Module 4D: Lower Appendicular Muscles Flashcards
what area of the body is your thigh?
hip to knee
what are of the body is your leg?
knee to ankle
what is the origin of the psoas major?
- the transverse processes
- bodies of lumbar vertebrae
what is the insertion of the psoas major?
lesser trochanter of femur
what are the actions of the psoas major?
- hip (thigh) flexion (both lifting and flexing the thigh of one or both sides)
- trunk flexion (contracting left and right together)
- lateral flexion of vertebral column (flexing one side)
which joint does the psoas major act directly on?
the hip joint
where is psoas major located in relation to quadratus lumborum?
deep
which muscle does the psoas major combine with as it runs under the inguinal ligament to insert on the femur?
iliacus
where does the inguinal ligament run from?
the anterior superior iliac spine to the pubic tubercle
- it is a major landmark for muscles, nerves, blood vessels and compartments
what is the action of the psoas major dependent on?
which of the bones or segments is kept stable
what is the origin of the iliacus?
iliac fossa
what is the insertion of the iliacus?
lesser trochanter of femur
what is the action of the iliacus?
hip (thigh) flexion
the iliacus is a ______ hip flexor.
powerful
when psoas major and iliacus are combined together, what are the called?
iliopsoas muscle
what is the most powerful flexors of the thigh?
psoas major and iliacus
the insertion on the lesser trochanter of the femur of the psoas major and the iliacus is _____ to the muscles of the thigh.
deep
which muscles are critically important for walking, running, standing?
the psoas major and iliacus
- through movement of the thigh with respect to the trunk and vice versa
what is the origin of the tensor fascia latae?
- crest of ilium (lateral aspect)
what is the insertion of the tensor fascia latae?
iliotibial band (to knee)
what is the actions of the tensor fascia latae?
- hip abduction
- medial rotation of hip
- provides support to knee
what does our tensor fascia latae do when we contract?
it pulls on the IT band and the fascia lata which helps stabilize the knee and hold the muscles and the thigh in place
damage to the tensor fascia latae can cause?
pain at the hip or knee or both
- very common in runners due to the constant stabilization of each leg with each footfall
what is fascia lata?
thick layer of deep fascia in thigh and gluteal region
is the fascia lata a muscle?
no
true or false: the outer layer of the deep fascia of the lower limb forms a stocking-like membrane covering the limb, beneath the superficial fascia layer. the fascia becomes particularly thick in the thigh and gluteal region where the fibers of the fascia are most circular, its called fascia lata.
true
what is the iliotibial band/tract?
- thickening of fascia lata on lateral thigh for tract/band where the fibers align vertically
- vertical fibers extend inferiorly on the lateral side of the thigh to form the IT band
- muscles insert into tract
- on the lateral side of the leg
what are the three gluteal muscles?
- gluteus maximus (largest)
- gluteus medius
- gluteus minimus (smallest)
what is the shape of the gluteus maximus?
quadrilateral
what is the origin of the gluteus maximus?
- sacrum (pretty much covers the full sacrum)
- gluteal surface of ilium
what is the origin of the gluteus medius and minimus?
- gluteal surface of ilium
what is the insertion of the gluteus maximus?
- gluteal tuberosity of femur (1/4)
- iliotibial band (3/4)
what is the insertion of the gluteus medius and minimus?
- greater trochanter of femur
what is the actions of the gluteus maximus?
- extension
- lateral rotation of thigh
important in stabilizing hips during walking/running
what is the actions of the gluteus medius and minimus?
- **abduction (because they are mostly over the top of the hip)
- medial rotation of thigh
important in stabilizing hips during walking/running
where is gluteus minimus with respect to gluteus medius?
gluteus minimus is directly deep of gluteus medius
which muscle is more medial, gluteus maximus or gluteus medius?
gluteus maximus is more superficial and more medial
what are the insertions of the gluteal muscles on the femur in order of superior to inferior
- gluteus minimus
- gluteus medius
- gluteus maximus
- each attach to the femur at slightly different angles so they will have different actions
why do the gluteus medius and minimus abduct and medially rotate the thigh over the stance limb?
to reduce pelvic drop over opposite swing limb during walking
- can be associated with increased risk of low back pain
what is the trendelenburg test?
- a clinical test for the gluteus medius and minimus
- a positive test is the pelvis drops on opposite side than the one being tested
- then indicative that the gluteal nerve is damaged or the gluteus medius or minimus has atrophy or weakness
improper control of the gluteus medius muscle bilaterally has been linked with?
an increased risk of low back pain
what is a good exercise for the gluteus medius and minimus?
clamshell exercises
what are the five muscles of the anterior thigh?
