MISSION

VISION “MABINI COLLEGES provides quality instruction, research and

“MABINI COLLEGES shall cultivate a CULTURE MABINI COLLEGES, INC. extension service programs at all educational levels as its
of EXCELLENCE in education.” monumental contribution to national and global growth and
College of Nursing and Midwifery development.
Specifically, it transforms students into:
1. God – fearing
Daet Camarines Norte 2. Nation – loving
3. Law abiding

Patient Data

Name: Patient X

Sex: Female

Age: 2 years

Address: Brgy Mataywanac, Batangas

Civil status: Single

Birth Date: March 1,2017

Birth Place: Batangas city

Religion: Unknown

Nationality: Filipino

Date admitted: May, 26 2019

Time admitted: 10:30 am

Diagnosis: congenital hip dislocation/Developmental dysplacia of the right hip

History of present illness:

Patient x had gait disturbance prior to admission accompanied by her

grandmother. According to the grandmother when patient was learning to walk,
guardian noted that when patient x is turning one year old they notice that it has
unstable gait at right side limp. On x-ray result it was noted that the right hip is
dislocated and have a shallow acetabulum. According to the grandmother the mother of
the patient had complete prenatal check-up and there is no history of illness and
accident during pregnancy.
 MISSION
VISION “MABINI COLLEGES provides quality instruction, research and
“MABINI COLLEGES shall cultivate a CULTURE MABINI COLLEGES, INC. extension service programs at all educational levels as its
of EXCELLENCE in education.” monumental contribution to national and global growth and
College of Nursing and Midwifery development.
Specifically, it transforms students into:
1. God – fearing
Daet Camarines Norte 2. Nation – loving
3. Law abiding
 MISSION
VISION “MABINI COLLEGES provides quality instruction, research and
“MABINI COLLEGES shall cultivate a CULTURE MABINI COLLEGES, INC. extension service programs at all educational levels as its
of EXCELLENCE in education.” monumental contribution to national and global growth and
College of Nursing and Midwifery development.
Specifically, it transforms students into:
1. God – fearing
Daet Camarines Norte 2. Nation – loving
3. Law abiding

Anatomy and Physiology of the hip bone

The hip region is located lateral and anterior to the gluteal region, inferior to the
iliac crest, and overlying the greater trochanter of the femur, or "thigh bone".
The hip joint, scientifically referred to as the acetabulofemoral joint is the
joint between the femur and acetabulum of the pelvis and its primary function is
to support the weight of the body in both static and dynamic postures The hip
joints have very important roles in retaining balance, and for maintaining the
pelvic inclination angle.

Synovial joint

formed by the articulation of the rounded head of the femur and the cup-like
acetabulum of the pelvis.

Axial skeleton

is the part of the skeleton that consists of the bones of the head and trunk of a
vertebrate. In the human skeleton, it consists of 80 bones and is composed of six parts;
the skull bones, the ossicles of the middle ear, the hyoid bone, the rib cage, sternum
and the vertebral column.

 Both joint surfaces are covered with a strong but lubricated layer called
articular hyaline cartilage

Articulal angles

Transverse angle of the acetabular inlet- also called Sharp's angle and is generally
the angle referred to by acetabular angle without further specification can be
determined by measuring the angle between a line passing from the superior to the
inferior acetabular rim and the horizontal plane; an angle which normally measures 51°
at birth and 40° in adults, and which affects the acetabular lateral coverage of the
femoral head and several other parameters.
 MISSION
VISION “MABINI COLLEGES provides quality instruction, research and
“MABINI COLLEGES shall cultivate a CULTURE MABINI COLLEGES, INC. extension service programs at all educational levels as its
of EXCELLENCE in education.” monumental contribution to national and global growth and
College of Nursing and Midwifery development.
Specifically, it transforms students into:
1. God – fearing
Daet Camarines Norte 2. Nation – loving
3. Law abiding

sagittal angle of the acetabular inlet- is an angle between a line passing from the
anterior to the posterior acetabular rim and the sagittal plane. It measures 7° at birth
and increases to 17° in adult.

Wiberg's centre-edge angle (CE angle)- is an angle between a vertical line and a
line from the centre of the femoral head to the most lateral part of the acetabulum.

