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MUSCULOSKELETAL ANATOMY PHYSIOLOGY PATHOLOGY Flashcards

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1
Q

External oblique

A

O: anterior iliac crest, pubic bone, abdominal aponeurosis

I: inferior border of R5-12

(BL) flexion (cc PPT)
(UL) IL lateral flexion (cc hip hike)
(UL) CL rotation
(BL) abdominal compression 
Depressed rib cage.
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2
Q

External oblique: palpation and MMT

A

Palpation: slight flexion with CL rotation. Palpate between iliac crest and lower ribs.

MMT: CL rotational sit up. Hold against gravity or apply force towards extension IL rotation

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3
Q

Internal obliques

A

O: inguinal ligament, iliac crest, thoracolumbar fascia

I: R10-12, abdominal aponeurosis

(BL) flexion (cc PPT)
(UL) lateral flexion (cc hip hike)
(UL) IL rotation
(BL) abdominal compression

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4
Q

Internal obliques: palpation and MMT

A

Palpation: slight flexion with IL rotation. Palpate between iliac crest and lower ribs.

MMT: IL rotational sit up. Hold against gravity or apply force towards extension CL rotation

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5
Q

Internal vs External Obliques: movement

A

Internal obliques IPSILATERAL rotation

External obliques CONTRALATERAL rotation

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6
Q

SCM

A

O: sternal head: anterosuperior manubrium; clavicular head: medal 1/3 clavicle

I: mastoid process

Cervical flexion
Capital extension
Lateral flexion
CL rotation

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7
Q

SCM: palpation and MMT

A

Palpation: supine. CL rotation, cervical flexion. Palpate away

MMT: same position. Stabilize sternum; apply pressure towards extension.

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8
Q

Glute Max

A

O: posterior iliac crest, posterolateral sacrum, coccyx, TLF, glute med fascia, sacrotuberous ligament

I: ITB, gluteal tuberosity of the femur

Hip extension, external rotation, upper 1/3 abduction, lower 2/3 adduction, PPT, knee extension via ITB

Inferior gluteal nerve (L5-S2)

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9
Q

Glute Max: palpation and MMT

A

Palpation: prone, knee flexed to 90º. Externally rotate, extend hip.

MMT (Vizniak): same position. Stabilize opposite PSIS. Apply pressure towards flexion.

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10
Q

Biceps Femoris

A

O: Long head: ischial tuberosity, sacrotuberous ligament
Short head: linea aspera, lateral supracondylar line of the femur

I: fibular head, lateral tibial condyle

Knee flexion, hip extension, lateral hip rotation, lateral knee rotation, adduction.

Sciatic nerve

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11
Q

Biceps Femoris: Palpation and MMT

A

Palpation: prone, knee flexed. Palpate from just distal-lateral to ischial tuberosity to fibular head. Extend knee to distinguish from vastus lateralis

MMT: prone, knee flexed 50-70º, externally rotated. Stabilize back of thigh, apply pressure towards knee extension, but not rotation.

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12
Q

Tibialis Anterior

A

O: Proximal 2/3 anterior tibia and interosseus membrane, lateral tibial condyle

I: first metatarsal and first cuneiform

Dorsiflexion, inversion

Deep fibular nerve

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13
Q

Tibialis Anterior: Palpation and MMT

A

Palpation: Seated or supine. Dorsiflexion plus inversion. Don’t extend toes.

MMT: Same position. Stabilize above ankle and apply pressure towards plantarflexion and eversion.

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14
Q

Pec Minor

A

O: Ribs 3-5
I: coracoid process

Scapular protraction, depression, downward rotation
Elevation of Ribs 3-5
*assists inspiration

Medial and lateral pectoral nerves

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15
Q

Pec Minor: Palpation and MMT

A

Palpation: Seated, hand behind back. Palpate just inferior to coracoid process. Lift hand from back.

MMT: supine, round shoulder forward (don’t press arm against table). Apply pressure toward table.

