Tufts DPT Anatomy: Week 2 - Questions, Origins, Insertions, Innervations, Functions

Genu valgum

genu verum

How ACL and PCL are injured

ACL: Posterior translation of the femur

PCL: Posterior translation of the tibia

screw home mechanism

-increases knee-joint stability by locking the femur on the tibia when the knee is fully extended.

-Allows for quad and hamstring relaxation while standing.

active insufficiency

when a 2 joint muscle contracts (shortens) across both joints simultaneously it can limit sufficiency across one of the joints.

passive insufficiency

when a 2 joint muscle is lengthened over both joints simultaneously it can limit sufficiency across one of the joints.

Order of structures in the retro inguinal space

"NAVL"

Nerve

Artery

Vein

Lymphatic (not important for this class)

all femoral

2 part of adductor magnus

adductor portion

hamstring portion

boundaries of femoral triangle

superior: inguinal ligament

medial: adductor longus

lateral: sartorius

floor: iliopsoas, pectineus

roof: fascia latae, subcut. tissue and skin

what goes through the adductor hiatus

Femoral artery and vein which turns into the popliteal artery

criteria of hamstrings

1) prox origin at ischial tuberosity

2) distal attachment to leg bones over the hip and knee joint

3) innervated by the tibial division of the sciatic nerve

what are the hamstring muscles?

semitendinosus, semimembranosus, biceps femoris long head

not a hamstring

bicep femoris short head

pes anserine group

semitendinosus, gracilis, sartorius

what goes through the popliteal fossa?

tibial nerve

common fibular nerve

popliteal artery

Pectineus

Origin: Pubic Ramus

Insertion: Pectilineal line of femur inferior to lesser troch.

Innervation: Femoral Nerve (L2-L3)

Action: Hip Adduction, Hip Flexion

Iliopsoas

Composed of: Psoas Major, Psoas Minor, Iliacus

Most powerful hip flexor with most range

Iliacus

Origin: Iliac Crest, Iliac fossa, Ala of sacrum, SIJ

Insertion: Tendon of psoas major, lesser trochanter

Innervation: femoral nerve (L2-L3)

Action: Hip flexion

Psoas major

Origin: Transverse Processes T12-L5 Vertebrae, Lat. aspects

Insertion: Lesser Trochanter

Innervation: Ventral Rami (L1-L3)

Action: Hip Flexion

Psoas Minor

Origin: T12-L5 Vertebrae

Insertion: Pectilineal Line, Iliopubic eminence via iliopectineal arch (Top of the pubis)

Innervation: Ventral Rami (L1-L2)

Action: Hip Flexion

Sartorius

Origin: ASIS and inferior notch

Insertion: Pes Anserine

Innervation: Femoral Nerve (L2,L3)

Action: Hip- Flexion, abduction, external rotation

Knee- flexion

What is pes anserine?

the tendons of the sartorius, gracilis, and semitendinosus muscles as they join and insert into the tibia at the medial side of the knee.

Quadriceps femoris common insertions, innervations, and actions

Insertion: Quadriceps tendon to base of patella -> patellar ligament to tibial tuberosity

Innervation: Femoral Nerve (L2-L4)

Action: Knee Extension

Rectus Femoris

Origin: AIIS

Insertion: Quadriceps tendon to base of patella -> patellar ligament to tibial tuberosity

Innervation: Femoral Nerve (L2-L4)

Action: Knee Extension, Flexes and Stabilizes Hip

Vastus Lateralis

Origin: Greater Trochanter, Linea Aspera

Insertion: Quadriceps tendon to base of patella -> patellar ligament to tibial tuberosity, tibia via aponeurosis

Innervation: Femoral Nerve (L2-L4)

Action: Knee Extension

Vastus Medialis

Origin: Intertrochanteric Line, Linea Aspera, Tendons of adductor magnus

Insertion: Quadriceps tendon to base of patella -> patellar ligament to tibial tuberosity, tibia via aponeurosis

Innervation: Femoral Nerve (L2-L4)

Action: Knee Extension

Vastus intermedius

Origin: Anterior and Lateral surface of the femur

Insertion: Quadriceps tendon to base of patella -> patellar ligament to tibial tuberosity

Innervation: Femoral Nerve (L2-L4)

Action: Knee Extension

Articularis Genu

Origin: anterior femur

Insertion: synovial membrane of knee, suprapatellar bursa

Innervation: Femoral Nerve (L2-L4)

Action: Pulls synovial membrane superiorly during extension

Adductor Longus

Origin: body of pubis inferior to pubic crest

Insertion: linea aspera

Innervation: Obturator Nerve (L2-L4)

Action: Hip Adduction

Adductor Brevis

Origin: body of pubis and pubic ramus

Insertion: pectineal line, proximal linea aspera

Innervation: Obturator Nerve (L2-L4)

Action: Hip Adduction, some flexion

Adductor Magnus (Adductor portion)

Origin: pubic ramus, ischial ramus

Insertion: linea aspera, gluteal tuberosity, medial supracondylar line

Innervation: Obturator Nerve (L2-L4)

Action: Hip Adduction, Flexion

Adductor Magnus (Hamstring Portion)

Origin: Ischial tuberosity

Insertion: Pes anserine

Innervation: Obturator Nerve (L2-L4)

Action: Hip Adduction, Knee Flexion, some internal rotation

Obturator Externus

Origin: surface of obturator foramen, Obturator membrane

Insertion: trochanteric fossa of femur

Innervation: Obturator Nerve (L2-L4)

Action: Hip external rotation, stabilize femoral head in acetab.

Contents of the Adductor canal

femoral artery, femoral vein, saphenous nerve

Semitendinosus

Origin: Ischial Tuberosity

Insertion: pes anserine

Innervation: tibial division of sciatic nerve (L5, S2)

Action: Hip extension, Knee Flexion, Knee Internal Rotation

Semimembranosus

Origin: Ischial Tuberosity

Insertion: medial condyle tibia

Innervation: tibial division of sciatic nerve (L5, S2)

Action: Hip extension, Knee Flexion, Knee Internal Rotation

Biceps Femoris Long head

Origin: Ischial Tuberosity

Insertion: head of fibula

Innervation: tibial division of sciatic nerve (L5, S2)

Action: Hip extension, Knee Flexion

Biceps femoris short head

Origin: linea aspera, supracondylar line

Insertion: head of fibula

Innervation: Common Fibular nerve (L5, S2)

Action: Knee flexion

*does not cross hip joint*

contents of popliteal fossa

popliteal artery

popliteal vein

tibial nerve

common fibular nerve