Lecture 12 Flashcards
What is the origin & insertion of psoas major?
- Ori: Bodies and TPs of L1 – L5
- Ins: Lesser trochanter of femur
What is the action of psoas major?
- flexion of thigh (hip joint)
- lateral rotation of thigh (hip joint)
- flexion of trunk @ spinal joints
- lateral flexion of trunk @ spinal joints
- anterior tilt of pelvis @ hip
What is the innervation of psoas major?
lumbar plexus (L1, L2, L3)
What is the origin and insertion of iliacus?
- origin: iliac fossa & sacral ala
- insertion: lesser trochanter of femur
What are the muscles that make up the iliopsoas muscle? Why?
The psoas major and the iliacus muscles are considered to be the iliopsoas M. because of their common distal attachment onto the lesser trochanter of femur
What is the action of iliacus?
- Flexion of thigh
- lateral rotation of thigh
- anterior tilt of pelvis @ hip
What is the innervation of iliacus?
femoral nerve
Which muscle has a role on lumbar hyper lordosis?
psoas major
What is the origin & insertion of sartorius?
- Ori: Anterior superior iliac spine (ASIS)
- Ins: Proximal part of medial surface of shaft of tibia (forms Pes anserine tendon)
What is the innervation of the anterior compartment of the thigh?
femoral nerve
What are the actions of sartorius?
- Flexion of thigh (hip joint)
- Abduction of thigh (hip joint)
- Lateral rotation of thigh (hip oint)
- Flexion of leg @ knee joint)
What is the innervation of sartorius?
femoral nerve
What is the origin & insertion of the rectus femoris?
Ori:
- Straight (Ant.) head: AIIS
- Reflected (Post.) head: Groove above the brim of acetabulum
Ins: Base of patella via the quadriceps tendon and then to tibial tuberosity via the patellar ligament (tendon)
How many muscles are in the quadriceps femoris group?
4
What is the only quadriceps muscle that will move the hip joint?
rectus femoris
What are the actions of rectus femoris?
- extension of leg (knee joint)
- flexion of thigh (hip joint)
What is the innervation of rectus femoris?
femoral
What is the origin and insertion of vastus lateralis?
Ori:
- Intertrochanteric line
- Gluteal tuberosity
- Lateral lip of linea aspera
Ins: Lateral border of patella via the quadriceps tendon and then to tibial tuberosity via the patellar ligament (tendon)
What are the four muscles of the quadriceps?
- rectus femoris
- vastus lateralis
What are the actions of the vastus lateralis?
extension of leg (knee joint)
What is the innervation of vastus lateralis?
femoral nerve
What are the origin and insertion of vastus medialis?
Ori:
- Intertrochanteric line
- Medial lip of linea aspera
- Medial supracondylar line.
Ins: Medial border of patella via the quadriceps tendon and then to tibial tuberosity via the patellar ligament (tendon)
What is the action of vastus medialis?
extension of leg (knee joint)
What is the innervation of vastus medialis?
femoral nerve
What is the origin and insertion of vastus intermedius?
Ori: Anterior and lateral surfaces of body of femur
Ins: Base of patella via the quadriceps tendon and then to tibial tuberosity via the patellar ligament (tendon)
What is the action of vastus intermedius?
Extention of leg (knee joint)
What is the innervation of vastus intermedius?
femoral nerve
What is the origin & insertion of articular genus?
Ori: anterior surface of the lower part of the body of the femur
Ins: upper part of the capsule and synovial membrane of the knee joint
What is the deepest muscle in the anterior compartment of the thigh?
articularis genus
What is the action of articularis genus?
It elevates (pulls superiorly) the capsule and the synovial membrane of the knee joint and prevents them from being pinched during extension of the leg
What is the origin & insertion of pectineus?
Ori: Superior ramus of pubis (Pectineal line of pubis)
Ins: Pectineal line of femur
What is the function of pectineus?
- Adduction of thigh (hip joint)
- Flexion of thigh (hip joint)
What is the innervation of pectineus?
femoral nerve
What is the only muscle in the medial compartment innervated by the femoral nerve?
pectineus
What is the origin & insertion of adductor longus?
