KIN 3304 Exam #3

The hip joint is a _____ joint

ball and socket

The tibiofemoral joint is a _____ joint

modified hinge

The _____ forms the ‘ball’ and the _____ forms the ‘socket’ of the hip joint.

femoral head, acetabulum

During standing, the weight of the body is transferred from the spinal column to the _____ (hip) to the _____ (upper leg) to the _____ (lower leg).

pelvis, femur, tibia

The three boney segments that form the pelvic skeleton are _____, _____ and _____

Ilium, ischium, pubis

The longest muscle in the body is the _____; the longest bone in the body is the _____

Sartorius, femur

The iliotibial (IT) band consists of the combined tendons from the _____ and the _____

Tensor fasciae latae, gluteus maximus

The group of muscles known as the iliopsoas consists of the _____ and the _____

Iliacus, psoas major/minor

The gastrocnemius, soleus, and plantaris muscles all insert at the _____ of the foot.

Posterior surface of calcaneus with achilles tendon

The _____ and _____ share the Achilles as a tendon of insertion.

Gastrocnemius, soleus

The muscle of the quadriceps group that crosses both the hip and knee joint is the ______

Rectus femoris

Muscles that cross the posterior aspect of the knee are usually involved in _____ at the knee.

Flexion

Supination of the foot is a combination of ______, _____, and forefoot ______

Ankle plantar flexion, subtalar inversion, forefoot adduction


Basically, plantar flexion, inversion, and adduction

The _____ is the prominent bony landmark on the distal end of the tibia.

Medial malleolus

There is more movement in the _____ and _____ regions of the spinal column than in the _____ region.

Cervical, lumbar, thoracic

The _____ muscles are different in that they attach from bone to an aponeurosis.

Abdominal

The fundamental movements of the hip joint are

Flexion, extension, abduction, adduction, internal rotation, external rotation, diagonal abduction (out and away from body), diagonal adduction (in and towards body), horizontal abduction, horizontal adduction

List the anterior hip muscles and the primary action of this group + action

Iliopsoas
Pectineus
Rectus femoris
Sartorius

Action: hip flexion

List the posterior hip muscles and the primary action of this group + action

Gluteus maximus
Bicep femoris*
Semitendinosus*
Semimembranosus*
External rotators

*These indicate the muscles that make up your hamstring, more action at knee than the hip

Action: Hip extension

List the deep posterior muscles of the hip and the primary action of this group + action

Deep lateral rotators (Quadratus femoris, piriformis, gemellus superior and inferior, internal, and external obturator)

Action: external rotation

List the lateral muscles of the hip and the primary action of the group + action

Gluteus Medius
Gluteus minimus
External rotators
Tensor fasciate latae

Action: Hip abduction

List the medial muscles of the hip and the primary action of the group + action

Adductor brevis
Adductor longus
Adductor magnus
Gracilis

Action: hip adduction

List the muscles of the hamstrings. What is the primary action of this group at the hip and knee joints?

Biceps femoris
Semitendinosus
Semimembranosus

Action at hip: Hip extension
Action at knee: Knee flexion

List the anterior knee muscles and the primary action of this group + action

Rectus femoris
Vastus intermedius
Vastus lateralis
Vastus medialis
Sartorius
Gracilis

Action: knee extension

List the posterior knee muscles and the primary action of this group + action

Bicep femoris
Semimembranosus
Semitendinosus
Popliteus
Gastrocnemius
Plantaris

Action: Knee flexion

List the muscles of the anterior compartment of the lower leg and the primary action of this group + action

Tibialis anterior (dorsiflexion, inversion)
Peroneus tertius (dorsiflexion, eversion)
Extensor digitorum longus (extends the toe, dorsiflexion)
Extensor hallucis longus (extends the big toe, dorsiflexion

Action: dorsiflexion

List the muscles of the lateral compartment of the lower leg and the primary action of the group + action

Peroneus longus
Peroneus brevis

Action: Eversion

List the muscles of the superficial posterior compartment of the lower leg and the primary action of the group + action

