LE Quiz Flashcards
Arthrokinematics of Hip Flex and Ext
Convex femoral head SPINS on the fixed concave acetabulum
Arthrokinematics of Hip abduction
Convex femoral head GLIDES inferiorly on the fixed concave acetabulum
Hip Flexion
AROM, End feel, Plane, Axis
0-120
soft/firm
Sagittal plane
Frontal axis
Arthrokinematics of Hip adduction
Convex femoral head GLIDES superiorly on the fixed concave acetabulum
Hip Extension
AROM, End feel, Plane, Axis
0-30
firm
Sagittal plane
Frontal axis
Arthrokinematics of hip IR
Convex femoral head GLIDES on the fixed concave acetabulum in posterior direction
Hip Abduction
AROM, End feel, Plane, Axis
0-45
firm
Frontal plane
Sagittal axis
Arthrokinematics of hip ER
Convex femoral head GLIDES on the fixed concave acetabulum in anterior direction
Hip adduction
AROM, End feel, Plane, Axis
0-30
Soft/firm
Frontal plane
Sagittal axis
Muscles that attach to the ASIS
TFL, Sartorius, inguinal ligament
Muscles that attach to the inferior ramus
Adductor magnus, adductor brevis, gracilis
What muscles attach to the ischial tuberosity
hamstrings and adductor magnus
Muscles that attach to the superior ramus
pectineus
What makes up the greater sciatic notch?
Sacrotuberous and sacrospinosus ligament
What structures make up the acetabulum?
Ilium, ischium, pubis
What passes through the greater sciatic notch?
sciatic nerve and piriformis
Ramus of the ischium is the attachment point for what muscles?
Adductor magnus, obturator internus and externus
What muscle attaches to the pectineal line?
adductor brevis
The adductor tubercles serves as an attachment for which muscle?
Adductor magnus
What structure does the iliopsoas attach to?
Lesser trochanter
What muscles attach to the greater trochanter?
Gluteus medius, minimus, and deeper rotator muscles
What motion does the superior capsule limit?
Adduction
What motion does the posterior capsule limit?
flexion and IR
What motion does the Inferior capsule limit?
abduction
What motion does the ischiofemoral ligament limit?
extension, abduction, adduction, IR
What motion does the pubofemoral ligament limit?
extension, abduction, IR
What motion does the iliofemoral ligament limit
hyperextension
What is the ligamentum teres?
Intracapsular ligament that assists in holding the head of the femur against the acetabulum
What motions does the ligamentum teres limit?
Abduction and ER
What structures in the shoulder function like the ligamentum teres?
Supraspinatus, infraspinatus & subscapularis, middle deltoid, deltoid complex, glenoid labrum
How does the supraspinatus Fx like the ligamentum teres?
It holds the humeral head into the glenoid fossa
How does the infraspinatus and subscapularis Fx like the ligamentum teres?
prevents inferior glide
How does the middle deltoid Fx like the ligamentum teres?
concurrent force around the shoulder joint
How does the glenoid labrum Fx like the ligamentum teres?
increases the depth of the fossa which increases stability
Angle of inclination of Coxa Valga?
How does the leg appear in weight bearing?
neck shaft angle greater than 125 degrees
Leg appears longer
Angle of inclination of Coxa Vara?
How does the leg appear in weight bearing?
neck shaft angle less than 125 degrees
Leg appears shorter
One joint muscle provide…..
control
Two joint muscles provide…..
ROM
What makes up the femoral triangle?
Inguinal ligament
Sartorius
Adductor longus
Is the Gracilis a one joint or two joint muscle?
two
The adductor longus and brevis are one joint or two joint muscles?
one
What are the six deep rotators of the hip
Obturator externus and internus
Quadratus femoris
Piriformis
Gemellus superior and inferior
What line of pull do the six deep rotators have?
Horizontal
What line of pull does the gluteus maximus have?
Diagonal
What line of pull does the gluteus medius have?
What shape does it have?
What muscle is it like?
Diagonal
Triangular
Deltoid (force couple)
What line of pull does the gluteus medius have?
