A&P 3 Flashcards
What type of joint is the tibiofemoral joint?
Hinge; uniaxial
What are the four muscles that make up the Quadriceps muscle group?
~Rectus femoris
~Vastus lateralis
~Vastus medialis
~Vastus intermedius
What is an important fact about the Quadriceps?
It should be about 25-30% stronger than the hamstring muscles.
What is the primary action of the Vastus lateralis?
Knee extension (slight internal rotation)
Origin
~Intertrochanteric line, anterior and inferior borders of the greater trochanter, upper half of the linea aspera and the entire lateral intermuscular septum
Insertion
~Lateral border of patella, patellar tendon to tibial tuberosity
Vastus lateralis
What is the primary action of the Vastus intermedius?
Knee extension
Origin
~Upper two-thirds of anterior surface of femur
Insertion
~Upper border of patella and the patellar tendon of tibial tuberosity
Vastus intermedius
What is the primary action of the Vastus medialis?
Knee extension (slight external rotation
Origin
~Whole length of linea aspera and medial condyloid ridge
Insertion
~Medial half of the upper border of the patella and patellar tendon to the tibial tuberosity
Vastus medialis
What muscles make up the Hamstrings?
~Biceps femoris
~Semimembranosus
~Semitendinosus
What is an important function of the hamstrings?
Their flexibility
What are the functions of the popliteus?
~Knee flexion
~Knee internal rotation
~Provides posteriorateral stability of the knee
Origin
~Posterior surface of the lateral condyle of the femur
Insertion
~Upper posterior medial surface of tibia
Popliteus
What is the cause of a knee ligament sprain?
A force overwhelms ligament strength
What are the grades of a knee sprain?
~Grade 1 (stretch)
~Grade 2 (Partial tear)
~Grade 3 (complete tear)
What is the diagnosis of a knee ligament sprain?
Swelling starts in twenty to thirty minutes
How long does each grade of a knee ligament sprain take to heal?
~Grade one heals in about 7 days
~Grade two takes 2-3 weeks
~Grade three requires surgery
What is the initial treatment for a knee ligament sprain?
RICE
What is an important fact about knee ligament sprains?
60% of all significant knee ligament injuries involve at least a partial injury to the ACL
What are the causes of a torn ACL?
~’Play” develops between the femur and tibia
~ACL functions as a restraining “guidewire”
~Often caused by a blow to the lateral knee (often rupturing the medial collateral ligament, too)
What is the diagnosis of a torn ACL?
Swelling starts twenty to thirty minutes after injury
What test can be used to diagnosis a torn ACL?
Anterior drawer test
How long does each grade of a torn ACL take to heal?
~Grade one heals in about 7 days
~Grade two takes 2-3 weeks
~Grade three requires surgery
What is an important fact about a torn ACL?
Without a fully functional ACL, the knee has a 50% chance of becoming permanently unstable
What are the causes for a torn meniscus?
~Twist down too hard, the cartilage will rip
~Almost impossible to do by yourself, need an awkward fall, tackle, etc..
What are two important facts about a torn meniscus?
~Medial meniscus is torn four times as often as the lateral meniscus
~A torn cartilage is torn for good
What is the diagnosis of a torn meniscus?
~Sensation that something has ‘given way’
~Excess synovial fluid accumulates and it is very hard to bend the knee
~Pain on the medial (or lateral) aspect of the knee
~Piece of free cartilage can caused ‘locked knee’
~Surgery is a MUST
What is the recovery time for a torn meniscus?
3-6 weeks
What is the best procedure to use when diagnosing a torn meniscus?
An arthrogram (dye and x-ray)
What are the causes for a patella sublaxation?
~Outer structures of the knee (vastus lateralis) overpower the inner structures (vastus medialis)
~A kneecap ‘rides high’ (common in thin people)
~Patellar surface on the femur is too shallow
How would you diagnosis a patella sublaxation?
~Straight track test with flexed extensors
~Medial-lateral test with relaxed extensors
What is the treatment for a patella sublaxation?
~Exercise/ support
~If exercise is ineffective, surgery can fix the patellar surface or tighten surrounding muscles
What are the causes of patella chondromalacia?
~Kneecap instability
~Direct blow (traumatic chondromalacia)
~Genetic abnormality
~Unknown (overuse?)
What is the diagnosis of patella chondromalacia?
~Pain at the patella
~Intensifies with prolonged sitting
~Squatting or kneeling is painful
What are the test used to diagnose patella chondromalacia?
The crepitus and quadriceps inhibition tests are positive
What is the treatment for patella chondromalacia?
~Rest and anti-inflammatory medication for two weeks
~Severe cases require ‘shaving’
What is an important fact about runner’s knee?
30% of all runners/joggers experience Runner’s Knee, making it the most common lower body ailment with the exception of the ankle sprain
What are the causes for Runner’s knee?
~Overuse
~Micro-trauma in the area of the iliotibial band
~Prevalent in distance runners– not common in sprinters
What is the diagnosis of Runner’s knee?
~Pain is not localized, but lies over a broad area of the lateral knee joint
~Starts with mild discomfort and gets progressively worse without rest
What is the treatment for Runner’s Knee?
