TEST 3

True or False? During a trendelenburg gait, when the right leg assumes weight bearing the left hip drops down

True.

Patellar ligament

a strong flat ligament connecting the lower patella with the tibial tuberosity

The following muscle shares a common origin with the extensor digitorum longus

peroneus tertius (distal 1/3 of the anterior fibula)

Normal Q angles for men and women

10-15 degrees- men 15-20 degrees- women

A trendelenburg gait indicates a weakness of the following muscle group

hip abductors (gluteus maximus/medius/minimus, and tensor fascia lata)

A contracture of the psoas major creates a strong anterior pull on the low back which results in

lordosis, from a supine lying position

True or False? The illiotibial band is a cluster of vertical fibers extending from the pubic symphysis to the lateral condyle of the femur

False. (Gerdy's tubercle). True--> Extends from the tubercle of the iliac crest to the lateral condyle of the femur

True or False? Lateral meniscus tears occur more often than medial meniscus tears

False. True--> medial more than lateral. more likely to occur in movements that involve the femur rotating on the tibia when the knee is flexed (runner suddenly changing positions). the torn portion usually rolls up and locks the joint

True or False? The pelvis begins as a single boney structure, but by the on set of puberty it evolves into 3 distinct structures

False. fuse into a single bone by the time of puberty.

True or False? Is the vastus medialis solely responsible for the final 15 degrees of knee extension?

False. Not solely responsible even though it stabilizes the patella during knee extension

True or False? The ankle joint provides a basis for the medial/lateral motions of the foot?

False. Provides a basis for anterior/posterior (plantar flexor and dorsiflexion) movement of the foot

True or False? The gracilis is longer than the sartorius

False. Sartorius is the longest muscle in the body

True or False? The vastus lateralis is the muscle most active through the greatest range of knee extension

False. vastus medialis

Which muscle is NOT classified as one of the deep lateral rotators of the hip?

pectineus

This muscle has no involvement in lateral hip adduction or external rotation

pectineus (flexes and adducts the thigh at the hip joint)

Name some movements the quadriceps are involved in

-isolated knee extension movements -compound movements involving hip and knee extension such as: squats, lunges, leg presses, stepping up onto elevated surfaces, standing up from a seated position -open chain--> leg extension (from a seated position)

What muscles can cause or prevent knee extension?

oblique popliteal ligament, weakness of the hamstrings (biceps femoris and semit. and semimem.) results in genu recurvatum (hyperextension of the knee)

Origin and insertion of the 6 lateral rotators of the hip

origin- anterior sacrum, the ischium, the obturator foramen insertion- greater trochantear of the femur

The 6 deep lateral rotators of the hip are (name top to bottom)

piriformis, gemellus superior, obturator internus, gemellus inferior, obturator externus, quadratus femoris all lie directly underneath the gluteus maximus

What is the function of the malleoli (lateral and medial)?

provide a pulley function for the tendon attachments of the muscles that activate medial and lateral ankle motions

Fascia lata attachment/features

proximal attachment on the pelvic, sacral and coccyx area (lower spinal column) and attaches distally to the patella, tibial condyles (top of the tibia, below the knee) and head of the fibula. thin on the medial side but very dense on the lateral side thickened and strengthened by the iliotibial band (tract)

The following muscle is a knee extensor but can function as a hip flexor when performing straight leg raises in a supine position

rectus femoris

The unique function of crossing ones leg over the knee while in the sitting postion is accomplished by the

sartorius

Longest muscle in the body

sartorius (ribbon-like)

The pes anserinus is a common distal tendon expansion for the following muscles

sartorius, gracilis, semitendinosus

The tendency of the knee to move into a postion of genu recurvatum would be most likely attributed to the following muscles

semitendinosus, semimembranosus, and biceps femoris (the hamstrings)

The right and left halves of the pelvis are joined anteriorly by the

symphysis pubis

Bone that is regarded as the keystone of the arch of the foot

talus no muscles are attached to the talus

Contraction of the following muscle medially rotates the tibia thus allowing the extended knee to flex

the popliteus

Collectively, what is the most powerful muscle group in the body?

the quadriceps (vasti muscles, and rectus femoris)

The 2 sections of the pelvic girdle attach posteriorly to

the sacrum

When the knee is in a flexed position the primary plantar flexor muscle of the ankle is

the soleus (regardless of knee position, unlike gastrocnemius)

What two muscles and how much insert onto the iliotibial band/tract?

the tensor fascia latae and 3/4 of the gluteus maximus. (Gerdy's tubercle) Iliotibial band thickens and strengthens the fascia latae on the lateral side of the thigh

The 2nd longest bone in the body is the

tibia

During a walking gait this muscle contracts eccentrically to prevent the forefoot from slapping down hard at heel strike

tibialis anterior

Which muscle runs right by the shin/tibia?

tibialis anterior

Prime mover for lifting the forefoot towards the shin

tibialis anterior (dorsiflexon)

The following muscle is a prime mover for moving the sole of the foot medially

tibialis posterior

The following muscle is a prime mover for foot inversion

tibilais posterior

Bilateral leg raises from a supine position creates a pull on the anterior portion of the lumbar vertebrae that

tilts the pelvis anteriorly resulting in lordosis. must be countered by strong abdominal contraction to maintain pelvic stability

What is screw home rotation? What degree is required?

to lock the knee in full extension requires about 10 degrees of external rotation. Mechanically linked to flexion and extension actions occurring in sequence with each other.

