KIN 3304 exam
The common groin muscles are located in which aspect of the hip?
medial
the _______ ________ is the prominent bony landmark on the distal end of the tibia
medial malleolus
What type of joint is the patellofemoral articulation?
plane
Which of the following is a long muscle found in the anterior aspect of the thigh? Gluteus maximus Sartorius Adductor magnus Semitendinosus
sartorius
How many menisci are located within a single knee joint?
2
What are the sit bones?
ischial tuberosities
The most posterior and inferior aspect of the innominate bone is the
ischium
arch injuries
low arch- over pronation, heel pain, difficulty supporting weight high arch- over supination, heel pain
the ankle joint described as "mortise and tenon" joint, where the _____ is the mortise and the ______ is the tenon
malleoli; talus
the ligaments of the knee that provide side-to-side stability of the joint and prevent adduction or abduction are ______ and _______
medial collateral ligament (MCL) and lateral collateral ligament (LCL)
four compartments of the lower leg
Extrinsic muscles of the foot Defined by fascia Location and function closely align Anterior muscles: Dorsal flexors, toe extensors Posterior muscles: Deep and Superficial Posterior Compartment: Plantar flexors, toe flexors Lateral muscles: Evertors Intrinsic
achilles tendon strain/tendonitis
Gastrocnemius and soleus muscles may be strained from increased activity, especially running and jumping Repeated plantarflexion If untreated, may rupture as result of progressive degeneration of the tissue Disabling, requires surgery
pes anserinus
Gracilis, semitendinosus, and Sartorius muscles all insert in medial aspect of proximal tibia Insertion of these 3 is called the pes anserinus 3 components of the pes anserinus flex the knee joint and internally rotate the lower leg
plantar flexion
Increasing the angle between the dorsal (top) aspect of the food and the anterior aspect of the lower leg Normal range of motion is up to ~55 degrees Limited by bone structure, tension of anterior ligaments and muscles
plantar fasciitis
Inflammation of the planter fascia Occurs from repeated stress, very common in runners May be more common in people with very high or very low arches Typically the point of attachment to the calcaneus is impacted Treatment: rest, stretching, orthotics
When sitting, the weight of the upper body is transfered to:
Ischial tuberosities
quadrates lumborum
origin: iliac crest insertion: transverse processes of L1-L4, rib 12 (posterior) action: stabilizes pelvis, forward tilt, lateral pelvic tilt to contralateral side
iliacus and iliopsoas
origin: inner surface of the ilium insertion: lesser trochanter of the femur action: flexes hip joint, assists with adduction and external rotation of hip. forward tilt/anterior pelvic rotation iliopsoas is the combo of psoas and iliacus
5 medial muscles of the hip and primary action
pectineus, adductor longus, adductor brevis, adductor Magnus, gracilis. hip adduction
acetabulum
pelvic bone that forms a deep, concave socket (for femur to create hip socket joint). located on the lateral aspect of each pelvic bone, at the intersection of the ilium, ischium, and pubic bones
the patellofemoral joint is a ______ joint
plane
ankle eversion
Lateral (outward) twisting movement of foot Normal range of motion ~ 20 degrees
vastus intermedialis
Origin: proximal 2/3 of femur Insertion: upper boarder of patella and patellar tendon, tibia tuberosity Action: knee extension Application: walking, running, standing, jumping, skipping Part of quadriceps group
gluteus maximus
posterior muscles origin: posterior aspect of iliac crest, sacrum, and coccyx insertion: lateral aspect of greater trochanter and IT band action: extension, adduction, external rotation, abduction of flexed hip. pelvis- backward tilt application: comes into action when hip joint passed 15 degrees extension, not used in walking, but in running, skipping, jumping, return from squatting
semitendinosus
posterior muscles very prominent, cord-like structure on medial aspect. origin: ischial tuberosity insertion: anterior medial tiba action: extension, internal rotation. pelvis- backward tilt application: hamstring group. most effective at extending hip when knee is straight
Posterior aspect of the pelvic ring
sacrum and coccyx
the iliotibial (IT) band consists of the combined tendons from the _______ and the _____