- sartorius
- quadriceps femoris group
- rectus femoris
- vastus medialis
- vastus intermedius
- vastus lateralis
which muscle of our anterior thigh is a
bi-articular or “strap” muscle?
the sartorius
- it crosses two joints (hip and knee)
what is the origin of the sartorius?
- anterior superior iliac spine
what is the insertion of the sartorius?
- medial side of tibia
what is the action of the sartorius?
- flexion
- lateral rotation of thigh
- knee flexion
what muscles insert at the inferior and medial tibial tuberosity?
- sartorius
- gracilis
- semitendinosus
why is the sartorius called the leg crossing muscle?
if you cross one leg over the other by putting your ankle on the opposite knee, you are doing all the motions/actions of the sartorius muscle
- you have flex and laterally rotate the thigh and you have to flex the knee
why is it called the quadriceps femoris group?
there is four muscles
what is the origin of the of the rectus femoris?
anterior inferior iliac spine (crosses the hip joint)
- bipinate fiber orientation so it looks like a feather
what is the origin of the vastus medialis?
medial aspect of femur
what is the origin of the vastus lateralis?
lateral aspect of femur
what is the origin of the vastus intermedius?
anterior surface of femur
- tucked directly under rectus femoris
where does the rectus femoris sit?
anteriorly and in the middle of the other quadriceps femoris muscles
what is the insertion of ALL the quadriceps muscles?
the patella
- they continue to the leg via the patellar ligament running from the patella to the tibial tuberosity
what is the action of the rectus femoris?
- knee extension
- hip flexion (because it crosses your hip joint)
what is the action of the vastus lateralis, medialis and intermedius?
knee extension
what is being achieved by all the quadriceps muscles inserting at the patella?
a lot more force can be generated
- through the attachment to the patella it has extra leverage, giving the ability to generate greater moments simply because of that greater distance away from that joint center
what is leg extension?
knee extension
what is thigh flexion?
hip flexion
in order to target the rectus femoris, what type of movements should the exercise require?
exercises/activities that require both knee extension and hip flexion
what is the medial thigh group?
group of muscles that hold in or bring the limb inward
what does magnus mean?
big
what are the muscles of the medial thigh?
- adductor magnus
- adductor longus
- adductor brevis
- pectineus
- gracilis
what is the origin of the gracilis?
pubis
what is the origin of the pectineus?
pubis
what is the origin of the adductor brevis?
pubis
what is the origin of the adductor longus?
pubis (near pubis symphysis)
what is the origin of the adductor magnus?
- pubis
- ramus of ischium
- ischial tuberosity
which is the largest and deepest muscle of the medial compartment of the thigh?
the adductor magnus
what is the form of the adductor magnus?
- triangular/fin-shaped muscle
- has its apex at the pelvis
- its an expanded base on the femur
- two parts: medial/hamstring (descends almost vertically) and a lateral part (adductor part) fans from medial to lateral
what is the medial/hamstring part of the adductor magnus?
descends almost vertically
what is the lateral/adductor part of the adductor magnus?
fans from medial to lateral
which muscle forms the distal posterior wall of the adductor canal that has an adductor hiatus in it?
the adductor magnus
what is an adductor hiatus?
- a large circular gap between the hamstring and adductor parts of the muscle inferiorly to simply allow the passage of the femoral artery and associate veins between the adductor canal and the anterior medial thigh in the popliteal fossa on the posterior of the knee
what is the insertion of the gracilis?
medial side of tibia (same as sartorius)
what is the insertion of the pectineus?
pectineal line (spiral line) of femur
what is the insertion of the adductor longus?
linea aspera of femur
what is the insertion of the adductor brevis?
upper 1/3 of linea aspera of femur
what is the insertion of the adductor magnus?
medial (hamstring part) - posterior shaft of femur and adductor tubercle (by medial condyle at distal femur)
lateral (adductor part) - via aponeurosis onto the medial supracondylar line
sufficient:
- posterior shaft of femur
what is the action of the gracilis?
- knee flexion (synergist to the knee flexion muscles)
- hip adduction
- flexion of thigh
what is the action of the pectineus?
- hip adduction
- flexion of thigh
what is the action of the adductor longus?
- hip adduction
- flexion of thigh
what is the action of the adductor brevis?
