KIN 340 Test 3
Anterior Pelvic Tilt (Rotation)
"Duck butt" Accomplished by hip flexion and lumbar extension.
Tarsal bones
3 Cuneiform Navicular Cuboid
Posterior Pelvic Tilt (Rotation)
Accomplished by hip extension and lumbar flexion
Anterior Cruciate Ligament (ACL)
Anterior ligament of knee Lateral to medial Hyperextension MOI
Menisci
Attached to tibia, deepen tibial fossa, enhance stability, thicker outside, complain of "locking" when injured.
Fibula
Attachment for the knee joint, no articulation with femur or patella.
Movements of the Knee
Extension Flexion Hyperextension of 10 degrees not uncommon. Slight external/internal rotation
Hip Movements
Flexion Extension Abduction Adduction Internal Rotation External Rotation
Hip Joint
Flexion and extension causes movement at the girdle. Pelvic rotation increases as stride length increases. Stable, few dislocations and subluxations. Strong and dense ligamentous capsule
Bursas
Fluid filled sacs 10-18 in knee depending on the individual Functions for shock absorption, lubrication, reduce friction. Some connected to synovial cavity.
Semimembranosus
Hamstring muscle Origin: Ischial tuberosity Insertion: Medial tibial condyle, closer to joint line than semitend. Action: Flexion of knee, extension of hip, internal rotation of the hip. Palpation: Knee flexion and internal rotation Strengthening: leg curls, squats Stretching: touching toes, reaching toward floor
Semitendinosus
Hamstring muscle Origin: Ischial tuberosity Insertion: Pes anserine (medial) Action: flexion of the knee, extension of hip, internal rotation of the hip. Palpation: Posteromedial thigh during knee flexion and internal rotation. Best during extension of the hip, flexion of knee, but together motion is weak. Strengthening: leg curls, squats Stretching: touching toes, reaching toward floor.
Biceps femoris
Hamstring muscle Origin: Ischial tuberosity and linea aspera Insertion: Lateral condyle of tibia, head of fibula Action: Flexes knee, extends hip, external rotation of hip, posterior pelvic tilt. Palpation: Posterior thigh Strengthening: leg curls, squats Stretching: touching toes, reaching toward floor
Knee Joint
Hinge joint with slight rotation to keep femur in place. Tibia bears most of the weight (medial side, 80%) Injuries always opposite the action.
Peroneal Nerve
Innervates anterior and lateral ankle muscles
Common Peroneal Nerve
Innervates fibular division: biceps femoris (short head)
Tibial Nerve
Innervates posterior and medial ankle muscles
Femoral Nerve
Innervates the knee extensors (quads)
Sciatic Nerve
Innervates tibial division: Semitendinosus, semimembranosus, biceps femoris (long head)
Medial Mensicus
Larger C shape Supports more rotation Attached to MCL
Lateral Collateral Ligament (LCL)
Lateral ligament of the knee Varus MOI Inside force
Arches
Longitudinal -Medial -Lateral Transverse Metatarsal
Medial Collateral Ligament (MCL)
Medial ligament of the knee Valgus MOI (large Q angle) OUside force going in, lower contact force
Rectus Femoris
One of the quadriceps. Origin: ASIS, AIIS Insertion: Superior patella, tibial tuberosity Action: flexion of the hip, extension of the knee, anterior rotation of the pelvis Palpation: Anterior thigh during resisted movements Force decreases as shortens, greater force of knee extension when hip is also extended. Strengthening: Squats, leg extension, etc. Stretching: Pull ankle backward in hand when standing
Tensor Fasciae Latae
Origin: ASIS Insertion: Gerdy's tubercle (lateral anterior tibia) Action: Abduction, flexion of hip Palpation: between iliac crest and greater trochanter Helps prevent external rotation of hip joint Strengthening: Side-lying, putting legs to side Stretching: Adduction, cross legs, lean to side
Sartorius
Origin: Anterior superior iliac spine (ASIS) Insertion: Pes anserine (superior medial tibia) Action: Flexion of the hip, flexion of the knee, anterior pelvic rotation Palpation: ASIS Longest muscle in the body Week doing both movements simultaneously Strengthening: lunges, squats, high knees, etc. Stretching: any extension.