tensor fasciae latae; gluteus maximus
pelvic movement applications
walking: hip flexion and extension with rotation of pelvic girdle running: pelvic rotation helps increase the length of stride kicking: results in greater range of motion in hip for increase distance/speed in the kick
This anatomical structure forms the 'socket' of the hip joint:
Acetabulum
the hip joint is a ____ _____ _______ joint
ball and socket
These ligaments connect the tibia to the lateral and medial condyles of the femur, crossing each other in the interior portion of the knee joint:
Cruciate ligaments
interphalangeal joints
Articulations between distal, middle, and proximal phalanges Hinge joints: Flexion and extension
shin splints/medial tibial stress symdromes
Refers to a variety of musculotendinous injuries Tears in the interosseous membrane Microfractures of tibia Inflammation of tibial or fibular periosteum Injuries to tibialis posterior/anterior, soleus, extensor digitorum longus Common among runners and dancers who have intensified their training Activity level inappropriate for current flexibility, strength, endurance May recover with rest and ice, or progress to a stress fracture
The inguinal ligament runs between
The anterior superior iliac spine and the pubic tubercle
What is meant by the term 'obligatory terminal rotation', also known as 'screw home' movement?
The fact that during the last 30 degrees of knee extension on a fixed femur, the tibia externally rotates
vastus lateralis
Origin: greater trochanter and intertrochanteric line, linea aspera Insertion: lateral patella, anterior lateral tibial condyle, rectus femoris tendon Action: knee: extension Application: walking, running, standing, jumping, skipping Extends the knee when the hip is flexed Part of quadriceps group
vastus medialis
Origin: linea aspera Insertion: Action: Application:
patellofemoral syndrome
Pain in and around the patellofemoral joint More common in females Potential cause is a greater Q angle
compartment syndrome
Pressure build-up within compartment secondary to injury, trauma, or overuse Sharp pain, swelling, weakness of compartment If severe, may require surgery to release fascia Permanent tissue damage
The anterior articulation of the two innominate bones is the:
Pubic symphysis
Which of the following muscles in NOT part of the muscle group commonly known as the hamstrings? Semitendinosus Biceps femoris Semimembranosus Rectus femoris
Rectus femoris
plantaris
Short belly with long tendon of insertion Origin: linea aspera and oblique popliteal ligament Insertion: calcaneus (heel) Action: flexion and internal rotation
tibiofibular joint
Similar to radioulnar joint Amphiarthrodial joint Minimal movement, mostly at proximal Fibula internally and externally rotates during plantar flexion and dorsiflexion Interosseous ligament Anterior and posterior tibiofibular ligaments
walking movements in ankle
Stance phase: Heel-strike: land on calcaneus, foot in supination and leg in external rotation Midstance: pronation of foot, internal rotation of leg Toe-off: supination of food, external rotation of leg Walking Swing phase: Initial swing, Midswing, Terminal swing Running: Differs from walking in that: One point with neither foot ground Both are never in contact with ground at same time
gastrocnemius
Origin: Lateral head: popliteal area medial to lateral femoral condyle Medial head: medial condyle of femur Insertion: calcaneus Action: knee flexion Application: propels body upwards and forwards Running, jumping, skipping
peroneus brevis
lateral muscle Origin: distal ½ of fibula Insertion: 5th metatarsal tuberosity Action: Eversion, plantarflexion Application: Primary everter, supports lateral longitudinal arch Strengthened by the plantarflexion during running, jumping
peroneus longus
lateral muscle Origin: head of fibula, upper 2/3 of lateral fibula Insertion: 1st metatarsal and medial cuneiform Action: eversion of food, plantar flexion of ankle Application: Strong everter, supports transverse arch Developed by placing foot forward in running/jumping
hip joint
multi-axial ball and socket joint, more stable than glenohumeral joint, bony architecture. ligaments: acetabulum socket is depended by the glenoid lip fibrocartilage rim on outer edge of acetabulum. surrounded by a strong and dense ligamentous capsule, prevent excessive movements that could move head of femur from socket.
