths from an anatomical landmark (ASIS to medial or lateral malleolus while supine).

Functional Leg Length Discrepancy

Affected Structures: Pelvic positioning, soft tissue, musculature.
Definition: Adaptive or compensatory posture resulting in shortening of one side of the lower quadrant.
MOI: Iliosacral pathology, compensation over time.
S/S: Different measurement compared to True Leg Length Discrepancy, likely presenting with compensatory posture .
Assessment: Measurement of umbilicus to medial malleolus on one side compared to the other

Pelvis/ SI Pathology

Affected structures: SI (sacroiliac) joint and pelvic musculature.
Definition: Condition affecting the Si joint or musculature, presenting with pain in the pelvis.
MOI: Falls, repetitive motions/stress.
S/S: Pain can be in the gluteal region or pelvis.
Assessments: Identify any abnormal or provocative movements.

Avulsion Fracture

Affected Structures: Bone attachments.
Definition: Tendon/ligament pulls away from the bone at the attachment point.
MOI: Sudden start, change in direction, forceful rotation, often within the younger population.
S/S: Pain, swelling, deformity, limited weight bearing, tenderness to the sight of fracture, possible antalgic gait (avoiding pain by limping or otherwise).

Apophysitis

Affected Structures: Secondary ossification centers of bones.
Definition: Condition involving inflammation (ex. bone spurs) or a stressed/stretched secondary ossification center.
MOI: Repetitive stress to the bone at the attachments, common within skeletally immature individuals.
S/S: Dull, aching pain, possible swelling, limited ROM, tenderness.

Osteitis Pubis

Affected structures: Pubic symphysis and surrounding muscle attachments.
Definition: Inflammatory condition at the pubic symphysis, due usually to repetitive loading on the region.
MOI: Repetitive and/or sudden stressing of the joint and surrounding muscles, not restricted to movement of pubic symphisial region.
Risk factors: Skeletally mature males, involving common sports like ice or kicking sports.
S/S: Pain at pubic symphysis or adductor muscle zone, painful ROM; localized pain with isometric hip adduction and trunk flexion, changes in COD, leg stance, or antalgic gait.

Stress Fractures (femoral neck)

Affected structures: Femur.
Definition: Partial or incomplete break in the bone due to repetitive loading.
MOI: Increased training load, activity, often insidious onset.
S/S: Deep aching pain, increased with activity (or even after the activity has ceased), pain present at night, limited ROM (especially at extremes of flexion/extension).
Distinguishing factors: Duration of symptoms, training level, and whether there are simultaneous symptoms with a reported tendinopathy that is not resolving.

Femoral Acetabular Impingement (FAI)

Affected Structures: Femoral head, acetabulum.
Definition: Bony irregularities of the femoral head and/or acetabulum.
MOI: Insidious onset often secondary to excessive or improper movement of the joint (ex. repeated over-extension).
Types: Cam (femoral head shape), Pincer (acetabulum shape), and mixed.
Risk factors: May be congenital or developed (via habitual postures, or pelvic positioning/posture); often in individuals with longstanding groin pain and may or may not be asymptomatic.
S/S: Pinching feeling in the hip joint (may or may not be overt), worsened/ provoked with specific movements, pain or discomfort is possible in specific positions.
Assessment: Specialized movements (ex. FADDIR) may provoke pain, crepitus, or limited ROM. Imaging needed to confirm diagnosis.

Hip Osteoarthritis

Affected structures: Acetabulum and femoral head.
Definition: Degenerative/inflammatory changes to the hip joint.
MOI: Commonly chronic, secondary to trauma, or irregular biomechanical stress over time.
Risk Factors: Increased with age, females, weight, activity levels (sedentary or over-active), family history. Several hip conditions are risk factors.
S/S: Achy or sharp pain, stiffness, weakness, decreased ROM (Internal Rotation is very common). Crepitus, clicking, and grinding possible; more overt presentation than FAI; worse during the morning and toward the end of the day.
Assessment: Note for any of the "intra-articular" movement tests (Ex. FABER, FADDIR etc.)

Labral Tear

Affected structures: Hip labrum.
Definition: Injury to the cartilage ring surrounding the hip socket.
MOI: Often an acute injury, but may start insidiously from various postural issues.
Risk factors: Structural/biomechanical issue, degeneration, postural dysfunction.
S/S: Intra-articular clicking, catching, popping, instability. Pain worse typically in movements changing from flexion to extension, and pain may be present (variable) in general motion.
Assessment: Labral tests (ex. scower, sign of the buttock)

Hip Sprains

Affected structures: Ligaments around the hip joint.
Definition: Injury to ligaments related to over-extension of the joint.
MOI: Trunk rotation with a fixed limb, often related to specific sports activities (running, cutting).
S/S: Deep pain, worsening with running or cutting, decreased ROM, and pain in specific hip movements.

