MUSCLES + LIGS OF THE LOWER LIMB Flashcards
What are the superficial gluteal muscles
- gluteus Maximus
- gluteus medius
What is the origin of glut max
- posterior gluteal line
- lateral surface of sacrum and coccyx
- thoracolumbar fascia
What is the insertion of glut max
- gluteal tuberosity (deep part)
- into the ITB, which insets on Gerdys tubercle of the tibia (superficial part)
What is the LOP/actions of glut max
- extends and laterally rotates hip joitn
- adduction of hip joint (lowest fibres)
- hip abduction (uppermost fibres, as the have a moment arm for this)
- fibre in the middle of glut max has a LOP that passes straight through the axis therefore it has zero moment arm therefore doesn’t abduct or adduct the hip joitn
What is the origin of glut medius
- between anterior and posterior gluteal lines on the gluteal surface of the ilium
What is the insertion of glut medius
- lateral aspect of the great trochanter of femur
What is the LOP/actions of glut medius
- abduction of the hip
- hip flexion and internal rotation (front most part)
- hip extension and external rotation (back most part)
What is the origin of gluteus minimus
- between the anterior and inferior gluteal lines of the gluteal surface of ilium
What is the insertion of glut minimus
- anterior aspect of the greater trochanter of femur
What is the LOP/actions of glut minimus
- abduction of the hip
- hip flexion and internal rotation (front most part)
- hip extension and external rotation (back most part)
What happens when gluteus medius and minimus are activated
- this is muscle synergy
- their flexion-extension and internal-external rotations will cancel out
- this leaves pure abduction
What are the 6 lateral rotators of the hip
- Piriformis
- Gemellus superior
- Obturator internus
- Gemellus inferior
- obturator externus
- Quadratus Femoris
What is the origin of Piriformis
- anterior surface of sacrum
- gluteal surface of ilium, near PIIS
What is the insertion of Piriformis
- greater trochanter of the femur (apex)
What is the LOP/actions of Piriformis
- hip abduction and lateral rotation
- it neither flexes or extends the hip as it’s LOP passes through the AOR (therefore it has a zero moment arm)
What is the origin of Gemellus superior
- ischial spine
What is the origin of Gemellus superior
- ischial spine
What is the insertion of Gemellus superior
- greater trochanter
What is the LOP/actions of gemellus superior
- has a LOP that passes straight through the hip joint for abduction/adduction and flexion/extension
- has a moment arm for lateral rotation
What is the origin of Obturator internus
- posterior surface of the obturator membrane
- body boundaries of Obturator foramen
What is the insertion of Obturator internus
- greater trochanter
What is the LOP of Obturator internus
- has a LOP that passes straight through the hip joint for abduction/adduction and flexion/extension
- has a moment arm for lateral rotation
What is the origin for Gemellus inferior
- ischial tuberosity
What is the insertion for Gemellus inferior
Greater trochanter
What is the LOP/action of Gemellus inferior
- has a LOP that passes straight through the hip joint for abduction/adduction and flexion/extension
- has a moment arm for lateral rotation
What is the origin of Obturator externus
- anterior surface of obturator membrane
- bony boundaries of obturator foramen
What is the insertion of obturator externus
- greater trochanter on the trochanteric fossa
What is the LOP/actions of
- hip adduction (as it has a moment arm for this)
- as its LOP passes straight through the AOR in the other two views, it has zero moment arms for hip flexion, extension, medial or lateral rotation !
