knee region muscle and movement Flashcards
what movement is your leg in if it is locked
in standard knee extension- the knee joint is locked in closed pack position, joint surfaces more congruent, femoral medial rotation or tibial lateral rotation anf extension tightens ligaments
where is the centre of gravity when the knee is locked
COG anterior to knee joint maintaining extension
how does the popliteus initiate unlocking mechanisms
by laterally rotating femur on fixed tibia
what position are ligamnets and posterior capsule in when the knee is locked
ligaments and posterior capsule are at their most taught- so you can rest in a very energy efficient form with the knee in closed pack position
knee locking mechanisms- closed kinetic chain- from sitting to standing
femoral condyles roll anteriorly over tibial condyles, femoral condyles glide posteriorly over tibial condyles (stops femoral condyles rolling off tibial condyles), shorter lateral femoral condyle movements stop first- shorter, femur medially rotates (spins) around fixed lateral condyle to complete the movement
knee (un) locking mechanisms
unlocking knee joint into open packed position (flexion)
knee (un) locking mechanisms closed pack mechanisms- closed kinetic chain
femur rotates (spins) laterally on the tibia, femoral condyles roll posteriorly on the tibial condyles (relatively fixed), femoral condyles glide anteriorly on the tibial condyles (this stops femoral condyles from rolling off the tibial condyles)
Knee extensors rectus femoris- origins and insertions
origins- 2 heads (bipennate)- straight head- AIIS, reflected head- rough area of ilium superior to acetabulum
insertions- 2 heads join quadriceps femoris tendon which inserts into the base of the patella
Knee extensors rectus femoris- action and nerve
action 2 joint muscle- extends knee and flexes hip, nerve supply- femoral nerve L2,3,4
Knee extensors vastus intermedius- origin and insertions
origin- femur- upper 2/3rds anterior and lateral surfaces, insertions- quadriceps tendon (deep part) and lateral border of patella
Knee extensors vastus medialis- origin and insertion
origin- femur-medial part of the intertrochanteric line, pectineal line, medial lip of linea aspera, medial supracondylar line
insertions- quadriceps tendon and medial border of patella- wrap around
vastus medialis controversy- historically
VM historically thought to be the only muscle to produce the final 15 degrees of knee extension- therefore patients were given specific exercises to train VM muscle in that range
VM controversy- modern evidence
evidence now suggests that VM is not specifically response for the final 15° of knee extension, VM acts throughout the range of knee extension with or without external resistance, VM medalists the patella
Knee extensors vastus lateralis- origin and insertion
origin- lateral part of the intertrochanteric line, lateral margin of greater trochanter, lateral margin gluteal tuberosity, lateral lip linea aspera
Vastus muscles- action and nerve supply
action- extends the knee, nerve supply- L2,3,4
Knee flexion bicep femoris- origin and insertion
origin- 2 heads long head- inferomedial part of upper area ischial tuberosity, short head- lateral lip of linea aspera (lateral supracondylar ridge)
insertion- head of fibula
Knee flexion bicep femoris- action and nerve
flexion and ER (lateral), nerve supply- sciatic nerve L5,S2
Knee flexion semitendinosus- origin and insertion
origin- inferomedial part of the upper ischial tuberosity
insertion- medial surface proximal tibia
Knee flexion semitendinosus- action and nerve
flexion and MR, nerve supply- sciatic nerve L5-S2
Knee flexion semimembranosus- origin and insertion
origin- superolateral impression ischial tuberosity
insertion- groove and adjacent bone medial and posterior surface medial tibial condyle
Knee flexion semimembranosus- action and nerve
flexion and MR and sciatic nerve L5-S2
Hamstring action
all 3 extends the hip and flex at the knee, BF laterally rotates the hip and knee joint, ST and SM medially rotates the hip and knee joints
nerve supply- sciatic nerve L5-S2 (S3 long head)
Knee flexion sartorius- origin and insertion
origin- ASIS, insertion- anterior surface of tibia just inferomedial to tibial tuberosity
Knee flexion Sartorius- action and nerve
action- MR, flexion (asister), nerve L2,3
Knee flexion gracilis- origin and insertion
origin- external surface body of pubis, inferior pubic ramus, ramus of ilium
insertion- medial surface of proximal shaft of tibia
Knee flexion gracilis- action and nerve
action- assister in medial rotation and flexion at knee
nerve- L3,4
Knee flexion gastrocnemius- origin and insertion
origin- 2 heads- medial and lateral heads from medial and lateral femoral condyles
insertions- achilles tendon into postero superior calcaneus (heel)
Knee flexion gastrocnemius- action and nerve
flex at knee and ankle PF,
Nerve- tibial nerve- S1,2
plantaris
NB evolutionary survivor, weak and sometimes not present
Knee flexion plantaris- origin and insertion
origin- lateral supracondylar line above lateral head of gastrocnemius
insertion- medial border if TA and post surface of calcaneus
Knee flexion plantaris- action and nerve
action- weak knee flexor and plantar flexor of foot
nerve- tibial nerve- S1,S2
what is the popliteus
small fat, feep, posterior muscle, part of floor of popliteal fossa
Knee flexion popliteus- origin and insertion
origin- lateral femoral condyle, insertion- proximal surface of posterior tibia
Knee flexion popliteus- action and nerve
action- unlocks the extended knee by laterally rotating the femur on fixed tibia, rotates knee medially, flexes knee
nerve supply- tibial nerve L5, S1, S2
Knee flexion tensor fasciae latae- origins and insertions
origi- ASIS and outer iliac crest to iliac tubercle
insertion- anterior surface of tibia just inferolateral to tibial tuberosity
Knee flexion tensor fasicae latae- action and nerve
stabilises knee laterally, nerve- superior gluteal nerve L5, S1
Knee joint active range of motion- flexion and limited by
135°- limited by soft tissue apposition, patellar tendon, PCL
Knee joint active range of motion- extension- limited by
0°, = or - 0-5° for hyperextension, limited by posterior capsule, ACL, MCL, LCL, oblique popliteal ligament, tension in antagonists
Knee joint active range of motion- medial rotation
20-30° in flexed knee
Knee joint active range of motion- lateral rotation
30-40° in flexed knee
what limits rotation
both limited by tension in antagonists
popliteal fossa borders- laterally
bicep femoris, lateral head of gastrocnemius
popliteal fossa borders- medially
semimembranosis, semitendinosus, medial head of gastrocnemius
popliteal fossa borders- floor
popliteal surface of femur
popliteal fossa borders- roof
Fascia and skin
contents of popliteal fossa
popliteal artery and vein, common peroneal and tibial nerve, lymph nodes and fat
Knee flexors
bicep femoris, semimembranosis, semitendinosus, gastrocnemius
knee extensors
rectus femoris, vastus lateralis, vastus medialis, vastas intermedius
medial rotators of tibia on femur
semitendinosus, semimembranosus, sartorius, popliteus
lateral rotators of tibia on femur
bicep femoris