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