- hip adduction
- flexion of thigh
what is the action of the adductor magnus?
- hip extension with the medial hamstring with the fibers that are a little bit more posteriorly (portion is synergist to the hamstrings)
- hip adduction
- flexion of thigh
what are the three long muscles of the posterior thigh (the hamstrings)?
- biceps femoris (lateral)
- semitendinosus (medial)
- semimembranosus (medial)
which muscle group is all antagonists to the quadriceps group?
the hamstring group (the posterior thigh)
what is the origin of the semitendinosus and the semimembranosus?
ischial tuberosity
what is the origin of the biceps femoris?
- long head: ischial tuberosity
- short head: posterior lateral side of femur (does not cross the hip joint)
what does femoris mean?
femur
what does biceps mean?
it has two heads
which is more superficial, semitendinosus or semimembranosus?
semitendinosus is superficial to semimembranosus
- semimembranosus is more muscle
- semitendinosus has more tendon
what is the insertion of the semimembranosus and semitendinosus?
medial side of tibia
what is the insertion of the biceps femoris?
head of fibula
what is the action of the semimembranosus and semitendinosus?
- hip extension (also with biceps femoris long head)
- knee flexion (also with biceps femoris short head)
what is the action of the long head of the biceps femoris?
- hip extension
what is the action of the short head of the biceps femoris?
- knee flexion
at the insertion of the hamstring muscles, which muscle is the only one on the lateral side?
biceps femoris
- semimembranosus and semitendinosus are on the medial aspect
which muscle in the hamstring group is the only one that does not cross the hip joint?
the SHORT head of the biceps femoris
are all the muscles of the hamstring group bi-articular?
yes
what is the main action of the hamstring muscle group?
knee flexion
- gluteal muscles are already the prime movers of the hip
what does the hamstring muscle group also contribute to the rotation of?
rotation at the hip and thigh
where is the popliteus?
the muscle at the posterior knee
what is the origin of the popliteus?
- just above lateral femoral condyle
what is the insertion of the popliteus?
- upper posterior surface of tibia
what is the action of the popliteus?
laterally rotates femur to unlock the knee, so the knee can flex
what does the femur do when the knee goes into full extension?
the femur is going to rotate slightly medially, on top of the tibia to lock the knee which tightens all of the ligaments and it aligns the femur and the tibia articulations so that the flatter areas of the femur interact directly with the flatter regions of the tibial plateau. and this alignment means you need minimal muscle force to simply maintain an extended knee position in a standing or weight-bearing position so we need the popliteus to function to unlock the knee when we are weight-bearing so that we can rotate the femur a little bit laterally on that fixed tibia which allows the other muscles to then flex the knee
what are the compartment groups that the leg muscles are divided into?
by location
- posterior group
- superficial (3 muscles)
- deep (3 muscles) - anterior group (4 muscles)
- lateral group (2 muscles)
what does the posterior leg muscles primarily do?
plantar flexion
what does the anterior leg muscles primarily do?
dorsi flexion
- where the dorsiflexors tendons cross the anterior ankle and the dorsal surface of the foot
what does the lateral leg muscles primary do?
their action depends on whether they insert to top or bottom of foot
- their tendons go behind the lateral malleolus
what are the three superficial posterior leg msucles?
- gastrocnemius
- plantaris
- soleus
what are the three deep posterior leg muscles?
- tibialis posterior
- flexor digitorum longus
- flexor hallucis longus
what are the four anterior leg muscles?
- tibialis anterior
- extensor hallucis longus
- fibularis tertius
- extensor digitorum longus
what are the two lateral leg muscles?
- fibularis longus (peroneus longus)
- fibularis brevis (peroneus brevis)
what are the two heads of the gastrocnemius?
- medial
- lateral
what is the origin of the gastrocnemius?
- above the knee joint
- just above medial and lateral condyles of femur (it will have an action at the knee)
what is the insertion of the gastrocnemius?
- calcaneus via calcaneal/achilles tendon
what is the action of the gastrocnemius?
- plantar flexion
- knee flexion (synergist to hamstrings)
what is the origin of the plantaris?
- just above lateral femoral condyle of femur (deep to gastrocnemius)
what is the insertion of the plantaris?
calcaneus via calcaneal/achilles tendon
what is the action of the plantaris?
- plantar flexion
- knee flexion
what is the origin of the soleus?
- posterior surface of fibula and tibia (deep to gastrocnemius)
what is the insertion of the soleus?