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16
Q

ECRB

A

Origin: lateral epicondyle of humerus (CET)

Insertion: posterior base of MC3

Wrist extension, radial deviation
Some elbow flexion

Radial nerve

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17
Q

ECRB: palpation and MMT

A

Palpation: Pinch wad of 3. Most posterior fingers will be on ECRB. Extend wrist and radially deviate

MMT: Seated, leaning forward so elbow flexed and shoulder extended. Stabilize elbow. Extend wrist and radially deviate. Apply pressure toward wrist flexion and ulnar deviation

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18
Q

Extensor Hallucis Brevis

A

O: dorsal surface of calcaneus

I: dorsal proximal phalanx #1

Extends big toe at MTP

Deep fibular nerve

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19
Q

EHB: Palpation and MMT

A

Palpation: place fingers 2-3 distal to lateral malleolus. Wiggle big toe. Differentiate from EDB by wiggling other toes (EDB will be lateral)

MMT: extend big toe. Stabilize at dorsum; apply pressure toward MTP flexion.

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20
Q

Rule of Three’s

A

For thoracic spine

T1-3, 10: SPs on same level as TVPs
T4-6, 11: SPs half a level below TVPs
T7-9, 12: SPs a full level below TVPs

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21
Q

Which SP is roughly at the same level as the superior angle of the scapula?

A

T2

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22
Q

Which SP is roughly at the same level as the inferior angle of the scapula?

A

T6/7

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23
Q

Which direction do the thoracic superior articular facets face?

A

Backwards
Upwards
Laterally

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24
Q

Freyette’s First Law

A

In lumbar and thoracic spines, when in neutral, lateral flexion and rotation will happen in opposite directions

