Muscles of the Lower Limbs Flashcards
Name the muscles acting on the hip joint (ball and socket)
Flexors/Extensors
Abductors/Adductors
Medial/Lateral Rotators
Name the muscles acting on the knee joint (condylar)
Extensors/Flexors, Medial/Lateral
Rotators of flexed knee
Name the muscles acting on the ankle (hinge) and foot
Plantarflexors/Dorsiflexors
Inverters/Everters
Name the muscles acting on the toes (hinge)
Flexors/extensors
What are the movements that occur at the hip joint?
Flexion Extension Abduction Adduction Medial (internal) rotation Lateral (external) rotation (Circumduction)
Name the different types of fascia you get in the lower limb.
Superficial fascia
Deep fascia
Fascia lata
Crural fascia
Describe the components of superficial fascia.
Fat, cutaneous nerves, lymphatics, superficial veins and arteries.
Describe the functions of the deep fascia.
Decrease friction
Aids venous return
Form intermuscular septa for compartments
Where is the fascia lata?
In thigh deep fascia
Thickened lateral side is the iliotibial band/tract ITB
Where is the crural fascia?
In leg deep fascia
Thickening of this fascia forms retinaculum/retinacula in the foot.
How many compartments are the lower limbs arranged in?
3 (anterior, posterior, medial)
What noticable feature does the posterior compartment contain?
Sciatic nerve
What noticable feature does the medial compartment contain?
Blood vessels
What is the iliotibial tract?
Thickened band of deep fascia in the thigh (fascia lata)
What is the function of the iliotibial tract?
Provides attachments for gluteus maximus and tensor fascia latae muscles
Stabilizes the femur on tibia (allows knee extensors to relax when standing)
Extends from iliac crest to lateral condyle of tibia
Name the main hip joint extensor
Gluteus maximus
Where does the nerve supply for the inferior gluteal come from?
L5, S1,2
Name all the hip joint extensors.
Gluteus maximus
Biceps femoris
Semitendinosus
Semimembranosus
What 3 muscles are known as the hamstring muscles?
Biceps femoris
Semitendinosus
Semimembranosus
They are knee flexors and rotators as well
Where is the semitendinosus, semimembranosus and long head of the biceps femoris from?
From the ischial tuberosity
Where does the short head of the biceps femoris come from?
From lower linea aspera
What are the muscles in the two regions that contribute to hip extension called?
Superficial gluteal group
Posterior thigh group
What is the posterior thigh group innervated by?
They are innervated by the sacral plexus-tibial n L4,5-S1,2,3
What are the hip joint flexor muscles?
Iliopsoas
Rectus femoris
Sartorius
What plane is the iliopsoas in, in proportion to the hip?
Anterior of hip
What makes up the iliopsoas?
Iliacus
Psoas Major
Where does the rectus femoris attach?
Attaches above hip joint to tibial tuberosity via patella ligament
Name the different muscles of the quadriceps femoris group.
Rectus femoris Vastus lateralis Vastus medialis Vastus intermedius *** All end in quadriceps tendon & patella & to tibial tuberosity via the patella ligament***
Which two groups in the anterior thigh region contribute to hip flexion?
Pelvic group (iliopsoas) Anterior thigh group
What innervates the pelvic group and anterior thigh group?
Lumbar plexus (L1-4)
Name the hip joint abductors.
Gluteus medias
Gluteus minimus (both to greater trochanter and laterally placed) (superficial gluteal group)
Tensor fascia lata (innervated by the sacral plexus)
What is a sign for weak hip abductor muscles?
Trendelenburg sign
Where does the nerve come from that innervates the gluteus medius and gluteus minimus?
Innervated by nerve from sacral plexus - superior gluteal n (L4,5,S1)
What is the Trendelenburg sign/gait?
Damage to the nerve from sacral plexus - pelvis wil drop on opposite side and give this gait.
What are the hip joint adductors?
Medial thigh group:
- adductor magnus
- adductor longus
- adductor brevis
- pectineus
- gracilis
Which compartment hosts the hip adductors?
Medial compartment
What innervates the hip adductors?
Innervated by the lumbar plexus - obturator nerve (L2-4)
Which is the largest of the adductors?
Adductor magnus
Which is the most superficial of the adductors?
Gracilis
What are the lateral rotators of the hip joint?
Deep gluteal group
- piriformis
- gemelli superior & inferior
- obturator muscles-internus & externus
- quadratus femoris
What are the medial rotators of the hip joint?
Superficial gluteal group
- gluteus medius
- gluteus minimus
Antero-lateral muscle - tensor fascia latae
Which are the stronger rotators of the hip joint? Medial or lateral
Lateral rotators
Describe the location of the piriformis.