popliteus
origin: insertion: action:
psoas major and psoas minor
origin: L1-L5 transverse processes, and bodies and intervertebral discs T12-L5. insertion: lesser trochanter of femur action: flexion and rotation of lumbar spine, flexion assists with adduction and external rotation of the hip, anterior pelvic rotation/forward tilt *psoas minor only present in 50% of population, just assists psoas major
during standing, the weight of the body is transferred from the spinal column to the ______ (hip) to the ______ (upper leg) to the _______ (lower leg)
pelvis; femur; tibia
2 muscles of the lateral compartment of the lower leg and primary action
peroneus longus and peroneus brevis. plantar flexion.
6 deep posterior muscles of the hip and primary action
piriformis, gemellus superior and inferior, obturator interns and externus, quadratus femoris. hip external rotation.
the ______ _______ is a fibrous band of connective tissue found superficial to most of the intrinsic muscles of the foot
plantar fascia
supination of the foot is a combination of _______, _______, and _______
plantar flexion; subtalar inversion; forefoot adduction
the ligament of the knee that is responsible for preventing posterior displacement of the proximal tibia off the distal end of the femur is ________
posterior crucial ligament (PCL)
biceps femoris (long head)
posterior muscles origin: ischial tuberosity insertion: head of fibular and lateral tibia action: extension, external rotation. pelvis- backward tilt. application: part of the hamstring group, extend hips when knees are straight, running jumping skipping.
semimembranosus
posterior muscles origin: ischial tuberosity insertion: medial tiba action: extension, internal rotation application: part of hamstring group
the articulation between the bodies of the pubic bones is the _______
pubis symphysis
deep external rotators
quadratus femoris, piriformis, Gemellus superior and inferior, internal and external obturator. external rotator
Which of the following is part of the quadriceps muscle group? Tensor fascia latae Biceps femoris Rectus femoris Gracilis
rectus femoris
the muscles of the quadriceps group that crosses both the hip and knee joint is the _______
rectus femoris
5 anterior knee muscles and primary action
rectus femoris, vastus lateralis, vastus intermedialis, vastus medialis, and genu articularis. extension.
muscles of quadricep group and primary action
rectus femoris, vastus lateralis, vastus intermedialis, vastus medialis. extension
9 posterior knee muscles and primary action
sartorious, gracilis, biceps femoris, semitendinous, semimembranosus, gastrocnemius, plantarus, popliteus. flexion.
the longest muscle in the body is the _______; the longest bone in the body is the ______
sartorius; femur
obligatory terminal rotation
screw home movement. during the last 30 degrees of knee extension on fixed femur, the tibia externally rotates about 10 degrees. the tibialfemoral joint "locks" into place during full extension. results from: condylar surface, ligament tension (ACL, medial, and lateral collateral ligaments)
menisci
semilunar firbocartilaginous structure within the joint city of the knee. from greek "menikos" meaning crescent. analogous to articular disco except disc covers entire joint cavity. each knee has menisci on proximal end of tibia, on medial and lateral condylar surfaces. flat on interior surface, concave on superior surface. helps distribute weight of body, reduce friction.
