Exam #2 (cumulative) Flashcards

1
Q

what muscles are included in the deep layer of intrinsic back muscles?

A

Transversospinales muscle group (semispinalis, multifidus, rotatores)

  • semispinalis is superficial
  • multifidus is deeper
  • rotatores are deepest
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2
Q

what are the 3 divisions of the semispinalis muscles?

A

semispinalis:

  • capitis
  • cervicis
  • thoracis
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3
Q

which muscle is responsible for the longitudinal buldge on each side in the back of the neck near the median plane?

A

semispinalis capitis

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4
Q

the rotatores muscles are best developed in which region?

A

thoracic

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5
Q

the multifidus muscles are best developed in which region?

A

lumbar

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6
Q

what is the origin, insertion, innervation, and action of the semispinalis muscles?

A
  • origin: arise from transverse processes of C4-T10 vertebrae
  • insertion: fibers run superiomedially to occipital bone and spinous processes in upper thoracic and cervical regions, spanning 4 to 6 segments
  • innervated by the posterior rami of spinal nerves
  • action: extend head and thoracic and cervical regions of vertebral column and rotates them contralaterally
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7
Q

what is the origin, insertion, innervation, and action of the multifidus muscle?

A
  • origin: arises from posterior sacrum, posterior superior iliac spine, aponeurosis of erector spinae, sacro-iliac ligaments, mammillary processes of lumbar vertebrae, transverse processes of thoracic vertebrae, and articular processes of C4-C7
  • insertion: thickest in lumbar region, fibers pass obliquely superomedially to entire length of spinous processes of vertebrae located 2 or 4 segments superior to origin
  • innervated by the posterior rami of spinal nerves
  • action: unilateral contraction rotates contralateral side; stabilizes vertebrae during local movements of vertebral column
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8
Q

what is the origin, insertion, innervation, and action of the rotatores muscles?

A
  • origin: aride from transverse processes of vertebrae; are best developed in thoracic region
  • insertion: fibers pass superomedially to attach to junction of lamina and transverse process or spinous process of vertebrae immediately (brevis) or 2 segments (longus) superior to vertebra of origin
  • innervated by the posterior rami of spinal nerves
  • action: may function as organs of proprioception; possibly stabilize vertebrae and assist with local extension and rotatory movements of vertebral column
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9
Q

what is the origin, insertion, innervation, and action of the interspinales muscles?

A

origin: superior surfaces of spinous processes of cervical and lumbar vertebrae
- insertion: inferior surfaces of spinous processes of vertebrae superior to vertebrae of origin
- innervated by the posterior rami of spinal nerves
- action: aid in extension and rotation of vertebral column

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10
Q

what is the origin, insertion, innervation, and action of the intertransversarii muscles?

A

origin: transverse processes of cervical and lumbar vertebrae
- insertion: transverse processes of adjacent vertebrae
- innervated by the posterior and anterior rami of spinal nerves
- action: aid in lateral flexion of vertebral column; acting bilaterally, stabilize vertebral column

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11
Q

what is the origin, insertion, innervation, and action of the levatores costarum muscles?

A

origin: tips of transverse processes of C7 and T1-T11 vertebrae
- insertion: pass inferolaterally and insert on rib between its tubercle and its angle
- innervated by the posterior rami of spinal nerves
- action: elevate ribs, assisting in respiration; assist with lateral flexion of vertebral column

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12
Q

where is the suboccipital triangle

A

-lies deep to the trapezius and semispinalis capitis muscles

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13
Q

what are the boundaries and the contents of the suboccipital triangle?

A
  • superomedially: rectus capitis posterior major
  • superolaterally: obliquus capitis superior
  • inferolaterally: obliquus capitis inferior
  • floor: posterior atlanto-occipital membrane and posterior arch of C1
  • roof: semispinalis capitis

-contents: vertebral artery and suboccipital nerve (C1)

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14
Q

what is the only capitis muscle that does not attach to the cranium?

A

obliquus capitis inferior

-attachments are to the spinous process of the C2 vertebrae and the transverse process of the C1 vertebrae

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15
Q

the head rotates to the right by the contraction of which muscles

A
  • sternocleidomastoid

- semispinalis capitis

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16
Q

the head rotates to the left by the contraction of which muscles?

A
  • obliquus capitis inferior
  • rectus capitis posterior (major and minor)
  • longissimus capitis
  • splenius capitis
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17
Q

what is the distribution of the suboccipital nerve?

A

-muscles of the suboccipital triangle

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18
Q

what is the distribution of the posterior rami of nerves

A

intrinsic back muscles and overlying skin adjacent to vertebral column

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19
Q

the lower limbs are specialized for what functions?

A
  • locomotion
  • supporting body weight
  • maintaining balance
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20
Q

how many regions are there in the lower limb? name them

A

1) gluteal region: transitional zone between trunk and free lower limbs (includes buttocks and hip region)
2) femoral region: referred to as the thigh. includes most of the femur
3) knee region: includes distal femur. proximal tibia and fibula, and patella
4) leg region: connects knee and ankle joints, includes tibia, fibula, calf
5) ankle or talocrural region: includes narrow distal leg and ankle (talocrural) joint
6) foot region: tarsus, metatarsus, phalanges

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21
Q

longest and heaviest bone in the body

A

femur

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22
Q

the angle of inclination of the femoral head in the adult is from ___ to ___ degrees, averaging ___

A

115, 140, 126

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23
Q

is the angle of the femoral head larger or lesser in females? why?

