Test 2. Anatomy

Mechanism of injury for LCL/FCL

-Varus forces -Severe hyperextension

Dislocation of the hip

- The hip joint is very stable and dislocates only after significant injury - Almost all dislocations are posterior **Most posterior hip dislocations result from car accidents**

Do patients with lower back pain benefits from training the abdominal muscles?

- lateral tension of the TLF can directly affect the ligaments of vertebral arch - Stabilize the sacroiliac joint based on the direct connection of the TLF to the supraspinous ligament and tension to this fascia and ligament can add tension to interspinous ligament

How common are disorders of the pelvic floor among women?

- prevalence increase with age, deliveries, and increased BMI - prevalence increased in the number of vaginal deliveries - > chance of incontinence with female athletes as compared to non-athlete counterparts - Pre operative pelvic floor exercise may improve continence at least in short term following surgery

How well are the ligaments of the ankle innervated?

-People with injuries in the ankle joint have diffiuclties with posture. -If not addressed they contribute to recurring injuries -can contribute to nociceptive and mechanic pain

Mechanisms of injury of PCL

-Posterior translation of the tibia in flexion -Axial rotation forces -Varus or valgus forces -Extreme of hyper-flexion

How can injury disrupt the blood supply to the hip joint?

-When the neck of the femur is fractured, it can hinder the blood supply to the hip joint -If the fracture is toward the greater trochanter, then it can be surgical repaired due to blood supply in the area

Mechanisms of injury of MCL/TCL

-valgus forces -Severe hyper-extension

Patellofemoral Syndrome

Overuse with muscular imbalance Repeated impact with knee in flexion leads to inflammation of patellofemoral groove

Posterior thoracolumbar fascia Middle throraco lumbar fascia fibers

PTLF: they run diagonally MTLF:run horizontally

What role does the thoracolumbar fascia play in the function of the intrinsic muscles of the spine?

Passively resists flexion and lateral flexion providing elastic assistance to extensors

talocalcaneonavicular joint and ligament

Plantar calcaneavicular (spring) ligament

A patient has sustained ankle injury and you determine that [] is involved. No structures on the opposite side were injured. Which excessive ankle motions were most likely the mechanism of injury?

Plantar flexion and eversion

What structure facilitates the transfer of energy from the upper body to the lower body during rotation of the trunk?

Posterior Thoracolumbar fascia

how does the multifidus function?

Primary function is to stabilize and less agonist or propioception -Generate primarily COMPRESSIVE forces -active in rotation to oppose the flexion effect of the abdominal muscles - Attachments to zygophyseal joint capsules protects capsule during contraction - Correlation with atrophy and lower back pain

What about the rotatores and the minor layer of deep instrinsic muscles?

Propioceptors>stabilizers>agonist

What nerve provides innervation to muscles of the perineum?

Prudendal nerve

Genu Varum

Reduced Q angle with outward bowing. Bow legged

Disruption of which arteries that provide the greatest quantity of direct blood supply to the femoral head are most likely to be disrupted through a displaced fracture of the femoral neck? Profunda femoris artery Artery to head of femur Retinacular arteries Obturator artery

Retinacular arteries

Which best describes the areas a patient would most likely experience somatic referred pain arising from diaphragm irritation associated with gall bladder disease? Left neck and upper back Left low back and pelvis Right neck and upper back Right low back and pelvis

Right neck and upper back

Injury affecting which spinal nerve is most likely to impair bowel, bladder, and sexual function? S1 L4 S4 L1

S4

Femoral region

Shaft, line aspera, head, fovea, neck, greater/lesser trochanter, medial/lateral epicondyle, medial/lateral condyle, intertrochanteric crest, fovea, and neck

spinalis muscle

Smallest and most medial of erector spinae group Poorly defined *Thoracis, cervicis*

What joints make up the leg?

1. Proximal tibiofibular 2. Inferior tibiofibular

What are the intermediate extrinsic back muscles?

