Muscles And Movements

Question 1

What is an accessory movement

Answer 1

• “A movement that a person cannot perform actively, but which can be performed on that person by an external force” (Maitland et al, 2001)
• They occur during all physiological movements
• They take the form of gliding 2 joint surfaces together
• The gliding may be medially, laterally, anteriorly, posteriorly, caudal or cephalad.

Question 2

Accessory movements at hip

Answer 2

• Longitudinal Caudad (pulling leg to “tail”)
• Distraction (separating the joint surfaces)
• Antero-posterior (gliding backwards)
• Postero-anterior (gliding forwards)

Question 3

Hip flexors

Answer 3

• Psoas Major
• Sartorius
• Iliacus
• Pectineus
• Rectus femoris
• Gracilis

•Limits Soft tissue/Hams

Question 4

Ilio psoas

Answer 4

•Origins
–Conjoined muscle and tendon of Psoas Major (TP T12-L4 and Iliacus (Iliac fossa)
•Insertions    
–Lesser Trochanter
•Action
–Hip flexion/trunk flexion at hip
•Innervation- L2-L3

Question 5

Pectineus

Answer 5

•Origins
–Superior pubic ramus
•Insertions
–Lesser trochanter to the linea aspera (Pectineal line)
•Action
–Flexes and adducts the thigh
•Femoral Nerve L2-L4

Question 6

Rectus femoris

Answer 6

•Origins
–Long Head (straight) -AIIS
–Short Head (reflected) - Ilium above acetabulum
•Insertion
–Quadriceps tendon of the Patella
•Action
–Extends the knee and flexes the hip
•Femoral Nerve L2-L4

Question 7

Sartorius

Answer 7

•Origins - ASIS
•Insertions
–Antero-medial surface of the proximal tibia
•Action
–Flexes, abducts, laterally rotates the thigh.
–Medially rotates the flexed knee
•Femoral Nerve - L2-L3

Question 8

Hip extensors

Answer 8

• Gluteus Maximus
• Adductor Magnas (ext part)
• Biceps Femoris
• Semimembranosius
• Semitendinosus

•Limits All Ligts, close pack

Question 9

Gluteus maximus

Answer 9

•Origins
–Outer surface of Posterior ilium sacrum and coccyx
•Insertions
–Iliotibial band, Gluteal tuberosity of femur
•Action
–Extension of trunk and thigh, lateral rotation of the thigh
•Inferior Gluteal Nerve
L5,S1-S2

Question 10

Biceps femoris

Answer 10

•Origin
–Long head-ischial tuberosity
–Short head-Linea aspera and lateral supracondylar ridge
•Insertions
–Head of fibular, lateral tibial condyle
•Action –Flexes and laterally rotates the knee, long head extends the hip
•Sciatic nerve L5, S1-S3

Question 11

Semitendinosus

Answer 11

•Origins
–Ischial tuberosity
•Insertions
–medial surface of the proximal tibia
•Action
–Extends the hip
–Flexes and medially rotates the knee
•Sciatic nerve L5,S1,S2

Question 12

Semimembranosus

Answer 12

•Origins
–Ischial tuberosity
•Insertions
–Posterior aspect of the medial tibial condyle
•Action
–Extends the hip, flexes and medially rotates the knee
•Sciatic nerve L5,S1,S2

Question 13

Hip abductors

Answer 13

• Gluteus Med & Min
• Sartorious
• TFL
• Piriformis (the flexed thigh)

•Limits:
Pubofem/Ilofem Med band

Question 14

Gluteus medius

Answer 14

•Origins
–Outer surface of the ilium
•Insertions
–Lateral greater trochanter
•Action
–Abducts and medially rotates the pelvis (Ant. fibres)
•Superior Gluteal Nerve L4-L5,S1

Question 15

Gluteus minimus

Answer 15

Origins
Outer surface of the ilium
Insertions
Anterior surface of greater trochanter
Action
Abducts and medially rotates the pelvis (Ant fibres)
Sup Gluteal Nerve  L4-L5,S1

Question 16

Tensor fasciae latae

Answer 16

•Origins
–ASIS and lateral iliac crest
•Insertions - via
–Iliotibial band and Gerdy’s tubercle lateral aspect proximal tibia
•Action
–Flexes and medially rotates the thigh
•Superior Gluteal nerve
•L4 L5 S1

Question 17

Piriformis

Answer 17

•Origins
–Internal surface of sacrum and gluteal surface of ilium
•Insertions
–Greater trochanter
•Action
–Lat. Rotation (deep lateral rotator) and
    Abduction of the flexed hip
•Nerve Supply
–1st 2nd Sacral Nerves

Question 18

Hip adductors

Answer 18

• Adductor Longus
• Adductor Brevis
• Adductor Magnus (add part)
• Pectineus
• Gracilis (very weak)

•Limits Iliofem Lat band/Teres

Question 19

Adductor Magnus

Answer 19

•Origins
–Inferior pubic ramus and ischial tuberosity
•Insertions
–Linea aspera, adductor tubercle
•Action
–Superior part Adducts, MR, Flex of the thigh
–Inferior part Adducts, (probably!), laterally rotates and extends
•Obturator nerve L3,L4 (Sup) Sciatic Nerve L4 (Inf)

Question 20

Adductor longus

Answer 20

•Origins
–Body of the pubis
•Insertions
–Middle 2/3 of linea aspera
•Action
–Adducts and medially rotates the thigh
•Obturator nerve L3 L4

Question 21

Adductor brevis

Answer 21

•Origins
–Inferior pubic ramus
•Insertions
–Lesser trochanter to proximal linea aspera
•Action
–Adducts and medially rotates the thigh
•Obturator nerve L3 L4

Question 22

Gracilis

Answer 22

•Origins
–Inferior ramus of pubis
•Insertions
–Upper aspect of medial shaft of tibia
•Action
–MR, adducts the hip
–Flexes and MR the knee
•Obturator nerve L3,L4

Question 23

Hip medial rotators

Answer 23

•Gluteus Med & Min
(Anterior fibres)
•TFL                    
•Adductor Magnus            
•Limits:
Ischiofem/post capsule

Question 24

Hip lateral rotators

Answer 24

• Gluteus Max
• Piriformis
• Obturator Int & Ext
• Gemellus Sup & Inf
• Quadratus Femoris
• Sartorious

•Limits Iliofem Lat band