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25
Freyette's Second Law
In flexion or extension, rotation and lateral flexion will occur in the same direction.
26
Anterior pillar
Functional division of the spinal column Vertebral bodies and discs Hydraulic, weight-bearing, shock absorbing portion of the spinal column.
27
Size of vertebral disc influences:
Amount of movement available between vertebrae
28
Posterior pillar
AKA vertebral arch Articular processes and facet joints, TVPs, SPs. Provide gliding mechanism for movement
29
Orientation of facets influence:
Direction of movement
30
Spinal unit
Two adjacent vertebrae and the joints in between.
31
Axis of movement for spinal unit
Nucleus pulposis of the IVD
32
Rectus Abdominis
O: pubic symphysis and crest I: xiphoid process and cartilage of R5-7
33
Rectus Abdominis: Palpation and MMT
Palpation: supine, palpate during mini-crunch MMT: Mini crunch. Hold against gravity, or stabilize thighs and apply pressure towards extension.
34
Transverse Abdominis
O: lateral 2/3 inguinal ligament, iliac crest, TLF, costal cartilage of R7-12 I: abdominal aponeurosis Abdominopelvic compression
35
TVA: Palpation and MMT
Palpation: supine, knees pillowed in flexion, or 90º/90º hip/knee flexion. Palpate anterolaterally during forced exhalation. MMT: Supine. 90º/90º hip/knee flexion with arms crossed over chest. Stabilize upper body (at elbows). Resist pressure applied to knees towards rotation.
36
Abdominal aponeurosis
AKA Rectus sheath Composed of the aponeuroses of the obliques and TVA. Envelops the rectus abdominis
37
Anterior triangle of the neck
Mandible/trachea/SCM
38
Posterior triangle of the neck
Upper traps/SCM/clavicle
39
Femoral triangle
Inguinal ligament Sartorius Adductor longus floor: pectineus, iliopsoas
40
Anatomical snuff box
medial: Extensor pollicis longus lateral: Adductor pollicis longus/Extensor pollicis brevis proximal: styloid process of radius floor: trapezium, scaphoid
41
Layer 1 of the plantar foot
Abductor hallucis Abductor minimi pedis Flexor digitorum brevis All originate at the calcaneal tuberosity and insert in the toes.
42
Abductor hallucis
O: calcaneal tuberosity I: medial dorsal surface of the proximal phalanx of the big toe Abduction of the big toe Weak MTP 1 flexion
43
Abductor hallucis: Palpation of MMT
Palpation: Palpate from calcaneal tuberosity to medial big toe, medial to plantar fascia, as person abducts big toe MMT: Grip heel. Abduct big toe. Pressure applied toward adduction. If client can't abduct big toe, have them attempt forefoot adduction against resistance.
44
Flexor Hallucis Brevis
O: cuboid and third cuneiform I: medial and lateral aspect of plantar surface of the big toe (proximal phalanx) Flexes toe at MTP #1 Even though layer #3, only deep to FHL tendon and plantar fascia
45
Flexor Hallucis Brevis: Palpation and MMT
Palpation: palpate medial sole of foot while flexing big toe. Medial to FHB, deep to plantar fascia
46
Fibularis Longus
O: Fibular head; proximal half of lateral fibula I: First cuneiform and first MT (medial/plantar foot) Eversion Plantarflexion
47
Fibularis Longus: Palpation and MMT
Palpation: Start at fibular head and palpate downwards during eversion. Becomes difficult to palpate distal to lateral malleolus. Travels to base of 5th metatarsal then veers to plantar surface. MMT: Sidelying or supine. Evert and plantarflex. Stabilize proximal to ankle. Apply pressure towards dorsiflexion and inversion
48
"Stirrup Muscles"
Fibularis Longus and Tibialis anterior OR Tibialis Posterior. Both the Fib Long and the Tib Ant insert into 1st cuneiform and MT1, and act to support the medial longitudinal arch of the foot.
49
Extensor Digitorum Longus
O: proximal 2/3 fibula, proximal 1/3 interosseus membrane, lateral tibial condyle I: dorsal surfaces of toes 2-5 Extends toes 2-5 at MTP and IP joints Dorsiflexion Weak eversion
50
Extensor Digitorum Longus: Palpate and MMT
