MSS10 Lower Limb Muscles Flashcards
- **Gluteal muscle:
- Posterior Superficial (2)
- Posterior Hip Abductor (2)
- Posterior Hip Lateral Rotator (6)
- Anterior (2)
Posterior:
Superficial:
- origin: Ilium and Sacrum
- insertion: Iliotibial tract (Deltoid of hip)
- function: stabilize hip when walking, stabilize lateral knee
1. Gluteus maximus (Extend + Lateral Rotate thigh)
2. Tensor fasciae latae (Flex + Medial Rotate thigh)
Hip abductors:
- insertion: ***Greater trochanter
- stabilize pelvis in coronal plane —> maintain pelvis in ***horizontal position
- Trendelenburg gait —> damage to Superior gluteal nerve
3. Gluteus medius (Abduct hip)
4. Gluteus minimus (Abduct hip)
Hip lateral rotators:
- origin: Pelvis
- converge to insert: Medial aspect of ***Greater trochanter + Back of femur
- obturator internus/externus cover inner/outer surface of obturator membrane respectively
1. **Piriformis (pear shaped; pass through **greater sciatic foramen)
2. Superior gemellus
3. **Obturator internus (pass through **lesser sciatic foramen)
4. Inferior gemellus
5. Quadratus femoris
6. ***Obturator externus
Anterior:
- Psoas major (Flex trunk)
- Iliacus (Flex hip)
- conjoined as Iliopsoas —> Insert into ***Lesser trochanter
- **Thigh muscle:
- Anterior (2)
- Posterior (4)
- Medial (5)
Anterior compartment (Extensor):
- Quadriceps femoris (Extend knee)
- insertion: ***Patella
- via patella and patellar ligament to tibial tuberosity
- -> Rectus femoris (also Flex hip, ∵ only it spans hip joint)
- -> Vastus lateralis
- -> Vastus medialis
- -> Vastus intermedius
**2. Sartorius (Flex, **Lateral Rotate, **Abduct thigh + Flex knee)
- origin: ASIS
- insertion: **Medial tibia, below medial condyle –> crosses hip joint and knee joint
***- Pes anserinus: 3 conjoined tendons:
Sartorius (最superficial), Gracilis, Semi-Tendinosus (最deep) (Say Grace before Tea)
Posterior compartment / Hamstrings (Flex + Rotate knee, Extend hip when walking):
- Common origin: ***Ischial tuberosity
1. Biceps femoris - Flex + ***Lateral Rotate knee
- insertion: Fibula head (lateral)
- long (Extend thigh) + short head (arise from linea aspea)
- **2. Semi-tendinosus
- Flex + Medial Rotate knee
- insertion: Medial Tibia
- Semi-membranosus
- Flex + Medial Rotate knee
- insertion: Back of Medial Tibial condyle
- upper part is aponeurotic (membranous) - Adductor magnus (hamstring portion)
- Extend thigh (後提大腿)
- insertion: Adductor tubercle above Medial Femoral condyle
* **Adductor magnus does not produce movement at knee joint
Medial compartment (**Adductor + **Medial Rotate thigh):
- flat triangular mass of muscle
- origin: Iliopubic ramus and Ischial tuberosity
- insertion: Back of Femur along ***Linea aspera
- **1. Gracilis (also Flex + Medial Rotate knee)
2. Pectineus
3. Adductor longus
4. Adductor brevis
5. Adductor magnus (Adductor portion) - **Adductor magnus does not produce movement at knee joint
(6. Obturator externus)
3 thigh muscle septa
- Lateral (between anterior / posterior)
- Medial (between anterior / medial)
- Posterior (between medial / posterior)
Fascia lata
Deep fascia that encloses the thigh muscles
- thick
- stocking-like layer
- attach around root of thigh (back of sacrum and coccyx, hip bone, inguinal ligament)
- laterally form Iliotibial tract (Deltoid of hip: run from **iliac crest to **lateral tibial condyle)
4 intermuscular septum of leg
- Anterior (separate anterior / lateral)
- Posterior (separate lateral / posterior)
- Transverse (separate posterior superficial / posterior deep)
- Interosseous membrane (separate anterior / posterior deep)
- **Leg muscles
- Anterior (4)
- Lateral (2)
- Posterior superficial (3)