1. Serratus posterior superior 2. Serratus posterior inferior

Coxa Vara and Coxa Valga

Angle of inclination varies with age, sex, and development of femur. It may also change with the pathological process that weakens the neck of the femur. When the angle of inclination is decreased, the condition coxa vara results causing mild abduction

External obliques innervation?

Anterior rami

Which is the most commonly injured in lateral ankle sprains?

Anteriortalofibular ligament

In general, what is the function of these muscles?

TONIC: Holding posture. In most, line of gravity anterior to spine pulling trunk into flexion lateral displacement of line of gravity pulls into lateral flexion PHASIC: DYNAMIC MOVEMENT Contract to create extension or ipsilateral flexion Crucial in control of flexion and contralateral lateral flexion Create longitudinal compression

Which joints combine to form the transverse tarsal joint? Talocrural and subtalar Talocrural and calcaneocuboid Talonavicular and calcaneocuboid Talonavicular and subtalar

Talonavicular and calcaneocuboid

Abdominal muscles

The abdominal muscles relax during inspiration. They contract during forced expiration, and assist the diaphragm by pushing it upwards. This decreases the volume of the thoracic cavity.

calcaneocuboid joint

The articulation between the calcaneus and the cuboid bones; part of the midtarsal joint. L: dorsal and plantar calcaneocuboid ligament long plantar ligament

What are the functions of the muscles of the spine?

The strong muscles of the back that attach to the spinous processes of vertebrae are necessary to support and move the vertebral column

Valgus vs Valgus forces

The terms valgus and varus refer to angulation (or bowing) within the shaft of a bone or at a joint. It is determined by the distal part being more medial or lateral than it should be. Whenever the distal part is more lateral, it is called valgus. Whenever the distal part is more medial, it is called varus

If Carlos was hit on the tibial side of his leg while playing soccer, what forces produce what movement that tear what ligament?

Varus forces-->adduction--->LCL

Which is considered an instrinsic ligament of the hip? Zona obicularis Ligament of head of femur iliofemoral ligament Transverse acetabular ligament

Zona orbicularis

perineal body

a fibromuscular itsssue between the urogenetial and anal triangle. A midline episiotomy is a vertical incison from teh posterior vaginal opening to the perineal body.

Subtalar Joint Ligaments

a joint in the ankle found between the talus and calcaneus. Medial, lateral, and posterior talocalcaneal ligament and interosseous talocalcaneal ligament

Anteversion/Retroversion

anterversion= medially rotated position "toed in" Retroversion=laterally rotated position "toed out" for males=7 degrees for females=12 degrees

The hip joint is structured as _______type of synovial joint capable of moving in Hinge in all planes ball and socket hinge, single plane ball and socket, all planes

ball and socket, all planes

External obliques

compress abdomen, flex vertebral column, rotate trunk, lateral flexion of trunk

What do the external obliques do isometrically?

constrain: bilateral trunk extension Unilateral: contralateral flexion ipsilateral rotation of trunk

arcuate line

demarcates the transition between the posterior rectus sheath covering the superior three quarters of the rectus abdominis proximally and the transversalis fascia covering the inferior quarter.

Inspiration is associated with __________ of the diaphragm and __________ pressure within the thoracic cavity. ascent, reduced descent, reduced ascent, increased descent, increased

descent, reduced

Normal exhalation muscles

diaphragm

Normal inspiration muscles

diaphragm and external intercostals

Thoraco-lumbar Fascia

extends and hyper extends torso

Which movement of the trunk is most directly controlled through eccentric contraction of the rectus abdominis? Lateral flexion Extension Flexion Rotation

extension

Focused abdominal muscle training is an essential element in the rehabilitation of all individuals with low back pain. True False

false

What ligaments limit abduction at the hip joint?

iliofemoral, ischiofemoral, pubofemoral

What ligaments limit extension at the hip joint?