Palpation: Extend toes to identify tendons on dorsum of foot. Palpate proximally towards origin MMT: Stabilize at big toe. Extend toes. Apply pressure towards flexion.
51
The fibularis tertius is actually believed to be part of what muscle?
Extensor digitorum longus
52
Flexor Digitorum Brevis
O: Calcaneal tuberosity, plantar fascia I: medial and lateral sides of digits 2-5 PIP and MTP flexion of digits 2-5
53
Flexor Digitorum Brevis: Palpation and MMT
Palpation: Flex toes and feel through plantar fascia along midline of sole. MMT. Stabilize proximal foot. Flex toes. Apply pressure towards PIP and MTP extension.
54
Gastrocnemius
O: medial and lateral femoral condyles I: calcaneus via the Achilles tendon Plantarflexion Knee flexion Inversion/supination
55
Gastrocnemius: Palpation and MMT
Palpation: duh MMT: Supine. plantarflex. Apply pressure towards dorsiflexion
56
Soleus
O: soleal line of the tibia; fibular head and proximal 1/3 of fibula I: calcaneus via the Achilles tendon Plantarflexion Weak inversion/supination
57
Soleus: Palpation/MMT
Palpation: prone, knee flexed to 90º. plantarflex. Palpate on either side ot belly of the gastrocnemius. MMT. Prone. Stabilize shin. Knee flexed to 100º. Plantarflex. Apply pressure to heel towards dorsiflexion,
58
Pronation: talocrural/ subtalar/forefoot
dorsiflexion/eversion/abduction
59
Supination: talocrural/subtalar/forefoot
plantarflexion/inversion/adduction
60
Claw toe
MTP hyperextension PIP/DIP flexion Defective lumbricals, interossei Associated with pes cavus, fallen metatarsal arch, spina bifida, neurological problems
61
Hammer toe
MTP extension contracture; PIP flexion contracture Interossei lose ability to maintain proximal phalanx in neutral, so it gets pulled into extension Heredity, footwear, muscle imbalance, hallux valgus
62
Mallet toe
Flexion deformity of the DIP Bad shoes.
63
Layer 2 of the plantar foot
Quadratus Plantae | Lumbricals Pedis
64
Layer 3 of the plantar foot
Flexor hallucis brevis Flexor digiti mini brevis Adductor hallucis
65
Layer 4 of the foot
Plantar interossei | Dorsal interossei
66
Tibialis Posterior
O: Proximal 2/3 posterior tibia, fibula, interosseus membrane I: navicular tuberosity, MT2-4, all of the tarsals except the talus. Pronation Inversion/supination
67
Tibialis Posterior: Palpation and MMT
Palpation: seated or supine. Identify tendon just posterior to medial malleolus (it will be most anterior of Tom, Dick & Harry; extend toes to exclude FDL and FHL). Palpate upwards. It will disappear under soleus MMT: supine. Stabilize just above ankle. Lateral rotate leg, plantarflex and invert. Apply pressure towards dorsiflexion and eversion.
68
Gluteus Medius
O: Just inferior to iliac crest; in between anterior and posterior gluteal lines I: Greater trochanter (lateral) All fibres: abduction, depress pelvis Posterior fibres: extension, lateral rotation, posterior pelvic tilt, contralateral rotation Anterior fibres: flexion, medial rotation, anterior pelvic tilt, weak ipsilateral rotation
69
Gluteus Medius: Palpation and MMT
Palpation: Sidelying. Just inferior to middle of iliac crest. Abduct. Palpate towards trochanter; fibres go deep to TFL and Glute Max MMT: Vizniak -- supine; stabilize opposite ankle. Abduct; resist pressure towards adduction. Kendall: sidelying; slight forward pelvic rotation. Stabilize pelvis; abduct; resist pressure toward adduction.
70
Anterior fibres of the glute med run in the same direction as
TFL
71
Posterior fibres of the glute med run in the same direction as
Piriformis
72
TFL
O: ASIS and anterior iliac crest I: ITB ``` Hip flexion Abduction Medial Rotation Anterior pelvic tilt Pelvic depression Knee extension (via ITB) ```
73
TFL: Palpation and MMT
Palpation: Supine. Place fingers just distal and lateral to ASIS. Hip flexion, medial rotation. Palpate toward ITB. MMT: Supine. Stabilize opposite ankle. Flex hip to 45-60º; abduct 30º; medially rotate. Resist pressure towards opposite ankle (extension and adduction)
74
Piriformis