Gastrocnemius
Soleus
Plantaris

Action at knee: flexion

Action at ankle: plantar flexion

List the muscles of the deep posterior compartment of the lower leg and the primary action of the group + action

Popliteus
Flexor digitorum longus
Flexor hallucis longus
Tibialis posterior

Action at ankle: plantar flexion

Action at foot: inversion, flexes toe

List the anterior muscles of the thorax and the primary action of the group

Rectus abdominis (lumbar flexion and posterior pelvic rotation)

External oblique abdominal (lumbar flexion, lumbar lateral flexion, posterior pelvic rotation)

Internal oblique abdominal (lumbar flexion, posterior pelvic rotation, lumbar lateral flexion)

Transverse abdominis (forced expiration)

Psoas major and minor (lumbar flexion, lumbar lateral flexion, anterior pelvic rotation)

Basically, lumbar flexion

List the posterior muscles of the thorax and the primary action of the group.

Erector spinae group : Iliocostalis, longissimus, spinalis ( extension, lateral flexion, and ipsilateral rotation of the spine and head, anterior pelvic rotation, contralateral pelvic rotation)

Quadratus lumborum (lateral flexion, extension of lumbar spine, anterior pelvic rotation, contralateral pelvic rotation)

Sternocleidomastoid (extension of head, cervical flexion, rotation and lateral flexion of cervical spine)

Splenius (extension of head, rotation and lateral flexion of cervical spine)

Basically, lateral flexion

List the muscles of the quadriceps group. What is the primary action of this group at the hip and knee joints?

Rectus femoris
Vastus intermedius
Vastus lateralis
Vastus medialis

Action: Hip flexion and Knee extension

Label the first movement

Hip flexion

Knee flexion

Label the second movement

Anterior pelvic tilt

Lumbar flexion

Label the third movement

Hip extension

Knee extension

Label the structure at 1 (tibia + fibula)

Tibial tuberosity

Label the structure at 2 (tibia + fibula)

Tibia

Label the structure at 3 (tibia + fibula)

Medial malleolus

Label the structure at 4 (tibia + fibula)

Lateral malleolus

Label the structure at 5 (tibia + fibula)

Fibula

Label the structure at 1 (knee)

Lateral condyle of femur

Label the structure at 2 (knee)

Medial condyle of femur

Label the structure at 3 (knee)

Posterior cruciate ligament

Label the structure at 4 (knee, lateral)

Fibular (lateral) collateral ligament

Label the structure at 4 (knee, medial)

Tibial (medial) collateral ligament

Label the structure at 5 (knee)

Anterior cruciate ligament

Label the structure at A

Xiphoid process

Label the structure at B

True ribs (vertebrosternal ribs)

Label the structure at C

Costal cartilage

Label the structure at D

Floating ribs (vertebral ribs)

Overview of the hip joint

Relatively stable due to bony architecture, strong ligaments, and large muscles

Functions in both weight bearing and locomotion (walking running jumping)

Wide range-of-motion

Overview of the femur + bony landmarks

The longest bone in the body

Bony landmarks:
Head
Great trochanter
Lesser trochanter
Linea aspera
Posterior shaft

What bones make up the pelvic girdle?

Ilium: superior
Ischium: posterior
Pubis: anterior

They make up the three rings and all move together, never independently

Fun fact about the pelvic girdle

As a kid, the ilium, ischium, and pubis are three separate part but then it fuses together through puberty

What are the bony landmarks on the pelvic girdle?

Iliac crest

Iliac spine

Ischial tuberosity: you can feel it while sitting down

Acetabulum

What type of joint is the pelvic girdle and what is its purpose?

Ampiarthrodial joint that consists of right and left pelvic bones

Function:
Minimal oscillating movement during hip flexion

Shock absorption

What type of joint is the hip?

Ball and socket joint

Head of femur (ball) with acetabulum (socket) of pelvic girdle

What are the movements of the hip joint?

