Case 9 anatomy Flashcards
what does the gluteux maximus do?
extends and laterally rotates the hip joint
- it also works with the tensor fasciae latae to extend the knee joint through the iliotibial tract
what do the gluteus medius and minimus do?
- abduct the hip joint
- medially rotate the hip joint
- tilt the pelvis when walking to permit the opposite leg to clear the ground
where do the deep gluteal muscles insert?
- The piriformis, superior & inferior gemelli and obturator internus all insert into the upper border of the greater trochanter
- The quadrate femoris inserts into the quadrate tubercle
what is the origin of the deep gluteal muscles?
- Piriformis = anterior surface of sacrum
- Superior gemellus = ischial spine
- Inferior gemellus = ischial tuberosity
- Obturator internus = inner surface of obturator membrane
- Quadratus femoris = lateral border of the ischial tuberosity
what makes up the quadriceps femoris?
three vastus muscles and the rectus femoris
what is the origin of the rectus femoris?
anterior inferior iliac spine
where does the sartorius originate and insert?
anterior superior iliac spine to medial surface of proximal tibia
where does the vastus intermedius lie?
underneath the rectus femoris
where does the gracilis originate and insert?
ischiopubic ramus to just behind the sartorius on the tibia
which is the most superficial adductor muscle?
adductor longus
origin and insertion of adductor muscles
adductor magnus:
- Adductor part – Originates from the inferior rami of the pubis and the rami of ischium, attaching to the linea aspera of the femur.
- Hamstring part – Originates from the ischial tuberosity and attaches to the adductor tubercle and medial supracondylar line of the femur.
adductor longus:
- Originates from the pubis, and expands into a fan shape, attaching broadly to the linea aspera of the femur
adductor brevis:
- Originates from the body of pubis and inferior pubic rami. It attaches to the linea aspera on the posterior surface of the femur, proximal to the adductor longus.
what do the muscles of the posterior compartment do?
extend the hip joint and flex at knee joint
what is most superficial out of the semitendonous or semimembranous?
semitendonous
what does the gracilis do?
adducts the thigh at the hip and flexes the leg at the knee
where does the pectineus originate and insert?
superior pubic ramus to the pectineal line of femur
what does the pectineus do?
adducts and flexes the thigh
what are the boundaries of the femoral triangle?
- Superior boundary = inguinal ligament
- Medial boundary = adductor longus muscle
- Lateral boundary = sartorius muscle
what is the ring of cartilage that surrounds the acetablum called? what does it do?
acetabular labrum
- increases the size of the articular area of the acetabulum
where is the distal attachment of the capsule of the hip joint incomplete?
in the posterior region ?
what type of joint is the hip joint?
ball and socket synovial joint
what are the ligaments of the hip joint?
- Ligamentum teres
- Transverse (bridges the acetabular notch and joins the two ends of the acetabular labrum, thus forming a complete ring)
- Ischiofemoral
- Pubofemoral
- Iliofemoral
which movement do you forget with the hip joint?
medial and lateral rotation
where does iliopsoas insert?
lesser trochanter
what are the flexors of the hip?
- PECTINEUS
- TENSOR FASCIA LATAE
- iliopsoas
- sartorius
- rectus femoris
(no gracilis)
what are the adductors of the hip?
- PECTINEUS
- adductor longus, brevis, magnus
- gracilis
what are the medial rotators of the hip?
- TENSOR FASCIA LATAE
- GLUTEUS MINIMUS
- GLUTEUS MEDIUS
describe the blood supply of the hip joint
- The main blood supply to the femoral head is provided by the retinacular vessels from the medial and lateral circumflex femoral arteries which are branches of the profunda femoris
- The retinacular vessels from the medial circumflex are the most important as they enter the hip by passing under the unattached posterior part of capsule
- The retinacular vessels from the lateral circumflex have to pierce the iliofemoral ligament so they are smaller and fewer
- A small artery is present in the ligamentum teres; it provides a good blood supply in young children but atrophies after the age of seven
what type of joint is the knee joint?
modified hinge joint
how many articulations are there in the knee joint?
three articulations; two femorotibial and one femoropatellar
describe the capsule of the knee joints and its attachments?