A

lesser, because of the increased width between the acetabulum and the greater obliquity of the shaft

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24
Q

why is the angle of inclination of the femoral head advantageous to bipedal walkers? Why is it harmful?

A
  • is allows greater mobility and flexibility
  • it imposes considerable strain on the neck of the femur, fractures of the neck may occur in older people a a result of a slight stumble if the neck has been weakened by osteoporosis
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25
Q

what is the function of the tibia

A

-weight bearing

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26
Q

the fibula assists in weight bearing

true or false?

A

false

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27
Q

what connects the tibia and the fibula?

A

interosseous membrane

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28
Q

what is the angle of inclination of the femoral head in a 3 year old child?

A

135 degrees

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29
Q

what is the angle of inclination of the femoral head in older adults?

A

120 degrees

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30
Q

how many tarsal bones are there

A

7

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31
Q

what is the largest and strongest bone in the foot

A

calcaneous

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32
Q

what is the superior surface of the talus called

A

the trochlea

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33
Q

what is the bone in the foot that carries the weight of the body?

A

talus

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34
Q

the _____ surface of the navicular projects to the tuberosity of the navicular

A

medial

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35
Q

a prominant _____ tuberosity is what may cause foot pain when pressed against the medial part of the shoe

A

navicular

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36
Q

all 3 cuneiforms articulate posteriorly with the navicular

true of false?

A

true

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37
Q

the metatarsus contain ___ long bones

A

5

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38
Q

the ____ metatarsal is the longest

A

2nd

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39
Q

how many phalanges do we have in 1 foot

A

14

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40
Q

which bones in the pelvic region are we able to palpate from the surface of the skin?

A
  • iliac crest
  • iliac tuberosity
  • anterior/posterior superior iliac spine
  • inguinal ligament
  • pubic crest
  • pubic symphysis
  • pubic tubercle
  • iliac tuberosity
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41
Q

which areas of the femur are we able to palpate from the surface of the skin?

A
  • greater trochanter
  • lateral epicondyle
  • medial epicondyle
  • patella
  • adductor tubercle
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42
Q

which areas of the leg can we palpate from the surface of the skin?

A
  • lateral/medial condyle of tibia
  • anterior tibial tubercle
  • head of fibula
  • neck of fibula
  • tibial tuberosity
  • anterior border and medial surface of tibia
  • lateral/medial malleolus
  • tuberosity of 5th metatarsal
  • tuberosity of navicular
  • calcaneal tuberosity
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43
Q

the fascia lata attaches to and is continuous with:

A
  • inguinal ligament, pubic arch, body of pubis, pubic tubercle, membranous layer of subcutaneous tissue
  • iliac crest
  • sacrum, coccyx, sacrotuberous ligament, ischial tuberosity
  • superficial aspects of knee bones
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44
Q

what are the 3 compartments of the thigh and gluteal regions?

A

-anterior (extensor), medial (adductor), posterior (flexor)

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45
Q

what is the main action of the anterior thigh muscles?

A

flexors of the hip, extensors of the knee

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46
Q

chief flexor of the hip joint

A

iliopsoas

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47
Q

what is the longest muscle of the body

A

sartorius

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48
Q

the actions of the sartorius muscle are mainly synergist

true or false?

A

true

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49
Q

the medial muscles’ primary function is what?

A

adduct the hip joint

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50
Q

the medial muscles of the thigh are innervated primarily by which nerve?

A

obturator nerve

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51
Q

the anterior thigh muscles of the thigh are primarily innervated by which nerve?

A

femoral nerve (except for psoas major = anterior rami of lumbar nerves)

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52
Q

what is the proximal attachment, distal attachment, innervation, and action of the pectineus muscle?

A

proximal: superior ramus of pubis
- distal: pectineal line of femur, inferior to lesser trochanter
- innervated by the femoral nerve, may receive branches from obturator nerve
- action: adducts and flexes hip joint, assist with medial rotation of the hip joint

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53
Q

what is the proximal attachment, distal attachment, innervation, and action of the sartorius muscle?

A
  • proximal: anterior superior iliac spine and superior part of notch inferior to it
  • distal: superior part of medial surface of tibia
  • innervated by the femoral nerve
  • action: flexes, abducts, and laterally rotates hip joint; flexes knee joint
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54
Q

what is the proximal attachment, distal attachment, innervation, and action of the psoas major muscle?

A
  • proximal: sides of T12-L5 vertebrae and discs between them; transverse processes of all lumbar vertebrae
  • distal: lesser trochanter of the femur
  • innervated by the anterior rami of lumbar nerves
  • action: acting with iliacus: flexing hip joint and stabilizing this joint; acting alone: postural muscle that helps control deviation of the trunk and is active during standing
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55
Q

what is the proximal attachment, distal attachment, innervation, and action of the iliacus?

A
  • proximal: iliac crest, iliac fossa, ala of sacrum, and anterior sacro-iliac ligaments
  • distal: tendon of psoas major, lesser trochanter, and femur distal to it
  • innervated by the femoral nerve
  • action: acting with psoas major: flexes hip joint and stabilizes this joint
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56
Q

what is the proximal attachment, distal attachment, innervation, and action of the rectus femoris?

A
  • proximal: anterior inferior iliac spine and ilium superior to acetabulum
  • distal: via common tendinous (quadriceps tendon) and independent attachment to base of patella, indirectly via patellar ligament to tibial tuberosity
  • innervated by femoral nerve
  • action: extend knee joint, stabilize hip joint and helps iliopsoas flex hip joint
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57
Q

what is the proximal attachment, distal attachment, innervation, and action of the vastus lateralis?

