Exam 1 Flashcards
iliofemoral ligament
O: AIIS, acetabular rim
I: greater trochanter and intertrochanteric line
-strongest of the hip ligaments
-prevents hyperextension
pubofemoral ligament
O: ant/inf body and superior ramus of the pubis
I: joint capsule and medial part of iliofemoral ligament
-tightens with ext and abd
ischiofemoral ligament
O: ischial portion of acetabular rim
I: medial to greater trochanter
-weakest of the 3 ligaments
Extracapsular ligaments of the knee
- LCL (doesn’t reinforce capsule)
- MCL
- Oblique popliteal lig. (post)
- Arcuate lig. (post)
Intra-articular ligaments of the knee
- ACL
- PCL
- Transverse lig.
- all don’t reinforce capsule
medial meniscus
- c shaped
- attached to 5 sites
lateral meniscus
- o shaped
- 3 attachments
LCL
- unattached to capsule
- attach to lateral epicondyle
- inserts on head of fibula
- cordlike
- resists varus force
MCL
- reinforces joint capsule
- flat, ribbon like
- superficial layer attaches to medial epicondyle
- deep inserts on medial tibial condyle
- have a bursa in between the layers
- resists valgus force
oblique popliteal ligament
- continuation of semimembranosus
- rums lateral to posterior medial of lateral femoral condyle
arcuate ligament
-runs from fibular head to lateral condyle of femur and popliteal lig.
ACL
- medial portion of lateral femoral condyle to medial tibial plateau
- main restraint to anterior tibial translation
- protects against hyperextension
PCL
-posterior/lateral aspect of tibial spine to lateral aspect of medial femoral condyle
transverse ligament:
-connects the menisci to each other along their anterior edges
portions of the cruciate ligaments are ___ in every joint position
taut
order of muscles that originate on the lateral femoral condyle
superior:
- plantaris
- lateral head of gastrocnemius
- popliteus
what joint does not contribute to motion at the knee joint:
superior tibiofibular joint
articularis genu
-helps pull suprapatellar bursa and synovium from joint
prevents entrapment of capsule
main function of fibula
: to be a site of muscle attachment
groove for flexor hallucis longus tendon on :
talus
groove for fibularis longus tendon on:
cuboid
deltoid ligament
Anterior tibiotalar part
Tibionavicular part
Tibiocalcaneal part
Posterior tibiotalar part
Normal angle of inclination of femur:
115-140 degrees
normal hip torsion angle
10-20 degrees
anterior
-retroversion rotated less than 10 deg anterior to frontal plan
-anteversion rotated greater than 20 deg
pectineal line location
posterior femur
Function of Labrum
- increases surface area by 10%
- enlarges acetabulum to 2/3 of a sphere
- covers 1/2 of femoral head
- controls deformation
- joint proprioception
ligament of the head
- lies in a joint cavity
- surrounded by synovial tissue and fluid
- not a primary stabilizer
- conducts artery of the head of the femur
VMO
- oblique fibers that attach to patella
- help stabilize patella and allow it to track normally
- helps counteract the lateral force from rectus femoris
Adductor canal borders
anterior and lateral: vastus medialis
- posteriorly: adductor magnus/longus
- medial: sartorius which forms the roof
what passes through the adductor canal
femoral artery
femoral vein
saphenous nerve
lateral circumflex artery passes…
laterally deep to sartorius and rectus femoris
transverse branch pierces lateralis, descending branch poster to RF supplying lateralis to knee
ant/post branches of internal iliac artery
anterior: obturator artery internal pudendal artery inferior gluteal artery posterior: superior gluteal artery
Trendelenburg Sign
- from weakness of gluteus medius and minimus
- seen in dropping of non weight bearing hip during gait
contents of greater sciatic foramen
- superior gluteal artery, vein and nerve
- inferior gluteal artery, vein and nerve
- piriformis
- sciatic nerve
- posterior femoral cutaneous n.
- nerve to obturator internus
- internal pudendal artery and vein
- pudental nerve
- nerve to quadratus femoris
contents of lesser sciatic foramen
- obturator internus tendon
- internal pudendal artery and vein
- pudendal nerve
- nerve to obturator internus
to be considered a hamstring it must:
- cross two joints
- innervated by tibial nerve
- originate from the ischial tuberosity
which ligament is most likely to rupture with a inversion ankle sprain?
