120 likes | 255 Views
Clinical Anatomy of the Hip. Will Collett Peer Support 2014. Objectives. Avascular necrosis Superior Gluteal Nerve Injury Inferior Gluteal Nerve Injury Thomas Test Injection Site. Avascular Necrois. What makes the femoral head susceptible to AVN?
E N D
Clinical Anatomy of the Hip Will Collett Peer Support 2014
Objectives • Avascular necrosis • Superior Gluteal Nerve Injury • Inferior Gluteal Nerve Injury • Thomas Test • Injection Site
Avascular Necrois • What makes the femoral head susceptible to AVN? • Medial and lateral circumflex arteries and ligamentumteres artery • Intracapsular Vs Extracapsular • How can we injure the hip causing AVN? • # NOF • Car crash • What are the signs and symptoms of AVN? • # NOF – shortened and externally rotated • Pain, reduced movement, Weight bearing Diagnosis?
Intracapsular Extracapsular
Superior Gluteal Nerve Injury • Innervates? • Lost ability to? • Abduct the hip • Trendelenburg gait or sign? Gluteus Medius & Minimus (L4-L5) Superior gluteal nerve (L4-L5)
Inferior Gluteal Nerve Gluteus Maximus (L5-S1) • Innervates? • Lost ability to? • Prevent trunk tipping forwards during gait • Extend the hip • Gait? • lurching backward when the weaker limb is on the floor during walking (heel strike) • Buttock wasting • Hamstring Compensation
Intramuscular Injection • Method 2 • - Vertical line through highest point of crest • - Line from PSIS to the greater trochanter • Method 1 • - Vertical line through highest point of iliac crest • - Horizontal line midway between ischial tuberosity and highest point of iliac crest