A
  • proximal: greater trochanter of the femur and lateral lip of linea aspera
  • distal: via common tendinous (quadriceps tendon) and independent attachment to base of patella, indirectly via patellar ligament; tibia and patella via aponeurosis
  • innervated by femoral nerve
  • action: extends knee joint
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58
Q

what is the proximal attachment, distal attachment, innervation, and action of the vastus medialis?

A
  • proximal: intertrochanteric line and medial lip of linea aspera
  • distal: via common tendinous (quadriceps tendon) and independent attachement to base of patella, indirectly via patellar ligament; tibia and patella via aponeurosis
  • innervated by femoral nerve
  • action: extends knee joint
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59
Q

what is the proximal attachment, distal attachment, innervation, and action of the vastus intermedius?

A
  • proximal: anterior and lateral surfaces of shaft of femur
  • distal: via common tendinous (quadriceps tendon) and independent attachment to base of patella, indirectly via patellar ligament
  • innervated by the femoral nerve
  • action: extend the knee joint
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60
Q

what are the walls and the contents of the femoral triangle?

A
  • superiorly by inguinal ligament, which forms the base
  • medially by adductor magnus
  • laterally by sartorius
  • apex is where the medial border of the sartorius crosses the lateral border of adductor longus
  • floor is formed by iliopsoas laterally and pectineus medially
  • roof is formed by fascia lata, cribriform fascia, subcutenaous tissue, and skin

contents:

  • femoral nerve
  • femoral artery
  • femoral vein
  • femoral canal
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61
Q

what is the proximal attachment, distal attachment, innervation, and action of the adductor longus muscle?

A
  • proximal: body of pubis inferior to pubic crest
  • distal: middle third of linea aspera of femur
  • innervated by the obturator nerve
  • action: adducts hip joint
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62
Q

what is the proximal attachment, distal attachment, innervation, and action of the adductor brevis?

A
  • proximal: body and inferior ramus of pubis
  • distal: pectineal line and proximal part of linea aspera of femur
  • innervated by the obturator nerve
  • action: adducts hip joint, and to some extend flexes it
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63
Q

what is the proximal attachment, distal attachment, innervation, and action of the adductor magnus (adductor part)?

A
  • proximal: inferior ramus of pubis, ramus of ischium
  • distal: gluteal tuberosity, linea aspera, medial supracondylar line
  • innervated by the obturator nerve
  • action: adducts hip joint, flexes hip joint
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64
Q

what is the proximal attachment, distal attachment, innervation, and action of the adductor magnus (hamstring part)?

A
  • proximal: ischial tuberosity
  • distal: adductor tubercle of femur
  • innervated by the tibial part of the sciatic nerve
  • action: adducts hip joint, extends hip joint
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65
Q

what is the proximal attachment, distal attachment, innervation, and action of the gracilis muscle?

A
  • proximal: body and inferior ramus of pubis
  • distal: superior part of medial surface of tibia
  • innervated by the obturator nerve
  • action: adducts hip joint, flexes knee joint, and helps rotate it medially
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66
Q

what is the proximal attachment, distal attachment, innervation, and action of the obturator externus?

A
  • proximal: margins of obturator foramen and obturator membrane
  • distal: trochanteric fossa of femur
  • innervated by the obturator nerve
  • action: laterally rotate hip joint, pulls head of femur into acetabulum holding pelvis steady
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67
Q

which nerve is the largest branch of the lumbar plexus?

A

femoral nerve

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68
Q

where does the femoral nerve divide into several terminal branches?

A

after entering the femoral triangle, divides into branches to the anterior thigh muscles

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69
Q

what is the terminal cutaneous branch of the femoral nerve

A

saphenous nerve

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70
Q

the obturator nerve descends along the _____ border of the _____ muscle and enters the thigh through the _______

A

medial, psoas, obturator foramen

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71
Q

what muscles are in the superficial layer of the gluteal muscles

A

gluteus maximus, medius, and minimus, and tensor fasciae latae

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72
Q

what is the proximal attachment, distal attachment, innervation, and action of the gluteus maximus?

A
  • proximal: ilium posterior to gluteal line, dorsal surface of sacrum and coccyx, and sacrotuberous ligament
  • distal: most fibers end in iliotibial tract, which inserts into lateral condyle of tibia: some fibers insert on gluteal tuberosity
  • innervated by inferior gluteal nerve
  • action: extends hip joint between flexed and standing positions and assists in its lateral rotation; steadies thigh and assists in rising form sitting position
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73
Q

what is the proximal attachment, distal attachment, innervation, and action of the gluteus medius?

A
  • proximal: external surface of ilium between anterior and posterior gluteal lines
  • distal: lateral surface of greater trochanter of femur
  • innervated by superior gluteal nerve
  • action: abduct and anterior portions medially rotate hip joint; keep pelvis level when opposite limb is elevated
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74
Q

what is the proximal attachment, distal attachment, innervation, and action of the gluteus minimus?

A
  • proximal: external surfaces of ilium between anterior and inferior gluteal lines
  • distal: anterior surface of greater trochanter of femur
  • innervated by the superior gluteal nerve
  • action: abduct and anterior portions medially rotate hip joint; keep pelvis level when opposite limb is elevated
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75
Q

what is the proximal attachment, distal attachment, innervation, and action of the tensor fascia latae?

