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43 Cards in this Set
- Front
- Back
Where are the two most common areas which hip fractures occur? |
Extracapsular or trochanteric, Femoral neck (intracapsular), and proximal femoral shaft
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What is the most common complication of hip fractures?
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Avascular necrosis of the femoral head
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True or False: Arterial thrombosis is the most common complication after hip fracture in the elderly.
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False, venous thrombosis
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What are the three clinical complications associated with subtrochanteric fractures? |
Mal-union, delayed union and nonunion
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What is the most important criteria used to progress a patient with a hip fracture from the maximum to minimum phase of rehab?
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Rate of bone healing
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What exercises are commonly done in the maximum phase of rehab after a ORIF for a fractured hip?
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Active ankle pumps, isometric quad sets, gluteal sets, heel slides, hip abd and add, and supine IR and ER.
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True or False: during the max protection phase, exercises should be done sub-maximally.
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TRUE
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True or False: treadmill walking can be done in the late healing phase of a fractured hip rehab program.
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TRUE
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True or False: exercises which combine diagonal or rotatory forces are contraindicated in the late phase of rehab following a fractured hip.
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False, they contraindicated in the early phase
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Name two exercises which are contraindicated in the early phase of rehab following a hip fracture treated with ORIF.
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Active SLR and supine hip bridges
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What weight bearing status is encouraged 2 days post-operatively?
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Touch down or PWB
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When can closed chain exercises be added to a post-op ORIF hip fracture?
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When the patient has achieved FWB status
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True or False: hemiarthroplasties are commonly performed in patients with arthritis.
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False, since this procedure requires a normal acetabular surface it is not done with arthritic patients.
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True or False: the most significant complication after THR is thromboembolic disease.
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TRUE
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What is a common complication that patients experience after noncemented THR?
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Thigh pain with an antalgic gait (painful limp gait)
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True or False: cemented THR patients should be able to achieve FWB status by 8 weeks post-op.
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False, three weeks post-op
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What are the universal hip precautions associated with a posterior approach for a THR?
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Avoid hip adduction, IR and flexion beyond 90 degrees and the combination of motions for up to 4 months post-op.
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What are some functional activities that are contraindicated following a posterior THR?
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Do not sit in low chairs, cross legs, sleep on the side, avoid bending over, and do not squat.
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True or False: Legg-Perthes disease is caused by avascular necrosis to the femoral head in growing children. |
True
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What are the goals of treatment for Legg-Perthes disease?
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Maintaining the femoral head in the acetabulum, regaining motion and reducing pain and dysfunction.
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True or False: the Thomas test is used to assess tightness in the ITB.
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False, its used to check tightness in the Iliopsoas.
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True or False: a + positive Ober test is commonly seen with trochanteric bursitis.
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True, stretching to the ITB is an important part of the rehab
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What combined motions should be avoided in the acute phase of a hamstring strain?
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Full knee extension combined with forward trunk flexion and full leg flexion.
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What structures does the Faber Test access?
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hip joint, SI joint, iliopsoas spasm
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What muscle strength does the Trendelenburg test access?
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Gluteus Medius
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What tests access the length of the rectus femoris?
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Kendell and Ely
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What anatomical landmarks are used to measure a true leg length?
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ASIS and the medial malleolus
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What combined motions are performed to assess a piriformis syndrome?
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Passive Hip flexion concurrent with IR or resistring hip extension and hip ER
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What hip imbalances are associated with an anterior pelvic tilt posture?
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Short TFL and IT band, limitation in ER, weakness in the gluteus medius and piriformis
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What hip imbalances are associated with a slouched posture?
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Shortened Rectus Femoris and hamstrings, weakness in the iliopsoas and gluteus medius, gluteus maximus
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What hip imbalances are associated with a flat back posture?
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Shortened Rectus Femoris and IT band and gluteus maximus
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What exercises should be used to correct a slouched posture?
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Stretch the Rectus Femoris and hamstrings and strengthen the iliopsoas and gluteus medius, gluteus maximus
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What exercises should be used to correct an anterior pelvic tilt posture?
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Stretch TFL and IT band and the internal rotators, strengthen the gluteus medius and piriformis
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Define a "hip pointer."
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Contusion to subcutaneous tissues of the iliac crest
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In an open kinetic chain, what direction would a PT mobilize the head of the femur to gain IR?
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Posterior glide
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What are the ROM percautions associated with a THR performed with an anterior approach?
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Avoid flexion >90 degrees, hip extension, adduction and ER past neutral
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What are the mechanisms of injury associated with a hip pointer?
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1. Direct contact from an external force or falling on the exposed iliac crest.
2. Sudden forceful contraction or overstretching of the muscles which originate to the iliac crest. |
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What assistive device would be best for a 74 year old male who suffers from dyspnea and who recently underwent a THR?
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Walker
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What surgical approach for THA has the highest rate of dislocation?
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Posterolateral
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True or False: an anterior joint mobilization to the head of the femur would increase hip extension.
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True
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True or False: an inferior joint mobilization to the head of the femur would increase hip adduction.
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False, hip abduction |
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Name the 3 special tests used to detect congenital hip dysplasia or dislocation. |
Barlow and Ortolani and telescoping sign |
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Name the common impairments associated with hip OA. |
Groin pain (L3 dermatome), loss of IR, stiffness after rest, limited extension, antalgic gait and impaired balance and posture |