Extension

Abduction

Adduction

Internal rotation

External rotation

Diagonal abduction (out and away from body)

Diagonal adduction (in and towards body)

Horizontal abduction

Horizontal adduction

Movements of the pelvic girdle

6 rotational movements in three planes

Results from motion at either hip and/or lumbar spine:
Anterior and posterior pelvic rotation
Left and right lateral pelvic rotation
Left and right transverse pelvic rotation

Consider each movement from perspective of person’s pelvic that is actually moving

Anterior pelvic rotation (anterior tilt)

Iliac crest tilts forward in sagittal plane

Posterior pelvic rotation (posterior tilt)

Iliac crest tilts backwards in sagittal plane

Left lateral pelvic rotation (left lateral tilt)

Frontal plane: left pelvis move inferiorly relative to right pelvis

Right lateral pelvic rotation (right lateral tilt)

Frontal plane: right pelvis moves inferiorly relative to left pelvis

Left transverse pelvic rotation

In horizontal plane, rotation of pelvis to the body’s left

Right iliac crest moves anteriorly relative to left iliac crest

Right transverse pelvic rotation

In horizontal plane, rotation of pelvis to the body’s right

Left iliac crest moves anteriorly relative to right iliac crest

Body part that moves the most will be the _____ stabilized

Least

Iliopsoas (true groin)

Anterior, contains the Iliacus, psoas major and minor

Origin: Ilium and lumbar vertebrae

Insertion: Lesser trochanter and pubis

Action at pelvis: anterior pelvic rotation, transverse pelvis rotation

Action at hip: Flexion and external rotation

Rectus femoris

Anterior, part of the quadriceps

Origin: Anterior inferior iliac spine, groove (posterior) above the acetabulum (inferior aspect of pelvic)

Insertion: Superior aspect of patella/patellar tendon on the tibial tuberosity

Action at pelvis: Anterior pelvic rotation

Action at hip: Flexion

Action at knee: Extension

Sartorius

Anterior, longest muscle in the body

Origin: Anterior superior iliac spine/ notch just below spine of ilium

Insertion: Below knee (biarticular, anterior medial surface of the tibia below the condyle)

Action at pelvis: Anterior pelvic rotation

Action at hip: Flexion, abduction

Action at knee: flexion

Is the rectus femoris and Sartorius great at doing motions at both joints at the same time?

Wont be great at doing motion at both joints at the same time

Due to optimal muscle length

Example: Rectus femoris in hip flexion -> not as effective at knee extension at the same time due to beginning at a slighlt shorter and contracted position

Pectineus (common groin)

Anterior

Origin: Pubis region

Insertion: Upper portion of femur

Action at pelvis: Forward tilt

Action at hip: Flexion, strong adductor and external rotator

Adductor magnus (common groin)

Medial

Origin: pubis

Insertion: linea Aspera

Action at hip: Adduction (main role, thigh), extension, external rotation

Adductor brevis

Medial

Origin: pubis

Insertion: upper shaft of medial anterior femur

Action at the hip: Adduction (thigh), external rotation

Adductor longus

Medial

Origin: Pubis

Insertion: Middle of linea aspera

Action at hip: Adduction (thigh), flexion

Gracilis (common groin)

Most medial

Origin: Pubis/ anterior medial edge of descending ramus of pubis

Insertion: Tibia (biarticular, anterior medial surface of tibia just below condyle)

Action at hip: Internal rotation

Action at knee: flexion, adduction

Gluteus maximus

Posterior

Origin: iliac crest, sacrum, coccyx

Insertion: posterior femur

Action at hip: Extension, adduction, external rotation, abduction of flexed hip

Action at pelvis: backward tilt

Deep lateral rotators

Posterior, lateral

Consists of quadratus femoris, piriformis, gemellus superior and inferior, internal and external obturator

Origin: pelvis

Insertion: greater trochanter

Action at hip: external rotation, also keeps the ball (head of femur) in the socket (acetebellum)

