Kines 227 exam 3

Pelvic Girdle

Pelvic Girdle

Sacrum

Coccyx

Ilium

Ischium

Pubis

Ilium: Iliac Crest

Site of muscle attachment: Gluteus maximus, tensor fascia latae, internal & external oblique, transversus abdominis, latissimus dorsi

Ilium: Iliac fossa

shallow depression

Attachment for iliacus

Ilium: Anterior superior iliac spine (ASIS)

Origin: sartorius

attachment for Iliacus, tensor fascia latae

Ilium: Anterior inferior iliac spine (AIIS)

Origin: rectus femoris

Ilium: Posterior superior iliac spine (PSIS) & Posterior inferior iliac spine (PIIS)

Site of articulation with the sacrum

Ilium: Greater sciatic notch

Creates a space for piriformis, superior and inferior gluteal nerves and arteries, and the sciatic nerve to travel

Ischium: Ischial tuberosity

Origin: hamstrings and adductor magnus

Attachment for biceps femoris (long head), Semitendinosus, semimembranosus

Ischium: Lesser sciatic notch

Passageway for nerves and vessels of the pelvis

Ischium: Obturator foramen

Passageway for obturator artery, vein, and nerve

Pubis: pubic tubercle

Bony prominence attachment of inguinal ring

Pubis: Superior and inferior pubic rami

Origin for adductors

Sacroiliac Joint

Articulation between sacrum & Ilium

Plane joint: gliding

Pubic Symphysis

Joint between left and right pubic bones

Cartilaginous Joint : gliding, fibrocartilage

Hip (femoroacetabular) Joint

Joint between the femur and acetabulum of the pelvis

Ball-and-socket joint: Flexion/extension, Abduction/Adduction, Medial/lateral rotation, Circumduction

Hip (femoroacetabular) Joint Ligaments

Iliofemoral, pubofemoral, ischiofemoral

Greater Trochanter

Gluteus Medius

Gluteus Minimus

Lateral rotators

Gluteal tuberosity

Gluteus maximus

Linea aspera

Vastus Lateralis

Vastus Medialis

Biceps femoris (long head)

Adductor longus

Adductor brevis

Adductor magnus

Pectineus

Lesser trochanter

Psoas major

Iliacus

Femoral shaft

Vastus intermedius

Posterior femoral condyles

Gastrocnemius

Popliteus (Lateral condyle)

supracondylar ridge

Plantaris

Posterior muscles that move the hip

Gluteus Maximus, Gluteus medius, Gluteus minimus, Lateral rotators (piriformis), Biceps femoris, Semimembranosus, Semitendinosus, Adductor magnus

Anterior muscles that move the hip

Rectus femoris, Sartorius, Iliacus, Psoas major

Lateral muscles that move the hip

Gluteus medius,

Gluteus minimus, Tensor fascia latae

Hip extension

Gluteus maximus

Biceps femoris

semimembranosus

Semitendinosus

Hip flexion

Psoas major

Iliacus

Sartorius

Rectus femoris

Hip lateral rotation

Gluteus maximus

Lateral rotators (piriformis)

Sartorius

Hip Abduction

Gluteus maximus

Gluteus medius

Gluteus minimus

Sartorius

Tensor fascia latae

Hip Adduction

Gracilis

Adductor longus

Adductor brevis

Adductor magnus

Pectineus

Hip medial rotation

Gluteus medius

Gluteus minimus

Gracilis

Adductor longus

Adductor brevis

Adductor magnus

Gluteus Maximus

Action: Hip extension, lateral rotation, and abduction

Origin: Iliac crest, sacrum, coccyx

Insertion: Iliotibial tract (IT band), gluteal tuberosity of femur

Innervation: Inferior gluteal nerve

Gluteus Medius

Action: Hip abduction and medial rotation

Origin: Posterior iliac crest

Insertion: Greater trochanter of femur

Innervation: Superior gluteal nerve

Gluteus Minimus

Action: Hip abduction and medial rotation

Origin: Lateral ilium

Insertion: Greater trochanter of femur

Innervation: Superior gluteal nerve

Piriformis

Action: Hip lateral rotation

Biceps Femoris

Action: Long head- Hip extension; Long and Short head: Knee flexion and lateral rotation