A
  • proximal: anterior superior iliac spine; anterior part of iliac crest
  • distal: iliotibial tract, which attaches to lateral condyle of tibia
  • innervated by the superior gluteal nerve
  • action: flexes hip joint, acts with gluteus maximus to stabilize the extended knee joint
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76
Q

what is the proximal attachment, distal attachment, innervation, and action of the piriformis?

A
  • proximal: anterior surface of 2nd-4th sacral segments; superior margin of greater sciatic notch and sacrotuberous ligament
  • distal: superior border of greater trochanter of femur
  • innervated by nerve to piriformis
  • action: laterally rotate extended hip joint, abduct flexed hip joint, steady femoral head into acetabulum
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77
Q

what is the proximal attachment, distal attachment, innervation, and action of the obturator internus?

A
  • proximal: pelvic surface of ilium and ischium, obturator membrane
  • distal: medial surface of greater trochanter of femur
  • innervated by nerve to obturator internus
  • action: laterally rotate extended hip joint; abduct flexed hip joint, steady femoral head into acetabulum
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78
Q

what is the proximal attachment, distal attachment, innervation, and action of the superior gemellus?

A
  • proximal: ischial spine
  • distal: medial surface of greater trochanter of femur
  • innervated by the nerve to obturator internus
  • action: laterally rotate extended hip joint; abduct flexed hip joint, steady femoral head into acetabulum
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79
Q

what is the proximal attachment, distal attachment, innervation, and action of the inferior gemellus?

A
  • proximal: ischial tuberosity
  • distal: medial surface of greater trochanter of femur
  • innervated by nerve to quadratus femoris
  • action: laterally rotate extended hip joint; abduct flexed hip joint, steady femoral head into acetabulum
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80
Q

what is the proximal attachment, distal attachment, innervation, and action of the quadratus femoris?

A
  • proximal: lateral border of ischial tuberosity
  • distal: quadrate tubercle on intertrochanteric crest of femur and area inferior to it
  • innervated by nerve to quadratus femoris
  • action: laterally rotate hip joint, also pulls femoral head into acetabulum to stabilize hip joint
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81
Q

which muscles of the gluteal region do not attach to the greater trochanter of the femur?

A

gluteus maximus, tensor fascia latae, quadratus femoris

82
Q

what muscles are part of the deep gluteal region muscles?

A

piriformis, obturator internus, superior and inferior gemelli, quadratus femoris

83
Q

guteal bursae

A

flattened membranous sacs cintainins a capillary layer of synovial fluid, separate the gluteus maximus from adjacent strucutres
-located in areas subject to friction

84
Q

what are the 3 bursae associated with gluteus maximus?

A
  • trochanteric bursae: separates deep aspect of gluteus maximus from greater trochanter
  • ischial bursae: separates inferior border of gluteus maximus from ischial tuberosity
  • gluteofemoral bursae: separates iliotibial tract from superior part of proximal attachmetn of vastus lateralis
85
Q

the posterior thigh muscles are innervated by which nerve?

A

tibial division of sciatic nerve

86
Q

how many joints do the posterior thigh muscles (semitendinosus, semimembranosus, biceps femoris long head) span?

A

2

87
Q

what is the proximal attachment, distal attachment, innervation, and action of the semitendinosus muscle?

A
  • proximal: ischial tuberosity
  • distal: medial surface of superior part of tibia
  • innervated by the tibial division of sciatic nerve
  • action: extend hip joint, flex knee joint and rotate the left medially when knee is flexed, when hip and knee are flexed, can extend trunk
88
Q

what is the proximal attachment, distal attachment, innervation, and action of the semimembranosus?

A
  • proximal: ischial tuberosity
  • distal: posterior part of medial condyle of tibia, reflected attachments form the oblique popliteal ligament
  • innervated by the tibial division of the sciatic nerve
  • action: extend hip joint, flex knee joint and rotate the left medially when knee is flexed, when hip and knee are flexed, can extend trunk
89
Q

what is the proximal attachment, distal attachment, innervation, and action of the biceps femoris long head?

A
  • proximal: ischial tuberosity
  • distal: lateral side of head of fibula, tendon is split at this site by fibular contralateral ligament of knee
  • innervated by the tibial division of sciatic nerve
  • action: flexes knee joint and rotates it laterally when knee is flexed; extends hip joint
90
Q

what is the proximal attachment, distal attachment, innervation, and action of the biceps femoris short head?

A
  • proximal: linea aspera and lateral supracondylar line of femur
  • distal: lateral side of head of fibula, tendon is split at this tite by fibular contralateral ligament of knee
  • action: flexes knee joint and rotates it laterally when knee is flexed; extends hip joint
91
Q

what is the distribution of the sciatic nerve?

A

-supplies no muscles in the gluteal region; supplies all muscles in the posterior compartment of the thigh

92
Q

what is the distribution of the superior gluteal nerve?

A

-innervates gluteus medius, gluteus minimus, and tensor fasciae latae

93
Q

what is the distribution of the inferior gluteal nerve?

A

innervates gluteus maximus

94
Q

what is the distribution of the nerve to quadratus femoris?

A

innervates hip joint; inferior gemellus and quadratus femoris

95
Q

what is teh distribution of the nerve to obturator internus?

A

supplies superior gemellus and obturator internus

96
Q

what is the popliteal fossa?

A

-mostly fat filled, diamond shaped space posterior to the knee joint; all important vessels and nerves from the thigh to the leg pass through this fossa

97
Q

what are the boundaries of the popliteal fossa?

