Lower Limb Muscles Flashcards
1
Q
What are the 2 groups of muscles in the gluteal region?
What are their functions?
A
Superficial muscles:
- they abduct and extend the femur
Deep muscles:
- they laterally rotate the femur
2
Q
What are the superficial muscles in the gluteal region?
A
- Gluteus maximus
- Gluteus medius
- Gluteus minimus
- Tensor fascia lata
They act to abduct and extend the lower limb at the hip joint
3
Q
What are the attachments, actions and innervation of gluteus maximus?
A
origin:
- gluteal surface of ileum, sacrum and coccyx
attachment:
- iliotibial tract and gluteal tuberosity of femur
actions:
- main extensor of the thigh
- assists in lateral rotation
innervation:
- inferior gluteal nerve
4
Q
What are the attachments, actions and innervation of gluteus medius?
A
Origin:
- gluteal surface of the ilium
Insertion:
- greater trochanter of femur
actions:
- abducts and medically rotates the lower limb
- secures the pelvis and prevents pelvic drop during walking
innervation:
- superior gluteal nerve
5
Q
What are the attachments, actions and innervation of gluteus minimus?
A
origin:
- ilium
insertion:
- greater trochanter
actions:
- abducts and medically rotates the limb
- prevents pelvic drop of the opposite limb during walking
innervation:
- superior gluteal nerve
6
Q
What are the attachments, actions and innervation of the tensor fascia lata?
A
Origin:
- anterior superior iliac spine
Insertion:
- iliotibial tract, which attaches to the lateral condyle of the tibia
action:
- assists gluteus medius and gluteus minimus in abduction and medial rotation of the lower limb
innervation:
- superior gluteal nerve
7
Q
What are the deep muscles of the gluteal region?
A
- Piriformis
- Superior and inferior gemelli
- Quadratus femoris
- Obturator internus
They laterally rotate the lower limb
8
Q
What are the attachments, actions and innervation of piriformis?
A
Origin:
- anterior surface of the sacrum
insertion:
- travels through greater sciatic foramen
- Inserts into greater trochanter of femur
actions:
- lateral rotation and abduction
innervation:
- nerve to piriformis
9
Q
What are the attachments, actions and innervation of obturator internus?
A
Origin:
- pubis and ischium at obturator foramen
insertion:
- travels through lesser sciatic foramen
- attaches to greater trochanter of femur
actions:
- lateral rotation and abduction
innervation:
- nerve to obturator internus
10
Q
What are the attachments, actions and innervations of the gemelli?
A
origin:
- superior gemellus - ischial spine
- inferior gemellus - ischial tuberosity
insertion:
- greater trochanter of femur
actions:
- lateral rotation and abduction
innervation:
- superior gemellus - nerve to obturator internus
- inferior gemellus - nerve to quadratus femoris
11
Q
What are the attachments, actions and innervation of quadratus femoris?
A
Origin:
- ischial tuberosity
insertion:
- quadrate tuberosity on the intertrochanteric crest
actions:
- lateral rotation
innervation:
- nerve to quadratus femoris
12
Q
Label the muscles of the gluteal region
A
13
Q
What is the innervation and general action of the muscles in the anterior compartment of the thigh?
A
Innervation:
- femoral nerve (L2-L4)
Action:
- extension of the leg at the knee joint
14
Q
What are the muscles within the anterior compartment of the thigh?
A
- Pectineus
- Sartorius
- Quadriceps femoris
- Iliopsoas (the end passes into the anterior compartment)
15
Q
What are the origins and insertions of iliopsoas?
A
Origin:
- Psoas major originates from the lumbar vertebrae
- iliacus originates from the iliac fossa
Insertion:
- lesser trochanter of femur
16
Q
What are the actions and innervation of iliopsoas?
A
Actions:
- flexes the thigh at the hip joint
innervation:
- psoas major - anterior rami of L1-L3
- iliacus - femoral nerve
17
Q
Label the muscles of the anterior thigh
A
18
Q
What are the 4 muscles that make up quadriceps femoris?
A
- Rectus femoris
- Vastus lateralis
- Vastus medialis
- Vastus intermedius
19
Q
What are the attachments, actions and innervation of vastus lateralis?
A
Origin:
- greater trochanter and lateral lip of linea aspera
Insertion:
- Quadriceps tendon, which attaches to the patella
Action:
- extends the knee joint and stabilises the patella
Innervation:
- femoral nerve
20
Q
What are the attachments, actions and innervation of vastus medialis?
