Topic 3

Question 1

glut max

Answer 1

prox attach - gluteal surface to posterior gluteal line, posterior iliac line, posterior sacrum, sacrotuberous ligament.

dist attach - iliotibial tract, gluteal tuberosity of femur.

actions - extension, ex rotation, AB and AD.

nerve supply - inferior gluteal nerve.

Question 2

glut med

Answer 2

prox - gluteal surface of ilium between posterior and anterior gluteal lines

dist - greater trochanter

actions - AB, internal rotation

nerve supply - superior gluteal nerve

Question 3

glut min

Answer 3

prox - gluteal surface of ilium between the anterior and inferior gluteal lines

dist - greater trochanter

actions - AB internal rotation

nerve supply - superior gluteal nerve

Question 4

iliopsoas

Answer 4

prox - external surface of ilium between iliac crest, posterior gluteal line and anterior gluteal line.

dist - lesser trochanter

actions - flexion, ex rotation

nerve - lumbar spinal nerve L1-L3 of spinal nerve

Question 5

psoas major

Answer 5

prox - bodies and adjacent transverse process
dist - lesser trochanter

action - flexion, ex rotation

nerve supply - direct branches of anterior rami off lumbar plexus

Question 6

iliacus

Answer 6

prox - upper and posterior two thirds of iliac fossa
dist - lesser trochanter
actions - flexion, ex rotation
nerve supply - branches of femoral nerve L2-L3

Question 7

tensor fascia latae

Answer 7

prox - anterior part of iliac crest and adjacent gluteal surface, anterior superior iliac spine.

dist - lateral condyle of the tibia via iliotibial band

actions - internal rotation, AB

nerve - superior gluteal nerve L5 to S1

Question 8

piriformis

P

Answer 8

prox - anterior aspects of the 2nd to 4th sacral segments, sacrotuberous ligament

dist - medial side of greater trochanter of the femur

actions - ex rotation, AD of femur during flexion

nerve - superior gluteal nerve L5-S1

Question 9

superior gemellius (pink)

G

Answer 9

prox - gluteal surface of ischial spine
dist - medial surface of greater trochanter via tendon of obturator internus

actions - ex rotation, AB
nerve supply - branches of sacral plexus

Question 10

obturator internus 
(white) 

O

Answer 10

prox - internal surface of obturator membrane
dist - medial surface of greater trochanter,

actions - Ex rotation of femur when extended, AB of flexed thigh.

nerve - obturator internus nerve

Question 11

inferior gemellus
(pink)

G

Answer 11

prox - upper part of ischial tuberosity
dist - medial surface of greater trochanter via the tendon of obturator internus.

actions - ex rotation, AB
nerve - branch of sacral plexus

Question 12

quadrate femoris

Q

Answer 12

prox - ischial tuberosity
dist - quadrate tubercle of the femur

actions - ex rotation
nerve - branch of sacral plexus

Question 13

obturator externus

O

Answer 13

prox - outer surface of obturator membrane and adjacent bone

dist - trochanteric fossa

actions - ex rotation and AB when femur is flexed.
nerve - obturator nerve L3 to L4

Question 14

gracilis

Answer 14

prox - anterior body of pubis, inferior ramus of the pubis

dist - medial surface of the upper part of the shaft of tibia.

actions - flexion, AD, internal rotation, internal rotation and knee joint flexion
nerve - branch of obturator femoris L2 to L4

Question 15

pectineus

Answer 15

prox - superior ramus of the pubis
dist - pectineal line of femur

actions - flexion, AD, external rotation and internal rotation of knee joint.
nerve - femoral nerve L2-L3

Question 16

adductor magnus

Answer 16

prox - ischiopubic ramus extending to the inferior part of ischial tuberosity

dist - pectineal line of femur

actions - flexion anteriorly, AD, extension

nerve - obturator nerve branch and sciatic nerve portion

Question 17

adductor longus

Answer 17

prox - anterior aspect of the body of pubis (between crest and symphasis)

dist - middle two quarters of the medial lip of linea aspera.

action - AD
nerve - obturator nerve branch L2 to L4

Question 18

adductor brevis

Answer 18

prox - anterolateral body of the pubis and inferior ramus of pubis

distal - proximal half medial lip of linear aspera

actions - AD, flexion and external rotation.
nerve - obturator nerve branch L2-L4

Question 19

what are the types of skeletal muscle

Answer 19

Smooth
Non-striated
Involuntary

Cardiac
Striated
Involuntary

Skeletal
Striated
Voluntary

Question 20

describe the microscopic structure of connective tissue

Answer 20

Fiber
Long cylindrical muscle cell
Multi-nucleated

Muscle fibre
Endomysium

Fascicle
Perimysium

Entire muscle
Epimysium

Question 21

describe the sliding filament theory

Answer 21

Actin (thin) & myosin (thick) filaments slide over

one another to produce muscle shortening

Question 22

describe the different types of attachments of skeletal muscle

Answer 22

Fleshy
 Muscle fibres attach directly to bone with
small amount of connective tissue

Tendon
 Muscle fibres attach to a cord of connective
tissue that then attaches to bone

Raphe
 Muscle fibres attach to a sheet of connective
tissue that then attaches to bone

Question 23

describe the effect of the orientation of muscle fibers on its final contracted length and the force it can exert.

Answer 23

Parallel muscles
 Maximum shortening of muscle belly (up to ½ of muscle length)
 Larger range of movement BUT with less force/power

Oblique muscles
 Less shortening of muscle belly
 Less range of movement but MORE force/power

Question 24

describe the structure and function of tendon sheaths

Answer 24

An accessory structure
 Similar to bursae at joints
 Which very often are about reducing friction with a muscle tendon

Tendon sheath
 Surround tendons as they pass through tunnels or over other structures
 Contain synovial fluid to reduce friction
 Common at distal ends of limbs
 Allow efficient ‘action’ long distances from muscle belly & prevent tendons pulling
away from skeleton

Question 25

what are the implications of a muscle that crosses two joints.

Answer 25

two joint muscles cannot work as one joint muscles
• implications for recruitment
• increased requirement for synergism
• implications for joint range testing

passive insufficiency
• maximum passive length is insufficient
to allow full range of movement at both
joints simultaneously
• active insufficiency
• maximum length change insufficient to
produce full range of movement at both
joints simultaneously
• when assessing – reassessing ROM
and strength wherever two joint
muscles are involved you must
ensure that the joints concerned are
in a standard position