TEST FOUR KINESIOLOGY

Ch 17, 18, 19 (Hip, Knee, Foot)

the segments of the lower extremity includes the _____.

-hip (pelvis)

-thigh (femur and patella)

-leg (tibia and fibula)

-foot (tarsals, metatarsals, and phalanges)

what is the longest bone in the body?

femur

during open kinetic chain the ___ moves on the ___

femur (convex) on pelvis (concave)

during closed kinetic chain, the ___ moves on the ___

pelvis (concave) on femur (convex)

the hip joint is an articulation between?

acetabulum of the pelvis (concave) and head of the femur (convex) the femur and pelvis

what movements occur at the hip joint?

flexion/extension

ab/adduction

IR/ER and circumduction of the hip.

what structure provides static stability to the hip?

labrum

the angle between the shaft and neck of the femur in a frontal plane.

angle of inclination

what is the normal angle of inclination in the average adult?

125 degrees

what is the angle of inclination at birth?

150-170 degrees

decreased angle of inclination in the femur is termed?

coxa vera (105)

increased angle of inclination in the femur is termed?

coxa valga (140)

___ is the angle between the shaft and the neck of the femur in the horizontal plane.

femoral torsion

what is the average angle of femoral torsion in the average adult/child?

8-15 degrees

femoral torsion angle increased over 15 degrees

anteversion (pigeon toes)

femoral torsion angle decreased less than 8 degrees

retroversion (toes pointed out)

formed by three pelvic bones - ilium, ischium, and pubis

acetabulum

-fibrocartilage rim attached to the acetabulum

-deepens acetabulum

-holds femoral head in place

acetabular labrum

what is the average ROM for hip flexion?

0-120

what is the average ROM for hip extension?

0-15

what is the average ROM for hip abduction?

0-45

what is the average ROM for hip adduction

0-25

what is the average ROM for hip IR

0-45

what is the average ROM for hip ER?

0-45

the greater trochanter is always facing?

posterior

what is the attachment for ligaments teres

fovea

the hip joint is a ____ joint and has ___ DOF

synovial ball and socket; 3

the end feel of hip flexion is __

soft

the end feel for hip extension, ab/adduction, IR/ER are

firm

attached to both sides of acetabular notch

attaches distally within fovea of femoral head

comes out of fovea head

ligamentum teres

provides stability and support

attaches to acetabulum and neck of femur

holds femur against acetabulum

held together by 3 ligaments

joint capsule of hip joint

-spans the hip anteriorly

-attached to AIIS and head of the femur

-reinforces the capsule anteriorly

-limits hip extension

iliofemoral ligament (Y ligament)

-attaches to acetabular rim and the neck of the femur

-reinforced the capsule inferiorly

-limits hip extension and abduction

pubofemoral ligament

-attaches to acetabulum and femoral neck

-limits hip extension and IR

ischiofemoral ligament

-attaches to ASIS and pubic tubercle

-iliac artery name change to femoral artery occurs here

inguinal ligament

what makes up the femoral triangle (M to L)

FEMORAL VEIN, FEMORAL ARTERY, FEMORAL NERVE

what makes up the femoral triangle?

-adductor longus, sartorius, inguinal ligament

gap or opening within distal attachment of adductor magnus between linea aspera and adductor tubercle; passageway for femoral artery and vein

adductor hiatus

what site does name change from femoral artery to popliteal artery occur?

adductor hiatus

-attaches to iliac crest, condyle of the tibia and inserts on Gerdy’s tubercle

-attachment site for gluteus max and tensor fascia latae

IT band (iliotibial band)

provides blood supply to the head of the femur

foveal artery

if the foveal artery ever gets pinched, bone death of tissue will occur, which will cause?

osteonecrosis

iliopsoas muscle

O: lilacus: iliac fossa

O: psoas major and minor: transverse processes T12-L5

I: lesser trochanter

A: primary flexor of the hip

N: Iliacus portion: femoral nerve (L2, L3)

N: psoas major/minor: ventral rami (L1-L3)

rectus femoris muscle

O: AIIS, via patellar ligament

I: tibial tuberosity

A: primary knee extensor, hip flexion

N: femoral never (L2-L4)

what is the longest muscle in the body?

sartorius

sartorius muscle

O: ASIS

I: pes anserine

A: hip flexion, abduction, ER, knee flexion

N: femoral nerve (L2, L3)

pectineus muscle

O: superior ramus of pubis

I: pectineal line of femur

A: hip adduction

N: femoral nerve (L2, L3)

adductor longus muscle

O: anterior pubis

I: linea aspera

A: hip adduction

N: obturator (L2-L4)

adductor brevis muscle

O: inferior ramus of pubis

I: pectineal line; linea aspera

A: hip adduction

N: obturator (L2, L3)

adductor magnus muscle

O: ischial tuberosity

I: linea aspera, adductor tubercle

A: hip adduction

N: obturator and sciatic nerve (L2-L4)

gracilis muscle

O: inferior ramus

I: pes anserine

A: hip adduction; knee flexion

N: obturator nerve (L2, L3)

gluteus maximus muscle

O: pos sacrum, coccyx, ilium

I: pos femur; IT band

A: primary extensor of the hip, static stabilizer of hip, ER of hip

N: inferior gluteal nerve (L5-S2)

what is the LARGEST muscle in the body?

gluteus max

gluteus medius

O: superior ilium

I: greater trochanter

A: primary hip abductor, IR of hip, dynamic stabilizer of the hip

N: superior gluteal nerve (L4-S1)

gluteus minimus muscle

O: lateral surface of ilium

I: greater trochanter (dynamic stabilizer)

A: hip abduction, IR

N: superior gluteal nerve (L4-S1)

deep rotator muscles?

obturator externus, obturator interns, quadratus femoris, Gemellus superior, Gemellus inferior, piriformis

obturator externus, obturator interns, quadratus femoris, Gemellus superior, Gemellus inferior muscles?