A
Origin:
- intertrochanteric line and medial lip of linea aspera
Actions:
- extends the knee joint and stabilises the patella
Innervation:
- femoral nerve
21
Q
What are the attachments, actions and innervation of vastus intermedius?
A
Origin:
- anterior and lateral surfaces of femoral shaft
Actions:
- extends the knee joint and stabilises the patella
Innervation:
- femoral nerve
22
Q
What are the attachments, actions and innervation of rectus femoris?
A
Origin:
- Ilium (just superior to acetabulum)
actions:
- flexes the thigh at the hip joint
- extends the leg at the knee joint
Innervation:
- femoral nerve
23
Q
What are the attachments, actions and innervation of sartorius?
A
Origin:
- anterior superior iliac spine
Insertion:
- superior, medial surface of the tibia
Actions:
- flexes, abducts and laterally rotates the hip
- flexes the knee joint
Innervation:
- femoral nerve
24
Q
Label the muscles
A
25
What is meant by pectineus being a “transitional muscle”?
it has a dual innervation
it is a transitional muscle between the anterior and medial thigh compartments
26
What is the passage of sartorius like?
it is long and thin and runs across the thigh in an **inferomedial** direction
it is more superficial than the other muscles in the leg
27
What are the attachments, actions and innervation of pectineus?
**Origin:**
* pectineal line on anterior surface of pelvis
**Insertion:**
* Pectineal line on posterior femur (just inferior to lesser trochanter)
**Actions:**
* adduction and flexion at the hip joint
**Innervation:**
* femoral nerve
* also receives a branch from the obturator nerve
28
Label the prosection image
29
What are the 5 medial thigh muscles?
What is their artery and nerve supply?
***The ‘hip adductors’***
1. Gracilis
2. Obturator externus
3. Adductor brevis
4. Adductor longus
5. Adductor Magnus
They are supplied by the obturator nerve and obturator artery
30
Label the muscles of the medial thigh
31
What are the attachments of the 2 parts of the adductor Magnus muscle?
**Adductor part:**
* originates from inferior rami of pubis and rami of ischium
* attaches to linea aspera
**Hamstring part:**
* orginates from ischial tuberosity
* attaches to adductor tubercle and medial supracondylar line of the femur
32
What are the actions and innervation of adductor magnus?
**Actions:**
* adduction of the thigh
* the adductor part also flexes the thigh
* the hamstring portion also extends the thigh
**Innervation:**
* ‘adductor part - obturator nerve (L2-L4)
* hamstring part - sciatic nerve (L4-S3)
33
What are the attachments, innervation and actions of adductor longus?
**Origin:**
* originates from the pubis and expands into a fan shape
**Insertion:**
* linea aspera of femur
**Innervation:**
* obturator nerve (L2-L4)
34
Why can the adductor brevis be used as an anatomical landmark?
it lies between the anterior and posterior divisions of the obturator nerve
35
What are the attachments, actions and innervation of the adductor brevis?
**Origin:**
* body of pubis and inferior pubic rami
**Insertion:**
* Linea aspera of femur
* proximal to adductor longus
**actions:**
* Adduction of the thigh
**Innervation:**
* obturator nerve (L2-L4)
36
What are the attachments, innervation and actions of obturator externus?
**Origin:**
* membrane of obturator foramen and adjacent bone
**Insertion:**
* posterior aspect of greater trochanter
**Actions:**
* adduction and lateral rotation of the thigh
**Innervation:**
* Obturator nerve (L2-L4)
37
What are the attachments and passage of gracilis?
Originates from the inferior ramus of the pubis and body of the pubis
descends vertically down the leg to attach to the medial surface of the tibia
it attaches between the tendons of sartorius (anteriorly) and semitendinosus (posteriorly)
38
What are the actions and innervation of gracilis?
**Actions:**
* adduction of the thigh at the hip
* flexion of the leg at the knee
**Innervation:**
* obturator nerve (L2-L4)
39
Label the medial thigh muscles
40
What are the muscles in the posterior compartment of the thigh?
***The Hamstrings***
1. Biceps femoris
2. Semitendinosus
3. Semimembranosus
41
What are the actions and innervation of the posterior thigh muscles?
they extend at the hip and flex at the knee
they are innervation by the sciatic nerve (L4-S3)
42
Label the muscles of the posterior thigh
43
What are the attachments of the biceps femoris muscle?
**Long head:**
* originates from the ischial tuberosity of the pelvis
**short head:**
* originates from the linea aspera on the posterior surface of the femur
**insertion:**
* the two heads form a tendon, which inserts into the head of the fibula
44
What are the actions and innervation of biceps femoris?