What type of contraction of the quadriceps (quad setting) occurs when the knee is fully extended?

Static contraction. Pulls up or "sets" the patella. Used in initial stages of knee rehabilitation. Pull on patella is at an angle from the femur.The pull angle of the quadriceps is referred to as the Q angle

Transverse ligament

a short, slender cordlike ligament that connects anterior margin of the lateral meniscus to the medial meniscus

Lateral collateral ligament (LCL)

a strong cord that attaches the lateral epicondyle of the femur to the lateral head of the fibula. Checks extension and prevents medial motion ("checks opposite")

Pes cavus is best defined as

a very high longitude arch structure. pes planus--> flat arch a low arch would need to be in conjunction with additional deviations such as pronation or eversion (of the foot) to be problematic

Based on alignment, the gluteus minimus is a stronger hip internal rotator than during....

abduction but it contributes to both actions

Flexing the knee 10-15 degrees from extension places the iliotibial band....

anterior to the lateral femoral condyle, positioning it to assist knee extension

From a standing position, how does the popliteus unlock the extended knee prior to knee flexion movements?

by medially rotating the tibia. also helps protect and stabilize the knee joint from forward dislocation of the femur when a person is maintaining a squatting position (okay to squat below parallel)

Within the subtalar joint the talus sits on top of the

calcaneus

From a weight bearing position, the ankle must dorsiflex to allow knee flexion to occur, therefore the triceps surae (soleus and gastrocnemius)....

can prevent the knees from buckling (when the knee flexes forward) in the absence of strong knee extensors by maintaining the ankle in a position of plantar flexion. --if you lock the ankle in at 90 degrees with a brace, prevents buckling

Anterior tibiofibular ligament

connects the tibia to the fibula on the front side

Unique function of the sartorius

crossing one leg over the opposite knee while in a sitting position (Tailor position)

The following ligament structure crosses the posterior aspect of the knee... extension and prevents knee from rotating when it is in extension

cruciate ligaments

This ligament structure provides medial stability to the ankle

deltoid ligaments

The lateral malleolus is located at the

distal end of the fibula

Concentric muscle contraction of the triceps surae (soleus and gastrocnemius) action results in

elevating the heel with the forefoot fixed to the ground

The sartorius is an active hip flexor when the knee is...

extended or it is a knee flexor when the hip is extended

The longest bone in the body is the

femur

The Achilles Tendon is the distal attachment for

gastrocnemius

The following posterior muscle crosses 2 joints

gastrocnemius (knee and ankle)

What does weakness of the hamstrings result in?

genu recurvatum (hyperextension of the knee) hyperextension of the knee causes the person to lean forward at the knee to maintain their center of mass over their base of support (when already tight, more prone to pull an Achilles tendon--> huge problem during squats)

The facia latae is the facia structure that encloses the

gluteal region and the thigh musculature (skin covering meat)

The gluteus maximus has a point of insertion on the

gluteal tuberosity of the femur and illiotibial band

In addition to the tensor facia latae, a portion of the following muscle has an attachment to illiotibial band

gluteus maximus

When in a prone position with your left knee flexed to 50 degrees hyperextending your hip .... Contraction of the

gluteus maximus. prone=on stomach

Based on alignment, the gluteus medius is stronger during...

hip abduction than internal rotation, but contributes to both

A Trendelenburg gait (or gluteus medias limp) during ambulation is the result of excessive tightness of the

hip adductors (adductor brevis/longus/magnus/minimus, pectineus, gracilis) Trendelenburg gait--> shift weight to opposite side

The psoas major shares a common distal attachment with the

iliacus (iliopsoas) powerful hip flexors

Lumbar lordosis would most likely result from tightness of

iliopsoas (muscle imbalance) semimembranosus?