iliofemoral, ischiofemoral, pubofemoral

What ligaments limit External rotation at the hip joint?

iliofemoral, pubofemora;

What are the ligaments of the hip joint?

iliofemoral, pubofemoral, ischiofemoral,--> extrensic external

Active Inspiration Muscles

in addition to diaphragm and ext. intercostals Sternoclaidomastoid and scalenes

Perineum boundaries

in females, the area between the anus and the vagina/scrotom. The perineum lies inferior to the inferior pelvic aperture and is separated from the pelvic cavity by the pelvic diaphragm.

coccygeus insertion

inferior end of sacrum and coccyx

Active muscles during exhalation

internal intercostals, abdominals

back strain

involve some degree of stretching or microscopic tearing of muscle fibers. Usually the muscles involved are the ones involved in producing movement of the lumbar joints.

rectus sheath

is a tendon sheath (aponeurosis) which encloses the rectus abdominis and pyramidalis muscles. It is an extension of the tendons of the external abdominal oblique, internal abdominal oblique, and transversus abdominis muscles

Coccygeous Origin

ischial spine

The __________ axis of the transverse tarsal joint is most readily associated with the talonavicular joint and provides for motion in the __________. longitudinal, coronal plane oblique axis, coronal plane oblique axis, sagittal and coronal planes longitudinal, sagittal and coronal planes

longitudinal, coronal plane

Genu Valgum

medical term for knock-knee. Greater risk of progression of osteoarthritis

linea alba

midline tendinous seam joining the abdominal muscles

cuneonavicular joint and ligaments

navicular with base of cuniform bones L: Dorsal and plantar cuneonavicular ligaments

What is the name if the ligaments that connect the medial side of the ankle joint?

the deltoid ligaments

How do the pelvic floor muscles contract and what happens to the abdominal pressure?

they elevate and shorten as the coccyx flexes the intrabdominal pressure increases fighting the urogenital hiatus, rectus hiatus

how do the obliques work together?

they work together during rotation

multifidus origin

transverse processes of all vertebrae

the structure the bones of the knee

Femur: Greater trochanter, lesser trochanter, Head, neck, medial/lateral epicondyles, medial/lateral femoral condyle Patella: medial/lateral Tibia: intercondylar eminence, medial/lateral condyle, tibial tuberosity, anterior border, medial malleolus.

Which best describes the type of joint of the interosseous membrane?

Fibrous syndesmosis

Which conditions are most readily associated with supination in weight bearing? Foot becomes less mobile and leg externally rotates Foot becomes more mobile and leg externally rotates Foot becomes less mobile and leg internally rotates Foot becomes more mobile and leg internally rotates

Foot becomes less mobile and leg externally rotates

How do muscles of the pelvis receive their nerve supply?

Nerve of elevator ani

Levetor ani innervation

Nerve to levator ani, inferior anal rectal nerve

Is the serratus posterior involved in respiration?

No. It is involved in propioception

How is the knee joint alligned? line representing the resultant line of force of the quadriceps, made by connecting point of the ASIS to the patella

Normal angle Male: 8-14 degrees Female:15-17 degrees

Fractures of the femoral neck

Often disrupt the blood supply to the head of the femur. The medial circumflex femoral artery supplies most of the blood to the head and neck of the femur. Retinacular arteries often are torn, with femoral neck fracture or hip joint is dislocated. Sometimes the only blood supply that remains is the one provided by the artery to the ligament of the femoral head.

What happens at the patellofemoral joint when the knee moves?