A
  • biceps femoris superolaterally
  • semimembranosus superomedially, medial to which is the semitendinosus tendon
  • lateral and medial heads of the gastrocnemius, inferolaterally and inferomedially
  • skin and popliteal fascia posteriorly (roof)
  • popliteal surface of the femur, posterior capsule of the knee joint, and the popliteus fasica covering the popliteus muscle
98
Q

what are the contents of the popliteal fossa?

A
  • tibial and common fibular nerves

- fat

99
Q

the leg contains the tibia, the fibula, and the femur

true or false?

A

false, the leg is considered only the lower part of the extremity, so only the tibia and fibula

100
Q

the leg is separated into how many compartments?

A

3

-anterior, lateral, posterior

101
Q

what is the main action of the anterior compartment of the leg

A

this is the dorsiflexor (extensor) compartment

102
Q

what are the 4 muscles in the anterior compartment of the leg?

A
  • tibialis anterior
  • extensor digitorum longus
  • extensor hallucis longus
  • fibularis tertius
103
Q

what is another name for the deep fibular nerve?

A

deep peroneal nerve

104
Q

the muscles of the anterior compartment of the leg are innervated by which nerve?

A

-deep fibular (peroneal) nerve

105
Q

what is the proximal attachment, distal attachment, innervation, and action of tibialis anterior?

A
  • proximal: lateral condyle and superior 2/3 of lateral surface of the tibia and interosseous membrane
  • distal: medial and inferior surfaces of medial cuneiform and base of first metatarsal
  • innervated by the deep fibular (peroneal) nerve
  • action: dorsiflexes ankle; inverts foot; supports medial longitudinal arch of foot
106
Q

what is the proximal attachment, distal attachment, innervation, and action of the extensor hallucis longus?

A
  • proximal: middle part of anterior surface of fibula and interosseous membrane
  • distal: dorsal aspect of base of distal phalanx of hallux
  • innervated by the deep fibular (peroneal) nerve
  • action: extends great toe; dorsiflexes ankle
107
Q

what is the proximal attachment, distal attachment, innervation, and action of extensor digitorum longus?

A
  • proximal: lateral condyle of tibia and superior 2/3 of anterior surface of fibula and interosseous membrane
  • distal: middle and distal phalanges of lateral 4 digits
  • innervated by the deep fibular (peroneal) nerve
  • action: extends lateral 4 digits, dorsiflexes ankle
108
Q

what is the proximal attachment, distal attachment, innervation, and action of the fibularis tertius?

A
  • proximal: inferior third of anterior surface of fibula and interosseous membrane
  • distal: dorsum of base of 5th metatarsal
  • innervated by the deep fibular (peroneal) nerve)
  • action: dorsiflexes ankle, aids in eversion of foot
109
Q

what is the proximal attachment, distal attachment, innervation, and action of fibularis longus?

A
  • proximal: head and superior 2/3 of lateral surface of fibula
  • distal: base of 1st metatarsal and medial cuneiform
  • innervated by the superficial fibular nerve
  • action: evert foot; weakly plantarflex ankle; supports transverse arch of foot
110
Q

what is the proximal attachment, distal attachment, innervation, and action of fibularis brevis?

A
  • proximal: middle part of lateral surface of fibula
  • distal: dorsal surface of tuberosity of base of 5th metatarsal
  • innervated by the superficial fibular nerve
  • action: evert foot; plantarflex ankle
111
Q

what is the main action of the lateral compartment of the leg muscles?

A

this is the everter compartment

112
Q

what are the 2 muscles of the lateral compartment of the leg?

A
  • fibularis longus

- fibularis brevis

113
Q

what nerve innervated the muscles of the lateral compartment of leg?

A

superficial fibular nerve

114
Q

the superficial fibular continues down the foot as which nerve?

A

cutaneous nerve

115
Q

what is the main action of the muscles of the posterior compartment of the leg?

A

this is the plantarflexor compartment

116
Q

the gastrocnemius and soleus together form the 3 headed ______

A

triceps surae

117
Q

what is the proximal attachment, distal attachment, innervation, and action of the gastrocnemius?

A
  • proximal: lateral head: lateral aspect of the lateral condyle of the femur; medial head: popliteal surface of femur, superior to medial condyle
  • distal: posterior surface of the calcaneus via calcaneal tendon
  • innervated by the tibial nerve
  • action: plantarflexes ankle when knee is extended; raises heal during walking; flexes knee joint
118
Q

what is the proximal attachment, distal attachment, innervation, and action of the soleus?

A
  • proximal: posterior aspect of head of fibula, superior quarter of posterior surface of fibula, soleal line, and medial border of tibia
  • distal: posterior surface of calcaneus via calcaneal tendon
  • innervated by the tibial nerve
  • action: plantarflexes ankle; steadies leg on foot
119
Q

what is the proximal attachment, distal attachment, innervation, and action of the popliteus?

A
  • proximal: lateral surface of lateral condyle of femur and lateral meniscus
  • distal: posterior surface of tibia, superior to soleal line
  • innervated by the tibial nerve
  • action: weakly flexes knee and unlocks it by laterally rotating femur on fixed tibia, may also medially rotate tibia of unplanted limb
120
Q

what is the proximal attachment, distal attachment, innervation, and action of the flexor hallucis longus?

A
  • proximal: inferior 2/3 of posterior surface of fibula and inferior part of interosseous membrane
  • distal: base of distal phalanx of the hallux
  • innervated by the tibial nerve
  • action: flexes great toe at all joints, weakly plantarflexes ankle, supports medial longitudinal arch of foot
121
Q

what is the proximal attachment, distal attachment, innervation, and action of flexor digitorum longus?

