Hip & Knee Function and Clinical Implications
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Questions and Answers

Which muscle contributes to hip flexion?

  • Biceps femoris
  • Gluteus maximus
  • Pectineus (correct)
  • Gracilis

What is the main function of the gluteus medius?

  • Hip adduction
  • Hip internal rotation (correct)
  • Hip external rotation
  • Hip flexion

Which nerve is primarily responsible for innervating the hip joint?

  • Obturator nerve (correct)
  • Ulnar nerve
  • Sciatic nerve
  • Radial nerve

Which condition is characterized by unstable or dislocatable hips in infants?

<p>Developmental Dysplasia of Hip (DDH) (B)</p> Signup and view all the answers

Which of the following muscles is classified as a hip extensor?

<p>Semitendinosus (D)</p> Signup and view all the answers

What are common joints affected by the condition mentioned?

<p>Hips and knees (C)</p> Signup and view all the answers

In which settings does occupational therapy typically operate?

<p>Community, hospital, clinic, and homes (A)</p> Signup and view all the answers

Which teams collaborate with occupational therapy?

<p>Interdisciplinary and transdisciplinary teams (C)</p> Signup and view all the answers

What aspect of the ICF is primarily examined in relation to participation?

<p>Environmental factors (B)</p> Signup and view all the answers

What is a common question asked when assessing function at the hip and knee joints?

<p>What activities of daily living do you use them for? (A)</p> Signup and view all the answers

What is a primary goal of occupational therapy (OT)?

<p>Promote participation and meaningful engagement (D)</p> Signup and view all the answers

Which factor is essential to consider in OT interventions?

<p>Environmental and contextual factors (D)</p> Signup and view all the answers

What type of surgery is the 42-year-old man waiting for?

<p>Total hip replacement surgery (A)</p> Signup and view all the answers

What consideration is essential for the 68-year-old woman living alone?

<p>Her desire to return to work after 6 weeks (B)</p> Signup and view all the answers

What is indicated about the man with a BMI of 49 kg/m2?

<p>He requires immediate surgical intervention for bilateral knee surgery (A)</p> Signup and view all the answers

Which of the following is a conservative option for self-management?

<p>Weight bearing exercises (A)</p> Signup and view all the answers

What is a common indication for surgical intervention?

<p>Osteoarthritis (A)</p> Signup and view all the answers

What is a potential short-term complication of arthroplasty?

<p>Hip dislocation (D)</p> Signup and view all the answers

What should be assessed during post-operative rehabilitation?

<p>Pain management strategies (D)</p> Signup and view all the answers

Which of the following is NOT a criterion for post-operative homecare?

<p>Previously diagnosed diabetes (A)</p> Signup and view all the answers

What is typically required for discharge home after surgery?

<p>Complete mobility and transfers independently (C)</p> Signup and view all the answers

What type of device is used to promote participation in mobility?

<p>Mobility aids (D)</p> Signup and view all the answers

What does 'weight bearing precautions' refer to post-surgery?

<p>Limiting pressure on the operated area (C)</p> Signup and view all the answers

Which factor can influence the choice of walking aid post-surgery?

<p>Pain level and weight bearing status (C)</p> Signup and view all the answers

Which of the following indicates the need for further inpatient rehabilitation?

<p>Limited social supports or planning (C)</p> Signup and view all the answers

What is a common symptom of osteoarthritis of the hip?

<p>Increased pain with standing or walking (A)</p> Signup and view all the answers

Which of the following is a typical treatment option for a hip fracture?

<p>Weight bearing and movement precautions (C)</p> Signup and view all the answers

Which condition is characterized by hip, groin, or buttock pain that may also refer pain to the knee?

<p>Osteoarthritis of Hip (C)</p> Signup and view all the answers

What movement is NOT allowed under universal hip precautions?

<p>Twisting (A)</p> Signup and view all the answers

Avascular necrosis primarily results from what physiological disruption?

<p>Interruption of blood supply (D)</p> Signup and view all the answers

During which activity might a patient experience snapping associated with iliotibial band syndrome?

<p>Running (B)</p> Signup and view all the answers

What type of hip fracture is most commonly associated with falls?

<p>Femoral neck fracture (D)</p> Signup and view all the answers

What is a potential complication following surgery for a hip fracture?

<p>Need for hip precautions (B)</p> Signup and view all the answers

What is the main role of the anterior cruciate ligament (ACL) in the knee?