O: Lateral aspect of anterior sacrum, sacrotuberous ligament I: superomedial greater trochanter of the femur Lateral hip rotation Hip extension Contralateral pelvic rotation When hip flexed past 60º: Medial hip rotation Ipsilateral pelvic rotation
75
Piriformis: Palpation and MMT
Palpation: Prone. Knee flexed to 90º. Palpate lateral to sacrum, between PSIS and apex. Laterally rotate hip. Palpate to insertion. Don't apply to much resistance or glute max will fire. MMT: Prone. Knee flexed to 90º. External hip rotation. Resist pressure towards medial rotation.
76
Psoas Major
O: anterolateral bodies of T12-L5, with IVDs in between. Anteriorly on TVPs L1-5 I: lesser trochanter ``` Hip flexion Posterior pelvic tilt Lateral hip rotation Ipsilateral hip hike Trunk flexion Anterior pelvic tilt Contralateral rotation Lateral flexion ```
77
Psoas: Palpation and MMT
Palpation: supine, knees flexed. Find point halfway between ASIS and navel, lateral to rectus abdominis. Palpate gently downward on exhalation. Slight hip flexion. MMT: Supine. Hip flexed to 60º, laterally rotated, abducted. Stabilize opposite hip. Apply pressure diagonally (medial to lateral) towards extension
78
VMO
O: medial lip of linea aspera; intertrochanteric line; medial supracondylar line I: Tibial tuberosity Knee extension
79
VMO: Palpation and MMT
Palpation: supine. Place hand medial and proximal to patella. Extend knee. Palpate toward origin. MMT: Seated or supine. Knee flexed 10-20º, tibia externally rotated. Stabilize behind knee. Apply pressure toward knee flexion
80
Sartorius
O: ASIS I: Pes anserine ``` Hip flexion Lateral hip rotation Abduction Medial tibial rotation Anterior pelvic tilt ```
81
Sartorius: Palpation and MMT
Palpation: Supine. Palpate distal and medial to ASIS. Hold thigh in hip flexion, lateral rotation. Palpate toward insertion. If can't hold in that position, figure 4 with lateral rotation, flexion MMT: Supine, knee bent. Patient may hold onto table for stability. Hip flexed, laterally rotated, abducted. Apply pressure toward extension, adduction, and medial rotation.
82
Palpate greater trochanter
Locate middle of iliac crest Slide fingertips inferiorly 4-6 inches along lateral thigh until you feel great big bump. Dynamic: medial and lateral rotation
83
Palpate gluteal tuberosity
Prone Locate posterior surface of greater trochanter Slide 1-2 inches distally along posterior femur until you feel tuberosity (may be flat, not bumpy) Dynamic: hip extension
84
Palpate femoral condyles
Mostly inaccessible. Supine, knee entended. Locate sides of patella. Shift patella medially and slide off into the lateral condyle; shift laterally and slide off into the medial condyle
85
Adductor pollicis
Oblique head - O: anterior base of MC2-3, capitate I: proximal phalanx 1, DDE Transverse head: O: distal base of MC 3 I: proximal phalanx 1 Adduction (CMC, MCP) Thumb extension.
86
Brachioradialis
O: lateral supracondylar ridge I: styloid process of the radius Elbow flexion supination/pronation to neutral
87
Brachioradialis: Palpation and MMT
Palpation: resist hammer curl. Palpate wad of three -- most anterior MMT: resist hammer curl
88
Longus Capitis
O: TVP C3-5 I: Occiput (inferior -- just anterior to foramen magnum) Cervical flexion Lateral flexion
89
Longus Capitis: Palpate and MMT
Palpation: Supine. Feel medial to SCM, press posterior and medial. Flex against resistance for contraction MMT: (general anterior neck flexor test). Supine. Stick 'em up cactus arms. Tuck chin and flex neck. Resist pressure toward extension.
90
Trapezius - upper
O: External occipital protuberance, medial 1/3 superior nuchal line, nuchal ligament, SP of C7 I: Lateral 1/3 clavicle, acromion process Elevation of scapula Retraction of scapula Upward rotation of scapula Cervical extension CL rotation Lateral flexion
91
Trapezius -- middle
O: SPs T1-5 I: acromion process and spine of scapula Scapular retraction
92
Trapezius -- lower