Vertical-centre-anterior margin angle (VCA)- is an angle formed from a vertical

line (V) and a line from the centre of the femoral head (C) and the anterior (A) edge of
the dense shadow of the subchondral bone slightly posterior to the anterior edge of the
acetabulum, with the radiograph being taken from the false angle, that is, a lateral view
rotated 25 degrees towards becoming fronta.

articular cartilage angle (AC angle, also called acetabular index or

Hilgenreiner angle)- is an angle formed parallel to the weight bearing dome, that is,
the acetabular sourcil or "roof" and the horizontal plane or a line connecting the corner
of the triangular cartilage and the lateral acetabular rim n normal hips in children aged
between 11 and 24 months, it has been estimated to be on average 20°, ranging
between 18° to 25 It becomes progressively lower with age

Femoral neck angle

The angle between the longitudinal axes of the femoral neck and shaft, called
the caput-collum-diaphyseal angle or CCD angle, normally measures
approximately 150° in newborn and 126° in adults (coxa norma).
Coxa vara- abnormally small angle
coxa valga- abnormally large angle
Changes in the CCD angle is the result of changes in the stress patterns applied
to the hip joint. Such changes, caused for example by a dislocation, change the
trabecular patterns inside the bones. Two continuous trabecular systems
emerging on the auricular surface of the sacroiliac joint meander and criss-cross
each other down through the hip bone, the femoral head, neck, and shaft.
 MISSION
VISION “MABINI COLLEGES provides quality instruction, research and
“MABINI COLLEGES shall cultivate a CULTURE MABINI COLLEGES, INC. extension service programs at all educational levels as its
of EXCELLENCE in education.” monumental contribution to national and global growth and
College of Nursing and Midwifery development.
Specifically, it transforms students into:
1. God – fearing
Daet Camarines Norte 2. Nation – loving
3. Law abiding

Capsule

Attaches to the hip bone outside the acetabular lip which thus projects into the capsular
space. On the femoral side, the distance between the head's cartilaginous rim and the
capsular attachment at the base of the neck is constant, which leaves a wider
extracapsular part of the neck at the back than at the front

Ligaments

Hip joint is reinforced by four ligaments, of which three are extracapsular and one
intracapsular

extracapsular ligaments - are the iliofemoral, ischiofemoral, and pubofemoral

ligaments attached to the bones of the pelvis (the ilium, ischium, and pubis
respectively)
intracapsular ligament - is attached to a depression in the acetabulum (the
acetabular notch) and a depression on the femoral head (the fovea of the head).
It is only stretched when the hip is dislocated, and may then prevent further
displacement

Blood supply

The hip joint is supplied with blood from the medial circumflex femoral and
lateral circumflex femoral arteries, which are both usually branches of the deep
artery of the thigh (profunda femoris), but there are numerous variations and
one or both may also arise directly from the femoral artery. There is also a small
contribution from the foveal artery, a small vessel in the ligament of the head of
the femur which is a branch of the posterior division of the obturator artery,
which becomes important to avoid avascular necrosis of the head of the femur
when the blood supply from the medial and lateral circumflex arteries are
disrupted (e.g. through fracture of the neck of the femur along their course.
 MISSION
VISION “MABINI COLLEGES provides quality instruction, research and
“MABINI COLLEGES shall cultivate a CULTURE MABINI COLLEGES, INC. extension service programs at all educational levels as its
of EXCELLENCE in education.” monumental contribution to national and global growth and
College of Nursing and Midwifery development.
Specifically, it transforms students into:
1. God – fearing
Daet Camarines Norte 2. Nation – loving
3. Law abiding

The hip has two anatomically important anastomoses, the cruciate and the
trochanteric anastomoses, the latter of which provides most of the blood to the
head of the femur. These anastomoses exist between the femoral artery or
profunda femoris and the gluteal vessels.

Muscles and movements

Lateral or external rotation - 30° with the hip extended, 50° with the hip flexed):
gluteus maximus; quadratus femoris; obturator internus; dorsal fibers of gluteus medius
and minimus; iliopsoas (including psoas major from the vertebral column); obturator
externus; adductor magnus, longus, brevis, and minimus; piriformis; and sartorius. The
iliofemoral ligament inhibits lateral rotation and extension, this is why the hip can rotate
laterally to a greater degree when it is flexed.

Medial or internal rotation (40°): anterior fibers of gluteus medius and minimus;
tensor fasciae latae; the part of adductor magnus inserted into the adductor tubercle;
and, with the leg abducted also the pectineus.

Extension or retroversion (20°): gluteus maximus (if put out of action, active
standing from a sitting position is not possible, but standing and walking on a flat
surface is); dorsal fibers of gluteus medius and minimus; adductor magnus; and
piriformis. Additionally, the following thigh muscles extend the hip: semimembranosus,
semitendinosus, and long head of biceps femoris. Maximal extension is inhibited by the
iliofemoral ligament

Flexion or anteversion (140°): the hip flexors: iliopsoas (with psoas major from
vertebral column); tensor fasciae latae, pectineus, adductor longus, adductor brevis,
and gracilis. Thigh muscles acting as hip flexors: rectus femoris and sartorius. Maximal
flexion is inhibited by the thigh coming in contact with the chest.