- calcaneus via calcaneal/achilles tendon
what is the action of the soleus?
- plantar flexion
it does not have an action at the knee because it does not cross the knee
what forms the triceps surrey muscles?
the soleus with the medial and lateral heads of the gastrocnemius
- surae means “of the calf” in Latin
all the tendons of the deep posterior leg muscles all travel around?
all travel around the medial malleolus of the tibia
what is the origin of the tibialis posterior?
- posterior tibia
- fibula
- interosseus
what is the insertion of the tibialis posterior?
- broad attachment on plantar surface of foot
what is the action of the tibialis posterior?
- ankle plantar flexion
- inversion of foot
what is the origin of the flexor digitorum longus?
- posterior surface of tibia
what is the insertion of the flexor digitorum longus?
distal phalanges of lateral 4 digits (#2-5)
what is the action of the flexor digitorum longus?
- toe flexion
- ankle plantar flexion
what is the origin of the flexor hallucis longus?
- posterior inferior surface of fibula
what is the insertion of the flexor hallucis longus?
- distal phalanx of big toe (hallux, #1)
what is the action of the flexor hallucis longus?
- toe flexion
- ankle plantar flexion
what is the superior and inferior extensor retinacula?
- band of tendon around our ankle
- stops the tendons from bowing
what is the origin of the tibialis anterior?
- anterior upper shaft of tibia
what is the insertion of the tibialis anterior?
- base of 1st metatarsal
- medial cuneiform
what is the action of the tibialis anterior?
- foot inversion (because it is very medial at the base of the first metatarsal and medial cuneiform while its origin is on the middle of the leg)
- ankle dorsiflexion
what is the origin of the extensor digitorum longus?
- lateral condyle of tibia
- fibula
- interosseous membrane
what is the insertion of the extensor digitorum longus?
- dorsal expansion on lateral four toes (#2-5)
what is the action of the extensor digitorum longus?
- extension of toes (not big toe)
- ankle dorsiflexion
what is the origin of the extensor hallucis longus?
- anterior surface of fibula
- interosseous membrane
what is the insertion of the extensor hallucis longus?
- distal phalanx of big toe
what is the action of the extensor hallucis longus?
- extension of toes (just the big toe)
- ankle dorsiflexion
what is the origin of the fibularis tertius?
- distal surface of fibula
what is the insertion of the fibularis tertius?
- base of 5th metatarsal
what is the action of the fibularis tertius?
- ankle eversion (inserts of the same side as its origin. it inserts on the opposite side to tibialis anterior)
- ankle dorsiflexion
what does hallucis mean?
big toe
- if this is in the name it means that it has an action on the big toe (because it crosses the joint)
what is another name for the fibularis tertius?
- peroneus tertius
which lateral leg muscle runs under the foot to the medial side for its insertion?
- the fibularis (peroneus) longus (has a long tendon)
which lateral leg muscle is shorter and inserts on the fifth metatarsal?
- the fibularis (peroneus) brevis (shorter tendon)
why is the fibularis (peroneus) tertius called tertious?
- because you find it third relative to the fibularis longus and fibularis brevis and move distally down the leg and runs to that fifth metatarsal
what bone do both the fibularis longus and the fibularis brevis originate?
on the fibula (hence the name “fibularis” in both of them)
where does the fibularis longus stop its insertion in relation to the fibularis brevis?
fibularis brevis stops at the fifth metatarsal while the fibularis longus wraps all the way around to the first metatarsal in the medial cuneiform
what is the origin of the fibularis longus?
- lateral side of fibula
what is the insertion of the fibularis longus?
- plantar surface of 1st metatarsal
- medial cuneiform
what is the action of the fibularis longus?
- ankle eversion
- plantar flexion (weak because muscles are smaller (synergist to gastrocnemius and soleus))
what is the origin of the fibularis brevis?
- lateral shaft of fibular (inferior to attachment of fibularis longus)
what is the insertion of the fibularis brevis?
- base(bottom) of 5th metatarsal
what is the action of the fibularis brevis?
- ankle eversion
- plantar flexion (weak because muscles are smaller (synergist to gastrocnemius and soleus))
what is fibularis longus’ positioning relative to the fibularis brevis and fibularis tertius?
- the fibularis longus is superficial to the fibularis brevis and the fibularis tertius
true or false: fibularis tertius is going to do plantar flexion and eversion because it is on the top of the first metatarsal
false: “is going to do dorsiflexion and eversion because it is on the top of the fifth metatarsal”