Starts inside the pelvis from sacrum & through the greater sciatic foramen to greater trochanter
Which muscle is the deepest of the gluteals?
Gluteus minimus
Name the extensor muscles of the knee joint.
Quadriceps femoris
Name the flexor muscles of the knee joint.
Hamstrings, gastrocnemius, sartorius
Name the medial rotators of the knee joint.
Semitendinosus
Semimembranosus
Sartorius, gracilis, popliteus
Name the lateral rotators of the knee joint.
Biceps femoris
What muscles in two regions contribute to knee flexion?
Posterior thigh group
Posterior leg group
What innervates the posterior thigh group and posterior leg group?
Tibial division of the sciatic nerve (L4,5,S1,2,3) from sacral plexus
Name the muscles that take part in dorsiflexion of the ankle.
Tibialis anterior
Extensor digitorum longus
Extensor hallucis longus
Name the muscles that take part in plantarflexion of the ankle.
Gastrocnemius, soleus
Flexor Digitorum Longus
Flexor Hallucis longus
Tibialis posterior
Name the inverter muscles of the foot.
Tibialis anterior and posterior
Name the everter muscles of the foot.
Fibularis/peroneus longus and brevis
List the superficial layer of plantarflexors in the ankle.
Gastrocnemius
Soleus
(plantaris)
List the deep layer of plantarflexors in the ankle.
Tibialis posterior
Flexor Hallucis Longus
Flexor Digitorum Longus
What holds the deep layer of plantarflexors in place?
The flexor retinaculum on the medial side of the ankle.
Name the structures associated with the tarsal tunnel.
Tibialis posterior Flexor digitorum longus Posterior tibial artery Posterior tibial vein Tibial nerve Flexor hallucis longus
Name the muscles in the anterior leg group for ankle dorsiflexion.
Tibialis anterior
EHL (extensor hallicus longus)
EDL (extensor digitorum longus)
What holds the anterior leg group muscles in place for ankle dorsiflexion?
Thickenings of the deep fascia - extensory retinaculum
What joint is responsible for foot inversion and eversion?
Subtalar joint (below talus and above calcaneus)
What are the different groups and muscles involved in foot inversion?
Deep posterior group - tibialis posterior
Anterior group - tibialis anterior
What are the different groups and muscles involved in foot eversion?
Lateral group of the leg - fibularis longus and fibularis brevis
Name the toe flexor muscles.
Posterior compartment - flexor hallucis longus & brevis, flexor digitorum longus & brevis
Name the toe extensor muscles.
Anterior compartment - EHL, extensor digitorum longus and brevis
Where are the toe flexor muscles situated?
Deep posterior group of the leg
Intrinsic muscles in sole of the foot
Four layers of muscles in sole of foot
All covered by the plantar aponeurosis
Where are the toe extensors situated?
Anterior leg group
Intrinsic foot muscles
Summary
What is the function of the pelvic group?
Hip flexion
Summary
What is the function of the superficial layer of the gluteal group?
Hip extension/abduction/medial rotation
Summary
What is the function of the deep layer of the gluteal group?
Hip lateral rotation
Summary
What is the function of the anterior group of the thigh?
Hip flexion; knee extension
Summary
What is the function of the posterior group of the thigh?
Hip extension; knee flexion
Summary
What is the function of the medial group of the thigh?
Hip adduction/medial rotation
Summary
What is the function of the anterior group of the leg?
Ankle dorsiflexion; foot inversion; toe extension
Summary
What is the function of the posterior group of the leg?
Ankle plantarflexion
Summary
What is the function of the superficial layer of the leg?
Knee flexion
Summary
What is the function of the deep layer of the leg?
Foot inversion; toe flexion
Summary
What is the function of the lateral group of the leg?
Foot eversion (ankle plantarflexion)
Name the hip muscles.
Anterior (iliopsoas, rectus femoris) Posterior (gluteus maximus, hamstrings) Medial (adductors) Lateral (gluteus medius, gluteus minimus, tensor fascia lata) Rotator muscles (deep posterior)
Psoas Major
Attaches to all lumbar vertebrae
Attaches onto lesser trochanter as iliopsoas tendon
Iliacus
In iliac fossa
Hip flexor
Attaches onto lesser trochanter as iliopsoas tendon
Where is the psoas minor positioned?
On top of the psoas major
Gluteus maximus
Hip Extensor
Inferior gluteal nerve L5-S2
Inserts into gluteal tuberosity and IT band
Attaches onto posterior gluteal surface of hip
Gluteus medius
Hip abductor
Superior gluteal nerve L4-S1
Attaches onto greater trochanter
Gluteus minimus
Hip abductor
Superior gluteal nerve L4-S1
Attaches onto greater trochanter
What side of the pelvis drops in the Trendelenburg gait?