O: SPs T6-12 I: Tubercle at the root of the spine of the scapula Scapular depression Scapular retraction Upward rotation
93
Trapezius: Palpation and MMT
Prone: palpation during scapular retraction (and active GH abduction?). Upper traps fire more with cervical extension. MMT: Upper traps -- seated. Shoulder elevated toward occiput, face turned away. Pressure towards shoulder depression and cervical anterolateral flexion Middle traps: Prone. Arm out to the side -- thumbs up Fonzie-style. Retract scapula. Pressure downward against forearm Upper traps: Prone, arm out in 1/2 Y position, thumb up. Retract scapula. Pressure downward agains forearm
94
Anterior Scalene
O: TVP C3-6 I: First rib Cervical flexion Lateral flexion CL rotation elevation of 1st rib (sniff)
95
Anterior and middle Scalene: Palpation
Clavicle, just lateral to SCM. Slight CL rotation. Sniff. Middle scalene will also contract -- anterior scalene is more medial.
96
Middle Scalene
O: TVP C2-7 I: First Rib Cervical flexion Lateral flexion elevation of 1st rib
97
Posterior Scalene
O: TBP C5-7 I: Second rib Lateral flexion Elevation of 2nd rib
98
Posterior Scalene: Palpation
Seated. Feel just above clavicle just medial to clavicular attachment of SCM. Sniff. (Lateral flexion may help) . Middle scalenes will also contract (They're more medial)
99
Scalene: MMT
Test as anterolateral neck flexors. Supine. Stick 'em up cactus arms. Rotate neck. Flex head. Pressure against temple toward taSplble
100
Rhomboids
O: SP C7-T5 I: Medial border of the scapula Retraction Elevation Downward rotation
101
Rhomboids: Palpation and MMT
Palpation: Prone or seated. Hand in small of back. Feel between scapula and spine. Palpate and hand moved away from back MMT: Prone. Arm out to side. Downward thumb. Pressure agains forearm toward floor.
102
Splenius Capitus
O: Nuchal ligaments C3-6; SPs C7-T4 I: mastoid process Cervical extension Lateral flexon IL rotation
103
Splenius Capitus: Palpation and MMT
Palpation: Prone. Feel posterior triangle (between SCM and trapezius. Extend and IL rotate head MMT: Prone, cervical IL rotation, lateral flexion. Slightly extend head. Stabilize upper T spine. Pressure on head towards flexion, opposite lateral flexion,
104
Teres Major
O: Inferior angle and inferior lateral border of the scapula I: medial lip of the bicipital groove Internal rotation Adduction Extension
105
Teres Major: Palpation and MMT
Palpation: prone. arm on table, foream dangling off. Feel lateral to inferior lateral border of scapula. Medially rotate arm to contract. MMT: Prone. Arm behind back. Stabilize around other scapula. Pressure against arm (above elbow) toward abduction and GH flexion.
106
Latissimus Dorsi
O: SP T7-L5, posterior sacrum, posterior iliac crest I: medial lip of bicipital groove Medial rotation Adduction Extension
107
Latissimus Dorsi: Palpation and MMT
Palpation: standing, therapist to front and side. Client arm on therapist shoulder. Attempt adduction/extension while therapist palpates from axilla to insertion, and toward origin MMT: Prone. Head CL rotated, arm semi-supinated (thumb pointing downward). Extend and adduct arm. Pressure against forearm toward abduction and flexion.
108
Extensor Pollicis Longus
O: posterior ulna (middle 1/3, interosseus membrane) I: Posterior surface of distal phalanx of the thumb Extends thumb at CMC, MCP and IP joints. Also laterally rotates and adduct CMC, extends and radially deviates at wrist, and supinates forearm.
109
EPL: Palpation and MMT
Palpation: Seated. Neutral forearm (semi-supinated). Feel posterolateral wrist. Extend thumb. Distal tendon makes up ulnar-side border of snuffbox. MMT: Sitting or supine. Neutral forearm. Stabilize by holding hand. Extend thumb. Pressure at dorsal IP towards flexion.
110
Flexor Carpi Radialis
O: CFT I: base of MC 2 and 3 Flexion, radial deviation Pronation Wrist flexion
111
Flexor Pollicis Brevis
O: flexor retinaculum and trapezium I: Proximal phalanx of the thumb Flexion at CMC and MCP joints
112
Coracobrachialis