Hip Muscular Pathology

Affected structures: Hip muscles.
Definition: Injury involving hip or pelvic musculature, causing pain/altered movement in the joint.
MOI: Acute: sudden/unexpected movement/ forces. Chronic: habitual posture/activity overuse.
Risk factors: Lifting, running, jumping, sudden change of direction, potentially related to smoking and potentially pregnancy/menstrual cycle.
S/S: Dull, aching, stiff, tight. Worsened by specific positions and/or movements.

Piriformis Syndrome

Affected structure: Piriformis muscle, sciatic nerve.
Definition: Condition in which the piriformis muscle irritates the sciatic nerve, often due to structural variation.
MOI: Often insidious (chronic), but can also occur from trauma.
Risk Factors: Various types of positions/activities, but is associated typically with positional change and/or trauma.
S/S: Pain and potential numbness or altered sensation along the sciatic nerve's path; pain worsened may be typically associated with movements potentially aggravating piriformis muscle (Ex. SLR, Slump, piriformis MMT)
Assessment: Specific tests for piriformis, sciatic nerve location, and other relevant movements.

Bursitis (Hip)

Affected structures: Bursal sac.
Definition: Inflammation of the fluid-filled sac surrounding the hip structures.
MOI: Mechanical (movement over time), Chemical (not within context), Septic (infection).
S/S: Pain at the site, possible swelling and heat.
Assessments: Note for symmetry, swelling, warmth, pain with movement.

Trochanteric Bursitis

Affected structures: Trochanteric bursa.
Definition: Inflammation of the bursa located near the greater trochanter.
MOI: Running mechanics/improper running surfaces (e.g., down hill, no banking), biomechanics, postural irregularities.
S/S: Pain in the greater trochanter, pain during hip flexion/extension, Internal/External rotation. possible crepitus.
Assessment: Repetitive motion or posture specific tests to provoke pain. Ober’s Test, and other repetitive/provocative tests to narrow down cause.

Ischial Bursitis

Affected structures: Ischial bursa.
Definition: Inflammation of the ischial bursa.
MOI: Falling directly on it; repetitive sitting and joint motions irritating the bursa. Proximal hamstring irritation.
S/S: Pain in the posterior aspect of the buttock. Localized, antalgic (painful) gait, pain in ROM flexion and extension.
Assessment: Localized pain and provoked motion in the region.

Snapping Hip Syndrome (Internal & External)

Definition: Syndrome where the tendons & tissue, such as IT band in external, and iliopsoas or other structures in internal, pass over other structures in the hip causing a "snapping" sound.
**Internal:**iliopsoas tendon/iliofemoral ligament on femoral head.
**External:**IT band over greater trochanter (likely).
MOI: Usually related to repetitive motion, and/or posture/ activity.
Risk Factors: Postural misalignment and/or related. Internal more closely associated with hip abduction/ adduction/ external rotation.
S/S: snapping pain or sound in the specific region (pain or no pain depending on the nature of the snapping hip), but may present in different hip movement patterns.
Assessment: Careful examination and provocation within those specific movements.

Intra-articular Hip Syndrome

Affected Structures: Structures within the hip joint/musculature, and the associated bony/ligamentous attachments that would otherwise affect the joint.
Definition: Condition affecting the structures within the hip joint.
MOI: Various intra-articular pathologies/ lesions
Risk Factors: Various types of intra-articular pathologies. Structural, postural, and movement irregularities.
S/S: Pain in groin, anterior hip, thigh. Common with pivoting and/or affected stance/ weight bearing.
Assessment: Intra-articular tests (Ex. FABER, FADDIR, Scouring etc)

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Test your knowledge on ankylosing spondylitis and central stenosis. This quiz covers symptoms, pain relief strategies, and key differences between spinal conditions. Perfect for healthcare students and professionals looking to enhance their understanding of these disorders.

Summary LIst of Hip Conditions

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Questions and Answers

What area of the body does ankylosing spondylitis primarily cause stiffness and pain?

When is the pain typically worst for patients with ankylosing spondylitis?

What activity is known to relieve symptoms of ankylosing spondylitis?

What are the two spinal regions where central stenosis is commonly observed?

What type of reflexes are typically observed in patients with central stenosis?

What is the main symptom differentiating foraminal stenosis from central stenosis?