Origin: Long Head: Ischial tuberosity; Short Head: Linea aspera

Insertion: Head of fibula

Innervation: Long head: Tibial division of sciatic nerve; Short Head: Common fibular (peroneal) division of sciatic nerve

Semimembranosus

Action: Hip extension, Knee flexion, and medial rotation

Origin: Ischial tuberosity

Insertion: Medial condyle of tibia

Innervation: Tibial division of sciatic nerve

Semitendinosus

Action: Hip extension, Knee flexion, and medial rotation

Origin: Ischial tuberosity

Insertion: Pes anserine insertion

Innervation: Tibial division of sciatic nerve

Psoas Major

Action: Hip flexion

Origin: Transverse processes of lumbar vertebrae

Insertion: Lesser trochanter, merging with iliacus to form the iliopsoas

Innervation: L1-L3

Iliacus

Action: Hip flexion

Origin: Iliac fossa

Insertion: Lesser trochanter, merging with psoas major to form iliopsoas

Innervation: Femoral nerve

Sartorius

Action: Hip- flexion, abduction and lateral rotation; Knee - flexion and medial rotation

Origin: Anterior superior iliac spine (ASIS)

Insertion: Pes anserine insertion

Innervation: Femoral Nerve

Rectus Femoris

Action: Hip- flexion; Knee- extension

Origin: Anterior inferior iliac spine (AIIS)

Insertion: Quadriceps tendon to patella and then patellar ligament to tibial tuberosity

Innervation: Femoral Nerve

Vastus Intermedius

Action: Knee extension

Origin: Anterolateral femur

Insertion: Quadriceps tendon to patella and then patellar ligament to tibial tuberosity

Innervation: Femoral nerve

Vastus Lateralis

Action: Knee extension

Origin: Greater trochanter, gluteal tuberosity, linea aspera

Insertion: Quadriceps tendon to patella and then patellar ligament to tibial tuberosity

Innervation: Femoral Nerve

Vastus Medialis

Action: Knee extension

Origin: Linea aspera

Insertion: Quadriceps tendon to patella and then patellar ligament to tibial tuberosity

Innervation: Femoral nerve

Gracilis

Action: Hip- adduction and medial rotation; Knee- flexion and medial rotation

Origin: inferior ramus of pubis

Insertion: Pes anserine insertion

Innervation: obturator nerve

Adductor Longus

Action: Hip adduction, medial rotation, and flexion

Origin: Pubic tubercle

Insertion: Linea aspera of femur

Innervation: Obturator nerve

Pectineus

Action: Hip adduction, medial rotation, and flexion

Origin: Pectineal line of pubis

Insertion: Pectineal line of femur

Innervation: Femoral nerve and obturator nerve

Adductor Magnus

Action: Adductor part- Hip adduction, medial rotation, and flexion; Hamstring part- Hip extension and lateral rotation

Origin: Inferior ramus of pubis and ischial tuberosity

Insertion: Adductor part: Linea aspera; Hamstring part: Adductor tubercle

Innervation: Adductor part- Obturator nerve; Hamstring part: tibial division of sciatic nerve

Tensor Fasciae Latae

Action: Hip flexion, abduction, and medial rotation

Origin: Iliac crest posterior to anterior superior iliac spine (ASIS)

Insertion: Iliobial tract (IT Band)

Innervation: Superior gluteal nerve

Bony anatomy of the knee

Femur

Patella

Tibia

Fibula

Tibiofemoral Femoral Joint

Tibia and Femur

Hinge joint

Flexion and extension

Medial and lateral rotation

Patellofemoral Joint

Patella and Femur

Plane Joint (gliding)

Ligaments of the Knee

Anterior Cruciate Ligament (ACL)

• Anterior tibia to posterior femur

Posterior Cruciate Ligament (PCL)

• Posterior tibia to anterior femur

Medial Collateral Ligament (MCL)

