lower extremity Flashcards
What type of joint is hip joint
multiaxial ball and socket
pelvic girdle
femur and acetabulum (where pelvis comes together)
SI joint
(Sacroiliac joint) where pelvis meets sacrum
3 pelvic bones
ilium
ischium
pubis
anterior pelvic tilt
big butt big gut
posterior pelvic tilt
old man walking
lateral pelvic tilt
hips moving up and down
hip flexor muscles and tendon location
anterior.
sartorius, tensor fasciae latae, rectus femoris, iliopsoas, pectinius
iliopsoas 3 parts, origin and insertion, and movement
iliacus, psoas major, psoas minor
o: ilium/ L1-5
i: lesser trochanter
flexion & external rotation
pectineus origin & insertion, movement
reverse pockets
o: pubis
i: lesser trochanter
FAdEr
sartorius origin & insertion, movement
o: ASIS (medial)
i: pes anserine
movement: FAbEr (cross leg)
rectus femoris origin & insertion
o: AIIS
i: Tibial Tuberosity
movement: hip flexion, knee extension
tensor fasciae latae origin & insertion, movement
o: ASIS
i: Gerdy’s Tubercle
movement: hip flexion and abduction
hip extensor muscles and tendon location
posterior
gluteus maximus, biceps femoris, semitendinosus, semimembranosus,
gluteus maximus origin & insertion, movement
o: posterior ilium/sacrum & coccyx
i: greater trochanter
movement: extension, external rotation
biceps femoris origin & insertion, movement
o: long head: ischial tuberosity, short head: linea aspera
i: head of fibula
m: knee flexion, external rotation of knee, hip extension, hip external rotation
semitendinosus origin & insertion, movement
o: ischial tuberosity
i: pes anserine
m: hip extension, hip internal rotation, knee flexion, knee internal rotation
semimembranosus origin & insertion, movement
o: ischial tuberosity
i: posterior medial tibial condyle
m: hip extension, hip internal rotation, knee flexion, knee internal rotation
semitendinosus vs semimembranosus
semitendinosus: further from bone
semimembranosus: closer to bone
hip abductors
tensor fascia latae, sartorius, gluteus medis, gluteus minimus
gluteus medius origin & insertion, movement
o: lateral ilium
i: posterior greater trochanter
m: abd, ext & in. rotation
gluteus minimus origin & insertion, movement
o: lateral ilium
i: anterior greater trochanter
m: abd, in. rotation
hip adductor muscles
adductor longus, adductor magnus, adductor brevis, gracilis, pectineus
adductor longus origin & insertion, movement
o: anterior pubis
i: middle 1/3 linea aspera
m: adduction
adductor magnus origin & insertion, movement
o: pubis/ ischial tub
i: length of linea aspera
m: adduction, external rotation
adductor brevis origin & insertion, movement
o: pubis
i: upper lip of linea aspera
m: adduction, external rotation
gracilis origin & insertion, movement
o: pubis
i: pes anserine
m: hip internal rotation, adduction, knee flexion
hip external rotator muscles
gluteus maximum, sartorius, pectineus, iliopsoas, biceps femoris, 6 external rotators
hip internal rotators
gracilis, semitendonosus, semimembranosus
tibiofemoral type of joint and movement
hinge, flex & ext
patellofemoral type of joint and movement
gliding, sesamoid (patella) within the quads
mcl
media collateral ligament
2 layers, broad, prevents valgus (knock-knee)
lcl
lateral collateral ligament
thinner, ropelike, prevents verus (knees out)
acl
prevents anterior translation of tibia
pcl
prevents posterior translation of tibia
meniscus
cushion between bones, attach to tibial plateaus, thicker on the outside, medial side is more c shaped and bigger.
purpose is to deepen tibial fossa and enhance stability
degrees of knee movement
flexion: 130-140
extension: 0
hyperextension: 10
scew home mechanism
due to shape of medial femoral condyle the joint must “screw home” to achieve the full knee extension.
