Structural Kinesiology Final Lower extremities

Foot intrinsics

Dorsal side: Extensor hallicus brevis, Extensor digitorum brevis, both help with dorsiflexion. Plantar side:;;; First layer (superfical): 2 abd Abductor hallicus, abductor digiti minimi, flexor digitorum brevis Second Layer: Quadratus plantae (toe flx) Lumbricals (4: toe flx, and ext) third layer: Flexor hallicus brevis, flexor digiti minimi, adductor hallucis Forth layer(deep): Dorsal interossei (4: DAB), Plantar Interossei 3(PAD)

Extensor hallucis longus

Dorsiflexion, Ext of Great toe, inversion of foot.

Fibularis Brevis

EVersion of foot, plantar flx, lateral malleolus

Gluteus Maximus Muscle

EXT of hip, ER of hip, Upper fibers assist in Abduction, lower fiber assist in ADDuction, Posterior pelvic rotation.

Tibiofemoral Joint:

EXT, FLX, IR,ER, modified hinge joint

Knee joint

Patella: pulley system. Tibia: weight supporting bone, Fibula: Muscle attachment.

Hip joint

Acetabular femoral joint, Relatively stable due to bony structure, strong ligaments, large supportive muscle. can withstand a lot of force and load.

Six Deep Lateral Rotator Muscles

All ER the hip: P GO, GO, Q. piriformis, Gemellus superior, Obturator inturnas, Gemellus inferior, obturator externus, quadratus femoris

Pelvic rotation

Anterior/posterior pelvic rotation: Think Squats Right and left Lateral Pelvic rotation: booty pose Transverse pelvic rotation: on a swivel

Joints of the hip and pelvis

Anterior: symphysis pubis (amphiarthrodial joint Posteriorly: Sacroiliac joint (gliding synovial joint)

Lower leg 4 compartments of nerves

Anterior: tibialis anterior, extersor hallicus longus, extensor digitorum longus ,fibularis tertius Lateral: Fibularis longus/Brevis Superfical: Gastroc, soleus, plantaris Deep posterior: Flx digitorum longus, flx hallicus longus, tibialis posterior, poplitieus. Sciatic nerve: Tibial Division: Posterior compartment (superficial& deep) Superfical fibular nerve: Anterior lateral Deep fibular nerve: Rest of anterior deep muscles.

Acetubulofemoral joint

Ball and Socket joint

Most common injuries

Shin splint symptoms

patellafemoral joint

gliding joint: synovial

intertarsal & tarsometatarsal joint

gliding, minimal movement

Ankle and Foot bones

Talus, calcaneus, navicular, cuboid, cuneiforms, metatarsals, phalanges.

Ligaments of the Acetabulofemoral joint

Teres ligament: or round ligament, attaches to head of femur, helps limit ADD Iliofemoral or Y ligament: Anterior side iliac to femur, prevents hyperextension. Pubofemoral ligament: Pubis to femer, limits extreme EXt, ABD Ischofemoral Ligament: Posterior, helps limit IR

Flexor Hallucis longus

big toe, flx inversion, plantar flx, on medial side medial malleolus

Tibialis anterior muscle

dorsiflexion, inversion

Movements of foot

dorsiflexion, plantar flx, Eversion, inversion, Toe flx, ext, Pronation: Toe out supination: toe in

Talocrural joint

hinge, talus, distal tib, distal fib, plantr flex, dorsal flx.

Subtalar & transverse tarsal joint

inversion, eversion gliding joint

Soleus muscle

plantar flx,

Gastrocnemius

plantar flx, flx of knee,

Fibularis tertius

small, eversion of foot, dorsiflexion

Flexor digitorum longus

wraps around medial mallioulus, flex of 4 lesser toes proximal and distal, inversion of foot, , plantar flx,

Tibialis posterior

wraps around medial mallioulus, planter flx, inversion of foot,

Gluteus medius muscle

ABD of hip, lateral pelvic rotation to ipsilateral side, IR, FLX, & Anterior pelvic rotation: anterior fibers, Er: EXT & posterior pelvic rotation (posterior fibers) like deltoid.