fibula and its landmarks
smaller, lateral bone of the lower leg. bears little weight. major source of soft tissue attachment. landmarks: apex, head, neck
ischium landmarks
spine of ischium, obturator foramen, lesser sciatic notch, ischial tuberosity (sit bones)
pelvic skeleton
strong ring of bones that supports organs and provides sites of attachment for powerful muscles in hip and leg
soleus
superficial posterior muscle Deep to Gastrocnemius Origin: Head and proximal 1/3 of fibula, middle 1/3 of tibia Insertion: calcaneus Action: Plantar flexion of ankle Gastrocnemius and soleus have a common tendon of insertion on the calcaneus: Achilles Tendon Application: one of the most important plantar flexors-running, walking, jumping, dancing on toes, skipping Triceps surae: refers to gastrocnemius and soleus together
articular capsule of knee
support structures of knee. connective tissue surrounds and stabilizes joint capsule
joint capsule of knee
support structures of knee. knee joint of synovial joint. inner synovial membrane lubricates the joint. outer fibrous membrane surrounds and protects the joint
collateral ligaments of knee
support structures of knee. provides stability to either side of the joint. prevents abduction and adduction. medial (tibial) collateral ligament: from medial condyle of the femur to medial condyle of tibia, with some attachment to meniscus. Lateral (fibular) collateral ligament: from lateral condyle of femur to fibula head
cruciate ligaments of knee
support structures. Anterior cruciate ligament: from tibia to lateral condyle of the femur, prevents anterior displacement of tibia off distal end of femur and hyperextension. posterior cruciate ligament: from tibia to medial condyle of femur, prevents posterior displacement of tibia distal end of femur
sacroiliac joints
synovial plane joints, between sacrum and 2 ilium bones. united by inguinal ligaments. weight of the body is transmitted through the sacrum and ilia to the femurs during standing and to the ischial tuberosities in sitting
hindfoot bones
tarsal bones, talus and calcaneus (largest tarsal bone)
midfoot bones
tarsal bones. cuboid (lateral)- articulates with calcaneus. navicular (medial; scaphoid) articulates with talus. cuneiforms- medial, intermediate, lateral Circus Needs More Interesting Little Clowns.
Which two muscles insert on the iliotibial band?
tensor fasciae latae and gluteus maximus
medial or lateral collateral ligament sprain
these ligaments stabilize the knee joint and prevent abduction and adduction Lateral force stress MCL Medial force stresses LCL
iliotibial band (IT band)
thick band of fascia connective tissue. insertion of tensor fasciae late and gluteus Maximus. passes across greater trochanter of the femur as the hip joint flexes and extends. trochantric bursa is located between IT band and greater trochanter to facilitate this movement excessive flexion or extension or direction trauma. Crosses the knee near lateral condyle of femur and inserts onto anterior portion of lateral tibial condyle.
When standing upright, the weight of the body is transferred from the femur to the:
tibia
4 muscles of anterior compartment of lower leg and primary action
tibialis anterior, extensor hallucis longus, extensor digitorum longus, peroneus Tertius. dorsiflexion.
3 muscles of the deep posterior compartment of the lower leg and primary action
tibialis posterior, flexor digitorum longus, flexor hallucis longus. plantar flexion.
hip movements and planes
triaxial joint with 3 planes of movement. flexion, extension in sagittal plane. abduction and adduction in frontal plane. internal and external rotation in horizontal plane.
excessive anterior/posterior tilt disorder
visual cues: forward tipped pelvis, increase anterior curve in the lumbar spine (sway back), a bulging abdomen. may lead to back, hip, and knee pain. may be caused by over-development/tension of muscles in the posterior spine and under-development of muscles in the anterior thorax. treatment: conditioning exercises, physical therapy.
hip pointer injury
a contusion (bruising) of soft tissues attached to ilium, common in contact sports, usually caused by ill fitting equipment. symptoms- tenderness, swelling, reduced range of motion in hip and pelvis. treatment- ice, compression, rest
common groin muscles
adductor braves, longus, Magnus, pectinous, and gracilis. hip adduction, strained by over stretching (common)
pubic symphysis joint
amphithrodial cartilaginous articulation, between the bodies of the pubic bones united by an interpubic fibrocartilage
5 major muscle groups of hip and thigh
anterior (5)- hip flexion. posterior (4)- hip extension. deep posterior (6)- hip external rotation. lateral (3)- hip abduction. medial (5)- hip adduction
tibialas anterior
anterior muscle Origin: lateral condyle of the tibia Insertion: Medial cuneiform and 1st metatarsal Action: dorsiflexion of ankle, inversion of foot Application: strongly contracts during ice-skating, walking on outside of food Supports medial longitudinal food
extensor hallucis longus
anterior muscle Origin: medial ½ of fibula and interosseous membrance Insertion: base of distal phalanx of great toe (hallucis) Action: Dorsiflexion of ankle, inversion of food, extension of great toe Application: contracted by walking on the heels
peroneus tertius
