Exam #2 (cumulative) Flashcards
what muscles are included in the deep layer of intrinsic back muscles?
Transversospinales muscle group (semispinalis, multifidus, rotatores)
- semispinalis is superficial
- multifidus is deeper
- rotatores are deepest
what are the 3 divisions of the semispinalis muscles?
semispinalis:
- capitis
- cervicis
- thoracis
which muscle is responsible for the longitudinal buldge on each side in the back of the neck near the median plane?
semispinalis capitis
the rotatores muscles are best developed in which region?
thoracic
the multifidus muscles are best developed in which region?
lumbar
what is the origin, insertion, innervation, and action of the semispinalis muscles?
- 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
what is the origin, insertion, innervation, and action of the multifidus muscle?
- 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
what is the origin, insertion, innervation, and action of the rotatores muscles?
- 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
what is the origin, insertion, innervation, and action of the interspinales muscles?
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
what is the origin, insertion, innervation, and action of the intertransversarii muscles?
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
what is the origin, insertion, innervation, and action of the levatores costarum muscles?
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
where is the suboccipital triangle
-lies deep to the trapezius and semispinalis capitis muscles
what are the boundaries and the contents of the suboccipital triangle?
- 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)
what is the only capitis muscle that does not attach to the cranium?
obliquus capitis inferior
-attachments are to the spinous process of the C2 vertebrae and the transverse process of the C1 vertebrae
the head rotates to the right by the contraction of which muscles
- sternocleidomastoid
- semispinalis capitis
the head rotates to the left by the contraction of which muscles?
- obliquus capitis inferior
- rectus capitis posterior (major and minor)
- longissimus capitis
- splenius capitis
what is the distribution of the suboccipital nerve?
-muscles of the suboccipital triangle
what is the distribution of the posterior rami of nerves
intrinsic back muscles and overlying skin adjacent to vertebral column
the lower limbs are specialized for what functions?
- locomotion
- supporting body weight
- maintaining balance
how many regions are there in the lower limb? name them
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
longest and heaviest bone in the body
femur
the angle of inclination of the femoral head in the adult is from ___ to ___ degrees, averaging ___
115, 140, 126
is the angle of the femoral head larger or lesser in females? why?
lesser, because of the increased width between the acetabulum and the greater obliquity of the shaft
why is the angle of inclination of the femoral head advantageous to bipedal walkers? Why is it harmful?
- 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
what is the function of the tibia
-weight bearing
the fibula assists in weight bearing
true or false?
false
what connects the tibia and the fibula?
interosseous membrane
what is the angle of inclination of the femoral head in a 3 year old child?
135 degrees
what is the angle of inclination of the femoral head in older adults?
120 degrees
how many tarsal bones are there
7
what is the largest and strongest bone in the foot
calcaneous
what is the superior surface of the talus called
the trochlea
what is the bone in the foot that carries the weight of the body?
talus
the _____ surface of the navicular projects to the tuberosity of the navicular
medial
a prominant _____ tuberosity is what may cause foot pain when pressed against the medial part of the shoe
navicular
all 3 cuneiforms articulate posteriorly with the navicular
true of false?
true
the metatarsus contain ___ long bones
5
the ____ metatarsal is the longest
2nd
how many phalanges do we have in 1 foot
14
which bones in the pelvic region are we able to palpate from the surface of the skin?
- iliac crest
- iliac tuberosity
- anterior/posterior superior iliac spine
- inguinal ligament
- pubic crest
- pubic symphysis
- pubic tubercle
- iliac tuberosity
which areas of the femur are we able to palpate from the surface of the skin?
- greater trochanter
- lateral epicondyle
- medial epicondyle
- patella
- adductor tubercle
which areas of the leg can we palpate from the surface of the skin?
- 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
the fascia lata attaches to and is continuous with:
- 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
what are the 3 compartments of the thigh and gluteal regions?
-anterior (extensor), medial (adductor), posterior (flexor)
what is the main action of the anterior thigh muscles?
flexors of the hip, extensors of the knee
chief flexor of the hip joint
iliopsoas
what is the longest muscle of the body
sartorius
the actions of the sartorius muscle are mainly synergist
true or false?
true
the medial muscles’ primary function is what?
adduct the hip joint
the medial muscles of the thigh are innervated primarily by which nerve?
obturator nerve
the anterior thigh muscles of the thigh are primarily innervated by which nerve?
femoral nerve (except for psoas major = anterior rami of lumbar nerves)
what is the proximal attachment, distal attachment, innervation, and action of the pectineus muscle?
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
what is the proximal attachment, distal attachment, innervation, and action of the sartorius muscle?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the psoas major muscle?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the iliacus?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the rectus femoris?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the vastus lateralis?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the vastus medialis?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the vastus intermedius?
- 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
what are the walls and the contents of the femoral triangle?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the adductor longus muscle?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the adductor brevis?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the adductor magnus (adductor part)?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the adductor magnus (hamstring part)?
- proximal: ischial tuberosity
- distal: adductor tubercle of femur
- innervated by the tibial part of the sciatic nerve
- action: adducts hip joint, extends hip joint
what is the proximal attachment, distal attachment, innervation, and action of the gracilis muscle?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the obturator externus?
- 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
which nerve is the largest branch of the lumbar plexus?
femoral nerve
where does the femoral nerve divide into several terminal branches?
after entering the femoral triangle, divides into branches to the anterior thigh muscles
what is the terminal cutaneous branch of the femoral nerve
saphenous nerve
the obturator nerve descends along the _____ border of the _____ muscle and enters the thigh through the _______
medial, psoas, obturator foramen
what muscles are in the superficial layer of the gluteal muscles
gluteus maximus, medius, and minimus, and tensor fasciae latae
what is the proximal attachment, distal attachment, innervation, and action of the gluteus maximus?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the gluteus medius?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the gluteus minimus?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the tensor fascia latae?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the piriformis?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the obturator internus?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the superior gemellus?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the inferior gemellus?
- 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
what is the proximal attachment, distal attachment, innervation, and action of the quadratus femoris?
- 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