~Should rest at least a week and ice twenty minutes twice daily
~Virtually all cases involve natural ankle inversion- treated with an orthotic
What joints are in the ankle?
~Tibiofibular
~Talocrural
~Subtalar and transverse tarsal
What type of joint is the tibiofibular joint?
Syndesmoses
What type of joint is the talocrural joint?
Hinge
What type of joints are the subtalar and transverse tarsal joints?
Gliding joints
What are the primary actions of the extensor digitorum longus?
~Ankle dorsiflexion
~Extension of the four lesser toes
Origin
~Lateral condyle of the tibia
~Head of the fibula, upper tow-thirds of anterior surface of fibula
Insertion
~Tops of middle and distal phalanges of four lesser toes
Extensor digitorum longus
What are the primary actions of the extensor hallucis longus?
~Ankle dorsiflexion
~Extension of the great toe
~Weak inversion of the foot
Origin
~Middle two-thirds of medial surface of anterior fibula
Insertion
~Top of base of distal phalanx of great toe
Extensor hallucis longus
What are the primary action of the Tibialis anterior?
~Ankle dorsiflexion
~Inversion of the foot
Origin
~Upper two-thirds of lateral surface of tibia
Insertion
~Inner surface of medial cuneiform, first metatarsal bones
Tibialis anterior
What are the primary actions of the gastrocnemius?
~Ankle plantar flexion
~Knee flexion
Origin
~Posterior surfaces of two condyles of femur
Insertion
~Posterior surface of calcaneus
Gastrocnemius
What is the primary action of the soleus?
Ankle plantar flexion
Origin
~Proximal two-thirds of posterior surfaces of tibia and fibula
Insertion
~Posterior surface of calcaneus
Soleus
What are the primary actions of the tibialis posterior?
~Ankle plantar flexion
~Foot inversion
Origin
~Posterior surface of upper half of interosseous membrane, adjacent surfaces of tibia and fibula
Insertion
~Lower inner surfaces of navicular and cuneiform bones, bases of second, third, fourth, and fifth metatarsal bones
Tibialis posterior
What are the primary actions of the flexor digitorum longus?
~Ankle plantar flexion
~Foot inversion
~Flexion of the four lesser toes
Origin
~Middle third of posterior surface of tibia
Insertion
~Base of distal phalanx of each of four lesser toes
Flexor digitorum longus
What are the primary actions of the flexor hallucis longus?
~Flexion of the great toe
~Foot inversion
~Ankle plantar flexion
Origin
~Middle two-thirds of oosterior surface of fibula
Insertion
~Base of distal phalanx of large toe, undersurface
Flexor hallucis longus
What are the primary action of the peroneus brevis?
~Foot eversion
~Ankle plantar flexion
Origin
~Lower two-thirds of lateral surface of fibula
Insertion
~Tuberosity of fifth metatarsal bone
Peroneus brevis
What are the causes for shin splints?
~Overuse early in season ~Sprained tibialis posterior (75%) ~Inflamed tibia bone ~Anterior compartment syndrome (interrupted blood flow) ~Tibial stress fracture
What is the diagnosis of shin splints?
Pain starts about 2-3 hours after exercise
What is the treatment of shin splints?
~Rest and ice
~6-8 aspirin
~If it still hurts after one week, see a doctor
~Severe cases are treated effectively with orthotics
What is an important fact about shin splints?
You should never suffer shin splints with proper arch support protection
What is is the most common athletic injury?
Sprained ankle
What are some important points about sprained ankles?
~Almost all ankle sprains are inversion sprains
~There are three grades (1, 2, & 3)
~One and two- ligament sprains
What is the diagnosis of a sprained ankle?
~Instant onset of pain
~Something may ‘pop’
~Ankle has a period of pain free ‘shock’
~Pain will return about 30 minutes later
What is the resting time for each grade of a sprained ankle?
~Grade one, 4-5 days
~Grade two, 7-10 days
~Grade three, 2-3 weeks
What is important when treating a sprained ankle?
Ensure proper external support is accomplished through taping
What type of joint is the acetabular-femoral joint?
Ball and socket; multiaxial
What are the primary actions of the iliopsoas?
~Flexion of hip
~External rotation of femur
Origin
~Lower borders of the transverse processes of lumbar vertebrae 1-5 (psoas major and minor)
~Inner surface of the ilium (iliacus)
~Sides of the bodies of the last thoracic (T12), all the lumbar vertebrae (L1-5), intervertebral fibrocartilages, and base of sacrum (psoas major and minor)
Insertion
~Lesser trochanter of femur and shaft just below (iliacus and psoas major)
~Pectineal line and iliopectineal eminence (psoas minor)
Iliopsoas
What are the primary actions of the sartorius?
~Flexion of the hip
~External rotation of the thigh as it flexes the hip and knee
Origin
~Anterior superior iliac spine and notch just below the spine of ilium
Insertion
~Anterior medial condyle of tibia
Sartorius
What are the primary actions of the rectus femoris?