What shape does it have?
What muscle is it like?
Diagonal
Triangular
Deltoid (force couple)
What line of pull does the gluteus minimus and TFL have?
anteriolateral
Nerve innervations gluteus maximus
Inferior gluteal nerve L5, S1, S2
Nerve innervations biceps femoris short head
common peroneal
Nerve innervations biceps femoris long head
sciatic nerve s1,s2,s3
Nerve innervations quadratus femoris
L5, S1
Nerve innervations Lumbar plexus
L1-L4
Innervates thigh and leg
Nerve innervations Sacral plexus
L5-S3
Innervates leg and foot
Describe normal muscle activation
insertion moves toward origin
Stable origin allows for mobile insertion
Describe reversal of muscle activation
Origin moves toward the insertion
Origin becomes mobile and insertion becomes stable
Side bending Muscle activation
Psoas origin moves toward insertion
Biceps brachii during chin ups
Humerus moves towards forearm
Origin moves towards stable insertion
What type of joints is the tibiofemoral joint?
Bicondylar
What type of joints is the patellafemoral?
incongruent
Arhtrokinematics of knee flexion?
Concave tibial condyles GLIDE posteriorly on the fixed convex femoral condyles
Arhtrokinematics of knee extension?
Concave tibial condyles GLIDE anteriorly on the fixed convex femoral condyles
Knee Flexion
AROM, End feel, Plane, Axis
0-135
soft
Sagittal plane
Frontal axis
Knee Extension
AROM, End feel, Plane, Axis
0
firm
Sagittal plane
Frontal axis
Arthrokinematics of tibial rotation
Proximal concave surface of the tibia SPINS on the convex condyles of the fixed femur
*spin occurs w/ roll & glide
Knee IR & ER
AROM, End feel, Plane, Axis
40-58 @ 90 knee flexion
Firm
Horizontal plane
Longitudinal axis
What type of joint is the knee
synovial hinge joint
What is the knee not a true hinge joint
b/c it has rotation
What motions do the ACL and PCL limit?
Extension and IR
What motions do the MCL and LCL limit?
extension and ER
What motion does the oblique popliteal ligament limit
Extension
When does the screw home mechanism occur?
the last 20 degrees of knee extension
What is the moment arm of the quadriceps?
The distance b/t the quad/patella tendon and the femur
Tibial plateau
medial and lateral condyles and the intercondylar eminence of the tibia
ACL attachment points
Anterior tibia to posterior femur
PCL attachment points
Posterior tibia to anterior femur
What type of tibia/femur displacement does the ACL prevent
tibia- anterior
femur- posterior
What type of tibia/femur displacement does the PCL prevent
tibia- posterior
femur- anterior
What is the q-angle
angle b/t the quad and patella tendon
do males or females have a greater q-angle?
females- wider pelvis
What is the normal range of the q-angle during knee extension?
What may occur if outside of that range?
13-19 degrees
knee/patella dysfunction
Which cruciate ligament sustains less injuries
PCL
Cruciate ligaments provide stability for what plane of motion
sagittal plane
Which motion causes the ACL to tighten?
Knee extension
What motion causes the PCL to tighten?
Knee flexion
Collateral ligaments provide stability for what plane of motion?
frontal plane
What motions cause the collateral ligaments to tighten or slacken?
tighten= knee extension Slacken= knee flexion
MCL attachment points
Femur to tibia/ blends into medial mensci
tibial collateral ligament
LCL attachment points
Femur to head of fibula (fibular collateral ligament)
The cruciate ligaments prevent….
Tibial translation and excessive hyperextension
What does the MCL prevent and what type of stability does it provide
excessive lateral motion of the knee
Medial stability
What does the LCL prevent and what type of stability does it provide
excessive medial motion of the knee
lateral stability
What does the LCL prevent and what type of stability does it provide
excessive medial motion of the knee
lateral stability
Which collateral ligament is strong and not susceptible to injury?