anterior muscles Origin: distal 1/3 of fibula and interosseous membrane Insertion: dorsal aspect of 5th metatarsal Action: dorsiflexion, eversion Application: small muscle, assists in dorsiflexion and eversion, may be absent
extensor digitorum longus
anterior muscles Origin: lateral condyle of tibia, proximal ¾ fibula Insertion: phalanges 2-5 Action: dorsiflexion, eversion, extension of toes 2-5 Application: maintain balance between planter and dorsal flexors
rectus femoris (quadrisect)
anterior muscles origin: anterior inferior spone of ilium insertion: superior aspect of patella action: hip- flexion, pelvis- forward tilt application: tendency to pull anterior pelvis downward, counteracted by abdominals. running jumping skipping etc, part of quads
iliopsoas true groin muscles
anterior muscles origin: lumbar vertebra (psoas), ilium (iliacus) insertion: lesser trochanter action: flexion, assists with adduction and external rotation of hip. forward tilt of pelvis, lumbar flexion application: raising leg while lying supine, less active when hips are flexed
sartorius
anterior muscles, longest muscle origin: anterior superior spine of ilium (ASIS) insertion: anterior medial aspect of proximal end of tibia action: hip: flexion, external rotation, abduction. pelvis: forward tilt application: latin- tailor. stretched when sitting cross-legged
ilium landmarks
anterior superior/inferior iliac spine, posterior superior iliac spine, crest of the ilium (iliac crest), greater sciatic notch (a passage for nerves and blood vessels)
true groin muscles
anterior thigh muscles. psoas major and minor, iliacus. hip flexion. strained by hyper flexion.
rectus abdominis
anterior thorax origin: crest of pubis insertion: cartilage of ribs 5-7, xiphoid process action: backward tilt
obliques (internal and external)
anterior thorax origin: internal- lateral inguinal ligament (pelvis), iliac crest. external- lower 8 ribs insertion: ribs 5-7, sternum. external: iliac crest, inguinal ligament, crest of pubis actions: backward tilt, lateral side rotation
anatomical landmarks of the femur
anterior: greater and lesser trochanters, insertion points of muscles responsible for joint muscle. greater trochanter can be palpated; as you rotate your thigh inwards your greater trochanter will move against your skin posterior: gluteal line, pectineal line, lines aspera Lateral and medial epicondyles for muscular attachment Lateral and medial condyles for articulation with tibia, patella and medial condyle is slightly more distal and slightly larger than lateral condyle Femur projects obliquely
inguinal ligament
between anterior superior spine of the ilium to the pubic tubercle
4 posterior hip muscles and primary action
bicep femoris, semitendinous, semimembranous, gluteus maximus. hip extension
Which of the following muscles is NOT part of the muscle group commonly known as the quadriceps femoris? Rectus femoris Vastus lateralis Biceps femoris Vastus medialis
biceps femoris
hamstrings
biceps femoris, semitendinous, semimembranous, hip extension, strained by hip hyper flexion/ knee hyperextension.
The gastrocnemius, soleus, and plantaris muscles all insert where?
calcaneus
the gastrocnemius, soleus, and planters muscles all insert at the _____ of the foot
calcaneus
flexor hallucis longus
deep posterior muscles Origin: Distal 2/3 of posterior fibula and interosseous membrane Insertion: distal phalanx of great toe Action: Plantarflexion, inversion, flexion of great toe Application: this muscle, along with other posterior muscle, has actions at the toes which helps maintain balance during walking
flexor digitorum longus
deep posterior muscles Origin: Posterior tibia Insertion: Base of distal phalanges of toes 2-5 Action: Plantarflexion, inversion, flexion of toes 2-5 Application: maintains longitudinal arch, strengthened by walking barefoot
tibialis posterior
deep posterior muscles Origin: middle 1/3 of tibia, head and proximal 2/3 of medial aspect of fibula, interosseous membrane Insertion: Navicular, medial cuneiform, 2-5 metatarsals Action: Plantarflexion, inversion, adduction Application: Supports medial longitudinal arch may be inflamed during shin splints
gemellus superior and inferior
deep posterior muscles latin meaning "twin" origin: ischial spine (superior), ischial tuberosity (inferior) insertion: greater trochanter action: external rotation application: part of external rotators group
quadrates femoris
deep posterior muscles origin: ischial tuberosity insertion: intertrochanteric ridge action: external rotation application: part of external rotators group
obturator interns and externus
deep posterior muscles origin: obturator foramen insertion: greater trochanter action: external rotation application: part of external rotators group
piriformis
deep posterior muscles origin: sacrum, sciatic notch insertion: greater trochanter action: external rotation application: part of external rotators group. used in throwing a baseball or swinging a bat. sudden contraction (strain) can impinge the sciatic notch of the pelvis, cause pain along route of sciatic nerve
during standing, the weight of the body is transmitted through the sacrum and ilia to the ______. During sitting, it is transmitted to the ________
femur; ischial tuberosities
Muscles which are found crossing the posterior aspect of the knee joint are generally involved in which movement at the knee?
