Hip, Thigh, and Knee

Question 1

what type of pattern are the hip ligaments in?

Answer 1

spiral fiber pattern

Question 2

when do hip ligaments tighten?

Answer 2

during hip extension to increase stability

Question 3

when are hip ligaments the tightest?

Answer 3

end of stance phase right before you push off

Question 4

what hip ligament limits natural tendency to hyperextend?

Answer 4

iliofemoral ligament

Question 5

what is the strongest ligament in the body

Answer 5

iliofemoral ligament

Question 6

what hip ligament limits abduction and external rotation of the hip

Answer 6

pubofemoral ligament

Question 7

what is the weakest of the 3 hip ligaments?

Answer 7

ischiofemoral ligament

Question 8

what hip ligament limits internal rotation?

Answer 8

ischiofemoral ligament

Question 9

what provides vascularization for the head of the femur?

Answer 9

ligament of head of femur

Question 10

what action do anterior thigh muscles do at the hip and knee?

Answer 10

hip - flex

knee - extend

Question 11

pectineus

Answer 11

Proximal attachment – superior pubic ramus
Distal attachment – pectinate line of femur
Innervation – dual innervated – femoral and obturator nerve L2, L3
Action – flex, adduct, internal rotator of hip

Question 12

iliopsoas

Answer 12

Proximal attachment – psoas major – body and transverse process of T12-L5, iliacus – iliac fossa – come together at level of inguinal ligament
Distal attachment – lesser trochanter
Innervation – psoas major – L1, L2, L3, iliacus – femoral nerve L2, L3
Action – flex hip, psoas major acts on vertebral column as bilateral flexor and unilateral ab/adductor and rotator

Question 13

Psoas minor

Answer 13

Proximal attachment – T12, L1 vertebra
Distal attachment – pubic bone
Innervation – L1, L2
Action – does not cross hip, act lumbar intervertebral joint – bilateral flexor, unilateral ab/adductor, and rotator

Question 14

sartorius

Answer 14

Proximal attachment – ileum – anterior superior iliac spine (ASIS)
Distal attachment – medial posterior tibia (pes anserinus)
Innervation – femoral nerve L2, L3
Action – flex, abductor, and external rotator of hip, flex knee

Question 15

what is the longest muscle in the body

Answer 15

sartorius

Question 16

what quadricep muscle acts on hip and knee?

Answer 16

rectus femoris

Question 17

rectus femoris

Answer 17

Proximal attachment – anterior inferior iliac spine
Distal attachment – quad tendon
Innervation – femoral nerve L2, L3, L4
Action – flex at hip, extend knee

Question 18

vastus lateralis

Answer 18

Proximal attachment – femur
Distal attachment – quad tendon
Innervation – femoral nerve L2, L3, L4
Action - extend leg at knee

Question 19

what do oblique fibers of vastus lateralis do?

Answer 19

VLO - stabilize patella/knee

Question 20

what do oblique fibers of vastus medialis do?

Answer 20

VMO - stabilize patella/knee

Question 21

vastus medialis

Answer 21

Proximal attachment – femur
Distal attachment – quad tendon
Innervation – femoral nerve L2, L3, L4
Action - extend leg at knee

Question 22

vastus intermedius

Answer 22

Proximal attachment – femur
Distal attachment – quad tendon
Innervation – femoral nerve L2, L3, L4
Action - extend leg at knee

Question 23

what is the function of vastus intermedius at articularis genu

Answer 23

pull suprapatellar bursa up during knee extension to prevent bursa from binding between patella and femur

Question 24

what is the action of muscles that cross hip inferior/medially?

Answer 24

adduct hip - adductor group

Question 25

adductor longus

Answer 25

Proximal attachment – body of pubic bone Distal attachment – linea aspera Innervation – obturator nerve L2, L3, L4 Action – adductor, flexor, and internal rotator of hip

Question 26

adductor brevis

Answer 26

Proximal attachment – inferior pubic body and ramus Distal attachment – linea aspera and pectinate line Innervation – obturator nerve L2, L3, L4 Action – adductor, flexor, and internal rotator of hip

Question 27

adductor magnus anterior and posterior

Answer 27

Proximal attachment – anterior – ischiopubic ramus, posterior – ischial tuberosity Distal attachment – anterior – linea aspera, posterior - adductor tubercle Innervation – dual innervated composite muscle – anterior – obturator nerve L2, L3, L4, posterior – tibial nerve L4 Action – anterior part acts in synergist with adductor group (adductor, flexor, internal rotator of hip), posterior part acts in synergist with hamstrings (hip extensor, adduct)

Question 28

adductor magnus anterior is part of what group?

Answer 28

hip adductor group

Question 29

adductor magnus posterior is part of what group?

Answer 29

hamstrings

Question 30

gracilis

Answer 30

Proximal attachment – inferior pubic ramus Distal attachment – posterior medial tibia (pes anserinus) Innervation – obturator nerve L2, L3 Action – flex at knee and hip

Question 31

what muscles attach at the pes anserinus?

Answer 31

gracilis, sartorius, and semitendinosis

Question 32

obturator externus

Answer 32

Proximal attachment – external surface of obturator membrane (obturator foramen) Distal attachment – greater trochanter passing posterior to neck of femur Innervation – obturator nerve L3, L4 Action - external rotator and abductor of hip

Question 33

boundaries of femoral triangle

Answer 33

1. superior: inguinal ligament running from anterior superior iliac spine to pubic tubercle. 2. medially: lateral border of adductor longus muscle 3. lateral/inferior: superior border of the Sartorius muscle 4. floor: iliopsoas (lateral floor), and pectineus (medial floor) muscles 5. roof: skin and fascia (fascia lata; cribriform) of thigh

Question 34

what is the space between inguinal ligament and hip bone?