LCL
Where is the prepatallar bursa located?
b/t patella and skin
Where is the deep infrapatella bursa located?
b/t proximal tibia and patellar ligament
Where is the suprapatellar bursa located?
b/t distal femur and quadriceps tendon
Where is the posterior bursa located?
b/t popliteal tendon and lateral femoral condyle
Where is the lateral bursa located?
b/t IT band at distal attachment
Where is the medial bursa located?
b/t the pes anserine under the tendons for the Sartorius, semitendinosus, and gracilis
Nerve innervations for the quads
femoral nerve L2-L4
Nerve innervations for the hamstrings
Sciatic nerve L5-S2
short head of the biceps Common peroneal L5-S2
Nerve innervations for the hamstrings
Sciatic nerve L5-S2
short head of the biceps Common peroneal L5-S2
What passes through the popliteal space?
tibial common peroneal nerve, popliteal artery and vein
What structures make up the popliteal space?
Medial= semimembranosus & semitendinosus Lateral= biceps femoris Inferior= heads of the gastroc
What unlocks the knee?
popliteal
What nerve innervates the gastroc?
tibial nerve S1, S2
What are the one joint muscles of the knee?
Anterior- vastus lateralis, medialis, intermedius
Posterior- popliteus, short head of biceps femoris
What are the two joint muscles of the knee?
Anterior- rectus femoris
Posterior- Long head of biceps femoris, semimembranosus, semitendinosus, Sartorius, gracilis, gastroc
What makes up the forefoot?
metatarsals and phalanges
What makes up the mid foot?
navicular, cuboid, cuneiforms
What makes up the hindfoot?
talus and calcaneus
Where is the sustentaculum tali located?
medial, superior portion of the calcaneus
What structures pass through the sustentaculum tali?
Tibialis posterior, flexor halluces longus, flexor digitorum longus, tibial nerve and artery
What is the largest bone in the foot?
calcaneus
What attaches to the calcaneus?
gastroc, soleus, and plantaris muscle
Fx of the ankle and foot
Shock absorber during gait cycle
Adapts to surface levels
Provides a stable base of support to propel from
Plantarflexion
AROM, End feel, Plane, Axis
0-50
firm/hard
Oblique sagittal plane
Oblique frontal axis
Dorsiflexion
AROM, End feel, Plane, Axis
0-20
firm/hard
Oblique sagittal plane
Oblique frontal axis
Inversion
AROM, End feel, Plane, Axis
0-35
firm
Oblique frontal plane
Oblique sagittal axis
Eversion
AROM, End feel, Plane, Axis
0-20
firm/hard
Oblique frontal plane
Oblique sagittal axis
Eversion
AROM, End feel, Plane, Axis
0-20
firm/hard
Oblique frontal plane
Oblique sagittal axis
What movements make up supination of the foot?
PF, inversion, ADD
What movements makes up pronation of the foot?
DF, eversion, ABD
Where are the medial ligaments of the ankle/foot?
Deltoid ligaments and spring ligament
What are the 4 sections of the deltoid ligaments
Anterior tibionavicular, tibiocalcaneal, posterior tibiotalar, anterior tibiotalar
What is the Fx of the deltoid ligaments
strengthen the medial side of the ankle joint
hold calcaneus & navicular against talus
help maintain strength of the medial longitudinal arch
Where does the spring ligament attach
calcaneus to navicular
What is the function of the spring ligament
support the medial side of the longitudinal arch
What bones does the medial longitudinal arch support
Calcaneus, talus, navicular, cuneiforms and metatarsals 1-3
Which arch is considered the keystone of the body?
medial longitudinal arch
What bones does the transverse arch support?
cuneiforms and cuboid
What are the fx of arches
Variety of motion in foot
Maintains shape of foot, ligaments, plantar fascia, and muscles
Weight is distributed in a triangle( 1st met- 5th met- calcaneus)
Supported by invertors and evertors
Where does the long plantar ligament and longest tarsal ligament attach?
cuboid and bases of 3-5 metatarsals
Where does the short plantar ligament attach
calcaneus to cuboid
What does the short plantar ligament assist
long plantar ligament
What supports the short plantar ligament
plantar fascia