flexion
muscles that cross the posterior aspect of the knee are usually involved in ________ at the knee
flexion
tibialfemoral joint
flexion and extension in sagittal plane. max extension: 5-10 degrees, max flexion: 120-150 degrees. femur rolls and glides over menisci
the fundamental movements of the hip joint are
flexion, extension, abduction, adduction, internal and external rotation
2 muscles of the superficial posterior compartment of the lower leg and primary action
gastrocnemius and soleus. plantar flexion.
the _______ and ________ share the achilles as a tendon of insertion
gastrocnemius; soleus
the fibrocartilaginous structure that deepens the socket of the hip is called the ________
glenoid lip
3 lateral muscles of the hip and primary action
gluteus medius and minimus, tensor fasciae latae. hip abduction
the _______________ forms the "ball" and the _______ forms the "socket" of the hip joint
head of the femur; acetabulum
inguinal hernia
hernia: an abnormal profusion of an organ. results form straining muscles that attach to the inguinal ligament, as abdominal contents may protrude through the strained muscle tissue. can be caused by improper lifting techniques. may require surgery.
The tibiofemoral joint is a _____ joint
hinge
5 anterior hip muscles and primary action
iliacus, psoas major and minor, rectus femoris, sartorius. hip flexion.
the group of muscles known as the iliopsoas consists of the _______ and the ______
iliacus; psoas
the three bones that form the pelvic skeleton are _______, ________, and _______
ilium, ischium, and pubis
extensor hallucis brevis
intrinsic muscle Origin: calcaneus Insertion: distal phalanx of great toe Action: extension of great toe
extensor digitorum brevis
intrinsic muscle Origin: calcanues Insertion: long extensor tendons of toes 2-5 Action: extension of toes 2-5
the ______ ________ are referred to as the "sit bones"
ischial tuberosities
tibiofemoral articulation
knee joint. femur articulates with tibia and patella. condyle on condyle joint, femoral condyles with tibia condyles. modified hinge joint. internal and external rotation.
patellofemoral articulation
knee joint. gliding joint. posterior base of patella fits between lateral and medial condyles on anterior surface of femur. plane joint. patella moves during knee flexion to improve mechanical advantage of quads, increases angle of pull muscles to increase the force.
tibia and its landmarks
larger, medial bone of lower leg. articulates with the femur and bears the weight of the body. landmarks: lateral and medial condyles, tibial tuberosity. Medial and lateral malleoli (lateral one most distal, medial more proximal)
patella and its landmarks
largest sesamoid bone, ossifies between 2-3 bones. landmarks: base, apex, lateral and medial articular surfaces on posterior (covered with articular cartilage and articulate with medial and lateral condyles of the femur)
sesamoid foot bones
2. plantar surface on head of first metatarsal bones. provide a bioanmechanical advantage for the muscle in which they are embedded.
footbones
28 in each foot- forefoot (19), mid foot (5), hind foot (2). 2 sesamoid bones. dorsal (top), plantar (bottom/sole)
metatarsalphalangeal joints
5 articulations between heads of metatarsal and bases or proximal phalanges Condyloid joints Flexion and extension Some abduction and adduction
forefoot bones
5 metatarsals, 14 phalanges, 3 per tow (except big toe has 2) proximal middle and distal, big toe bears most of weight of body while walking.