Gluteus medius
Origin: Ilium below crest Insertion: greater trochanter Action: Abduction, lateral pelvic rotation to ipsilateral side Anterior fibers - IR, FL, Ant PR Posterior fibers - ER, Ext, Post PR Strengthening: leg raises, side-lying Stretching: cross legs (add)
Gluteus Minimus
Origin: Just below gluteus medius, more in iliac foss than below crest Insertion: Greater trochanter Action: abduction Strengthening: Abduction (leg raises, side lying) Stretching: Crossing leg over (adduction)
Peroneus Brevis
Origin: Lower 2/3 of lateral surface of fibula Insertion: Base of 5th metatarsal Action: Eversion and plantar flexion Strengthening: Any eversion or plantar flexion movement Stretching: extreme inversion and dorsiflexion with knee flexed.
Flexor Digitorum Longus
Origin: Middle 1/3 of posterior tibia Insertion: Distal phalanx of 4 lesser toes Action: Flexion of 4 lesser toes, inversion and plantarflexion of ankle. Strengthening: Towel grabs (cramp easily if underdeveloped) Stretching: Extreme extension of 4 lesser toes, while ankle in eversion and dorsiflexion.
Extensor Hallicus Longus
Origin: Middle 2/3 of anterior fibula Insertion: Distal phalanx of great toe Action: Dorsiflexion of ankle and extension of great toe Strengthening: Extend toe against resistance and ankle dorsiflexion Stretching: Great toe in full flexion and plantar flexion
Flexor Hallicus Longus
Origin: Middle 2/3 of posterior fibula Insertion: Distal phalanx of big toe, plantar surface Action: flexion of big toe, inversion, and plantarflexion of ankle Strengthening: Towel grabs, walk (with toes), cramp easily if underdeveloped Stretching: Extreme extension of big toe, while ankle in eversion and dorsiflexion
Soleus
Origin: Posterior proximal fibula, proximal 2/3 of posterior tibia Insertion: Posteior calcaneus (achilles' tendon) Action: Plantar flexion Strengthening: heel raises with knee bent Stretching: extreme dorsiflexion with knee bent
Tibialis Posterior
Origin: Posterior upper 2/3 of interosseus membrane. Insertion: Navicular, cuneiform, and bases of 2-5 metatarsals Action: Inversion and plantarflexion Strengthening: Heel raises and inversion exercises Stretching: Extreme eversion and dorsiflexion with knee flexed
Gracilis
Origin: Pubic ramus Insertion: Pes anserine Action: Adductions and internal rotation of hip, weak hip flexion Palpation: medial thigh during resisted adduction, medial to semitendinosus Grouped with all other adductors (magnus, brevis, longus) Strengthening: Breast stroke, horseback riding (adduction) Stretching: abduction
Iliopsoas
Origin: Transverse processes of 5 lumbar intervertebral discs of 12th thoracic vertebrae and iliac fossa. Insertion: Lesser trochanter Action: flexion of hip, flexion of lumbar spine Palpation: Difficult (adjacent to rectus abdominus) True groin muscles (hyperextension) Strengthening: Flexion Stretching: Extension
Tibialis Anterior
Origin: Upper 2/3 of lateral tibia Insertion: Medial cuneiform and base of the 1st metatarsal Action: Dorsiflexion and inversion Strengthening: Any inversion or dorsiflexion activity or walking barefoot. Stretching: Extreme eversion and plantar flexion
Peroneus Longus
Origin: head and upper 2/3 of lateral fibula Insertion: Underside of medial cuneiform and 1st metatarsal Action: Eversion and plantar flexion Strengthening: Turning sole of foot out Stretching: Extreme inversion and dorsiflexion with knee flexed.