Answer 34

retroinguinal space

Question 35

contents of femoral triangle

Answer 35

femoral vein, artery, and nerve

Question 36

contents of adductor (femoral) canal

Answer 36

femoral artery/vein, saphenous vein, and cutaneous branch of femoral nerve (lower leg, medial calf)

Question 37

when does femoral artery become popliteal artery?

Answer 37

when it passes through adductor hiatus

Question 38

femoral artery comes off of what superior artery

Answer 38

external iliac artery at inguinal ligament

Question 39

blood is shunted in what direction in venous blood flow in the lower limb

Answer 39

blood is shunted from superficial to deep through perforating veins

Question 40

what makes up the femoral nerve

Answer 40

lumbar plexus, posterior divisions of ventral rami L2-L4

Question 41

what makes up obturator nerve

Answer 41

lumbar plexus, anterior divisions of ventral rami L2-L4

Question 42

articulations that form knee

Answer 42

medial femorotibial (medial condyle of femur and tibia), lateral femorotibial (lateral condyle of femur and tibia), and femuropatellar

Question 43

what type of joint is the knee

Answer 43

shallow hinge synovial joint

Question 44

what ligaments prevent knee hyperextension and limit rotation?

Answer 44

collateral ligaments

Question 45

what knee ligament limits adduction or varus?

Answer 45

fibular collateral

Question 46

what knee ligament limits abduction of valgus?

Answer 46

tibial collateral

Question 47

what limits femur from sliding posterior and tibia from sliding anterior

Answer 47

anterior cruciate ligament

Question 48

what knee ligament opposes hyperextension

Answer 48

anterior cruciate ligament

Question 49

what limits the femur from sliding anterior and tibia from sliding posterior?

Answer 49

posterior cruciate ligament

Question 50

what knee ligament limits hyperflexion?

Answer 50

posterior cruciate ligament

Question 51

what is the Q angle?

Answer 51

angle between the axis of the femur and axis of the tibia to move the legs more toward the central axis of the body

Question 52

what does the Q angle look for?

Answer 52

looks at the degree of valgus and varus

Question 53

gluteus maximus

Answer 53

Proximal attachment – posterior iliac crest, posterior superior iliac spine, sacrum and coccyx Distal attachment – deep – gluteal tuberosity, superficially – forms IT band and attach distally to Gerdy tubercle Innervation – inferior gluteal nerve L5, S1, S2 Action – extends and external rotator of hip – when gluteus maximus contracts TFL together they synergize to abduct at the hip

Question 54

gluteus medius and minimus

Answer 54

Proximal attachment – external surface of ala Distal attachment – greater trochanter Innervation – superior gluteal nerve L5, S1 Action – at midline they are abductors (main action), anterior medius and minimus will flex and internal rotate, posterior medius and minimus will extend and external rotate – stabilize during stance phase when you are unbalanced

Question 55

Tensor fascia lata (TFL)

Answer 55

Proximal attachment – anterior superior iliac spine (ASIS) Distal attachment – lateral condyle of fibula Innervation – superior gluteal nerve L5, S1 Action – flexes at hip, synergize with gluteus max to abduct hip

Question 56

piriformis

Answer 56

Proximal attachment – sacrum Distal attachment – greater trochanter Innervation – S1, S2 ventral rami Action – abductor and lateral (external) rotator

Question 57

obturator internus

Answer 57

Proximal attachment – internal surface of obturator membrane/foramen Distal attachment – greater trochanter Innervation – L5, S1 ventral rami Action – abductor and lateral (external) rotator

Question 58

superior and inferior gemelli

Answer 58

Proximal attachment – superior – on ischial spine inferior – ischial tuberosity Distal attachment – merge with obturator internus to form common attachment on greater trochanter Innervation – L5, S1 ventral rami Action – abductor and lateral (external) rotator

Question 59

quadratus femoris

Answer 59

Proximal attachment – ischial tuberosity Distal attachment – intertrochanteric crest on posterior surface of femur Innervation – nerve to quadratus femoris – lumbosacral plexus L5, S1 Action – external rotation – it will not abduct

Question 60

obturator externus

Answer 60

Proximal attachment – obturator membrane Distal attachment – greater trochanter of femur Innervation – obturator nerve Action – abduct and external rotator

Question 61

semitendinosis

Answer 61

Proximal attachment – ischial tuberosity Distal attachment – pes anserinus Innervation – tibial nerve L5, S1, S2 Action – extend hip, flex knee, internally rotate foot

Question 62

semimembranosis

Answer 62

Proximal attachment – ischial tuberosity Distal attachment – medial plateau of the tibia Innervation – tibial nerve L5, S1, S2 Action – extend hip, flex knee, internally rotate foot

Question 63

Biceps femoris

Answer 63

Proximal attachment – long head – ischial tuberosity, short head – linea aspera Distal attachment – lateral plateau of tibia and fibula, short head - fibula Innervation – long head – tibial nerve, short head – fibular nerve – both are L5, S1, S2 ventral rami Action – long head extend hip, long and short – flex knee, external rotator of foot mostly at knee but some at hip joint