<p>Provides stability by restraining anterior translation (B)</p> Signup and view all the answers

Which of the following knee flexors is NOT part of the hamstring group?

<p>Popliteus (C)</p> Signup and view all the answers

What condition would most likely be indicated by an inability to bear weight and visible swelling?

<p>Distal femur fracture (C)</p> Signup and view all the answers

Which of the following classes of ligaments helps resist external rotation of the tibia?

<p>Medial collateral ligament (MCL) (D)</p> Signup and view all the answers

Which structure primarily offers stability to the knee during flexion?

<p>Medial collateral ligament (MCL) (B)</p> Signup and view all the answers

What type of joint is the tibiofemoral joint classified as?

<p>Hinge joint (A)</p> Signup and view all the answers

Which of the following conditions involves excessive inward tilting of the knee?

<p>Genu valgum (B)</p> Signup and view all the answers

What is the primary function of bursae in the knee joint?

<p>Reduce friction and pressure (D)</p> Signup and view all the answers

What is a common symptom associated with an ACL injury?

<p>Knee gives out (B)</p> Signup and view all the answers

What best describes a bucket handle tear in the meniscus?

<p>A tearing of meniscus that results in a locking mechanism (A)</p> Signup and view all the answers

Which of the following actions should be avoided post-hip arthroplasty?

<p>Resisted internal rotation (A)</p> Signup and view all the answers

Which ligament helps resist excessive knee flexion?

<p>Lateral collateral ligament (LCL) (D)</p> Signup and view all the answers

What symptom might indicate meniscal injury?

<p>Pain at the joint line (A)</p> Signup and view all the answers

Which structure connects the patella to surrounding knee structures?

<p>Retinaculum (C)</p> Signup and view all the answers

Flashcards

Developmental Dysplasia of the Hip (DDH)

A condition where the femur (thigh bone) is not properly seated in the acetabulum (hip socket). This can make the hip unstable or dislocatable.

Hip Adductors

These muscles are responsible for moving your leg inward towards your body's midline - think of bringing your knees together.

Hip External Rotators

These muscles rotate your hip outward, away from your body's midline.

Hip Abductors

A group of muscles that help you lift your leg away from your body - think of kicking your leg to the side.

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Hip Flexors

These muscles are involved in bending your hip, bringing your knee towards your chest.

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Bilateral Joint Involvement

A medical condition that often affects the same joint on both sides of the body, such as the hips and knees.

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ICF Framework

The International Classification of Functioning, Disability and Health (ICF) is a framework used to understand and measure health and disability. It describes an individual's health and functioning within a social context.

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Activities of Daily Living

Activities of Daily Living (ADLs) are everyday tasks that people perform, such as eating, dressing, and bathing. ADLs are often assessed to understand a person's functional abilities.

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Occupational Therapy Role

Occupational therapists work with individuals to improve their ability to participate in activities they need or want to do. They help people adapt to limitations and maximize their independence.

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Functional Assessment

Assessing a patient's functional capabilities involves understanding their physical abilities, limitations, and how these factors impact their activities of daily living.

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Occupational Therapy (OT) Intervention

A client-centered approach that focuses on promoting participation and meaningful engagement in everyday activities.

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Occupational Therapy Assessment

The process of gathering information about a client's needs, goals, and environment to develop a personalized intervention plan.

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OT Interventions

Strategies used by OTs to help clients improve their physical function, cognitive skills, and participation in daily activities.

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Functional Independence

The ability to perform daily tasks and activities independently.

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Environmental Modifications

Modifications and adaptations made to the environment to support a client's participation and independence.

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Bursitis

Inflammation of the small fluid-filled sacs (bursae) that cushion joints and reduce friction.

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Iliotibial band syndrome (ITB)

A condition where the thick band of tissue on the outside of the thigh (iliotibial band) rubs against the bone, causing pain, usually at the hip or knee.

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Avascular Necrosis

Occurs when the blood supply to a bone is interrupted, leading to bone death. This weakens the bone and makes it prone to fractures.

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Hip Fracture

A fracture of the upper part of the thigh bone (femur), often occurring due to a fall.

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Acetabular fracture

A fracture of the socket joint of the hip (acetabulum).

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Osteoarthritis of the Hip

A condition where the cartilage in the hip joint wears down over time, causing pain, stiffness, and limited movement.