A
  • proximal: medial part of posterior surface of tibia inferior to soleal line and by a broad tendon to fibula
  • distal: bases of distal phalanges of lateral four digits
  • innervated by the tibial nerve
  • action: flexes lateral 4 digits ; plantarflexes ankle; supports the longitudinal arch of foot
122
Q

what is the proximal attachment, distal attachment, innervation, and action of the tibialis posterior?

A
  • proximal: interosseous membrane, posterior surface of tibia inferior to soleal line, and posterior surface of fibula
  • distal: primarily to tuberosity of navicular; also to cuneiforms, cuboid, and the base of metatarsal 2nd-4th
  • innervated by the tibial nerve
  • action: plantarflexes ankle inverts foot; supports medial longitudinal arch of foot
123
Q

the ____ is considered to be an antigravity muscle (the predominant plantarflexor for standing and strolling)

A

soleus

124
Q

which muscle in the posterior compartment of the leg is absent in 5-10% of people? This muscle is often used for tendon grafting since it has no real purpose)

A

plantaris

125
Q

what is the distribution and origin of the tibial nerve?

A
  • distribution: supplies plantar flexor muscles of posterior compartment of leg and knee joint
  • origin: branch off sciatic nerve
126
Q

what is the origin and distribution of the common fibular nerve?

A
  • origin: sciatic nerve
  • distribution: supplies skin on lateral part of posterior aspects of leg via its branch, the lateral sural cutaneous nerve; also supplies knee joint via its articular branch
127
Q

what is the origin and the distribution of the superficial fibular nerve?

A
  • origin: common fibular nerve
  • distribution: supplies fibular muscles of lateral compartment of leg and skin on distal third of anterior surface of leg and dorsum of foot, except skin of first interdigital cleft
128
Q

what is the origin and distribution of the deep fibular nerve?

A
  • origin: common fibular nerve
  • distribution: supplies dorsiflexor muscles of anterior compartment of leg, extensor muscles on dorsum of foot and skin of first interdigital cleft; sends articular branche to joints it crosses
  • supplies extensor digitorum/extensor hallucis brevis
129
Q

the skeleton of the foot consists of ___ tarsals, ___ metatarsals, and ___ phalanges

A

7, 5, 14

130
Q

the hindfoot is comprised of which bones?

A

talus and calcaneus

131
Q

the midfoot is comprised of which bones?

A

-navicular, cuboid, and cuneiforms

132
Q

the forefoot is comprised of which bones?

A

-metatarsals and phalanges

133
Q

we have ___ plantar muscles, ___ intermediate muscles, and ___ dorsal extensor muscles

A

14, 4, 2

134
Q

the plantar muscles main function is what?

A

-primarily function as a group during the support phase of stance to maintain the arches of the foot

135
Q

plantar interossei muscles ______, whereas dorsal interossei muscles _____

A

adduct, abduct

136
Q

what is the proximal attachment, distal attachment, innervation, and action of abductor hallucis?

A
  • proximal: medial tubercle of tuberosity of calcaneus, flexor retinaculum, and plantar aponeurosis
  • distal: medial side of base of proximal phalanx of 1st digit
  • innervated by the medial plantar nerve
  • action: abducts and flexes 1st digit
137
Q

what is the proximal attachment, distal attachment, innervation, and action of flexor digitorum brevis?

A
  • proximal: medial tubercle of tuberosity of calcaneus, plantar aponeurosis, and intermuscular septa
  • distal: both sides of middle phalanges of lateral 4 digits
  • innervated by the medial plantar nerve
  • action: flexes lateral 4 digits
138
Q

what is the proximal attachment, distal attachment, innervation, and action of abductor digiti minimi

A
  • proximal: medial and lateral tubercles of tuberosity of calcaneus, plantar aponeurosis, and intermuscular septa
  • distal: lateral side of base of proximal phalanx of 5th digit
  • innervation: lateral plantar nerve
  • action: abducts and flexes 5th digit
139
Q

what is the proximal attachment, distal attachment, innervation, and action of quadratus plantae?

A
  • proximal: medial surface and lateral margin of plantar surface of calcaneus
  • distal: posterolateral margin of tendon of flexor digitorum longus
  • innervation: lateral plantar nerve
  • action: assists flexor digitorum longus in flexing lateral four digits
140
Q

what is the proximal attachment, distal attachment, innervation, and action of lumbricals?

A
  • proximal: tendons of flexor digitorum longus
  • distal: medial aspect of expansion over lateral 4 digits
  • innervation: medial one: medial plantar nerve; lateral 3: lateral plantar nerve
  • action: flex proximal phalanges, extend middle and distal phalanges of lateral four digits
141
Q

what is the proximal attachment, distal attachment, innervation, and action of flexor hallucis brevis?

A
  • proximal: plantar surfaces of cuboid and lateral cuneiform
  • distal: both sides of base of proximal phalanx of first digit
  • innervation: medial plantar nerve
  • action: flexes proximal phalanx of 1st digit
142
Q

what is the proximal attachment, distal attachment, innervation, and action of adductor hallucis?