Gurdy's Tubercle is the distal attachment of the

iliotibial band (tract)

The 3 components of the pelvic girdle are

ilium, ishium, and pubis

Just as the scapula tilts or rotates to put the glenoid fossa in a support position to the humeral head during shoulder movement, the pelvic girdle tilts and rotates the acetabulum....

in a support position to the femoral head during hip movement

When the knee is flexed the semitendinsosus and semimembranosus are involved in...

internal rotation of the knee

The rectus femoris can function as a hip flexor when the knee...

is extended

The hamstrings are powerful hip extensors when the knee...

is extended (its involvement in hip extension is deactivated when the knee is flexed)

The Biceps femoris has an origin on the

ischial tuberosity

The following muscles constitute the strongest and most powerful muscle group is the

knee extensors (the quadriceps--> rectus femoris, vastus medialis/lateralis/intermedius)

Anterior and Posterior Cruciate ligaments (ACL and PCL)

2 strong cordlike ligaments that cross in the back of the knee connecting the femur to the tibia. Cruciate ligament functions: -limit extension and prevent rotation when the knee is in extension -prevent forward and backward sliding of the femur on the tibia, thus maintaining the anterior/posterior stability of the knee

Does the pelvic girdle move independently or as a unit?

As a unit.

What type of chain action is the femoral-on-tibial extension? Example?

Closed chain actions of knee extension. Such as standing up from a deep squat position (extremities still, body moves)

How do you remedy shin splints?

Concentric and eccentric strengthening of the dorsiflexor muscles. Stretching exercises to increases the flexibility of the plantar flexors

Explain the concentric/eccentric contraction involving the tibialis anterior during a walking gait

During human walking, the tibialis anterior contracts concentrically to lift the forefoot as the weight bearing foot clears the ground. --> Without this concentric action, excessive hip flexion would be required for the toe to clear. --> The tibialis anterior contracts eccentrically to prevent excessive plantar flexion at heel strike. (decelerator of the movement) --> Without this eccentric action, the foot would slap down hard at heel strike (foot slap).

True or False? The pull on the patella is directly verticle to the femur (regarding the Q angle)

False. True--> at an angle to the femur

Describe the iliotibial band function in knee flexion/extension

Flexing the knee 10-15 degrees (from extension), places the iliotibial band anterior to the lateral femoral condyle, positioning it to assist knee extension. As the knee continues to flex beyond 10-15 degrees, the iliotibial band shifts to a position posterior to the lateral femoral condyle and becomes a flexor of the knee joint.

What are the lateral and medial hamstrings?

Lateral- biceps femoris (lateral side of the posterior thigh) Medial- semitendinosus and semimembranosus

Name and describe the two arch structures

Longitudinal arch- extends from the heel to the heads of the 5 metatarsals Transverse arch- the side-to-side concavity on the underside of the foot formed by the anterior tarsal bones and the metatarsals (metatarsal arch- the anterior boundary of the transverse arch, underneath the metarsal heads)

What are pelvic girdle movements dependent on?

Lumbosacral and other lumbar joints (hip vs. trunk movement)

What type of muscle fibers is the soleus composed of?

More Type I (slow twitch) fibers (for endurance)

What is the pectineus' most favorable position?

Most favorable position for adduction when the hip is in some position of flexion

What muscles cause shin splints?

Muscle imbalance of tibialis posterior, soleus, and tibialis anterior, and possibly extensor digitorum longus

Does the iliposoas cross 2 joints from its origin to its insertion?

No.

Is the posterior superior iliac spine a measuring site of the Q angle?

No. Is measured with the patella, anterior superior iliac spine, and tibial tuberosity.

What type of chain action is the tibial-on-femoral extension? Example?

Open chain actions of knee extensions. Such as knee extension performed from a seated position (distal extremity moving in space)

True or False? The acetabulum provides a deeper receptacle for the femoral head as to compare to the humeral head and the glenoid fossa

True.

True or False? The metatarsal arch forms the anterior boundary of the transverse arch

True. underneath the metarsal heads.

True or False? The adductor magnus does NOT have a point of insertion on the greater trochanter of the femur

True. (insertion--> gluteal tuberosity of the femur, medial lip of linea aspera, medial supracondylar ridge, and adductor tubercle)

What type of muscle fibers is the gastrocnemius composed of?

Type I and Type II (fast twitch) fibers (for endurance and power/strength)

Yes or No? Does the pelvic girdle support hip movement in the same manner that the shoulder girdle movements support shoulder movement?

Yes.

Medial collateral ligament (MCL)

a broad flat band that attaches the medial epicondyle of the tibia. It is attached to the medial meniscus. Checks extension and prevents lateral motion ("checks opposite")

Oblique popliteal ligament

a broad flat ligament covering the back of the knee and attaching the posterior surface of the femur to the posterior head of the tibia (links femur to tibia). Protects against knee hyperextension.

How would you only use the vastus muscles?

lay them down on the table (supine), rectus femoris stretched, now extend knee to engage rectus femoris as well. Use vastus muscles only when the knee is flexed

Deltoid ligaments

located on the inside (medial) of the ankle and connects the tibia to the talus and calcaneus. provides MEDIAL stability to the ankle

What is the subtalar joint responsible for?

medial/lateral motion of the foot