- The capsule of the knee attaches proximally to the margins of the femoral condyles and distally to the margins of the tibial plateau
- The distal attachment is incomplete as the posterior edge of the tibia is crossed by the popliteus tendon
what are the intracapsular ligaments of the knee joint?
- Posterior cruciate ligament
* Anterior cruciate ligament
what are the extracapsular ligaments of the knee joint?
- lateral collateral ligament
- Medial collateral ligament
- Patellar ligament (patella to tibia)
- Oblique popliteal ligament (expansion of tendon of semimembranosus – arises from medial tibial condyle and passes toward lateral femoral condyle)
- Arcuate popliteal ligament (Y-shaped and is attached to the posterior portion of the had of the fibula)
which collateral ligament is separated from their meniscus?
lateral - by the popliteal tendon
what are the popliteal tendons?
Oblique popliteal ligament = an expansion of the semimembranosus tendon that strengthens the posterior aspect of the capsule
Arcuate popliteal ligament = a thickening of the posterior capsule fibres which arches over the tendon of the popliteus
where is the anterior cruciate ligament located? what does it do?
extends from the anterior intercondylar area of the tibial plateau to the posteromedial aspect of the lateral femoral condyle – it prevents anterior displacement of the tibia on the femur
where is the posterior cruciate ligament located? what does it do?
extends from the posterior intercondylar area of the tibial plateau to the anterolateral aspect of the medial femoral condyle – it prevents posterior displacement of the tibia on the femur
what are the mensici made of?
fibrocartilage
describe the lateral mensicus and where does it attach?
pad of fibrocartilage cartilage that forms four-fifths of a circle, it is attached anterior and posteriorly to the tibia and attached loosely to the capsule – it is separated from the lateral collateral ligament by the popliteal tendon
describe the medial mensicus and where does it attach?
a semi-circular pad of fibrocartilage that is attached anterior and posteriorly to the tibia – it is firmly attached to the capsule and medial collateral ligament
(MEDIAL MENISCUS IS BIGGER)
name the different bursae
- Suprapatellar
- Prepatellar (in front of patella)
- Deep infrapatellar
- Subcutaneous infrapatellar
- Gastrocnemius (lateral)
- Gastrocnemius (medial)
- Semimembranosus (behind)
- Anserine
- Popliteus (between popliteus tendon and capsule)
what are the flexers of the knee?
- GASTROCNEUMIUS
- SARTORIUS
- gracilis
- biceps femoris
- semimembranOSUS
- semitendinosus
what is another name for the ankle joint?
talocrural joint
what is the ankle joint? what type of joint?
between distal ends of tibia and fibula nad upper part of body of talus
hinge joint
where is the ankle joint weak and strong? where is it strongest?
capsule of the ankle joint is weak anteriorly and posteriorly but is strengthened medially and laterally by the medial and lateral ligaments respectively - medial ligament is strongest
what is the medial ligament called?
deltoid ligament
what is the lateral ligament made up of?
three parts:
• anterior talofibular
• posterior talofibular
• calcaneofibular
what is inversion and eversion of the ankle? where does it take place?
inversion (toes point in) and eversion of the ankle take place at the talocalcaneal (subtalar) articulation and at the transverse tarsal joints (calcaneocuboid and talonavicular)
what is the tarsus? what is the other bone that you get confused with?
cluster of 7 articulating bones
talus
what are the inverters of the ankle?
- Extensor hallucis longus
- Flexor hallucis longus
- Tibialis anterior
- Tibialis posterior
what are the everters of the ankle?
- Peroneus longus
- Peroneus brevis
- Peroneus tertius
what are the other joints of the foot?
- cuneonavicular (navicular and cuneiform bones)
- cuboideonavicular
- intercuneiform
- cuneocuboid
- tarsometatarsal
- intermetatarsal
- metatarsophalangeal
- interphalangeal
what is hilton’s law?
nerves that innervate the muscles that act on a joint, and those that innervate the skin over the joint, also innervate the joint
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