Adductor Magnus
Origin: ischial tuberosity Insertion: Linea aspera and adductor tubercle Action: adduction, external rotation and extension of hip Palpation: Between gracilis and hamstrings Strengthening: Breast stroke, horseback riding (adduction) Stretching: Abduction
Popliteus
Origin: lateral condyle of the femur Insertion: Posterior, superior tibia Action: "unlocks" the knee, flexion of the knee, internal rotation of flexed knee Strengthening and stretching are not important.
Extensor Digitorum Longus
Origin: lateral condyle of tibia, fibula head, upper 2/3 of anterior fibula. Insertion: Middle and distal 4 lesser toes Action: Extension of foot and dorsiflexion of ankle Strengthening: Lifting toes up against resistance Stretching: 4 lesser toes in full flexion and plantar flexion
Gastrocnemius
Origin: medial femoral condyle, lateral femoral condyle. Insertion: Calcaneus (achilles' tendon) Action: plantar flexion, knee flexion Strengthening: Heel raises with knee straight Stretching: extreme dorsiflexion with knee straight
Gluteus Maximus
Origin: sacroiliac joint (SI), lateral sacrum and coccyx Insertion: Oblique ridge (superior of femur) Action: Extension, Abduction, Adduction Palpation: Butt Worked especially beyond 15 degrees of hip extension. Used in squatting. Strengthening: squatting, "Jane Fonda", etc. Stretching: Hip flexion
Anterior Hip Muscles
Perform Hip Flexion Iliopsoas Rectus femoris (Q) Sartorius
Lateral Hip Muscles
Perform hip abduction Gluteus medius Gluteus minimus External rotators Tensor fasciae latae
Medial Hip Muscles
Perform hip adduction Adductor magnus Gracilis
Posterior Hip Muscles
Perform hip extension Gluteus maximus Biceps femoris (HS) Semitendinosus (HS) Semimembranosus (HS)
Posterior Cruciate Ligament (PCL)
Posterior ligament of the knee
Anterior Ankle Muscles
Produce dorsiflexion
Lateral Ankle Muscles
Produce eversion
Medial Ankle Muscles
Produce inversion
Posterior Ankle Muscles
Produce plantarflexion
Vastus Intermedius
Quadriceps muscle Origin: Anterior femur Insertion: Patella and tibial tubeosity (middle) Action: Knee extension Strengthening: extension of the knee Stretching: knee flexion
Vastus Medialis
Quadriceps muscle Origin: Close to lesser trochanter, anterior medial femur Insertion: Patella and tibial tuberosity (medially) Action: knee extension Strengthening: Last few degrees of extension Stretching: knee flexion
Vastus Lateralis
Quadriceps muscle Origin: greater trochanter, anterior/lateral aspect of the femur Insertion: Patella and tibial tuberosity (laterally) Action: Extension of the knee Strengthening: Extension of the knee Stretching: Knee flexion
Quadriceps
Rectus femoris Vastus medialis Vastus lateralis Vastus intermedius (deep to rectus)
Pes Anserine insertion
Sartorius Semitendinosus Gracilis
Patella
Sesamoid (floating) bone Embedded in quadriceps tendon and patellar tendon Pulley system: decreased mechanical advantage. Keeps tendon off the bone, makes walking easier.
Screw Home Mechanism
Slight rotation of the knee to fully extend due to the shape of medial femoral condyle. As knee approaches full extension, tibia must externally rotation 10 degrees to achieve proper alignment of tibial and femoral condyles. During initial flexion from full extension, knee "unlocks" by internally rotating to a degree from its externally rotated position to achieve flexion.
Lateral Meniscus
Smaller O shape Not attached to LCL
Left Pelvic Rotation
When the left side of the pelvis moves inferiorly.
Right Transverse Pelvic Rotation
When the pelvis moves clockwise (more movement in the pelvic girdle than femur)
Left Transverse Pelvic Rotation
When the pelvis moves counterclockwise (more movement in the pelvic girdle than femur).
Right Pelvic Rotation
When the right side of the pelvis moves inferiorly.