Which patient age group is at greater risk for developing central stenosis?

What position generally provides relief for symptoms associated with central stenosis?

Differentiate between vascular and neurological pain symptoms in thoracic outlet syndrome (TOS).

What role does rest play in alleviating symptoms associated with thoracic outlet syndrome?

Identify two observable signs that suggest vascular complications in TOS.

Explain the significance of Erb's point in neurodynamic testing for thoracic outlet syndrome.

What is the primary assessment method for confirming scoliosis presence?

What is the best test among vascular tests for diagnosing thoracic outlet syndrome?

How does muscle spasm affect breathing assessments in patients with scoliosis?

Describe the relevance of true leg length discrepancy in the context of scoliosis assessment.

List two symptoms that suggest compression of nerves in thoracic outlet syndrome.

What impact does shoulder positioning have on thoracic outlet syndrome symptoms?

What connection is established between forward head posture and thoracic outlet syndrome?

How might decreased range of motion relate to causal factors in thoracic outlet syndrome?

Identify the two primary interventions recommended for structural scoliosis.

What are the five contraindications represented by the acronym PSycH in testing?

List the three precautions indicated by the acronym SSS that should be taken before testing.

Why is technique particularly important in testing for patients with neurological issues?

During passive tests, what should symptoms not exceed in intensity?

What should a patient do before performing an active movement test?

Name the three golden tests associated with the condition discussed.

What two types of incidents are most typically associated with vertebrobasilar insufficiency?

What demographic is at greater risk for experiencing symptoms related to vertebrobasilar insufficiency?

List the five primary signs and symptoms reported most commonly using the acronym VHLGUM.

What anatomical structures surround the thoracic outlet?

What two structures passing through the thoracic outlet are critical for upper extremity function?

What is the more common form of thoracic outlet syndrome, acute or chronic?

What factors can make individuals more susceptible to developing thoracic outlet syndrome?

What condition, present statistically in 0.2-1% of the population, could lead to thoracic outlet syndrome symptoms?

What does a hypomobility finding in joint play at the ribs indicate?

What might hypermobility with joint play at the ribs signify?

What movements should be approached with caution in rib joint dysfunction?

What does the term PAIVM refer to, and is rib motion typically classified as one?

List two aggravating activities commonly associated with rib joint dysfunction.

What is a key consideration when performing PPIVMs and accessory movements?

What may be indicative of negativity in muscle dynamics associated with adverse neurodynamics?

What could the presence of muscle spasm indicate in patients with rib joint dysfunction?

How does habitual poor posture relate to rib joint dysfunction?

What does often painful and reduced mobility in rib joint assessments suggest?

What is the expected pain quality described in rib joint dysfunction?

What is the impact of inhaling and exhaling in patients with rib joint issues?

What special test considerations are crucial for assessing adverse neurodynamics?

In what instance may a normal neurodynamic test be insufficient for an athlete?

How may smoking and specific occupations relate to rib joint dysfunction?

What differentiates spondylolisthesis from spondylolysis?

What is the significance of knowing whether a patient has stenosis or disc pathology?

Which spinal region is predominantly affected by spondylolisthesis?

What are the typical symptoms associated with spondylolisthesis?

What is a DEXA scan used for in relation to osteoporosis?

Name one observation that might be present in a patient with osteoporosis.

What is the primary risk factor for osteoporosis in terms of gender and age?

What movement is typically most aggravating for patients experiencing facet joint dysfunction?

How does spondylolysis predispose a patient to spondylolisthesis?

What specific condition is suggested by the term 'retrolisthesis'?

What does the term 'Gower's sign' indicate in a clinical assessment?

What are two potential consequences of osteoporosis in daily life?

In which activity would tightness in the hamstrings commonly be palpated?

What role does corticosteroid use play in the risk of osteoporosis?

What measurement difference typically indicates the necessity for intervention in leg-length discrepancies?

Why is it recommended to proceed with caution when addressing a 1 cm leg-length discrepancy?

What two points are commonly used for measuring leg-length discrepancies?

What maneuver is performed before checking for functional leg-length discrepancies and why?

What can be concluded if true leg-length is normal yet measurements show a discrepancy?

Which two primary muscular structures are affected by an iliac crest contusion?

What condition is associated with an iliac crest contusion?

What is a potential consequence of an avulsion fracture at the hip?

In which sports are iliac crest contusions most frequently observed?

What role does the bulk of the quadriceps play in measuring leg-length discrepancies?

What differentiates a structural leg-length discrepancy from a functional one?

How can significant pain in a diving-related injury be described?