- At full flexion the patello femoral joint is at most stable due to minimized tension - As the knee moves to extension the patella glides and rolls superiorly. - At full extension this joint is most mobile

Ligaments of the knee joint

- Become taut when knee is extended - These extracapsular and capsular ligaments are • Fibular and tibial collateral ligament • Oblique popliteal ligament • Arcuate popliteal ligament

anococcygeal ligament

- Connects external anal sphincter to coccyx

Which receives innervation from the femoral nerve? Psoas major Transversus abdominis Internal oblique Iliacus

Iliacus

Which muscles make up the levator ani? Iliococcygeus and pubococcygeus Coccygeus and pubococcygeus Illiococcygeus and ischiocavernosis Coccygeus and ischiocavernosis

Iliococcygeus and pubococcygeus

What does the Rectus abdominis cotrols eccentrically?

Trunk extension

What does the Rectus maintains isometrically?

Trunk extension

What does the Rectus abdominis create concentrically?

Trunk flexion

Dave misses his golf ball and instead he hits his fibula with the golf club, what forces produce what movement that tear what ligament?

Valgus forces-->abduction-->MCL

Mechanisms of injury of the ACL

-Hyperflexion -Valgus forces -Axial rotation forces -Quadriceps contraction in or near full extension

Does the thoracolumbar fascia play a role in the function of these muscles?

-Composite of fascia sheets ana apenuerosis - Reinforces retinacular sheets enveloping instrinsic muscles -Passively reinforces flexion and lateral flexion providing elastic assistance to extensors - Aids in creating hydraulic amplifier effect= generating longitudinal forces -Moving into flexion or lateral flexion, stretches the thoracolumbar fascia building up potential energy, assisting the muscles in returning the body to upright position-

What is clinically relevant about the menisci?

-Distribute compressive forces -Guide movement -Stabilization -lubrication -Propioception -Injury with axial rotation of flexed knee in weight bearing

What are the main functions of the intermediate intrinsic muscles?

-create: spine extension, ipsilateral lateral flexion of the spine. -Control:spine flexion -unilateral action:contralateral lateral flexion of spine -Constraint: bilateral action=spine flexion unilateral action=contralateral lateral flexion of spine.

Femoral Fractures

-fractures of neck most common -due to impact injuries like car accidents -if not treated quickly can cause necrosis as a result of interrupted blood supply

What are the 2 major groups of muscles of the back?

1. Extrinsic: Superficial and intermediate muscles that produce and control limb and respiratory movements. 2. Intrinsic back muscles: deep muscles acting on vertebral column producing movements and maintaining posture.

Perioneum triangle

1. Anal triangle: lies posterior to this line and contains the anal canal and its orifice, the anus 2.. Urogenital triangle (UG) triangle: containing the root of the scrotum and penis in males and vulva in female, is anterior to this line.

tibiofemoral joint ligaments/meniscus

1. Anterior cruciate ligament 2. Posterior cruciate ligament 3. Lateral collateral ligament 4. Medial Collateral ligament 5. Transverse meniscus

Ligaments of Leg

1. Anterior ligament of the fibula 2. Anterior tibiofibular ligament 3. Posterior ligament of the head of fibula 4. Posterior tibiofibular ligament. * Interosseous membrane

What are ligaments that stabilize the ankle joint?

1. Anterior tibiotalar ligament 2. Tibionavicular ligament 3. Posterior tibiotalar ligament 4. Tibiocalcaneal ligament 5. Posterior talofibular ligament 6. Calcaneofibular ligament 7. Anterior talofibular ligament

How does the structures of the hip joint receives nutrition?

1. Artery of the head of the femur 2. Retinacular arteries 3. Lateral circumflex femoris artery 4. Obturator artery 5. Medial Circumflex Artery 6. Profunda Femoris Artery.

Muscles of the pelvic floor

1. Coccygeus 2: Levator ani A. Pubococcygeus Pubovaginalis Puborectalis B. Iliococcygeous

How do we assess the integrity of the tibiofibular joint?