A
  • proximal: oblique head: bases of metatarsals 2-4; transverse head: plantar ligament of 3rd to 5th metatarsophalangeal joints
  • distal: tendons of both heads attach to the lateral side of base of proximal phalanx of first digit
  • innervation: deep branch of lateral plantar nerve
  • action: adducts 1st digit; assists in maintaining transverse arch of foot
143
Q

what is the proximal attachment, distal attachment, innervation, and action of flexor digiti minimi brevis

A
  • proximal: base of 5th metatarsal
  • distal: base of proximal phalanx of 5th digit
  • innervation: superficial branch of lateral plantar nerve
  • action: flexes proximal phalanx of 5th digit, thereby assisting with its flexion
144
Q

what is the proximal attachment, distal attachment, innervation, and action of plantar interossei (3 muscles)

A
  • proximal: bases and medial metatarsals 3-5
  • distal: medial sides of bases of proximal phalanges of 3rd to 5th digits
  • innervation: lateral plantar nerve
  • action: adducts digits (3-5) and flex metatarsophalangeal joints
145
Q

what is the proximal attachment, distal attachment, innervation, and action of dorsal interossei (4 muscles)

A
  • proximal: adjacent sides of metatarsals 1-5
  • distal: first: medial side of proximal phalanx of 2nd digit; second to fourth: lateral sides of 2nd-4th digits
  • innervation: lateral plantar nerve
  • action: abducts digits 2-4 and flex metatarsophalangeal joints
146
Q

what is the distribution and origin of the medial plantar nerve?

A
  • origin: tibial nerve
  • distribution: supplies plantar aspect of medial foot and 3 1/2 digits, plus sides and distal dorsal aspects of those digits; also supplies abductor hallucis, flexor digitorum brevis, flexor hallucis brevis, and first lumbrical
147
Q

what is the origin and distribution of the lateral plantar nerve?

A
  • origin: tibial nerve
  • distribution: supplies quadratus plantae, abductor digiti minimi, and flexor digiti minimi; deep branch supplies plantar and dorsal interossei, lateral three lumbricals, and adductor hallucis
148
Q

the gait cycle consists of which 2 phases?

A
  • stance phase: begins with the heel strike when the heel strikes the ground and begins to assume the body’s full weight and ends with push off from the forefoot
  • swing phase: begins after push off, when the toes leave the ground, and ends when the heel strikes the ground

(swing phase = 40% of walking cycle, stance phase = 60%)

149
Q

what are the active muscle groups during the heel strike of the stance phase?

A
  • ankle dorsiflexors
  • hip extensors
  • intrinsic muscles of foot
  • long tendons of foot
150
Q

what are the active muscle groups during the loading response of the stance phase?

A
  • knee extensors
  • ankle plantarflexors
  • hip abductors
  • intrinsic muscles of foot
  • long tendons of foot
151
Q

what are the active muscle groups during the midstance of the stance phase?

A
  • knee extensors
  • ankle plantarflexors
  • hip abductors
  • intrinsic muscles of foot
152
Q

what are the active muscle groups of the terminal stance of the stance phase?

A
  • ankle plantarflexors
  • hip abductors
  • instrinsic muscles of foot
  • long tendons of foot
153
Q

what are the active muscle groups in the preswing of the stance phase?

A
  • long flexors of digits
  • intrinsic muscles of foot
  • long tendons of foot
  • flexors of hip
154
Q

what are the active muscle groups during the initial swing of the swing phase?

A
  • flexor of hip

- ankle dorsiflexors

155
Q

what are the active muscle groups during the midswing of the swing phase?

A

-ankle dorsiflexors

156
Q

what are the active muscle groups during the terminal swing of the swing phase?

A
  • hip extensors
  • knee flexors
  • ankle dorsiflexors
  • knee extensors
157
Q

what are the attachments of the iliofemoral ligament? what is its action?

A
  • attaches to the anterior inferior iliac spine and acetabular rim, intertrochanteric line distally
  • action: prevents hyperextension of the hip joint
158
Q

what are the attachments and the action of the pubofemoral ligament?

A
  • attachments: arises from the obturator crest of the pubic bone, merges with the fibrous part layer of the joint capsule, blends with the medial part of the iliofemoral ligament
  • action: resists excessive abduction of the hip
159
Q

what are the attachments and the action of the ischiofemoral ligament?

A
  • attachments: arises from ischial part of acetabular rim, neck of femur
  • action: weak ligament, action not specified in textbook
160
Q

which muscles act as flexors at the hip joint?

A
  • iliopsoas
  • sartorius
  • tensor fasciae latae
  • rectus femoris tendon
  • pectineus
  • adductor longus
  • adductor brevis
  • adductor magnus
  • gracillis
161
Q

which muscles act as adductors at the hip joint?

A
  • pectineus
  • adductor longus
  • adductor brevis
  • adductor magnus
  • obturator externus
  • gracilis
162
Q

which muscles act as lateral rotators at the hip joint?

A
  • obturator externus and internus
  • piriformis
  • gemelli
  • quadratus femoris
  • gluteus maximus
  • gluteus medius and minimus
163
Q

which muscles act as extensors at the hip joint?

A
  • gluteus maximus
  • semitendinosus
  • semimembranosus
  • long head of biceps femoris
  • adductor magnus
164
Q

which muscles act as abductors at the hip joint?

A
  • gluteus medius
  • gluteus minimus
  • tensor fasciae latae
165
Q

whic muscles act as medial rotators at the hip joint?

A
  • gluteus medius
  • gluteus minimus
  • tensor fasciae latae
166
Q

which structures limit flexion at the hip joint?

A
  • soft tissue apposition
  • tension of joint capsule posteriorly
  • tension of gluteus maximus
167
Q

which structures limit extension at the hip joint?