Ori: Anterior surface of pubis
Ins: Middle part of linea aspera
What are the actions of adductor longus?
- adduction of thigh (hip joint)
- flexion of thigh (hip joint)
- lateral rotation of thigh (hip joint)
What is the innervation of adductor longus?
obturator nerve
What is the origin & insertion of adductor brevis?
Ori: Body & Inferior ramus of pubis
Ins: Proximal 1/3 of linea aspera of femur
What are the actions of adductor brevis?
- adduction of thigh (hip joint)
- flexion of thigh (hip joint)
- lateral rotation of thigh (hip joint)
What is the innervation of adductor brevis?
obturator
What is the origin & insertion of adductor magnus?
Ori:
- Anterior head (adductor part): Ischiopubic ramus
- Posterior head (hamstring or ischial part): Ischial tuberosity
Ins:
- Anterior head (adductor part): Linea aspera, Gluteal tuberosity, Medial supracondylar line
- Posterior head (hamstring or ischial part): Adductor tubercle
What are the actions of adductor magnus?
- adduction of thigh (hip joint)
- flexion of thigh (hip joint) (the Ant. or pubic attachment)
- extension of thigh (hip joint) (the Post. or hamstring or ischial attachment)
- lateral rotation of thigh @ hip joint
What passes through the adductor hiatus?
femoral artery & vein
What forms the adductor hiatus?
distal aspect of the insertion of the two heads of the adductor magnus muscle
What is the innervation of adductor magnus?
- Anterior head (Pubic) by obturator N.
- Post. Head (Hamstring or Ischial) by tibial N
What is the origin and insertion of gracilis?
Ori:
- Body of pubis
- Inferior ramus of pubis
Ins: Proximal part of medial surface of shaft of tibia (forms Pes anserine tendon)
What are the actions of gracilis?
- adduction of thigh (hip joint)
- flexion of thigh (hip joint)
- flexion of leg (knee joint)
- medial rotation of leg (knee joint)
What is the weakest muscle in the medial (adductor) compartment of the thigh?
gracilis
What is the innervation of gracilis?
Obturator nerve
What is also known as the fourth hamstring?
adductor magnus
In patients with cerebral palsy, which muscles are spastics causing scissor gait?
Adductor muscles - need tenotomy
T/F: Gracilis is used for surgical reconstruction
True
What is the pes anserinus (latin for goosefoot)?
Proximal medial side of the tibia where the sarterious, gracilis, and semitendinosus muscles attach to in a 3-prolonged pattern
What are the borders of the femoral triangle?
- Lateral: sartorius
- Medial: adductors
- Superior: inguinal ligament
What are the contents of the femoral triangle?
- Nerve (femoral)
- Artery (femoral)
- Vein (femoral)
- Empty space
- Lymph nodes
What is the very bottom of the femoral triangle connected to?
adductor hiatus
Inverted cone-shaped fascial space medial to the femoral vein within the upper femoral triangle
femoral canal
What does the femoral canal open superiorly as?
femoral ring
What is the purpose of the femoral canal?
serves to allow the femoral vein to expand when there is increased venous return from the lower limb
When do you get a femoral hernia?
lifting something way too heavy –> push on bowel and it looks for somewhere to go –> heads to empty space in femoral triangle
What are consequences of femoral hernia?
- can compress artery –> coldness and palar in lower limb
- compress femoral nerve –> extension in leg @ knee decreases
- lead to venous pooling in the leg
- obvious lump in proximal thigh
What are the 3 compartments of the leg?
- anterior
- posterior
- lateral
What actions is the anterior compartment responsible for?
- dorsi flexion
- extension of toes
- inversion & eversion
What is the innervation of the anterior compartment of the leg?
deep fibular nerve
What are the actions of the lateral compartment of the leg?
- eversion
- plantar flexion
What is the innervation of the lateral compartment of the leg?
superficial fibular nerve
T/F: Anterior compartment of the leg is divided into superficial and deep muscles
False, posterior
What are the actions of the superficial posterior compartment of the leg?
plantar flexion
What are the actions of the deep posterior compartment of the leg?