O: coracoid process I: medial shaft of humerus flexion adduction
113
Hyoid Group
8 muscles (4 infrahyoid, 4 suprahyoid) All move mandible (directly or indirectly) at TMJ, and stabilize hyoid during mandibular depression
114
Suprahyoid Group
``` Muscles above hyoid bone Depress mandible (except styloid process) ``` Geniohyoid Mylohyoid Digastric Stylohyoid
115
Digastric
Suprahyoid Posterior belly: mastoid notch --> hyoid Anterior belly: mandible --> hyoid Depresses mandible Cervical flexion Elevation of hyoid
116
Mylohyoid
Suprahyoid inner surface of mandible --> anterior hyoid Depresses mandible Cervical flexion Elevates hyoid
117
Geniohyoid
Suprahyoid inferior mental spine of mandible --> anterior hyoid Depresses mandible Cervical flexion Elevates hyoid
118
Stylohyoid
Styloid process --> hyoid Elevates hyoid Extends head
119
Which hyoid muscles are innervated by CN V
The Trigeminal nerve innervates: Posterior belly of the digastric Mylohyoid
120
Which hyoid muscles are innervated by CN VII
The Facial nerve innervates: Stylohyoid Anterior belly of the digastric
121
Why hyoid muscles are innervated by CN XII
The Hypoglossal nerve innervates: Thyrohyoid Geniohydoid
122
Infrahyoids
Below hyoid All depress hyoid and flex neck Sternohyoid Sternothyroid Thyrohyoid Omohyoid
123
Sternohyoid
Infrahyoid Posterior manubrium and clavicle --> medial posterior hyoid Depresses hyoid Flexes neck
124
Sternothyroid
Infrahyoid Posterior manubrium and first costal cartilage --> lamina of thyroid cartilage Depresses hyoid Flexes neck
125
Thyrohyoid
Infrahyoid Thyroid cartilage (lamina) --> hyoid Depresses hyoid Flexes neck
126
Omohyoid
Inferior belly: scapula --> clavicle Superior belly: clavicle --> hyoid Depresses hyoid Flexes neck
127
Infrahyoids: innervation
All ansa cervicalis, except thyrohyoid (CN XII)
128
Q Angle
Quadriceps angle Formed by a line drawn between ASIS and centre of the patella, and another line connected centre of patella and the tibial tubersity Standing: normally 13-18º Seated, quads relaxed: nada Seated, quads engaged:
129
If Q Angle is too large?
Over 13º -- risk of patellar instability | Over 18º risk of patellar tracking dysfunction
130
Medial collateral ligament
Medial epicondyle to medial shaft of tibia Attached to meniscus Taut with knee extension, abduction of tibia on femur, forward translation of tibia, external tibial rotation
131
Patellofemoral ligament
Adductor tubercle --> medial patella Can become irritated with PatFem tracking disorder.
132
Lateral collateral ligament
Shorter, rounder than MCL Lateral epicondyle --> fibular head Superficial to popliteus tendon; runs between it and biceps femoris tendon Doesn't attach to meniscus Taut with knee extension, adduction of tibia, external tibial rotation. Resists varus stress and hyperext ensign
133
Anterior Cruciate ligament
Anterior intercondylar area of the tibia --(backwards upwards lateral) to lateral femoral condyle Main function: prevent anterior movement of tibia and check lateral tibial rotation in flexion. Also checks (hyper)extension of the knee.
134
Posterior Cruciate ligament
Intercondylar area of the the tibia --(forward, medial, up) --> medial femoral condyle Main functions: checking posterior translation of the tibia. Also checks (hyper)extension.
135
Fat pad, ACL and PCL are ...
Intercapsular and extrasynovial
136
Medial femoral condyle ...
Extends further distally, creating a 10° valgus angle
137
Lateral femoral condyle ...
Extends more anteriorly, preventing lateral dislocation of the patella
138
Which tibial condyle is larger?
Medial
139
Medial meniscus
Horns attach by ACL and PCL attachments Attached to capsule, MCL and coronary ligaments Less mobile
140
Lateral meniscus
Horns attach closely to each other Attached to tibia, coronary ligaments, capsule, but not LCL More mobile
141
Fabella
The fabella (Latin for little bean) (or flabella) is a small sesamoid bone found in some mammals embedded in the tendon of the lateral head of the gastrocnemius muscle behind the lateral condyle of the femur. Only about 10% population has one.