~Flexion of the hip
~Extension of the knee
Origin
~Anterior inferior iliac spine
~Groove (posterior) above the acetabulum
Insertion
~Superior aspect of the patella and patellar tendon to the tibial tuberosity
Rectus femoris
What are the primary actions of the pectineus?
~Flexion of the hip
~Adduction of the hip
~Internal rotation of the hip
Origin
~Space 1 inch wide on front of pubis above crest
Insertion
~Rough line leading from lesser trochanter to linea aspera
Pectineus
What are the primary actions of the gluteus maximus?
~Hip extension
~Hip external rotation
Origin
~Posterior one-fourth of the crest of ilium, posterior surface of the sacrum and coccyx near the ilium, and fascia of the lumbar area
Insertion
~Oblique ridge on lateral surface of the greater trochanter and iliotibial band of fascia latae
Gluteurs maximus
What are the primary actions of the semitendinosus?
~Hip extension
~Knee flexion
~Internal rotation of the hip
~Internal rotation of the knee
What two muscles provide important medial stability to the knee?
Semitendinosus & semimembranosus
Origin
~Ischial tuberosity
Insertion
~Upper anterior medial surface of tibia
Semitendinosus
What are the primary actions of the semimembranosus?
~Hip extension
~Knee flexion
~Internal rotation of the hip
~Internal rotation of the knee
Origin
~Ischial tuberosity
Insertion
~Posteromedial surface of the medial tibial condyle
Semimembranosus
What are the primary actions of the biceps femoris?
~Hip extension
~Knee flexion
~external rotation of the hip
~External rotation of the knee
What muscle provides important lateral stability to the knee joint?
Biceps femoris
Origin
~Ischial tuberosity
~Lower half of linea aspera, lateral condyloid ridge
Insertion
~Lateral condyle of tibia, head of fibula
Biceps femoris
What is the primary action of the external rotator muscles?
External hip rotation
What muscles make up the external rotator muscles?
~Piriformis ~Gemellus superior ~Gmellus inferior ~Obturator externus ~Obturator internus ~Quadratus femoris
Origin
~Sacrum, posterior portions of ischium and obturator foramen
Insertion
~Greater trochanter and posterior aspect of the greater trochanter
External rotator muscles
What are the primary actions of the tensor fasciae latae?
~Hip abduction
~Hip flexion
Origin
~Anterior iliac crest and surface of the ilium just below the crest
Insertion
~One-fourth of the way down the thigh into the iliotibial tract, which in turn inserts onto Gerdy’s tubercle of the anterolateral tibial condyle
Tensor fasciae latae
What are the primary action of the gluteus medius?
~Hip abduction
~Internal rotation
~External rotation
Origin
~Lateral surface ilium just below the crest
Insertion
~Posterior and middle surfaces of greater trochanter of the femur
Gluteus medius
What are the primary action of the gluteus minimus?
~Hip abduction
~Internal roation
Origin
~Lateral surface of ilium below the origin of the gluteus medius
Insertion
~Anterior surface of greater trochanter of the femur
Gluteus minimus
What are the primary action of the adductor longus?
~Adduction of the hip
~Assists with hip flexion
Origin
~Anterior pubis just below its crest
Insertion
~Middle third of the linea aspera
Adductor longus
What are the primary actions of the adductor brevis?
~Adduction of the hip
~External rotation with adduction (soccer kick)
Origin
~Front of the inferior pubic ramus just below the origin of the longus
Insertion
~Lower two-thirds of the pectineal line of the femur and the upper half of the medial lip of the linea aspera
Adductor brevis
What are the primary actions of the adductor magnus?
~Adduction of the hip
~External rotation as hip adducts (soccer kick)
Origin
~Eduge of entire ramus of the pubis and the ischium and ischial tuberosity
Insertion
~Whole length of linea aspera, inner condyloid ridge and adductor tubercle
Adductor magnus
What are the primary actions of the gracilis?
~Hip adduction
~Weak knee flexion
~Internal rotation of the hip
Origin
~Anterior medial edge of descending ramus or pubis
Insertion
~Anterior medial surface of tibia below condyle
Gracilis
What is avascular necrosis?
Bone marrow ischemia– a deterioration of the cartilage and bone
Who’s career eded due to bone marrow ischemia?
Bo Jackson
What is the cause for hip pointer?
A sharp blow to the hip results in tearing tendons at the iliac crest
What is the diagnosis for hip pointer?
~2-3 hours after injury the hip becomes sore
~A limp develops and it’s difficult to run
~Swelling
What is the treatment for hip pointer?
Rest and ice (2X daily for 20 mins)
What are the causes for a pelvic bone avulsion?
~Growing muscles overpower tendinous attachments
~Tendon snaps a bony attachment
~Powerful sprinting with ‘cold’ muscles (overuse)
What is an important point about bone avulsions?
80% of bone avulsions in young athletes occur at the hip
What is the diagnosis of a pelvic bone avulsion?
~Discoloration
~Pain with stretching
~X-rays are essential
What is the treatment for a pelvic bone avulsion?
Rest with crutches for 7-10 day
How long is the recovery time for a pelvic bone avulsion?
6 weeks to heal completely