- flexion of toes
- plantar flexion
- inversion
What is the innervation of the posterior compartment of the leg?
tibial nerve
Which retinacula is behind the medial malleolus?
flexor retinacula
Which retinacula is on the lateral side of the foot?
fibular (peroneal) retinaculum
Which retinacula is on the anterior side of the foot?
extensor retinaculum
What movements does the ankle axis permit?
- dorsiflexion
- plantar flexion
What movements does the subtalar axis permit?
inversion & eversion
What are the muscles that pass the ankle joint on the anterior side of the foot able to do?
dorsiflexion
What is the origin and insertion of the gastrocnemius muscle?
Ori:
- Medial head: Medial condyle of femur
- Lateral head: Lateral condyle of femur
Ins: Calcaneus via calcaneal (Achilles)tendon
What are the actions of gastrocnemius?
- plantar flexion of foot (ankle joint)
- flexion of leg (knee joint)
What is the innervation of gastrocnemius?
tibial
What is the origin & insertion of soleus?
Ori:
- Soleal line of tibia.
- Head of the fibula
- Proximal posterior surface of body of fibula
Ins: Calcaneus via calcaneal (Achilles)tendon
What is the action of soleus?
- plantar flexion of foot (ankle joint)
What is the innervation of the soleus?
tibial
What is the gastrocnemius & soleus muscle known as together?
triceps surae
Sesamoid bone found in lateral head of gastrocnemius
fabella
Why is the gastrocnemius & soleus referred to as 2nd heart of the body?
really big muscles –> some blood vessels b/w them , when you contract, it can press the veins & helps with venous return
Where is the deep tendon reflex of S1?
calcaneal tendon
What is the origin & insertion of plantaris?
Ori: Lower part of the lateral supracondylar ridge of femur. Ins: Calcaneus via calcaneal (Achilles)tendon
What are the actions of plantaris?
- plantar flexion of foot (ankle joint)
- flexion of leg (knee joint)
What is the innervation of plantaris?
tibial
What is the origin & insertion of flexor hallucis longus?
Ori: Inferior 2/3 of posterior surface of fibula and interosseous membrane.
Ins: Distal phalanx of big toe
What are the actions of flexor hallucis longus?
- flexion of big toe @ MTP & IP joints
- plantar flexion of foot @ ankle joint
- inversion of foot @ subtalar joint
What is the origin & insertion of flexor digitorum longus?
Ori: middle 1/3 of tibia
Ins: Base of distal phalanges of toes 2-5
What is the actions of flexor digitorum longus?
- flexion of toes #2-5 @ MTP, PIP, DIP joints
- plantar flexion of foot @ ankle joint
- inversion of foot @ subtalar joint
What is the innervation of flexor hallucis longus?
tibial nerve
What is the innervation of flexor digitorum longus?
tibial nerve
What is the origin & insertion of tibialis posterior?
Ori: Proximal of posterior surface of tibia, fibula and interosseous membrane
Ins:
- 2nd & 3rd & 4th metatarsals
- Navicular
- All three cuneiforms
- Cuboid
- Calcaneus
What are the actions of tibialis posterior?
- plantar flexion of foot @ ankle joint
- inversion of foot @ subtalar joint
What is the innervation of tibialis posterior?
tibial nerve
What is the origin & insertion of popliteus?
Ori: Lateral surface of lateral condyle of femur
Ins: above the soleal line on the posterior tibia.
What are the actions of popliteus?
- flexion of leg @ knee joint
- medial rotation of leg @ knee joint (to unlock extended knee)
What is the innervation of popliteus?
tibial
Which muscle has a role in un-locking the knee?
popliteus
Which muscle acts on the lateral meniscus?
popliteus
What are the structures passing being the medial malleolus (in the tarsal tunnel)?
Tibialis posterior
Flexor Digitorum longus
Artery (tibial)
Vein
Nerve (tibial)
Flexor Hallucis longus
What forms the tarsal tunnel?