• Femur and Tibia

Lateral Collateral Ligament

• Femur and Fibula

Menisci

Medial meniscus

• “C” shaped

Lateral meniscus

• “O” shaped

Poor blood supply

Anterior muscles that move the knee

Rectus femoris

Vastus intermedius

Vastus lateralis

Vastus medialis

Sartorius

Posterior muscles that move the knee

Biceps femoris

Semimembranosus

Semitendinosus

Knee extension

Rectus femoris

Vastus intermedius

Vastus lateralis

Vastus medialis

Knee flexion

Sartorius

Biceps femoris

Semimembranosus

Semitendinosus

Knee medial rotation

Sartorius

Semimembranosus

Semitendinosus

Knee lateral rotation

Biceps femoris

Bone anatomy of the leg

Tibia

Fibula

Talus

Proximal Tibiofibular Joint

• Tibia and fibula

• Plane joint (gliding)

Interosseous membrane

• Fibrous syndesmosis between tibia and fibula

Distal Tibiofibular Joint

• Tibia and Fibula

• Plane joint (Gliding)

Ligaments of the ankle

Anterior Tibiofibular ligament (distal)

• Distal tibia and fibula

Posterior Tibiofibular ligament (distal)

• Distal tibia and fibula

Anterior Talofibular Ligament

• Talus and fibula

Calcaneofibular ligament

• Calcaneus and fibula

Posterior talofibular ligament

• Talus and fibula

Deltoid ligament

• Talus, navicular, and tibia

Lower leg compartments

Anterior (Deep fibular nerve)

Lateral (Superficial fibular nerve)

Superficial Posterior (Tibial nerve)

Deep posterior (Tibial nerve)

Anterior leg compartment

Extensor digitorum longus

Extensor hallucis longus

Fibularis (peronus) tertius

Tibialis anterior

Lateral leg compartment

Fibularis (peroneus) longus

Fibularis (peroneus) brevis

Superficial posterior leg compartment

Gastrocnemius

Soleus

Plantaris

Deep posterior leg compartment

Flexor digitorum longus

Flexor hallucis longus

Tibialis posterior

Popliteus

Tarsal Tunnel

Tibialis posterior

Flexor digitorum longus

Posterior tibial artery

Tibial nerve

Flexor hallucis longus

Extensor Digitorum Longus

Action: Toes 2-5 MTP, PIP, & DIP extension, ankle dorsiflexion, and eversion

Origin: Lateral condyle of tibia, anterior fibula, interosseous membrane

Insertion: Distal phalanges of toes 2-5

Innervation: Deep fibular nerve

Extensor Hallucis Longus

Action: Toe 1 MTP & IP extension, ankle dorsiflexion and inversion

Origin: Anterior fibula

Insertion: Distal phalanx of toe 1

Innervation: Deep fibular nerve

Fibularis Tertius

Action: Ankle dorsiflexion and eversion

Origin: Anterior distal fibula

Insertion: Base of 5th metatarsal

Innervation: Deep fibular nerve

Tibialis Anterior

Action: Ankle dorsiflexion and inversion

Origin: Lateral condyle and proximal tibia

Insertion: 1st metatarsal and 1st (medial) cuneiform

Innervation: Deep fibular nerve

Gastrocnemius

Action: Knee flexion, ankle plantar flexion

Origin: Posterior surfaces of femoral epicondyles

Insertion: Calcaneus (via Achilles tendon)

Innervation: Tibial nerve

Soleus

Action: Ankle plantar flexion

Origin: Head and proximal shaft of fibula, medial border of tibia

Insertion: Calcaneus (via Achilles tendon)