What lines define the Q angle?
A vertical line between the tibial tuberosity and patella, and a line between the tibia tuberosity and the anterior superior iliac spine. In men, this angle tends to be between 10-15 degrees In women, this angle tends to be between 15-20 degrees A Q angle greater than 20 will out extra stress on the patellofemoral joint
These muscles are located on the medial side of the thigh, and are collectively identified by their action, and are known as the _________longus, brevis, and magnus
Adductor
Which of the following scenarios is most likely to result in a sprain to the anterior cruciate ligament? Any person experiencing a lateral impact to the side of the knee on a fully weighted leg. An older heavy set female twisting her femur and tibia in opposite directions on the leg supporting her body weight. A young lightweight male twisting his femur and tibia in opposite directions on the leg supporting his body weight. Any person experiencing a medial impact to the side of the knee on a fully weighted leg.
An older heavy set female twisting her femur and tibia in opposite directions on the leg supporting her body weight.
talocrual joint
Articulation between tibia, talus, and fibula Synovial joint: Mortise-and-tenon joint Mortise(rectangular hole) of the joint is formed by the lateral (fibular) and medial (tibial) malleoli Tenon(peg) of the joint is the talus Dorsiflexion and plantarflexion
inter tarsal joint
Between tarsal bones, particularly: Subtalar joint: talus and calcaneus Transverse tarsal joint: between cuboid and navicular, talus Plane joint: Allows inversion and eversion
Side-to-side stability of the knee joint (that is, preventing excessive abduction and adduction) is provided by which ligaments?
Collateral ligaments
ankle pronation
Combination of ankle dorsiflexion, subtalar eversion, and forefoot abduction Foot moves up and away from center of body
supination
Combination of ankle plantar flexion, subtalar inversion, and forefoot adduction Foot move down and towards center of body
Which of the following muscles pulls the articular capsule of the knee proximally during knee extension? Pes anserinus Vastus medialis Genu articularis Vastus intermedius
Genu articularis
dorsiflexion
Decreasing the angle between the dorsal aspect of the foot and the anterior aspect of lower leg Normal range of motion is up to ~20 degrees Limited by bone structure, tension in Achilles tendon
genu articularis
Deep muscle found below vastus intermedius Origin: anterior surface of femur proximal to condyles Insertion: synovial membrane Action: pulls articular capsule of the knee proximally during the knee extension Application: prevents synovial membrane from becoming impinged between the femur, the patella, and the tibia
Anterior cruciate ligament sprain
Femur and tibia twisting in opposite directions under full body weight stresses ACL. Ankle braces and certain footwear may transfer stress to the knee. Imbalances in quads-hamstring strength ratio. Females tend to injure ACL more than males. Potential causes: Females have greater Q angle, more lax ligaments (estrogen), smaller intercondylar femoral notch and smaller femoral condyle
ankle sprains
Greatest risk of ankle strains in side-to-side movements Inversion: impacts lateral aspect Eversion: impacts medial aspect High sprain: spraining of anterior and posterior tibiofibular ligaments Turf toe: spraining of ligament of first metatarsophalangeal joint If return to use occurs before healing, ligaments may stretch, leading to decreased ankle stability and increasing chance of subsequent sprain
Backward tilt of the pelvis involves:
Lumbar flexion and hip extension
ankle inversion
Medial (inward) twisting movement Normal range of motion ~30 degrees
toe extension
Movement of the toes away from plantar Surface of the foot
toe flexion
Movement of the toes towards the plantar surface of the foot
intrinsic muscles
One is found on dorsal aspect, remaining are on plantar aspect Plantar: 4 layers, superficial to deep Covering all muscles is the plantar fascia Fibrous bands that protects muscle ,blood vessels, and nerves Stabilizes medial longitudinal arch Propels body forward during later stance phase
male pelvis vs female pelvis
Opening in ring of bones is larger in females Female pelvis is proportionally wider and flatter compared to male Female pelvis has a forward tilt compare to male
Which of the following is true regarding movements at the pelvis? They are only present in females There are no movements in the pelvis They result from movements in the lumbar spine and the hip joint They include flexion and extension
They result from movements in the lumbar spine and the hip joint
torn meniscus
Very common in sports, particularly the medial meniscus. Excessive rotation of femur on a fixed tibia. Stress to medial collateral ligament could disrupt the meniscus. Results in "popping noise", "locking knee", eventual pain and swelling. Different tears have different treatments; Bucket handle is most common: middle portion of meniscus splits and inner portion separates form main body of meniscus. Of outer portion tears, may heal on own; inner tears need surgery
When is the IT band located anterior to the lateral femoral condyle?