- flexor retinaculum
- medial malleolus
- calcaneus
Where do you take the pulse of the tibial artery?
tarsal tunnel
Diamond shaped fossa behind the knee joint
popliteal fossa
What are the borders, roof, and floor of the popliteal fossa?
Borders:
- superior: biceps femoris on lateral border, semitendinosus & semimembranosus on medial
- inferior: lateral & medial heads of gastrocnemius side
On roof: deep fascia
- deep fascia on roof is pierced by small saphenous vein
On floor:
- popliteal surface of femur on top
- popliteus muscle on bottom part
- posterior aspect of ankle joint
What are the contents of the popliteal fossa?
- branches of sciatic nerve –> tibial and common fibular (peroneal) nerve
- popliteal vein
- popliteal artery
- fat
- lymph nodes
Where do you take the pulse of the popliteal artery?
popliteal fossa
What is the origin and insertion of tibialis anterior?
Ori: lateral condyle and upper 2/3 of lateral surface of tibia; and interosseous membrane.
Ins:
- 1st (medial) cuneiform
- Base of the 1st metatarsal
What are the actions of the tibialis anterior?
- dorsiflexion of foot @ ankle joint (prime mover of DF)
- inversion of foot @ subtalar joint
What is the innervation of tibialis anterior?
deep fibular (peroneal)
What is the origin & insertion of extensor hallucis longus?
Ori: middle 1/3 of anterior surface of fibula and interosseous membrane.
Ins: Base of distal phalanx of big toe
What are the actions of extensor hallucis longus?
- extension of big toe @ MTP & IP joints
- dorsiflexion of foot @ ankle joint
- inversion of foot @ subtalar joint
What is the innervation of extensor hallucis longus?
deep fibular (peroneal)
What is the origin & insertion of extensor digitorum longus?
Ori:
- lateral condyle of tibia
- Proximal 2/3 of anterior surface of fibula
- interosseous membrane.
Ins: Middle and distal phalanges of toes 2-5 (Via dorsal digital expansion)
What are the actions of extensor digitorum longus?
- extension of toes #2-5 @ MTP & IP (DIP & PIP) joints
- dorsiflexion of foot @ ankle joint
- eversion of foot @ subtalar joint
What is the innervation of digitorum longus?
deep fibular (peroneal)
What is the origin & insertion of fibularis (peroneus) tertius?
Ori: Distal 1/3 of anterior surface of fibula and interosseous membrane
Ins: Base of the 5th metatarsal (anterior to tuberosity)
What are the actions of fibularis (peroneus) tertius?
- dorsiflexion of foot @ ankle joint
- eversion of foot @ subtalar joint
What is the innervation of fibularis (peroneus) tertius?
deep fibular (peroneal)
What does compartment syndrome refer to?
pressure inside compartment increases (ex., enlargement of muscle) –> press of nerve & damage/loss of movement
What happens if the deep fibular nerve is compressed in the anterior compartment of the leg?
drop foot
What is the origin & insertion of fibularis (peroneus) longus?
Ori:
- Head of fibula
- Proximal 1\2 of lateral surface of fibula.
Ins:
- Base of the 1st metatarsal
- 1st cuneiform
What are the functions of fibularis (peroneus) longus?
- eversion of foot @ subtalar joint
- plantar flexion of foot @ ankle joint
What is the innervation of fibularis (peroneus) longus?
superficial fibular (peroneal)
What is the origin & insertion of fibularis (peroneus) brevis?
Ori: Distal 1/2 of lateral surface of fibula
Ins: Tuberosity of the 5th metatarsal bone
What is the inneravtion of fibularis (peroneus) brevis?
superficial fibular (peroneal)
What are the actions of fibularis (peroneus) brevis?
- eversion of foot @ subtalar joint
- plantar flexion of foot @ ankle joint
Peroneal (fibularis) muscles are a group , 1 in front (fibularis tertius) of lateral malleolus, and two behind (fibularis longus & brevis) BUT?
their action at the ankle joint is different