approaching extension: tibia ex rot about 10 degrees
initial flexion: tibia int rot (unlocks)
open chain
ext: tibia ER
flex: tibia IR
closed chain
ext: femur IR
flex: femur ER
knee extension muscles
aka quads
rectus femoris, vastus lateralis, vastus intermedius, vastus medialis
vastus lateralis origin & insertion
o: upper 2/3 femur
i: tib tub
vastus intermedius origin & insertion
o: lateral femur
i: tib tub
vastus medialis origin & insertion
o: linea aspera
i: tib tub
knee flexion muscles
hamstrings (semimembranosus, semitendinosus, biceps femoris), sartorius, gracilis, popliteus
popliteus origin & insertion, movement
unlocking muscle
o: posterior lateral femoral condyle
i: posterior medial tibia
m: flex, IR
internal hip rotator muscles
on medial side
gracilis, semimembranosus semitendonosus
external hip rotator muscles
on lateral side
biceps femoris
why don’t quads do knee rotation
they attach at tib tub
what muscle acts as a decelerator
quads, decrease speed, change direction, prevent falling
should be 20-35% stronger than hamstrings
what muscle acts as an accelerator
hamstrings, running muscle
tib fib joint
holds tibia and fibula together, proximal and distal
interosseous membrane
space between tib and fib that keeps it together
talocrural joint type and movement
ankle joint
hinge
plantar/dorsiflexion
subtalar joint type and movement
gliding (rocks back and forth)
inversion and eversion
metatarsophalangeal joint movement
mtp
flexion/extension
ab (splay toes), adduction (squeeze toes)
PIP
proximal interphalangeal joint
DIP
distal interphalangeal joint
IP joints
joint between phalanges
DIP, PIP
all toes have both except big toe (only has IP)
types of phalanges in feet
proximal, middle, distal
lateral ankle ligaments
protects against inversion
anterior talofibular ligament (ATF)
calcaneofibular ligament (CF)
posterior talofibular ligament (PTF)
medial ankle ligaments
protects against eversion
deltoid ligament (series of multiple ligaments)
3 types of aches
medial, lateral, and transverse
medial and lateral arch origin & insertion
o: calcaneus
i: metatarsals
transverse arch location
base of metatarsals
high arch
pes cavus supinator
low arch
pes planus pronator
purpose of fascia
surrounds and binds each compartment
facilitate venous return
prevent excess swelling
anterior compartment of leg movement
dorsiflexors
lateral compartment of leg movement
evertors
posterior compartment of leg movement
superficial: plantarflexors
deep: plantarflexors & invertors
plantarflexor muscles (straight back)
gastrocnemius, soleus
gastrocnemius origin & insertion, movement
o: femoral condyles
i: achilles tendon
m: knee flex, plantarflex
soleus origin & insertion, movement
o: posterior tib & fib
i: achilles tendon
m: plantarflex
plantarflexor muscles (medial)
tom dick harry muscles
posterior tibialis
flexor digitorum longus
flexor hallucis longus
posterior tibialis origin & insertion, movement
o: upper interosseus & adjoining tib & fib
i: navicular, cuneiforms, & base of 2-5
m: foot inversion, plantar flexion
flexor digitorum longus origin & insertion, movement
o: middle 1/3 posterior tibia
i: base 2-5 toes
m: foot inversion, toe flexion, plantarflexion
flexor hallicis longus origin & insertion, movement
o: middle 2/3 posterior fib
i: base great toe
m: toe and plantar flexion, foot inversion
plantarflexor muscles (lateral)
peroneus longus, peroneus brevis
peroneus longus origin & insertion, movement
o: head & upper fib
i: plantar aspect of med cuneiform & 1st metatarsal
m: plantarflexion, eversion
peroneus brevis origin & insertion, movement
o: lower 2/3 of fib
i: base of 5th metatarsal
m: plantarflexion, eversion
dorsiflexor muscles
peroneus tertius, anterior tibialis, extensor digitorum longus, extensor hallicus longus
peroneus tertius origin & insertion, movement
o: distal 1/3 ant. fib
i: base of 5th metatarsal
m: eversion & dorsiflexion
anterior tibialis origin & insertion, movement
o: upper 2/3 tibia
i: cuneiform & base of 1st metatarsal
m: inversion & dorsiflexion
extensor digitorum longus origin & insertion, movement
o: lateral tibia condyle & head of fib
i: middle & distal 2-5 phalanges
m: eversion, dorsiflexion, toe extension
extensor hallicus longus origin & insertion, movement
o: middle 2/3 fibula
i: base of distal 1st toe
m: dorsiflexion, toe extension
leg invertors muscles (medial)
flexor digitorum longus, flexor hallicus longus, posterior tibialis, and anterior tibialis
leg evertors muscles (lateral)
peroneus longus, brevis, & tertius , extensor digitorum longus
low arches vs flat feet
low: anatomical, non-weight-bearing
flat feet: collapsed arch due to standing, functional
why are inversion sprain more common than eversion
- medial ligaments stronger
- fibula is longer and blocks eversion
- supination/ inversion (gait)
- more muscles on medial side
how to isolate soleus muscle for stretching
bend the knee