What is the origin of Quadratus Femoris
Lateral aspect of the ischial tuberosity (it originates from hamstring)
What is the insertion of Quadratus Femoris
Greater trochanter on the quadrate tubercle on the trochanteric crest
What is the LOP/actions of Quadratus Femoris
- hip adduction
- hip extension
- hip lateral rotation
What is the sciatic nerve
It is a loose binding of two functional nerves - common fibular and tibial nerve. It leaves the pelvis vials the greater sciatic for area and enters the posterior thigh
Where should clinicians perform buttock injections
Above the nerve as it means they are less likely to jab the sciatic nerve
What is the origin of the sciatic nerve
L4, L5, S1-S3
What is the insertion of the sciatic nerve
Greater trochanter
Where do the superior and gluteal vessels pass through
The greater sciatic foramen, along with the superior gluteal nerve
Where are the superior and gluteal vessels (arteries and veins) and nerve located
Their location is determined by their relation to Piriformis
What is the origin of tensor fascia latae (TFL)
- ASIS
- anterior iliac crest
What is the insertion of TFL
Lateral condyle of the tibia, via the ITB
What is the LOP/actions of TFL
- hip abduction
- hip flexion
- hip medial rotation
What is the origin of the Iliotibial band (ITB)
- iliac crest
- hip joint capsule
- TFL
What is the origin of the Iliotibial band (ITB)
- iliac crest
- hip joint capsule
- TFL
What is the insertion of ITB
- Lateral condyle of the tibia, gerdy’s tubercle
What is the origin of Psoas major
- vertebral bodies of T12-L4
- intervertebral discs between T12-L4
- TP of L1-L5 vertebrae
What is the insertion of Psoas major
Lesser trochanter of the femur, via the iliopsoas tendon
What is the LOP/actions of Psoas major
- hip joint adduction (medial fibres)
What is the origin of Psoas minor
Vertebral bodies of T12 and L1
What is the insertion of Psoas minor
- superior pubic ramus
- Iliopubic eminence
What is the LOP/actions of Psoas minor
- has no action on the hip as it doesn’t cross the hip joint ]
- weak flexion/lateral flexion of trunk
What is the origin of Iliacus
Iliac fossa
What is the insertion of Iliacus
Lesser trochanter of the femur
What is the LOP/actions of Iliacus
- hip joint abduction (lateral fibres)
Out of Iliacus and Psoas major, which is more of a hip abductor
Iliacus
what are the 5 hip adductors
- Gracilis
- adductor longus
- Pectineus
- adductor brevis
- adductor Magnus
Which is known as a two-joint hip adductor
Gracilis as it insets on the leg, therefore acts across the knee
What is the origin of Gracilis
- anterior body of pubis
What is the insertion of the gracilis
Medial surface of tibia, via pes anserinus
What is the LOP/actions of Gracilis
- hip adduction
- hip internal rotation
- hip flexion
What is the origin of adductor longus
- pubic body
What is the insertion of adductor longus
Medial lip of linea aspera of femur
What is the LOP/actions of adductor longus
- hip adduction
- hip flexion
- hip internal rotation
What is the origin of Pectineus
- Superior pubic ramus
- Pectineal line of pubis
What is the insertion of Pectineus
- Pectineal line of femur
- linea aspera of femur
What is the LOP/actions of Pectineus
- hip adduction
- hip flexion
- hip internal rotation
What is the origin of adductor brevis
- Inferior pubic ramus
- anterior body of pubis
What is the insertion of adductor brevis
- medial lip of linea aspera of the femur
What is the LOP/actions of adductor brevis
- hip adduction
- hip flexion
- hip internal rotation
What are the two parts of adductor Magnus
- true adductor part
- ex hamstring part
What is the uppermost part of adductor Magnus called
Adductor minimus/adductor quartus
What is the origin of adductor magus (‘true’ adductor part)
Inferior pubic ramus
What is the insertion of adductor Magnus (‘true’ adductor part)
- gluteal tuberosity
- medial lip of linea aspera
- medial supracondylar lien
What is the LOP/actions of adductor Magnus (‘true’ adductor part)
- hip adduction
- hip flexion
- hip internal rotation
What is the origin of adductor Magnus (ex-hamstring part)
- ischial tuberosity
What is the insertion of the adductor Magnus (ex hamstring part)
Adductor tubercle of the femur
What is the LOP/actions of adductor Magnus (ex hamstring part)
- hip adduction
- hip extension
- hip internal rotation
What are the 4 quadriceps Femoris muscles
- rectus Femoris
- vastus medialis
- vastus lateralis
- vastus intermedius
What is the origin of rectus Femoris
AIIS
What is the insertion of rectus Femoris
Patella via the quadriceps Femoris tendon
What is the LOP/actions of rectus Femoris
- knee extension
- hip flexion
What is the origin of vastus medialis
- intertrochanteric line of femur
- medial lip of linea aspera
What is the insertion of vastus medialis
Patella via quadriceps tendon
What is the LOP/actions of vastus medialis
- knee extension
- pulls the patella up and in
What is the origin of vastus lateralis
- greater trochanter of femur
- lateral lip of linea aspera
What is the insertion of vastus lateralis
Patella via quadriceps Femoris tendons
What is the LOP/actions of vastus lateralis
- knee extension
- pulls patella up and out