**Actions:**
* flexion at the knee
* also extends the thigh at the hip
* laterally rotates the hip and knee
**Innervation:**
* long head - tibial part of sciatic nerve
* short head - common fibular part of the sciatic nerve
45
What are the attachments, actions and innervation of semitendinosus?
**Origin:**
* ischial tuberosity of pelvis
**Insertion:**
* medial surface of the tibia
**Actions:**
* flexion of the leg at the knee joint
* extension of the thigh at the hip
* medially rotates the thigh and leg
46
What are the attachments, actions and innervation of semimembranosus?
**Origin:**
* ischial tuberosity of pelvis
* more superiorly than the semitendinosus and biceps femoris
**Insertion:**
* medial tibial condyle
**Actions:**
* flexion of the leg at the knee joint
* extension of the thigh at the hip joint
* medially rotates the thigh and leg
**Innervation:**
* tibial part of sciatic nerve
47
Label the cross section of the thigh
48
What are the 4 muscles in the anterior compartment of the leg?
1. Tibialis anterior
2. Extensor digitorum longus
3. Extensor hallucis longus
4. Fibularis tertius
49
What is the general action of the anterior leg muscles?
What is their blood supply and innervation?
They dorsiflex and invert the foot at the ankle joint
they are innervated by the **deep fibular nerve** (L4 - S1)
they are supplied by the **anterior tibial artery**
50
What are the attachments, actions and innervation of tibialis anterior?
**Origin:**
* lateral surface of the tibia
**Insertion:**
* medial cuneiform and the base of metatarsal I
**Actions:**
* dorsiflexion and inversion of the foot
**Innervation:**
* deep fibular nerve
51
Label the muscles of the anterior leg
52
What are the attachments, actions and innervation of extensor digitorum longus?
**Origin:**
* lateral condyle of the tibia and medial surface of fibula
**Insertion:**
* the tendons insert onto the dorsal surface of the 4 toes
**Actions:**
* extension of the lateral four toes
* dorsiflexion of the foot
**Innervation:**
* deep fibular nerve
53
What are the attachments, actions and innervation of extensor hallucis longus?
**Origin:**
* medial surface of the fibular shaft
**Insertion:**
* the tendon attaches to the base of the distal phalanx of the big toe
**Action:**
* extension of the big toe
* dorsiflexion of the foot
**Innervation:**
* deep fibular nerve
54
Label the tendons of the foot
55
What is significant about fibularis tertius?
It arises from the most inferior part of the EDL
It is not present in all individuals
56
What are the attachments, actions and innervation of fibularis tertius?
**Origin:**
* originates with the EDL from the medial surface of the fibula
**Insertion:**
* the tendon attaches to metatarsal V
**Actions:**
* Eversion and dorsiflexion of the foot
**innervation:**
* deep fibular nerve
57
What is footdrop a clinical sign of?
What is it usually a consequence of?
It indicates paralysis of the muscles in the anterior compartment of the leg
It occurs due to damage to the common fibular (peroneal) nerve (from which the deep fibular nerve arises)
58
What is the appearance of the leg like in foot drop and why?
The muscles in the anterior compartment are paralysed
the unopposed pull of the muscles in the posterior leg produce permanent plantarflexion
59
What are the 2 muscles in the lateral compartment of the leg?
What is their innervation and main function?
1. Fibularis brevis
2. Fibularis longus
They are innervated by the **superficial fibular nerve**
Their main function is **eversion** (turning the sole of the foot outwards)
60
Label the muscles of the lateral leg?
61
What are the attachments and path of the tendon of fibularis longus?
**Origin:**
* superior and lateral surface of the fibula and lateral tibial condyle
**Path of the tendon:**
* the tendon descends into the foot, posterior to the lateral malleolus
* it crosses under the foot
**Insertion:**
* bones on the medial side of the foot - mainly medial cuneiform and base of metatarsal I
62
What are the actions and innervation of fibularis longus?
**Actions:**
* eversion and plantarflexion of the foot
* supports the lateral and transverse arches of the foot
**Innervation:**
* superficial fibular (peroneal) nerve (L4-S1)
63
What are the attachments, actions and innervation of fibularis brevis?
**Origin:**
* inferolateral surface of fibular shaft
**Insertion:**
* tendon passes posterior to the lateral malleolus and over the calcaneus and cuboidal bones
* attaches to a tubercle on metatarsal V
**Actions:**
* eversion of the foot
**Innervation:**
* superficial fibular (peroneal) nerve
64
What is the general action and innervation of the muscles in the posterior compartment of the leg?
the posterior compartment muscles are organised into a superficial and deep layer
they act to **plantarflex** and **invert** the foot
they are innervated by the **tibial nerve**
65
What is the insertion of the superficial muscles in the posterior leg?