- Posterior deep (4)
Anterior compartment (Extensor):
- **Dorsiflex foot + **Extend toes
- Invert / Evert foot depend on insertion
- origin: Tibia / Fibula / Interosseous membrane
- insertion: Tarsal / Metatarsals / Phalanges
- Tibialis anterior
- Dosiflex, ***Inversion
- insertion: Medial Cuneiform, adjacent 1st Metatarsal - Extensor hallucis longus
- Extend big toe - Extensor digitorum longus
- Extend 2-5th toes - Peroneus tertius
- ***Eversion (not always present, part of extensor digitorum longus)
Lateral compartment (Everters):
- **Plantaflex + **Evert foot
- tendons run behind Lateral Malleolus
- Peroneus longus (fibularis longus)
- winds around Lateral Cuboid
- insertion: Medial Cuneiform, adjacent 1st Metatarsal - Peroneus brevis (fibularis brevis)
- insertion: 5th Metatarsal tuberosity
- inversion –> avulsion fracture of 5th Metatarsal
Posterior Superficial compartment (Flexor, Calf muscle):
- **Plantarflex, **Flex knee, Flex digits, ***Invert STTN complex
- Gastrocnemius (2 heads)
- Plantarflex, Flex knee - Soleus
- Plantarflex
–> Gastrocnemius + Soleus –> Triceps surae, share common tendon (***Archilles tendon / tendo calcaneus)
- Plantaris (may be absent)
Posterior Deep compartment (Flexor, Calf muscle):
- do not cross knee joint
- **Plantarflex, Flex digits, **Invert STTN complex
- **1. Popliteus
- unlock knee joint by Lateral Rotate Femur on Tibia —> allow Knee flexion + Medial rotation
- Tibialis posterior
- Plantarflex + ***Inversion - Flexor digitorum longus
- Flex DIP of 2-5th toes + Plantarflex - Flexor hallucis longus
- Flexes distal phalanx of big toe
Tendons around ankle
Anterior / Extensor:
Extensor hallucis longus
Extensor digitorum longus
Posterior:
Flexor hallucis longus
Flexor digitorum longus
Lateral / Everters:
Peroneus tertius
Peroneus longus
Peroneus brevis
Medial / Inverters:
Tibialis anterior
Tibialis posterior
***Tarsal tunnel
Roof: flexor retinaculum
Floor: talus and calcaneus
Side: ***medial malleolus
3 tendons, 1 artery, 1 nerve: (Tom, Dick And Nervous Harry) (medial —> lateral)
- *Tibialis posterior
- Flexor *Digitorum longus
- ***Posterior tibial *Artery
- Tibial *Nerve
- Flexor *Hallucis longus
Supporting foot arches
Muscle: Tonic contraction of: 1. Tibialis anterior (Tie) 2. Peroneus longus (Sling) 3. Peroneus brevis 4. Tibialis posterior (Sling) 5. Flexor hallucis longus 6. short muscles (Ties in concavity)
Ligaments:
- Interosseous ligaments (Ties near concavity)
- Plantar ligaments (Ties in concavity)
- Plantar aponeurosis (Ties between bases)
Intrinsic muscles of foot
Dorsal group: (ONLY one)
- Extensor digitorum brevis
- Extensor hallucis brevis
- Extend 1-4 digits
Plantar group:
- 4 layers
- short
- Flex / Extend, Abduct / Adduct the digits
- functions are comparatively crude
- individual actions are relatively unimportant
1. Interossei
2. Lumbricals - -> Arch support
- -> act as Ties
- -> keep IP joints straight against pull of flexors
- -> prevent curling of toes when walking
4 layers of intrinsic plantar muscle
1st layer
- Flexor digitorum brevis
- Abductor digiti minimi
- Abductor hallucis
2nd layer
- Lumbricals
- Quadratus plantae
3rd layer
- Flexor hallucis brevis
- Flexor digiti minimi brevis
- Adductor hallucis
4th layer
- Plantar Interossei
- Dorsal Interossei
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Popliteal fossa
Superomedial: Semitendinosis, Semimembranosus
Superolateral: Biceps femoris
Inferomedial: Medial Head of Gastrocnemius, Plantaris
Inferolateral: Lateral Head of Gastrocnemius
Floor: Popliteal muscle, Oblique Popliteal ligament, Popliteal surface of Femur
Roof: Skin, Superficial fascia, Deep fascia