Abduction (50° with hip extended, 80° with hip flexed): gluteus medius; tensor
fasciae latae; gluteus maximus with its attachment at the fascia lata; gluteus minimus;
piriformis; and obturator internus. Maximal abduction is inhibited by the neck of the
 MISSION
VISION “MABINI COLLEGES provides quality instruction, research and
“MABINI COLLEGES shall cultivate a CULTURE MABINI COLLEGES, INC. extension service programs at all educational levels as its
of EXCELLENCE in education.” monumental contribution to national and global growth and
College of Nursing and Midwifery development.
Specifically, it transforms students into:
1. God – fearing
Daet Camarines Norte 2. Nation – loving
3. Law abiding

femur coming into contact with the lateral pelvis. When the hips are flexed, this delays
the impingement until a greater angle.

Adduction (30° with hip extended, 20° with hip flexed): adductor magnus with
adductor minimus; adductor longus, adductor brevis, gluteus maximus with its
attachment at the gluteal tuberosity; gracilis (extends to the tibia); pectineus,
quadratus femoris; and obturator externus. Of the thigh muscles, semitendinosus is
especially involved in hip adduction. Maximal adduction is impeded by the thighs
coming into contact with one another. This can be avoided by abducting the opposite
leg, or having the legs alternately flexed/extended at the hip so they travel in different
planes and do not intersect.
 MISSION
VISION “MABINI COLLEGES provides quality instruction, research and
“MABINI COLLEGES shall cultivate a CULTURE MABINI COLLEGES, INC. extension service programs at all educational levels as its
of EXCELLENCE in education.” monumental contribution to national and global growth and
College of Nursing and Midwifery development.
Specifically, it transforms students into:
1. God – fearing
Daet Camarines Norte 2. Nation – loving
3. Law abiding

Laboratory Procedures

laboratory Result Normal values Indications

increase decrease
Dehydration, Anemia, bone
4.O-5.5 Million mcl pulmonary marrow failure,
RBC 5.20
fibrosis, renal cell hemolysis,
carcinoma leukemia,
malnutrition
Hemoglobin 13.8 11-13 gm/dl Polycythemia Iron deficiency,
Vera,Lung Vitamin B-12
disease, deficiency, Kidney
Dehydration, disease, Liver
Excessive disease
vomiting
Hematocrit 0.41 0.37-0.47 Dehydration, Bleeding, over
Erythrocytosis hydration

leukocyte

Diagnostic Procedure

x-ray

 are a type of radiation called electromagnetic waves. X-ray imaging creates

pictures of the inside of your body. The images show the parts of your body in
different shades of black and white. This is because different tissues absorb
different amounts of radiation. Calcium in bones absorbs x-rays the most, so
bones look white. Fat and other soft tissues absorb less, and look gray. Air
absorbs the least, so lungs look black.
 MISSION
VISION “MABINI COLLEGES provides quality instruction, research and
“MABINI COLLEGES shall cultivate a CULTURE MABINI COLLEGES, INC. extension service programs at all educational levels as its
of EXCELLENCE in education.” monumental contribution to national and global growth and
College of Nursing and Midwifery development.
Specifically, it transforms students into:
1. God – fearing
Daet Camarines Norte 2. Nation – loving
3. Law abiding

 The most familiar use of x-rays is checking for broken bones, but x-rays are also
used in other ways. For example, chest x-rays can spot pneumonia.
Mammograms use x-rays to look for breast cancer.

Surgical procedure

Closed reduction

A closed reduction is a procedure to line up the ends of a broken (fractured) bone

without the need for surgery. This will help the fractured bone heal correctly. It may be
done right after your injury or several days later. The ball is placed in the socket
without making any large cuts (incisions)

Prosthesis

Is an artificial device that replaces a missing body part, which may be lost through
trauma, disease, or a condition present at birth (congenital disorder). Prostheses are
intended to restore the normal functions of the missing body part.
 MISSION
VISION “MABINI COLLEGES provides quality instruction, research and
“MABINI COLLEGES shall cultivate a CULTURE MABINI COLLEGES, INC. extension service programs at all educational levels as its
of EXCELLENCE in education.” monumental contribution to national and global growth and
College of Nursing and Midwifery development.
Specifically, it transforms students into:
1. God – fearing
Daet Camarines Norte 2. Nation – loving
3. Law abiding

Case Analysis
in
Philippines orthopedic center

(congenital hip Dislocation)

Submitted to:

Rafmarc D. Genorga RN.,MAN

Submitted by:

Ailyn Ibita BSN III

 MISSION
VISION “MABINI COLLEGES provides quality instruction, research and
“MABINI COLLEGES shall cultivate a CULTURE MABINI COLLEGES, INC. extension service programs at all educational levels as its
of EXCELLENCE in education.” monumental contribution to national and global growth and
College of Nursing and Midwifery development.
Specifically, it transforms students into:
1. God – fearing
Daet Camarines Norte 2. Nation – loving
3. Law abiding

Case analysis
In
San lazaro
(Pulmonary tuberculosis)

Submitted to:

Rafmarc D. Genorga RN.,MAN

Submitted by:

Ailyn Ibita BSN III