They all insert into the calcaneus of the foot via the calcaneal tendon
66
What are the two bursae associated with the calcaneal tendon?
What is their role?
**Subcutaneous calcaneal bursa:**
* lies between the skin and calcaneal tendon
**Deep bursa of the calcaneal tendon:**
* lies between the tendon and the calcaneus
The bursae work to minimise friction during movement
67
What are the muscles in the superficial layer of the posterior leg?
1. Plantaris
2. Gastrocnemius
3. Soleus
68
What are the attachments of gastrocnemius?
**Origin:**
* lateral head originates from lateral femoral condyle
* medial head originates from medial femoral condyle
* the fibres converge to form a single muscle belly
**Insertion:**
* The muscle belly combines with soleus to form the calcaneal tendon
* this inserts onto the calcaneus
69
What are the actions and innervation of gastrocnemius?
**Actions:**
* plantarflexion of the ankle
* flexion of the knee
**Innervation:**
* tibial nerve
70
Label the superficial layer of posterior leg muscles
71
What are the attachments, actions and innervation of plantaris?
**Origin:**
* lateral supracondylar line of femur
**Insertion:**
* the tendon blends with the calcaneal tendon
**Actions:**
* weak plantarflexor of the ankle
* weak flexor of the knee
**Innervation:**
* tibial nerve
72
What are the attachments, actions and innervation of soleus?
**Origin:**
* soleal line of the tibia and proximal fibular area
**Insertion:**
* joins the calcaneal tendon
**Actions:**
* plantarflexion of the ankle
**Innervation:**
* tibial nerve
73
What are the 4 muscles in the deep compartment of the posterior leg?
1. Popliteus
2. Tibialis posterior
3. Flexor digitorum longus
4. Flexor hallucis longus
74
Label the muscles in the deep layer of the posterior thigh
75
What are the attachments, actions and innervation of popliteus?
**Origin:**
* lateral condyle of femur and posterior horn of lateral meniscus
**Insertion:**
* it inserts above the origin of the soleus muscle
**Actions:**
* laterally rotates the femur on the tibia
* this is “unlocking” the knee joint so that flexion can occur
**Innervation:**
* tibial nerve
76
What are the attachments, actions and innervation of tibialis posterior?
**Origin:**
* interosseous membrane between tibia and fibula
**Insertion:**
* the tendon enters the foot posterior to the medial malleolus
* it inserts onto the plantar surface of the medial tarsal bones
**Actions:**
* inversion and plantarflexion of the foot
* maintains the medial arch of the foot
**Innervation:**
* tibial nerve
77
What are the attachments, actions and innervation of flexor digitorum longus?
**Origin:**
* medial surface of tibia
Insertion:
* plantar surfaces of the lateral four digits
**Actions:**
* flexes the lateral four toes
**Innervation:**
* Tibial nerve
78
What are the attachments, actions and innervation of flexor hallucis longus?
**origin:**
* posterior surface of the fibula
**Insertion:**
* plantar surface of the phalanx of the big toe
**Actions:**
* flexes the big toe
**Innervation:**
* tibial nerve
79
Label the tendons of the posterior leg
80
What are the 2 intrinsic muscles on the dorsal aspect of the foot?
What is their innervation?
1. Extensor digitorum brevis
2. Extensor hallucis brevis
They are both innervated by the **deep fibular nerve**
81
What are the attachments, actions and innervation of extensor digitorum brevis?
**Origin:**
* calcaneus, interosseous talocalcaneal ligament and inferior extensor retinaculum
**Insertion:**
* attaches to long extensor tendons of the 4 lateral digits
**Actions:**
* aids EDL in extending lateral four toes at metatarsophalangeal and interphalangeal joints
**Innervation:**
* deep fibular nerve
82
What are the attachments, actions and innervation of extensor hallucis brevis?
**Origin:**
* calcaneus, interosseous talocalcaneal ligament and inferior extensor retinaculum
**Insertion:**
* base of the proximal phalanx of the big toe
**Action:**
* aids EHL in extending the big toe at the metatarsophalangeal joint
**Innervation:**
* deep fibular nerve
83
What is the collective action of the intrinsic muscles in the sole of the foot?