Ligaments of knee

ACL (anterior curciate ligament): prevents anterior movement of tibia, most injured. PCL (posterior cruciate ligament): no injured a ot prevents posterior translation of tibia. LCL (Lateral collateral ligament): infrequently injured, Ex varas, hit on middle side. MCL (Medial Collateral Ligament): prevents valgus from happening, injury is common. Unhappy triad: MCL, ACL, medial meniscus, MCL attaches to medial meniscus.

Adductor Brevis Muscle

ADD of hip, ER as Adducts hip, assists in Flx of hip, anterior pelvic rotation.

Adductor Magnus

ADD of hip, Er as and hip ADD, EXT of hip

Adductor longus muscle

ADD of hip, Flx of hip, ER, anterior pelvic rotation

Gracilis muscle

ADD of hip, weak Flx of knee, IR of hip, Assits with Flx of hip, Weak IR of knee.

Gluteus minimus muscle

Abd of hip, lateral pelvic rotation to ipsilateral side, IR as femur abducts, Flx of hip, anterior pelvic rotation.

Fibularis longus

Eversion of foot, plantar flx, lateral malleolus,

Extensor digitorum longus

Ext of 2-5 digits, Dorsiflexion, Eversion

iliopsoas Muscle

Flx of hip, ER of Hip, Anterior Pelvic rotation, Transvers Pelvic rotation, Flx of lumbar spine, lateral pelvic rotation contralaterally.

Rectus Femoris

Flx of hip, EXT knee, Anterior pelvic Rotation.

Pectineus Muscle

Flx of hip, adduction of hip, ER of hip, Assist w/anterior pelvic rotation.

Sartorius

Flx of hip, flx of knee, ER of hip, ABD of hip, helps with crossing one knee over another.

Tensor Faciae latae

Flx of knee, EXt of hip, ER of hip, Er rotation of Flx knee, posterior pelvic rotation.

Biceps femoris

Flx of knee, EXt of hip, Er of hip, ER rotation of Flx knee, posterior pelvic rotation.

Semitendinosus muscle

Flx of knee, EXt of hip, IR of hip, Ir of flexed knee, Posterior pelvic rotation.

metatarsaphalangeal joint

Great toe, Condyloid DiP, IP, PiP: hinge joins

Q angle

Looks at the pull of the quads on the tibia. can help with diagnosis.

Muscles that connect the hip and knee

Rectus femoris, sartorius, gracilis, semitendinosis, semimembrinosus, biceps femoris, tensor facea latae,

Pelvic Bone

Three parts: Upper 2/5= ilium Posterior and lower 2/5= ischium Anterior and Lower 1/5= Pubis

Screw home mechanism

To get into full extension there is a little ER about 5 degrees of outward. when flexion occurs you have about 5 degrees of IR. The tibia is ER/IR rotating.

Semimembranosus

Under Semitendinosus, Flx of knee, EXt of hip, Ir of hip, Ir of Flx knee, posterior pelvic rotation.

Muscles of the Knee:

Vastus lateralis, vastus intermedius, vastus medialis. all ext knee

Popliteus Muscle

Very Deep (posterior side) lateral to medial, Flx of knee, Ir of flexed knee, helps unlock the knee.

Nerves

all come through lumbar and Sacral plexus, lumbosacral plexus: major nerve. Femoral nerve: Anterior muscles (including illisopasas) Obturator Nerve: Adductor muscles Pectinius is innervated by both Sacral Plexus: Superior Gluteal nerve: innervate l4,l5,s1, superior lateral side of leg; gluteus medias, gluteus minimus, tensor facia latae. Inferior Gluteal nerve: l5,s1,s2 innervates gluteus maximus Branches from Sacral plexus: P, Go,Go,Q. l4,l5,s1,s2 Sciatic nerve: medial side: tibial nerve lateral side: fibular/common fibular. Tibial innervates: semitendiosus, semimembranousu, biceps femoris(long), adductor magnus, poplitieus. Fibular: Short head of biceps femoris.

Joints of the ankle and foot

ankle joint, talonavicular joint, navioculo cuneiform joint, tarsometatarsal joint, metatarsophalangeal joints, interphalangeal joint, calcaneocuboid joint, subtalar joint.

Joints

ligaments: Tibiofibular ligament which is most injured in high ankle sprain. Deltoid ligament is rarely sprained.

Joint Stability

menisci: Shock absorption, helps deepen the facia. Medial: C shape, Lateral: O Shaped. Creates more stability.

Ankle joint injury

most injured is the lateral side.