O: pelvis

I: greater trochanter

A: ER of the hip

piriformis muscle

O: anterior pelvis

I: greater trochanter

A: 0-90 - ER, 90-135 - IR

N: L5-S2

what nerve comes out of piriformis?

sciatic

what is the percentages of sciatic nerve running through or below piriformis?

87% - TYPE 1 - runs below the muscle

13% - TYPE 2 - runs through the muscle

semimembranousus muscle

O: ischial tuberosity

I: pos surface of medial condyle

A: hip extension (with knee extended), knee flexion

N: sciatic nerve (tibial division (L5-S2)

semitendinousus muscle

O: ischial tuberosity

I: pes anserine

A: hip extension (with knee extended), knee flexion

N: sciatic nerve - tibial divison (L5-S2)

biceps femoris muscle

O: LH: ischial tuberosity

O: SH: distal femur

I: fibular head

A: LH: hip extension (with knee extended), knee flexion

A: SH: knee flexion

N: LH: sciatic nerve - tibial divison (L5-S2)

N: SH; common fibular (perineal) nerve (L5-S2)

tensor fascia latae muscle

O: ASIS

I: IT band

A: combo movement: hip flexion with abduction

N: superior gluteal nerve (L4-S1)

what is the largest joint in the body?

the knee

what type of joint is the knee?

synovial modified hinge joint

largest sesamoid bone in the human body

patella

what is the function of the patella

serves as a lever to the knee

increases the force (angle of pull) of the quadriceps muscles to allow them to do their job

what is the end feel for knee flexion?

soft

what is the end feel for knee extension?

firm; due to collateral ligaments and posterior capsule

what happens at the knee joint in closed kinetic chain?

femur (convex) on tibia (concave)

what happens at the knee joint in open kinetic chain?

tibia (concave) on femur (convex)

what is the ROM for knee flexion?

0-145

what is the ROM for knee extension?

0-10

what is ROM for knee ab/adduction?

minimal

what is the ROM for knee IR and ER

0-15

__ is observed during terminal extension, when the faster roll of the femoral medial condyle produces lateral tibial rotation

screw-home mechanism

-shock absorbers of the knee

-deepens and holds joint in place

meniscus

the knee joint is an articulation of ____ and ___

distal end of femur and proximal end of tibia

cruciate ligaments provide stability within which plane of motion?

sagittal plane (flexion/extension insults)

the collateral ligaments provide stability within which plane?

frontal plane (medial and lateral insults to the knee)

medial collateral ligament, gracilis, sartorius, and semitendinosus (pes anserine) contribute to ____ stability

medial stability

what is the normal q angle range?

13-19 degrees

-attaches to the medial condyle of femur and tibia

-stabilizes medial aspect of the joint

-extra-capsular

-protects knee from valgus forces

medial collateral ligament (tibial coll. lig) MCL

-attaches to lateral femoral condyle and head of fibula

-stabilizes lateral aspect of joint (frontal plane)

-hardest ligament in the knee to tear

-extra-capsular

-protects knee from varus forces

lateral collateral ligament (fibular coll. lig) LCL

-intra-capsular

-ascend pos. and lateral

-attaches to anterior surface of tibia and lateral femoral condyle

-job: minimize tibias anterior movement on the femur

anterior cruciate ligament (ACL)

-intra-capsular

-attaches to the tibia

-job: limits tibias posterior movement on the femur

-ascends anterior and medial

posterior cruciate ligament (PCL)

vastus lateralis muscle

O: linea aspera

I: tibia tuberosity via patellar lig

A: knee extension

N: femoral nerve (L2-L4)

vastus medialis muscle

O: linea aspera

I: tibia tuberosity via patellar ligament

A: knee extension

N: femoral nerve (L2-L4)

vastus intermedius muscle

O: anterior femur

I: tibia tuberosity via patellar ligament

A: knee extension

N: femoral nerve (L2-L4)

gastrocnemius muscle

O: medial and lateral condyles

I: calcaneus via Achilles tendon

A: knee flexion, ankle plantar flexion

N: tibial nerve (S1, S2)

popliteus muscle

O: lateral condyle of femur

I: medial condyle of femur

A: unlocking a locked knee

N: tibial nerve (L4-S1)

plantaris muscle

O: lateral supracondylar ridge

I: calcaneous

A: knee flexion, ankle plantar flexion

N: tibial nerve (S1, S2)

malalignment of the lower extremity in which the knees tend to touch while the ankles are apart. this could be caused by trauma, or disrupting the medial aspect of the knee

genu valgum

is malalignment in which the distal segments are positioned more medially than normal, the ankles tend to touch when the knees are apart

genu varum

is knee extension exceeding 5 degrees of extension

genu recurvatum

is inflammation of the epiphyseal growth plate of the tibial tuberosity. it occurs during growth “spurts” and is exacerbated by stresses imposed by high levels of knee activity

osgood-schlatter disease

is a knee injury caused by a single blow to the knee when in a closed kinetic chain, involving tears to the ACL, MCL, and medial meniscus

terrible triad