1. Compression: Pain at the distal fibiotibular joint confims involvement of this joint and rules out fractures 2.External rotation: Also to assess the integrity of the tibiofibular joint

Muscles of the perineum

1. External anal sphincter 2.Bulbospongiosum 3. Ischiocavernosus 4. Superficial transverse perineal 5. Deep transverse perineal 6. External urethras sphincter

What are the superficial extrinsic back muscles? Connect the upper limb to the trunk

1. Trapezius 2. Latissimus dorsi 3. Levator scapulae 4. Rhomboids

What makes up the knee joint?

1. tibiofemoral joint 2. proximal tibiofibular 3. patelofemoral

What are the functions of the pelvic floor muscles?

1. visceral control 2. Pelvic joint support 3. Movement of coccyx 4. Sphincter control 5. Sexual function

Which movement of the tibia on the femur is required to attain full extension of the tibiofemoral joint? 45 degrees of external rotation 45 degrees of internal rotation 10 degrees of internal rotation 10 degrees of external rotation

10 degrees of external rotation

What is the average angle of inclination for an adult?

126 degrees and it is less in females

Abdominal wall divisions

Although the abdominal wall is continuous, for descriptive purposes it is divided into anterior wall, right and left lateral walls, and posterior wall.

Anterior Cruciate Ligament (ACL)

A ligament in the knee that attaches to the anterior aspect of the tibial plateau. restricting anterior movement of the tibia on the femur

lateral raphe

A ridge along the lateral margin of the erector spinae muscles formed by the aponeurosis of the latissimus dorsi internal oblique and transversus abdominis muscles and the layers of the thoracolumbar fascia. - The lateral raphe is in a position to distribute tension from the surrounding hypaxial and extremity muscles into the layers of the TLF -TLF. resistance of flexion and lateral flexion limits lateral expansion during contraction

ankle sprain

A stretch or tear in one of the ligaments surrounding the ankle. Expossure to excessive tensile forces. Ankle sprains resulting from inversion injury usually rupture the lateral ligaments

Are the intermediate intrinsic muscle of the spine function more as agonist or as stabilizer and proprioception

AGONISTS

Popliteal cysts

Abnormal fluid filled sacs of the synovial membrane in the region of the popliteal fossa. Usually results from a complication of chronic knee joint effusion. May results from herniation of the gastrocnemius or semimembranosus bursa through the fibrous layer of the joint capsule into the popliteal fossa.

levetor ani origin

Body of pubis

Coxa Vara Angle (<120)

Bows the lower limb inward

In which area is pain arising from the hip joint most commonly experienced? Buttock Groin Anterior thigh Lateral leg

Buttock

Spinal cord injury at which level would directly impair function of the diaphragm? L2 C2 S2 T2

C2

SUBTALAR JOINT: WEIGHT BEARING-pronation

CORONAL PLANE: Calcaneal Eversion Transverse plane: talar adduction upon calcaneus Sagittal plane: plantar flexion

SUBTALAR JOINT: NON-WEIGHT BEARING-PRONATION

CORONAL PLANE: Calcaneal eversion Transverse plane: Calcaneal abduction Sagittal plane: Dorsiflexion

Which best describes pronation at the subtalar joint during weight bearing? Calcaneal inversion with abduction and dorsiflexion of the talus upon the calcaneus Calcaneal inversion, adduction, and plantar flexion Calcaneal eversion, abduction, and dorsiflexion Calcaneal eversion with adduction and plantar flexion of the talus upon the calcaneus

Calcaneal inversion, adduction, and plantar flexion

Which ligament provides direct resistance against supination of the subtalar joint? Calcaneofibular Tibiocalcaneal Short plantar Long plantar

Calcaneofibular

Transverse abdominis excersice

Cat/Cow

Bursitis in knee region

Caused by a friction between the skin and the patella. If inflammation is chronic the bursa becomes distended with fluid and forms a swelling to the knee

How is the stability of the ankle joint assessed? What does anterior translation test?

Checking the integrity of the anterior talus ligament

What are the superficial extrinsic back muscles function ?