A
  • ligaments: iliofemoral, ischiofemoral, and pubofemoral

- tension of iliopsoas

168
Q

which structures limit abduction at the hip joint?

A
  • ligaments: pubofemoral, ischiofemoral, and inferior band of iliofemoral
  • tension of hip adductors
169
Q

which structures limit adduction at the hip joint?

A
  • soft tissue apposition

- tension of iliotibial band, superior joint capsule, superior band of iliofemoral ligament, and hip abductors

170
Q

which structures limit internal rotation at the hip joint?

A
  • ligaments: ischiofemoral and posterior joint capsule

- tension of external rotators of hip joint

171
Q

which structure limit external rotation at the hip joint?

A

-ligaments: iliofemoral, pubofemoral, and anterior joint capsule

172
Q

name the joints of the knee

A
  • 2 femorotibial joints

- 1 intermediate femoropatella articulation

173
Q

what are the 5 ligaments that strengthen the knee joint?

A
  • patellar
  • tibial collateral
  • oblique popliteal
  • arcuate popliteal
  • fibular collateral
174
Q

fibular (lateral) collateral ligament

A
  • rounded, cord like, and strong
  • extends from lateral epicondyle of the femur to lateral surface of head of fibula
  • tendon of popliteus passes deep to LCL, separating it from lateral meniscus
175
Q

tibial (medial) collateral ligament

A
  • strong flat band
  • extends from medial epicondyle of femur to the medial condyle and superior part of the medial surface of the tibia
  • at its midpoint, deep fibers are firmly attached to the medial meniscus
176
Q

oblique popliteal ligament

A
  • reflected expansion of the tendon of semimembranosus that strengthens joint capsule posteriorly
  • arises posterior to the medial tibial condyle and passes to attach to the central part of the posterior aspect of the joint capsule
177
Q

arcuate popliteal ligament

A

-arises from the posterior aspect of the fibular head, passes over the tendon of the popliteus, and spreads over the posterior surface of the knee joint

178
Q

what do the cruciate ligaments join?

A

femur and tibia

179
Q

during ____ rotation of the tibia on the femur, the cruciate ligaments wind around each other, thus the amount of _____ rotation is limited to 10 degrees

A

medial, medial

180
Q

because the cruciate ligaments become unwound during _____ rotation, nearly ___ degrees of rotation is possible

A

lateral, 60

181
Q

which of the cruciate ligaments is the weakest?

A

anterior

182
Q

what are the attachments of the anterior cruciate ligament?

A
  • arises from the anterior intercondylar area of the tibia, just posterior to the attachment of the medial meniscus
  • attaches to the posterior part of the medial side of the lateral condyle of the femur
183
Q

what does the ACL do?

A
  • limits posterior rolling of the femoral condyles on the tibial plateau during flexion
  • also prevents posterior displacement of femur onto tibia and hyperextension of the knee
184
Q

what are the attachments of the posterior cruciate ligament?

A
  • arises from the posterior intercondylar area of the tibia

- attaches to anterior part of lateral surface of medial condyle of the femur

185
Q

what does the PCL do?

A
  • limits anterior rolling of the femur on the tibial plateau during extension
  • prevents hyperextension of the knee
  • main stabilizing factor for the femur when knee is flexed and weight bearing
186
Q

what are the roles of the menisci?

A
  • shock absorption

- thicker at external margins

187
Q

how can we differentiate the medial meniscus from the lateral meniscus?

A
  • medial menuscus is C-shaped and broader posteriorly than anteriorly; the medial meniscus firly adheres to the deep surface of the tibial collateral ligament
  • the lateral meniscus is nearly circular, is smaller, and is more freely movable, tendon of popliteus separates the lateral meniscus from the fibular collateral ligament
188
Q

which structure limit flexion at the knee joint?

A
  • soft tissue apposition posteriorly
  • tension of vastus lateralis, medialis, and intermedius
  • tension of rectus femoris
189
Q

which structure limit extension at the knee joint?

A

-ligaments: anterior and posterior cruciate ligaments, fibular and tibial collateral, posterior joint capsule, and oblique popliteal ligament

190
Q

which structures limit internal rotation of the knee joint?

A

-ligaments: anterior cruciate and posterior cruciate

191
Q

which structures limit external rotation at the knee joint?

A

-ligaments: fibular and tibial collateral

192
Q

how many bursae are around the knee joint? why?

A

at least 12, most tendons run parallel to the bones and pull lengthwise across the knee joint during movement

193
Q

where is the suprapatella bursa located?

A

-between the femur and tendon of quadriceps femoris

194
Q

where is the popliteus bursa located?

A

between tendon of popliteus and lateral condyle of tibia

195
Q

where is the anserine bursa located?

A

separates tendons of sartorius, gracilis, and semitendinosus from tibia and tibial collateral ligament

196
Q

where is the subcutaneous prepatellar bursa located?

A

between skin and anterior surface of patella

197
Q

where is the subcutaneous infrapatellar bursa located?

A

between skin and tibial tuberosity

198
Q

normal alignment of the Q-angle starts at the ________ and passes through the _____ all the way down the tibia to the foot

A

femoral head, patella

199
Q

genu varum

A
  • decreased Q-angle
  • gap on the lateral aspect of the knee, resulting in a buldge on the lateral side of the knee
  • cowboys
200
Q

genu valgum

A
  • increased Q-angle
  • gap on the medial side of the knee
  • knees facing inwards