Side opposite to the damaged superior gluteal nerve.
Name the innervation and supply of the abductors of the hip.
Gluteus medius, minimus and tensor fascia lata are supplied by the superior gluteal nerve, artery and vein.
What fibres of which muscles are medial rotators of the hip?
Anterior fibres of the gluteus minimus and gluteus medius.
Tensor Fascia Lata
Hip abductor/medial rotator of hip
Anterior superior iliac spine to IT band
Piriformis
Lateral rotator of hip
Front of 2nd to 4th sacral segments through greater sciatic foramen onto medial aspect of greater trochanter
Quadratus femoris
Lateral rotator
Posterior aspect
Obturator externus
Lateral rotator
Huge attachment to exterior part of hip
Obturator internus
Lateral rotator
Internal attachment to hip
Superior/Inferior Gemelli
Lateral rotators
Sandwich obturator internus
State the order of the muscles near the gluteal surface of the hip.
Piriformis Superior Gamellus Obturator Internus Inferior Gamellus Quadratus Femoris
What is the innervation and supply of the anterior compartment of the thigh?
Femoral nerve
Deep femoral artery/vein
What are the muscles in the anterior compartment of the thigh?
Sartorius
Quadriceps femoris - rectus femoris, vastus intermedialis, vastus lateralis, vastus medialis
What is the function of the sartorius?
Knee flexor
Hip flexor
Medial rotator of the knee
Describe the attachments of the sartorius.
ASIS to pes anserinus which inserts onto tibia
What are the functions of the quadriceps femoris group?
Hip flexor
Knee extensor
Which muscle attaches lower down in the quadriceps femoris group?
Vastus medialis
Which side is the patella more likely to dislocate?
Laterally
Which side is the patella more likely to dislocate?
Laterally
What is the innervation and supply for the posterior compartment of the thigh?
Sciatic nerve (tibial branch, except for short head of biceps femoris which is common fibular branch) Deep femoral artery/vein
Name the subdivisions of the hamstring muscles and their functions.
Biceps femoris (long and short heads) - hip flexor, lateral rotator of knee
Semitendinosus*
Semimembranosus*
* Both are hip flexors and medial rotators of the knee
Which two hamstring muscles come from the same tendon?
Long head of biceps femoris and semitendinosus
Which nerve supplies the short head of the biceps femoris?
Common fibular nerve
Which muscles form the pes anserinus tendon?
Sartorius
Semitendinosus
Gracilis
What is the innervation and supply of the medial compartment of the thigh?
Obturator nerve
Deep femoral artery/vein
Name the muscles of the medial compartment of the thigh.
Gracilis Pectineus Adductor longus Adductor brevis Adductor magnus
Name the borders of the femoral triangle.
Inguinal ligament (superior) Sartorius (lateral) Adductor longus (medial)
Name the contents of the femoral triangle.
From lateral to medial: Femoral nerve Femoral artery Femoral vein Lymphatics = NAVY
Name the innervation and supply of the anterior compartment?
Deep fibular nerve
Anterior tibial artery
Name the muscles of the anterior compartment of the leg.
Tibialis anterior
EHL
EDL
Where does the tibialis anterior attach?
Medial cuneiform and base of 1st metatarsal
What causes foot drop?
Damage to the common fibular nerve
Where does the FHL and FDL attach?
Dorsal surface on the base of the distal phalanx
What is the innervation and supply of the posterior compartment of the leg?
Tibial nerve and posterior tibial artery
Name the muscles in the superficial layer of the posterior compartment of the leg vs the muscles in the deep layer.
Superficial layer = gastrocnemius, soleus and popliteus
Deep layer = tibialis posterior, FHL, FDL
Where does the posterior tibialis muscle attach?
Navicular and medial cuneiform
What is the innervation and supply of the lateral compartment of the leg?
Superficial fibular nerve
Fibular artery
Name the muscles of the lateral compartment of the leg.
Fibularis longus and fibularis brevis
Where does the fibularis longus insert?
Medial cuneiform and base of 1st metatarsal
Where does the fibularis brevis attach?
Base of 5th metatarsal
What structures are involved in forming the tarsal tunnel?
Talus
Calcaneus and sustentaculum tali
Flexor retinaculum
Medial malleolus
Name the contents found in the tarsal tunnel.
Tibialis posterior FDL Posterior tibial artery Posterior tibial vein Tibial nerve FHL