Connect the upper limb to the trunk

metatarsophalangeal joint and ligaments

Connects the metatarsals to the digits. L: Collateral and plantar ligaments

tarsometatarsal joint and ligaments

Connects the tarsal bones to the metatarsal bones L:Dorsal, plantar, and interosseous tarsometatarsal ligaments

What does the transverse abdominis function eccentrically?

Control: Expansion of viscera

how does the intermediate intrinsic muscles of the spine act eccentrically?

Control: bilateral spine flexion Unilateral action: contralateral flexion of the spine

how does the intermediate intrinsic muscles of the spine act isometrically?

Control: bilateral spine flexion Unilateral action: contralateral flexion of the spine

What do the external obliques do eccentrically?

Control: bilateral trunk extension Unilateral: contralateral flexion ipsilateral rotation of trunk

What do internal obliques do eccentrically?

Control: trunk extension Unilateral action:contralateral lateral flexion of trunk, contralateral rotation of trunk

SUBTALAR JOINT: NON-WEIGHT BEARING-SUPINATION

Coronal Plane: Calcaneal inversion Transverse plane: calcaneal adduction Sagittal plane: Calcaneal plantar flexion

SUBTALAR JOINT: WIEGHT BEARING-SUPINATION

Coronal Plane: Calcaneal inversion Transverse plane: calcaneal adduction Sagittal plane: Calcaneal plantar flexion

Which femoral structure is most readily associated with outward bowing of the lower limb of the knee? Coxa valga Coxa vara Excessive anteversion Retroversion

Coxa valga

how does the intermediate intrinsic muscles of the spine act concentrically?

Create: bilateral spine extension Unilateral action: ipsilateral flexion of the spine

What do the external obliques do concentrically?

Create: bilateral trunk flexion Unilateral: ipsilateral lateral flexion of trunk contralateral rotation of trunk

How does the transverse abdominis function concentrically?

Create: compression of the viscera

What do internal obliques do concentrically?

Create: trunk flexion Unilateral action: ipsilateral lateral flexion of trunk, ipsilateral rotation of trunk

Which provides direct motor innervation to the intrinsic muscles of the spine? Dorsal root Ventral ramus Dorsal ramus Ventral root

Dorsal ramus

intermetatarsal joints and ligaments

Dorsal, plantar, interosseous tarsometarsal ligaments

How muscles of the spine receive their nerve supply?

Dorsal/potserior ramus

What motion of this joint are most associated with pronation in non-weight bearing?

Dorsiflexion, eversion, and abduction of the calcaneus

In moving from erect standing into left lateral flexion of the spine, which best describes the type of contraction performed by the right erector spinae? Concentric Eccentric Isometric

Eccentric

Which function of the extensor muscles of the spine is enhanced by the thoracolumbar fascia? Horizontal force transmission Lateral expansion during contraction Elastic assistance moving from flexion

Elastic assistance moving from flexion

Arthroscopy of Knee Joint

Endoscopic examination that allows visualization of the internal knee joint cavity with minimal disruption of the tissue

What are the intermediate intrinsic back muscles?

Erector spinae (iliocostalis, longissimus, spinalis)

Fractures of Hip Bone

Fractures of the hip bone are "pelvic fractures," although the term hip fracture is most commonly applied, unfortunately, to fractures of the femoral heads, neck, or trochanters. Avulsion fractures of the hip bone may occur during sports that require sudden acceleration or deceleration of forces. A small part of the bone with a piece of tendon or ligament attached is "avulsed" (torn away)—for example, the anterior superior and inferior iliac spines, and the ischial tuberosities

Back Spasm

From muscle or ligament injury, after performing and activity or movement, often sudden that puts excessive stress on back or other pathologies such as herniated/ruptured discs or arthritis.

Functions of the abdominal muscles

Functions-form a strong expandable support for this region, protect the abdominal viscera from injury, compress the abdominal viscera to maintain or increase intra-abdominal pressure, produced the force required for defecation, micturition, vomiting and parturition, produce anterior and lateral flexion and rotation of the trunk and help maintain posture.