Gluteus medius

Lateral

Origin: Lateral surface of ilium below crest

Insertion: greater trochanter

Action at hip: abduction, flexion, extension, internal and external rotation

Action at pelvis: anterior and posterior pelvic rotation, lateral tilt

Various action depend on which aspect of muscles fibers are contracted

Gluteus minimus

Lateral

Origin: lateral ilium, below gluteus medius

Insertion: Greater trochanter

Action at hip: abduction, flexion, internal rotation

Action at pelvis: anterior pelvic rotation, lateral tilt

Used in walking, maintains proper hip abduction while running

Tensor fasciate latae (TFL)

Lateral + a bit anterior

Origin: Anterior iliac crest

Insertion: below knee- along with IT band

Action at hip: abduction, flexion, internal rotation

Action at pelvis: anterior rotation, lateral tilt

Prevents external rotation of hip when hip is flexed by other muscles, helps direct the leg forward to ensure proper foot placement while walking/running

True groin function + muscles contained in it

Hip flexion

Psoas major and minor, iliacus

Strained by hyperextension

Common groin function + muscles contained in it

Hip adduction

Adductor brevis, longus, magus, pectineus, and gracilis

Strained by overstretching, more common

Iliotibial band (IT band)

Thick band of connective tissue

Insertion of tensor fasciae latae and gluteus maximus

Passes across greater trochanter of the femur as the hip joint flexes and extends

Trochanerica burs finish latera

Overview of the knee

Large, complex joint:
Both weight bearing and involved in locomotion
This combination places stress on the joint

Stability:
In extension: vertical alignment and the fit of the joint surfaces
In flexion: capsule and ligament, muscles

Bones apart of the knee

Femur

Patella: sesamoid

Tibia: weight-bearing

Fibula: non-weight bearing

Distal femoral landmarks

Lateral and medial femoral condyles

Articulation

Medial condyle: more distal, larger

Tibial landmarks

Lateral and media tibial condyles

Articulation with femur

Patellofemoral articulation: type of joint + function

Posterior base of patella fits between lateral and medial condyles on anterior surface of femur

Plane joint

Function:
Improves the mechanical advantage of quadriceps group
Increases angle of pull

What motion does the patellofemoral joint provide?

Gliding motion

Tibiofemoral articulation (knee joint): type of joint + function

Femoral condyles with tibia condyles

Modified hinge joint (condyloid?):
Flexion and extension

Internal and external rotation during flexion

Static stability from ligaments, dynamic stability from hamstrings and quadriceps muscle groups

Collateral ligaments: function

Provides side-to-side stability

Prevents abduction and adduction

Cruciate ligaments

Provide front-to-back stability

Prevents anterior/posterior displacement

Menisci

Fibrocartilaginous

Proximal end of tibia on condylar surfaces:
Lateral meniscus
Medial meniscus

Function:
Cushion
Enhances stability
Deepen receptacle for femoral condyle

Tibiofemoral joint movement

Sagittal plane:
Extension and flexion

Transverse plane:
With knee flexed 30 degree or more

Why is the menisci important?

Femur rolls and glides over both menisci during extension-flexion

Obligatory terminal rotation (screw home movement)

Tibia externally rotates during knee extension on fixed femur

The tibiofemoral joint “locks” into place in full extension

Q angle

Central line of pull of quadriceps runs from the anterior superior iliac spine to the center of patella

Line of pull of patella tendon runs from center of patella to center of tibial tuberosity

Angle formed by the intersection of these two lines at the patella is the Q angle

Biarticular muscles

Muscles that have actions at two different joints

Action at hip and knee:
Semimembranosus, semitendinosus, bicep femoris, rectus femoris, Sartorius, and gracillis

Action at knee and ankle:
Gastrocnemius
Plantaris

Vastus lateralis

Origin: Proximal end of femur

Insertion: Patella

Action: Knee extension

Vastus medialis

Origin: proximal end of femur

Insertion: patella

Action: knee extension, important to stability