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Universal Hip Precautions

These are precautions taken after hip surgery to prevent dislocation or injury to the hip joint.

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Hip Precautions: No crossing midline, no bending past 90°, no twisting

These precautions are aimed at protecting the hip from movement that could cause dislocation or injury. They are crucial during the healing process after surgery.

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Conservative Management

Conservative treatment approaches for musculoskeletal conditions that do not involve surgery. This includes exercise, lifestyle changes, and non-invasive therapies like bracing or medication.

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Self-Management Options

These are the methods of treatment that help to restore function and alleviate issues by addressing the underlying cause of the condition. Includes weight-bearing exercises, physical therapy, and ergonomic adaptations.

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Surgical Intervention

Surgical intervention is often considered when conservative options fail or when the condition poses significant functional limitations. Common surgical procedures include arthroplasty and fracture repair.

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Arthroplasty

A surgical procedure involving the replacement or repair of the articular surface of a joint to relieve pain and restore function.

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Fracture Repair

This involves fixing a fractured bone using surgical techniques. The procedure might include plates, screws, or other fixations to promote healing.

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Post-Operative Complications - Arthroplasty

Possible complications that can arise after an arthroplasty procedure, both in the short term and long term. These can include infection, dislocation, loosening of components, and nerve injury.

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Acute Care Rehabilitation

The process of rehabilitating a patient after surgery to help them regain strength, mobility, and function. This involves exercises, pain management, and education on managing their condition.

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Dressing Aids

Devices designed to help individuals with dressing, such as button hooks, zipper pulls, and sock aids. They are used for people who have difficulty with their fine motor skills or dexterity due to illness, injury, or disability.

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Mobility Aids

Tools that help individuals with mobility, such as walkers, canes, and crutches. The choice of walking aid depends on their weight-bearing status, strength, and pain levels.

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Discharge Home

This involves assessing the patient's condition, their home environment, and their support system to ensure they can safely return home after surgery. It involves ensuring they have the necessary equipment, assistance, and education to manage their recovery.

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What bones make up the tibiofemoral joint?

The femur, tibia, and fibula join to form the tibiofemoral joint, which is the hinge joint of the knee.

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Describe the patellofemoral joint.

The patellofemoral joint is the joint between the patella (kneecap) and the femur (thigh bone).

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What is the main function of the ACL?

The anterior cruciate ligament (ACL) is a crucial ligament in the knee, responsible for maintaining knee stability. It prevents the tibia from moving forward and rotating.

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Describe the role of the PCL in the knee.

The PCL (posterior cruciate ligament) is a strong ligament in the knee that restricts the tibia from moving backward and internally rotating.

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What is the function of the MCL?

The MCL (medial collateral ligament) is a vital knee stabilizer, especially during knee flexion. It resists valgus forces and external rotation of the tibia.

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What is the purpose of the LCL in the knee?

The LCL (lateral collateral ligament) helps stabilize the knee by resisting excessive knee flexion and external rotation. It also helps prevent varus forces (the knee bending inwards).

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What are the menisci and their role in the knee?

The menisci are C-shaped pieces of cartilage that act as shock absorbers and distribute weight evenly across the knee joint.

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What is the primary function of the quadriceps muscles?

The quadriceps muscles are responsible for extending the knee. They consist of the rectus femoris, vastus medialis, vastus intermedius, and vastus lateralis.

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What is the primary role of the hamstring muscles?

The hamstrings are a group of muscles that flex the knee. They include the semimembranosus, semitendinosus, and biceps femoris.

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What are bursae and what is their function in the knee?

Bursae are fluid-filled sacs that reduce friction and pressure in the knee joint. They help prevent inflammation and maintain smooth movement.

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What is genu varum and how does it present?

Genu varum (bow legged) refers to a condition where the legs are bowed outwards, causing a gap between the ankles.

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What is genu valgum and how does it present?

Genu valgum (knock knees) refers to a condition where the legs are bowed inwards, causing the knees to touch when the feet are apart.

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What is genu recurvatum and describe its appearance.

Genu recurvatum (hyperextension) is a condition where the knee bends backward, making the legs look as if they are constantly extending.

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What is O'Donoghue's triad?

An ACL injury often results in three associated injuries known as O'Donoghue's triad: ACL tear, medial meniscus tear, and MCL tear.

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Describe osteoarthritis of the knee.