What is an ankle sprain in the posterior tibiofibular ligament called?

High ankle sprain

Which are risk factors are associated with increased incidence of pelvic floor disorders in women as well as in men who have undergone treatment for prostate cancer? Higher body mass index and younger age Lower body mass index and younger age Higher body mass index and older age Lower body mass index and older age

Higher body mass index and older age

gluteal region: buttocks and hip. bony features. Be able to label them

Hip bone: Illium (contributes to the superior part of acetabulum): illiac crest, ala, anterior superior iliac spine, inferior superior iliac spine, greater sciatic notch, iliac fossa, posterior gluteal line, anterior gluteal line. *sup. Acetabulum Ischium: Ischium ramus, Ischiopubis ramus, ischial tuberosity, lesser sciatic notch, body of ischium, obturator foramen. *post. Acetabulum Pubis: pubis tubercle, inferior ramus of pubis

coxa valga (>135)

How does the shape of the femur affect the hip joint relative to the entire lower limb? Outward turning of the hip joint.

knee replacement

If a person's knee is diseased, an artificial knee joint may be inserted. The artificial knee joint consists of plastic and metal components that are cemented to the femoral and tibial bone ends after removal of defective areas.

How is the stability of the ankle joint assessed? What does inversion/eversion test?

Integrity of all the lateral ligaments

Which have direct attachments to the middle layer of the thoracolumbar fascia? Internal oblique and transversus abdominis External oblique and latissimus dorsi External oblique and transversus abdominis Internal oblique and latissimus dorsi

Internal oblique and transversus abdominis

Which muscles of the spine to focus?

Intrinsic intermediate: Erector Spinae. (iliocostalis, longissimus, spinalis) deep: Multifidus, semispinalis, rotadores

What ligaments limit internal rotation at the hip joint?

Ischiofemoral

internal intercostals

Muscle fibers in the internal intercostals run downward and backward between the ribs. Contraction of these muscles pull the ribs downward and inward. This decreases the volume of the thoracic cavity and assists forced expiration. The internal intercostals are innervated by intercostal nerves.

How does a disorder affecting spinal nerves S2 will impair functions?

It will affect bowel, sexual, and bladder

What are the walls of the pelvic cavity?

Lateral wall Posterior pelvic wall Pelvic floor

Leg and foot bones

Leg:femur, patella, tibia, fibula, Foot: tarsals, metatarsals, phalanges, calcaneous

The integrity of which ligament is most directly assessed through the application of a valgus force leading to relative abduction of the leg relative to the thigh? ACL MCL PCL LCL

MCL

What does the apenourosis of the TA and internal obliques blend with?

MTLF and PTLF AT the lateral raphe

What does the transverse abdominis function eccentrically?

Maintain Expansion of viscera

What do internal obliques do isometrically?

Maintain: trunk extension Unilateral action:contralateral lateral flexion of trunk, contralateral rotation of trunk

iliocostalis muscle

Most lateral *Lumborum, thoracis* *cervicis (inserts onto posterior tubercles of TPs C4-6)* Action: Extension (bilateral), lateral flexion same side (unilateral)

Which functions primarily in a stabilizing role? Intertransversarii Spinalis Multifidus Interspinalis

Multifidus

external intercostals

Muscle fibers in the external intercostals run downward and forward between the ribs. Contraction of these muscles raises and rotates the ribs, which increases the volume of the thoracic cavity. These muscles are involved in both quiet and forced inspiration. The external intercostals are innervated by intercostal nerves.

Can the muscles of respiration be trained?

Specially for exercise and sport performance Not proven beneficial for treatment of neuromuscular disorders Patients with neck pain have been shown to have imparements in max inspiration pressure, max. voluntary ventilation mobility of thoracic wall.

perineal membrane

Structure that separates deep and superficial perineal spaces

Which structures of the knee are innervated?