What is the origin of vastus intermedius
- anterior and lateral surfaces of femoral shaft
What is the insertion of vastus intermedius
- fibres insert into the top of knee capsule
- patella via quadriceps Femoris tendon
What is the LOP/actions of vastus intermedius
- ## knee extension
What is the origin of sartorius
ASIS
What is the insertion of sartorius
Tibia at the pes anserinus
What is the LOP/actions of sartorius
- hip abduction
- hip flexion
- hip lateral rotation
Where does the posterior (dorsal) interosseous sacroiliac lig run between
From the iliac tuberosity to the posterior surface of the sacrum
What is the function of the posterior (dorsal) interosseous sacroiliac lig
- prevents forward and downward dislocation Of Sarum from ilia
- prevents sacral nutation (rotation in sagittal plane which moves the top forward and coccyx backwards)
Where does the Inguinal lig run between
Runs between ASIS and pubic tubercle
What is the function of the Inguinal lig
- doesn’t cross a joint so it cannot limit any joint movement
- serves as an attachment for the abdominal wall muscles
- protects important structures that pass beneath it (femoral vessels and nerves) as they travel from trunk to thigh
What is the function of the Inguinal lig
- doesn’t cross a joint so it cannot limit any joint movement
- serves as an attachment for the abdominal wall muscles
- protects important structures that pass beneath it (femoral vessels and nerves) as they travel from trunk to thigh
Where does the long posterior sacroilaic lig run between
From the PSIS to the lateral crest of the sacrum
What is the function of the long posterior sacroiliac lig
Prevents extreme counternutation
Where does the iliolumbar lig run between
Runs from iliac crest to transverse process of the 5th lumbar vertebra
What is the function of iliolumbar lig
- prevents forward dislocation (glide/translation) of L5 on the downward-slopping upper surface of the sacrum
Where does the Sacrotuberous lig run between
Runs from lateral sacrum to ischial tuberosity
What is the function of the sacrotuberous lig
Prevents sacral nutation
Where does the sacrospinous lig run between
Runs from the lateral sacrum to ischial spien
What is the function of the sacrospinous lig
Prevents sacral nutation
Where does the anterior longitudinal lig of the spinal column run
Runs along anterior surface of the vertebral column, attaching to each vertebra it passes
Where does the anterior longitudinal lig of the spinal column run
Runs along anterior surface of the vertebral column, attaching to each vertebra it passes
What is the function of the anterior longitudinal lig of the spinal column
Tightens in and limits spine extension
Where is the superior interpubic lig situated
It is situated on the superior aspect of the pubic symphysis attaching laterally to the pubic tubercles
What is the function of the superior interpubic lig
Helps bind the left and right hip bones together at the front across the pubic symphysis
Where is the inferior interpubic lig (arcuate lig) located
it is a thick fibrous band that connects the inferior parts of the joitn
What is the function of the interior interpubic lig (Arcuate lig)
Helps bind the left and right hip bones together at the front across the pubic symphysis
What is the function of the interior interpubic lig (Arcuate lig)
Helps bind the left and right hip bones together at the front across the pubic symphysis
Where does the sacrococcygeal lig run
It runs between the inferior portion of the sacrum and the coccyx
What is the function of the sacrococcygeal lig
It strengthens the joint between the sacrum and coccyx which prevents dislocation of the joint
Where is the acetabular labrum located
It is a fibrocartilaginous ring around the rim of the acetabulum
What is the function of the acetabular labrum
It deepens the hip joint concavity and serves as part of the attachment of the hip joint capsule
Where does the transverse acetabular lig run between
It joins the two ends of the acetabular labrum
What is the function of the transverse acetabular lig
- converts bony acetabular notch into a foramen by crossing where the acetabular labrum would be
- nutrient vessels pass through the foramen
Where does the Supraspinous lig of the spinal column run
Runs alongside the superficial midline of the posterior VC, attaching to the spinous processes as it passes
What is the function of the Supraspinous lig of the spinal column
Limits extreme flexion of the vertebral column
What is the iliofemoral lig
The strongest lig in the body
What is the function of the iliofemoral lig
- gets tight in hip extension
- stabilises the hip joint when tight in standing
What is the function of the pubofemoral lig
Prevents extreme abduction
What is the function of the pubofemoral lig
Prevents extreme abduction
What is the function of the ischiofemoral lig
Mostly restricts medial rotation of the hip
What are the attachments of the ligament of the head of femur
It enters the femur through and within the fovea capitis (a pit). The other end of the leg attaches just deep to the transverse acetabular lig at the acetabular notch
What is the attachment of the ligamentum teres