- anterior talofibular
- calcaneofibular
- posterior talo fibular ligament
which ligament gives you the high arch of the foot?
spring ligament: plantar calcaneonavicular ligament
femur articulation with patella
articulates with both facets from full extension to 90 degrees felxion
anterior meniscofemoral ligament
- helps control movement of meniscus
- Humphreys
posterior meniscofemoral ligament
- help control movement of meniscus
- Wrisberg
- more common for people to have Wrisberg
types of meniscus tears
- horizontal
- vertical longitudinal (bucket-handle)
- vertical radial/transverse
- flap/oblique
- complex degeneration (most common pathology)
Medial meniscus attachments:
5 on tibial planteau
- MCL
- semimembranosus
where do the tibial nerve and posterior tibial artery travel in the leg?
compartment in the transverse intermuscular septum
-between superficial and deep muscles of posterior leg
important landmarks of talus
-medial tubercle on posterior process (sulcus for tendon of FHL)
shape of phalanges
concave base
convex head
which tibiofibular joint is stronger?
posterior tibiofibular ligament
shape of the talocrural joint
-frontal plane: talar dome concave
Parasagittal plane: talar dome convex
ligaments at the subtalar joint
- interosseous talocalcaneal ligament
- medial talocalcaneal
- lateral talocalcaneal
- posterior talocalcaneal
- spring ligament
midtarsal joints
- talonavicular
- calcaneocuboid
long plantar ligament creates a tunnel for what?
tendon of fibularis longus
2nd layer of plantar surface of foot contains:
- quadratus plantae
- lumbricals
- tendon of FHL
- tendon of FDL
anterior division of L2-L4 supplies:
medial musculature of thigh
-obturator nerve
posterior division of L2-L4 supplies
anterior musculature of thigh
-femoral nerve
hip pointer nerve
iliohypogastric nerve
-runs over iliac crest
which nerve is susceptible to trauma during hernia repair?
ilioinguinal n
-runs inside of iliac crest into inguinal region
which nerve regulates cremaster reflex?
genito femoral n
L1-L2
-pierces psoas major
what is the only branch of the femoral nerve that goes distal to the knee?
saphenous nerve
what artery do you find deep/distal to the lumbosacral trunk?
superior gluteal artery
largest branch of the sacral plexus
sciatic nerve
when does common fibular and tibial nerve emerge from their common sheath?
-once they pass the piriformis (this is variable)
what nerve is susceptible to damage from tight clothing, belts, weight gain or pregnancy?
lateral femoral cutaneous nerve
Actions of piriformis
hip abd, ext, ER
actions of the tensor faciae latae
tenses fasciae latae
hip abd, IR, flexion
actions of obturator internus
hip add, ER, ext
superior gemellus actions
hip add, ER, ext
inferior gemellus actions
hip add, ER, ext
actions of quadratus femoris
hip ER, adduction
actions of pectineus
hip add, ER, slight flexion
actions of obturator externus
hip add, ER
extensor digitorum brevis actions
ext MTP and PIP joints
extensor digitorum brevis insertion
2-4 middle phalanges
lumbricals insertion
2-5 toes at dorsal aponeurosis
lumbricals actions
flex MTP
ext IP
add toward big toe
flexor hallucis brevis origin
cuboid
lateral cuneiforms
plantar calcaneocuboid ligament
flexor hallucis brevis actions
flex MTP 1st toe
ankle is more stable in which position?
dorsiflexion
main articulation that allows inversion and eversion of the foot
subtalar joint
functions of foot arches
- distribute weight onto heel and ball of foot
- act as shock absorbers during locomation
- enhance flexibility of foot on uneven surfaces
keystone of the medial longitudinal arch
talus
lateral longitudinal arch
- flatter than medial arch
- formed by calcaneus, cuboid and lateral metatarsals
transverse arch is formed by
cuboid, cuneiforms, bases of metatarsals
-crosses the midfoot
medial compartment of sole of foot
abductor and flexors of 1st digit
central compartment of sole of foot
short and long flexors of 2-4, adductor hallucis, lumbricals, quadratus plantae
lateral compartment of sole of foot
abductor and flexor of 5th digit
medial arch
highest part of the longitudinal arch
passive stablizers of the foot
- plantar aponeurosis
- plantar calcaneonavicular lig.
- long plantar lig.
- short plantar lig. (plantar calcaneocuboid lig.)
active stabilizers of transverse arch
fibularis longus tibialis posterior adductor hallucis (transverse head)
active stabilizers of longitudinal arch
- FHL (medial)
- Abd. Hallucis
- Flexor digitorum brevis
- Abd. digiti minimi
- Flex. hallucis brevis
- Tibialis posterior
- Adductor Hallucis
structures associated with the sustentaculum tali
plantar calcaneonavicular lig. medial talocalcaneal lig. tibiocalcaneal part of deltoid ligament FHL tendon supports the talus
which gender has a smaller angle of inclination of the femur?
women
-because of their wider pelvis