When knee is at extension or up to 10-15 degrees of flexion
tensor fasciae latae
lateral muscles origin: iliac crest, ilium surface insertion: IT band action: hip- abduction, flexion, internal rotation. pelvis- forward tilt, lateral tilt, to ipsilateral side application: prevents external rotation of hip when hip is flexed, helps direct the leg forward to ensure proper foot placement when walking or running
gluteus medius
lateral muscles origin: lateral surface of ilium insertion: greater trochanter action: hip- abduction, flexion, extension, internal and external rotation. pelvis- forward tilt, backward tilt, lateral tilt to ipsilateral side application: various actions depend on which aspect of muscle fibers are contracted. used in stabilization during walking
gluteus minimus
lateral muscles origin: lateral surface of ilium insertion: greater trochanter action: hip- abduction, flexion, internal rotation. pelvis- forward tilt, lateral tilt to ipsilateral side application: used in walking, maintaining proper hip abduction while running
anterior and lateral aspects of pelvic ring
left and right pelvic (innominate) bones -ilium- lateral, superior, portion - ischium- lateral, inferior portion -pubic bone- anterior portion bones separate until puberty, fuse after 25 years
femur
longest and largest bone in the body. long bone (head and shaft), distal end articulates with tibia to transfer body weight form femur to lower leg at the knee.
erector spinae muscles
longissimus: origin: iliac crest, sacrum, transverse processes of L1-L5. insertion: mastoid process, spinous processes of C2-C6, T1-T12, lower ribs (posterior) illiocostalis: originL iliac crest, sacrum, lower 9 ribs (posterior). insertion: transverse processes of C4-C7, ribs 1-12 (posterior) actions and application: forward tilt, lateral pelvic rotation to the contralateral side
adductor longus
medial muscles can be seen in butterfly stretch. origin: anterior pubic bone insertion: linea aspera action: adduction, flexion application: other adductors and this create powerful movement of thigh adduction
gracilis
medial muscles origin: anterior pubic bone insertion: anterior medial tibia action: adduction, flexion, internal rotation
adductor brevis
medial muscles origin: anterior pubic bone insertion: pectineal line action: adduction, flexion, external rotation
Pectineus
medial muscles origin: anterior pubic bone insertion: pectineal line on femur action: hip flexion, strong adductor and external rotator. pelvis- forward tilt application: works with iliospoas
adductor magnus
medial muscles origin: anterior pubic bone, ischium, ischial tuberosity insertion: linea aspera action: adduction, extension, external application: used in great stroke of swimming, horseback riding
arches of the foot
metatarsal and transverse arches dorsal surface. longitudinal arch (medial: calcaneus to tarsals and medial metatarsal, lateral: calcaneus to cuboid and 4th and 5th metatarsal). functions: support weight of body, provide space for blood vessels/nerves/tendons, shock absorption and balance.
Pelvic movements
minimal movement, mostly gliding or oscillating like when walking or in hip flexion. backward tilt/posterior rotation- flexion of lumbar spine, extension of hip joint. forward tilt/anterior rotation- extension of lower spine and flexion of hip joint lateral tilt/lateral rotation- lateral flexion of lumbar spine, abduction of one hip joint and adduction of the other. rotation- rotation of lumbar spine and internal rotation of one hip joint and external rotation of the other