Innervation: Tibial nerve

Plantaris

Action: Knee flexion, ankle plantar flexion

Origin: Lateral supracondylar ridge of femur

Insertion: Posterior calcaneus

Innervation: Tibial nerve

Flexor Digiorum Longus

Action: Ankle plantar flexion and inversion, Digits 2-5 MTP, PIP, & DIP flexion

Origin: Posteromedial tibia

Insertion: Distal phalanges of toes 2-5

Innervation: Tibial nerve

Flexor Hallucis Longus

Action: Ankle plantar flexion and inversion, Digit 1 MTP & IP flexion

Origin: Posterior inferior fibula

Insertion: Distal phalanx of toe 1

Innervation: Tibial nerve

Tibialis Posterior

Action: Ankle plantar flexion and inversion

Origin: Fibula and tibia

Insertion: Metatarsals 2-5, distal tarsals

Innervation: Tibial nerve

Popliteus

Action: Tibial medial rotation, knee flexion

Origin: Lateral condyle of femur

Insertion: Posterior proximal tibia

Innervation: Tibial nerve

Fibularis Longus

Action: Ankle eversion and plantar flexion

Origin: Head and superior portion of fibula, lateral tibial condyle

Insertion: Base of 1st metatarsal, 1st (medial) cuneiform

Innervation: Superficial fibular nerve

Fibularis Brevis

Action: Ankle eversion and plantar flexion

Origin: Mid-lateral fibula

Insertion: Base of 5th metatarsal

Innervation: Superficial fibular nerve

Muscles that Dorsiflex the ankle

Anterior (deep fibular nerve)

• Extensor digitorm longus

• Extensor hallucis longus

• Fibularis (peroneus) tertius

• Tibialis anterior

Muscles that plantar flex the ankle

Superficial Posterior Compartment (Tibial nerve)

• Gastrocnemius

• Soleus

• Plantaris

Deep Posterior Compartment (Tibial nerve)

• Flexor Digitorum Longus

• Flexor Hallucis Longus

• Tibialis Posterior

Muscles that evert the ankle

Anterior (Deep fibular nerve)

• Extensor Digitorum Longus

• Fibularis (peroneus) Tertius

Lateral Compartment (Superficial fibular nerve)

• Fibularis (peroneus) Longus

• Fibularis (peroneus) Brevis

Muscles that invert the ankle

Anterior (Deep fibular nerve)

• Extensor Hallucis Longus

• Tibialis Anterior

Deep Posterior Compartment (Tibial nerve)

• Flexor Digitorum Longus

• Flexor Hallucis Longus

• Tibialis Posterior

Bony anatomy of the foot

Phalanges

Metatarsals (1st-5th)

Cuneiforms (1-3)

Navicular

Cuboid

Calcaneus

Talus

Joints of the foot

Interphalangeal (IP)

• Hinge joint → flexion/extension

Metatarsophalangeal (MTP)

• Condyloid/Ellipsoid joint → flexion/extension, ab/adduction

Midfoot

• plane joints → gliding

Motion of the toes

Flexion

Extension

Abduction (Splay)

Adduction

Circumduction

• Combination of flexion/extension/abduction/adduction

• ONLY at MTP joints

Motions of the foot

Inversion

• Turning foot INward (medially)

Eversion

• Turning foot OUTward (laterally)

Dorsal surface (Deep Fibular Nerve)

Extensor Digitorum Brevis

Extensor Hallucis Brevis

Plantar Surface Medial (Medial Plantar Nerve)

Flexor Digitorum Brevis

Abductor Hallucis

Flexor Hallucis Brevis

Lumbricals (1 medial)

Plantar Surface Lateral (Lateral Plantar Nerve)

Adductor Hallucis

Flexor Digiti Minimi Brevis

Dorsal Interossei

Plantar Interossei

Abductor Digiti Minimi

Quadratus Plantae

Lumbricals (3 lateral)

Extensor Hallucis Brevis

Action: Digit 1 MTP extension

Origin: Calcaneus

Insertion: Toe 1 proximal phalanx

Innervation: Deep fibular nerve

Extensor Digitorum Brevis

Action: Digits 2-4 MTP & IP extension

Origin: Calcaneus

Insertion: Toes 2-4 middle phalanges

Innervation: Deep fibular nerve

Flexor Digitorum Brevis

Action: Digits 2-5 MTP & PIP flexion

Origin: Calcaneus

Insertion: Digits 2-5 middle phalanges

Innervation: Medial plantar nerve

Abductor Hallucis

Action: Digit 1 abduction (MTP)

Origin: Calcaneus

Insertion: Digit 1 proximal phalanx

Innervation: Medial plantar nerve

Abductor Digiti Minimi

Action: Digit 5 abduction (MTP)

Origin: Calcaneus

Insertion: Digit 5 proximal phalanx

Innervation: Lateral plantar nerve

Quadratus Plantae

Action: Aligns flexor digitorum longus tendons to aid in digits 2-5 flexion

Origin: Calcaneus

Insertion: Flexor digitorum longus tendons

Innervation: Lateral plantar nerve