Suprapatellar puch, infrapatellar fat pad are the structures with more pain PCL, articular cartilage, medial meniscus, and ACL have no pain - Bursa and fat pads are some of the most sensible structures at the knee joint

What is the type of joint is the anterior head of the fibula ligament found?

Synovial plane

Surgical hip replacement

TA metal prosthesis anchored to the person's femur replaces the femoral head and neck and the acetabulum is often lined with a metal/plastic socket.

What about the talus provides stability to the fibiotibular joint?

The body of the talus is wider anteriorly

What about surface anatomy and back muscles can be visible?

The erector spinae muscles produce prominent vertical bulges on each side of the furrow. When upper limbs are elevated, the scapulae move laterally on thoracic wall, making the rhomboid and teres major muscles visible.

Interphalengeal joints and ligaments

The head of a phalanx to the base distal to it. L: collateral and plantar ligaments

Knee joint injuries- unhappy triad

The lateral side of the knee is struck more often (football tackle), the tibial collateral ligament is the most frequently torn ligament at the knee. The unhappy triad is the tibial collateral ligament (MCL), medial meniscus and the anterior cruciate ligament.

the intrinsic back muscles

They act to maintain posture and control movements of the vertebral column. They extend from the pelvis to the cranium and are enclosed by deep fascia.

Do the oblique muscles always work isometrically?

They don't Runner left rotation of trunk---> Right : EO & left: IO-->CONC/ Left: EO & right: IO-->ECC Right rotation--->left: EO& right: IO -concent Right: EO and left: IO: Ecc

extrinsic back muscles function

Thin muscles, commonly designated superficial respiratory muscles more likely proprioceptive rather than motor function

What does the interspinous, supraspinous-thoracolumbar ligament complex

Thought to prevent ligamentum of Flavum from buckling in the spinal canal during extension of spine or longitudinal compression.

Which ligament provides direct resistance against pronation of the subtalar joint? Calcaneofibular Tibiocalcaneal Short plantar Long plantar

Tibiocalcaneal

What are the ligaments that hold the head of the femur in the acetabulum?

Transverse acetabular ligament

levetor ani insertion

perineal body

rectus abdominis origin

pubic crest and symphysis

What kind of patients will benefit from respirataotry muscle training?

pulmonary disorders, cardiovascular disorders, post-mechanical ventilation, pre-post operatively, exercise/sport performance

Inspiration is associated with __________ volume and __________ pressure within the abdominal cavity. increased, increased increased, reduced reduced, reduced reduced, increased

reduced, increased

Defecation is associated with __________ of the coccygeus and __________ of the coccyx. contraction, flexion contraction, extension relaxation, extension relaxation, flexion

relaxation, extension

As the left lower limb trails behind and the right upper limb swings back, rotation of the trunk is controlled by eccentric contraction of the __________ external oblique and __________ internal oblique muscles. right, left left, right left, left right, right

right, left

multifidus insertion

spinous processes 2-4 segments superior to origin

What are the superficial intrinsic back muscles?

splenius capitis and splenius cervicis

Abdominal wall fascia

superficial fascia - superficial layer and deep layer (continuous with investing fascia of scrotum/penis) deep fascia transversalis fascia - investing fascia of entire abdominal wall, sep from peritoneum from extraperitoneal fatty tissue, forms femoral sheath and internal spermatic fascia

What type of clinical disorders are associated with pelvic floor dysfunction?

urinary incontinence urinary abnormalities pelvic organ prolapse fecal incotinence defecatory dysfunction sexual disfunction pelvic pain

Genu __________ has been associated with increased incidence of tibiofemoral osteoarthritis as well as greater risk of osteoarthritis progression in the __________ compartment of the tibiofemoral joint. varum, lateral varum, medial varum, medial valgum, medial

varum, medial

rectus abdominis insertion

xiphoid process and costal cartilages of ribs 5-7