Osteoarthritis of the knee is a degenerative condition characterized by progressive joint damage, causing pain, stiffness, and limited mobility.

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Study Notes

Hip & Knee Function, Conditions, and Clinical Implications

  • The presentation covered the function, conditions, and clinical implications of hip and knee joints.
  • The University of Alberta acknowledges Treaty 6 territory.
  • Students will be able to apply biomechanical principles, understand common conditions, and describe how occupational performance is affected by hip & knee issues.
  • Key functions of the hip include supporting the upper body, transferring forces between pelvis and lower limbs, and allowing for a large range of motion (ROM).

Hip Bones

  • The hip is composed of three bones: the ilium (largest), pubis (smallest), and ischium.

Hip Ligaments

  • Two intra-articular ligaments: the ligamentum teres and transverse acetabular ligament.
  • Three extra-articular ligaments: iliofemoral, pubofemoral, and ischiofemoral ligaments attach the femur to the hip joint.
  • Each ligament has a specific function, limiting movement and providing stability

Hip Muscles

  • Flexors: Psoas major/minor, iliacus, pectineus, adductor longus, brevis, magnus, tensor fasciae latae
  • Extensors: Gluteus maximus, inferior adductor magnus, hamstrings (biceps femoris, semimembranosus, semitendinosus)
  • Abductors: Gluteus medius, gluteus minimus, piriformis
  • Adductors: Adductor brevis, adductor longus, adductor magnus, gracilis, pectineus
  • External Rotators: Lateral rotator group (obturator externus, piriformis, superior gemellus, inferior gemellus, quadratus femoris)
  • Internal Rotators: Hip adductor group, gluteus medius (anterior), gluteus minimus, tensor fasciae latae

Hip Conditions

  • Developmental Dysplasia of the Hip (DDH): Femur misalignment in the acetabulum.
  • Bursitis: Inflammation of bursae (trochanteric, iliopsoas).
  • Iliotibial band syndrome (ITBS): Pain from the IT band rubbing over the greater trochanter.
  • Avascular Necrosis: Death of bone tissue due to lack of blood supply.
  • Hip Fracture: Common result from falls.
  • Acetabular fracture: Usually requires surgical repair and weight bearing restrictions.
  • Osteoarthritis: Progressive changes to the hip joint.
  • Rheumatoid Arthritis: chronic, systemic inflammatory condition, affecting joint tissues and potentially other organs

Knee Joint Structures and Functions

  • Tibiofemoral joint: The articulation of the femur, tibia, and fibula.
  • Patellofemoral joint: Involving the patella and femur.
  • Proximal tibiofibular joint: Connecting the tibia to the fibula.
  • "Hinge" joint: Permits movement in one plane.
  • MCL, LCL, ACL, PCL: Types of knee Ligaments

Knee Muscles

  • Flexors: Hamstrings, semitendinosus, semimembranosus, biceps femoris, popliteus, gastrocnemius
  • Extensors: Quadriceps: rectus femoris, vastus medialis, vastus intermedius, vastus lateralis.

Knee Conditions

  • Ligament Injuries: ACL injury, O’Donoghe's triad, medial meniscus, MCL injury
  • Meniscal tears: Caused by twisting strains, leading to longitudinal tears. Symptoms of pain, locking of the knee, and springy block of full extension along with pain.
  • Patella dislocation: Caused by shallow femoral sulcus, quadriceps insertion abnormalities, and muscle imbalance.
  • Trauma/Fractures: Distal femur and proximal tibia fractures
  • Osteoarthritis: progressive joint issues causing flaking and exposure of free nerve endings in the joint with bone changes
  • Congenital Conditions: Genu varum (bow legs), genu valgum – knock knees

Supporting Information

  • Various surgical and rehabilitation procedures are available for each condition.
  • Appropriate assistive devices for mobility, dressing, and other support based on patient situation and needs
  • Home care support can help with home exercises, self-care, home environment, and cognitive support.
  • Rehabilitation and physical therapy are necessary for healing and recovery after certain conditions or surgeries.
  • Medical complications like deep vein thrombosis, pulmonary embolism, infection are possible after hip and knee surgery as well as loosening of the joint over time

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Description

This quiz explores the biomechanics of hip and knee joints, focusing on their functions, common conditions, and clinical implications. Understand how these joints impact occupational performance and review key anatomical features, including bones, ligaments, and muscles involved. Suitable for students studying rehabilitation or physical therapy.

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