It is a weak lig that transmits the acetabular branch of the obturator artery, into the head of the femur
What is the function of the ligamentum teres
It has little influence on hip joint stabilisation
What is the articular surface of acetbular, as a lig
It is a Lunate shaped lig that borders the acetabular fossa, which is filled with fat
What is the function of the acetabular labrum
It deepens the socket that the head of the femur joins, which increases the stability of the hip joint
What is the attachment of the tibial/medial collateral lig
It attaches the medial femoral epicondyle to the medial condyle of the tibia. It also attaches to the medial meniscus
What is the function of the tibial/medial collateral lig
Resists abduction (valgus) of the knee
What is the function of the tibial/medial collateral lig
Resists abduction (valgus) of the knee
Where does the fibular/lateral collateral lig run between
Attaches the lateral femoral epicondyle to the head of the fibula
Where does the fibular/lateral collateral lig run between
Attaches the lateral femoral epicondyle to the head of the fibula
What is the function of the fibular/lateral collateral lig
Resists knee adduction (varus stress)
What is the attachments of the anterior cruciate lig (ACL)
It attaches the back part of the intercondylar area of the femur to the front of the top of the tibia
What is the function of the ACL
Mostly resists anterior sliding of the tibia relative to the femur
What is the attachments of the posterior cruciate lig (PCL)
Attaches the front of the intercondylar area of the femur to the back of top of the tibia
What is the function of the PCL
Mostly resists posterior sliding of the tibia relative to the femur
What are the attachments of the lateral and medial meniscus
It attaches a tibial spine to another tibial spine
What is the function of the lateral and medial meniscus
It mostly resists rotators stress at the knee. The four tibial spines comprise the intercondylar eminence
What are the functions of the menisci
They deepen the joint and contributes to rotational stability
What are the attachments of the oblique popliteal lig
It is at the back of the knee, it is attached to the tendon of insertion of semimembranosus and it runs laterally from this
What is the function of the oblique popliteal lig
Stabilises the posterior knee
What are the attachments of the arcuate popliteal lig
It is at the back of the knee and is a y-shaped from the fibula head and covers the tendon of popliteus
What is the function of the arcuate popliteal lig
It stabilises the posterior knee
What is the attachment posterior mensicofemoral lig
It attaches the menisci to the femur and the anterior to the ACL. The menisci are also attached to the fibrous joint capsule by coronary ligs
What is another name for the transverse lig
Anterior meniscofemoral lig
What does the transverse/anterior meniscofemoral lig attach
It attaches the 2 menisci together at the front of the knee
What is the function of the transverse lig
Prevents the menisci from separating and stop their anterior horns from moving forwards
Ligament around the ankle joint
- Tibiofibular (anterior, Interosseus and posterior)
- Medial collateral/Deltoid lig
- Lateral collateral lig
What is the functions of the tibiofibular lig (anterior, Interosseus and posterior)
- all syndesmoses = fibrous Joint in which 2 parallel bones are untied to each other by fibrous connective tissue
- these bind the tibia to the fibula
What is the deltoid ligament
A triangular band that attaches to the medial malleolus proximally and to the calcaneus, talus and navicular bones distally
- it has anterior, intermediate, deep and posterior segments
What is the function of the deltoid/medial collateral lig
To stop Eversion as injury is caused if the foot overinverts
What does the tibionavicular lig (superficial part of deltoid lig) compose of
Superficial fibres of the medial collateral lig that descend from the medial malleolus to attach distally on the navicular tuberosity
What is the function of the tibionavicular lig
Resists Eversion of the foot
What does the tibiocalcaneal lig (superficial part of deltoid lig) compose of
Intermediate part of the medial collateral lig that passes almost vertically downwards from the medial malleolus, attaching onto the sustentaculum tali
What is the function of the tibiocalcaneal lig
Prevents valgus (knee lock) displacement
Where does the anterior Tibiotalar lig (deep part of deltoid lig) originate from
Originates from the apex of the medial malleolus, and then descends to attach onto the medial tubercle of the talus
What is the function of the anterior Tibiotalar lig
Prevents lateral displacement and external rotation of the talus
Where does the posterior Tibiotalar lig (deep part of deltoid lig) originate from
On the apex of the medial malleolus and attaches to the non-articular posterior part of the medial talar surface
What are the attachments of the anterior talofibular lig (lateral collateral lig)
It extends between the anterior margin of the lateral malleolus of the fibula to the lateral aspect of the neck of the talus a
What is the function of the anterior talofibular lig