What is their innervation?
they stabilise the arches of the foot and control movement of the digits
they are all innervated by either the **medial plantar nerve** or the **lateral plantar nerve**
these are both branches of the **tibial nerve**
84
What are the 3 muscles in the first layer of plantar muscles?
The first layer is located immediately underneath the plantar fascia
1. Abductor hallucis
2. Flexor digitorum brevis
3. Abductor digiti minimi
85
What are the attachments, actions and innervation of abductor hallucis?
**Origin:**
* medial tubercle of calcaneus, flexor retinaculum and the plantar aponeurosis
**Insertion:**
* medial base of proximal phalanx of the big toe
**Action:**
* abducts and flexes the big toe
**Innervation:**
* medial plantar nerve
86
Label the first layer of plantar muscles
87
What are the attachments, actions and innervation of flexor digitorum brevis?
**Origin:**
* medial tubercle of calcaneus and plantar aponeurosis
**Insertion:**
* middle phalanges of lateral 4 digits
**Actions:**
* flexes the lateral 4 digits at the proximal interphalangeal joints
**Innervation:**
* medial plantar nerve
88
What are the attachments, actions and innervation of abductor digiti minimi?
**Origin:**
* medial and lateral tubercles of the calcaneus and the plantar aponeurosis
**Insertion:**
* lateral base of the proximal phalanx of the 5th digit
**Actions:**
* abducts and flexes the 5th digit
**Innervation:**
* lateral plantar nerve
89
What are the muscles that make up the second layer of plantar muscles?
1. Quadratus plantae
2. Lumbricals
3. Tendons of flexor digitorum longus
90
Label the second layer of plantar muscles
91
What are the attachments, actions and innervation of quadratus plantae?
**Origin:**
* medial and lateral plantar surface of the calcaneus
**Insertion:**
* Attaches to the tendons of flexor digitorum longus
**Actions:**
* Assists FDL in flexing the lateral four digits
**Innervation:**
* lateral plantar nerve
92
What are the attachments, actions and innervation of the four lumbrical muscles of the foot?
**Origin:**
* tendons of flexor digitorum longus
**Insertion:**
* extensor hoods of the lateral 4 digits
**Actions:**
* flexes the metatarsophalangeal joints, whilst extending the interphalangeal joints
**Innervation:**
* the most medial lumbrical is innervated by the medial plantar nerve
* the remaining 3 are innervated by the lateral plantar nerve
93
What muscles make up the third layer of plantar muscles?
1. Flexor hallucis brevis
2. Adductor hallucis
3. Flexor digiti minimi brevis
94
Label the third layer of plantar muscles
95
What are the attachments, actions and innervation of flexor hallucis brevis?
**Origin:**
* plantar surfaces of the cuboid and lateral cuneiforms
**Insertion:**
* base of the proximal phalanx of the big toe
**Actions:**
* flexes the proximal phalanx of the big toe at the metatarsophalangeal joint
**Innervation:**
* medial plantar nerve
96
What are the attachments, actions and innervation of adductor hallucis?
**Origin:**
* oblique head - bases of 2nd, 3rd and 4th metatarsals
* transverse head - plantar ligaments of the metatarsophalangeal joints
**Insertion:**
* lateral base of proximal phalanx of the big toe
**Actions:**
* adduction of the big toe
* assists in forming the transverse arch of the foot
**Innervation:**
* deep branch of lateral plantar nerve
97
What are the attachments, actions and innervation of flexor digiti minimi brevis?
**Origin:**
* base of fifth metatarsal
**Insertion:**
* base of proximal phalanx of fifth digit
**Actions:**
* flexes proximal phalanx of fifth digit
**Innervation:**
* superficial branch of lateral plantar nerve
98
What makes up the fourth layer of plantar muscles?
the plantar interossei - which are unipennate
and
the dorsal interossei - which are bipennate
99
What are the attachments, actions and innervation of the 3 plantar interossei?
**origin:**
* the medial side of metatarsals 3 to 5
**insertion:**
* medial sides of phalanges of digits 3 to 5
**Actions:**
* abducts digits 3 to 5
* flexes the metatarsophalangeal joints
**innervation:**
* lateral plantar nerve
100
What are the attachments, actions and innervation of the 4 dorsal interossei?
**Origin:**
* sides of metatarsals 1 to 5
**Insertion:**
* first muscle attaches to medial side of proximal phalanx of the second digit
* second to fourth muscles attach to lateral sides of the proximal phalanges of digits 2 - 4
**Actions:**
* abducts digits 2 to 4
* flexes the metatarsophalangeal joints
**Innervation:**
* lateral plantar nerve