- prevents extreme inversions
- provides passive stability to the ankle joint
What is the function of the posterior talofibular lig (lateral collateral lig)
- stops posterior sliding
- limits external rotation of talus or internal rotation of the fibula
What is the attachment of the calcaneofibular lig (lateral collateral lig)
Long and thick fibrous cord that connect the calcaneus and fibula
- crossed by the tendons of FL and FB muscle (under the tendons)
What are the functions of the calcaneofibular lig
- stabilises ankle joint
- gets taut in dorsiflexion of ankle
What is the origin of gastrocnemius
Lateral and medial condyle of the femur
What is the insertion of the gastrocnemius
Posterior surface of the calcaneus via the calcaneal tendon
What is the action of gastrocnemius
- plantarflexion of ankle with an extended knee
- leg flexion
What Is the motor nerve supply of gastrocnemius
Tibial nerve (s1, s2)
What is the origin of soleus
Soleal line and medial border of tibia
Head of fibula
What is the insertion of soleus
Posterior surface of calcaneus via the calcaneal tendon
What Is the motor nerve supply of soleus
Tibial nerve (s1,s2)
What is the actions of soleus
- plantarflexion of the foot at ankle joint
What is the origin of popliteus
Lateral condole of femur and lateral meniscus of knee joint
What is the insertion of popliteus
Posterior surface of proximal tibia
What are the actions of popliteus
- flexion and medial rotation of leg at knee joint
- lateral rotation of femur on tibia
- stabilises the knee joint
- unlocks the knee
What Is the motor nerve supply of popliteus
Tibial nerve (l4-s1)
What is the origin of plantaris
Lateral supracondylar line of femur and oblique popliteal lig of knee
What is the Insertion of plantaris
Posterior surface of calcaneus via calcaneal tendon
What are the actions of plantaris
- assist gastrocnemius in plantarflexion of the ankle joint
- leg flexion at knee joint
What Is the motor nerve supply of plantaris
Tibia nerve (s1,s2)
What is the origin of tibialis posterior
posterior surface of tibia, posterior surface of fibula, interosseous membrane
What is the insertion of TP
tuberosity of navicular bone, all cuneiform bones, cuboid bone, bases of 2-4 metatarsal bones
What are the actions of TP
- Plantarflexion of foot at ankle joint
- Foot inversions
- Supports medial longitudinal arch of foot
What is the Motor supply of TP
Tibial nerves (L4,L5)
What is the origin of FDL
posterior surface of tibia (inferior to soleal line)
What is the insertions of FDL
bases of distal phalanges of digits 2-5
What are the actions of FDL
- Flexion of lateral 4 digits
- Plantarflexion of the foot at the ankle joint
- Inversion of foot
What is the motor supply for FDL
Tibial nerve (L5, S1, S2)
What is the origin of FHL
posterior surface of fibula, interosseous membrane, posterior inter muscular septum of leg
What is the Insertion of FHL
base of distal phalanx of great toe
What are the actions of FHL
- Flexion of great toe
- Weakly plantarflexes ankle
- Inversion of foot
What is the motor supply of FHL
Tibial nerve (S2, S3)
What is the origin for TA
lateral surface of tibia, interosseous membrane
What is the insertion of TA
medial cuneiform bone, base of metatarsal bone 1
What are the actions of TA
- Dorsiflexion of ankle
- Inversion of foot
- Supports medial arch of the foot
What is the motor supply of TA
Deep Fibular nerve (L4, L5)
What is the origin of EHL
middle 3rd of medial surface of fibula, interosseous membrane
What is the insertion for EHL
base of distal phalanx of great toe
What are the actions of EHL
- Extension of great toe
- Dorsiflexion of foot at ankle joint
What is the motor supply for EHL
Deep Fibular nerves (L5, S1)
What is the origin of EDB
proximal half of medial surface of fibula, lateral tibial condyle, interosseous membrane
What is the insertion of EDL
distal and middle phalanges of digits 2-5
What are the actions of EDL
- Extension of lateral 4 digits
- Dorsiflexion of ankle
- Eversion of the foot
- ½ evert and ½ invert
What is the motor supply of EDL
Deep Fibular nerve (L5, S1)
What is the insertion of FT
medial surface of fibula, interosseous membrane, intermuscular septum
What is the insertion of FT
dorsal surface of base of metatarsal bone 5
What are the actions of FT
- Dorsiflexion of ankle
- Everison/pronation of the foot
what is the motor supply of FT
Deep Fibular nerve (L5, S1)
What is the origin of FL
head of fibula, proximal 2/3 of lateral surface of Fibular, intermuscular septa
What is the insertion of FL
medial cuneiform bone, metatarsal bone 1
What is the action of FL
- Everison of the foot
- Weak Plantarflexion of foot at ankle joint
- Supports lateral longitudinal and transverse arches of the foot
What is the motor supply of FL
Superficial Fibular nerves (L5, S1)
What is the origin of FB
Distal 2/3 of the lateral surface of fibula, anterior intermuscular septum
What is the insertion of FB
tuberosity of the 5th metatarsal bone
What are the actions of FB
- Everison of foot at subtalar joint
- Weak plantarflexion of foot at ankle/talocrucal joint
What is the motor supply of FB
Superficial Fibular nerve (L5, S1)