142
Oblique popliteal ligament
Post-med tibial meniscus, tibial condyle --> blends with semimem tendon --> to lateral femoral condyle Reinforced post-med capsule Controls ant-med rotary instability
143
Arcuate popliteal ligament
Y shaped Thickening of post-lat capsule Fibula --> popliteal fascia / posterior horn of lateral meniscus and lateral femoral condyle
144
Patellar Retinaculum
Medial and lateral extensions of the aponeuroses of the vastus lateralis and VMO
145
What happens during knee extension?
Patella moves upward and laterally. Fat pad fills patellar groove and covers trochlear groove. Menisci glide anteriorly MCL, LCL, and medial fibres of ACL and PCL tighten Tibia externally rotates in last 15-20° (Closed chain -- femoral internal rotation )
146
Primary rotary stabilizers of the knee
Cruciate ligaments
147
Hallux ridigus
Limited extension/dorsiflexion of the big toe. Often OA at MTP 1 Also extra long MT 1 bone, pronation, trauma. More frequent in men Acute (usually adolescent) or chronic.
148
Transverse tarsal joint
Talonavicular and calcaneocuboidal (saddle/stellar) joints Essentially ball and socket Closed packed in supination Supported by calcaneocuboid, bifurcated and long plantar ligaments. Gliding, conjunction rotation
149
Tarsometatarsal joints
Plane synovial Closed packed in supination Collectively referred to as Lisfranc joint
150
Posterior tibiofibular ligament
Inferior tibfib joint Prevents excess gapping and posterior glide
151
Posterior talocalcaneal ligament
Subtalar joint Connects lateral tubercle of talus to medial calcaneus
152
Deltoid ligament
Talocrural joint (medial) Triangular. Medial malleolus --> fans out to distal attachments Collectively resists reversion, rotation, tilt and ant/post tarsal glide Tibionavicular (anterior) Anterior tibiotalar Tibiocalcaneal Posterior tibiotalar
153
Tibionavicular ligament
Part of anterior deltoid ligament (superficial) Medial malleolus --> blends with spring ligament/ navicular Collectively resists reversion, rotation, tilt and ant/post tarsal glide
154
Anterior tibiotalar
Part of anterior deltoid ligament (deep) Resists rotation and lateral translation of talus Medial malleolus --> deep anterior talus
155
Posterior tibiotalar
Part of the deltoid ligament Superficial Medial malleolus --> medial talus Collectively resists reversion, rotation, tilt and ant/post tarsal glide
156
Tibiocalcaneal ligament
Part of the deltoid ligament (middle fibres) Almost vertical orientation Medial malleolus to sustenaculum tali Collectively resists reversion, rotation, tilt and ant/post tarsal glide
157
Posterior talofibular ligament
Fossa of lateral malleolus --> lateral tubercle of posterior talus Checks excessive dorsiflexion.
158
Short Plantar Ligament
AKA plantar calcaneocuboid ligament Reinforces calcaneocuboid joint
159
Long plantar ligament
Aka long calcaneocuboid ligament. Reinforces calcaneal cuboid joint
160
What muscles make up the erector spinae group?
Iliocostalis Longissiumus Spinalis
161
Collectively what are the actions of the erector spinae?
Extension Lateral flexibility IL rotation Anterior pelvic tilt
162
Iliocostalis
Most lateral erector spinae Lumbar, thoracic and cervical O: Medial iliac crest, sacral crests, angles of R3-12 I: angles of R1-12, TVP of C4-7 Inferior attachment medial; superior attachment lateral Extension Lateral flexibility IL rotation APT
163
Longissimus
Middle erector spinae muscle Thoracis, cervicis, capitis O: medial iliac crest, posterior sacrum, TVPs and SPs of L1-5 and TVPs of T1-5, articular processes C5-7. I: TVPs T1-12, R4-12 (between tubercles and angles), TVPs of C2-6, mastoid process Extension Lateral flexion IL rotation APT
164
Spinalis
Most medial erector spinae muscle Thoracis, cervicis, capitis O: SPs T11-L2 and C7, nuchal ligament I: SPs T4-8, C2. Extension Lateral flexion
165
Transversospinalis group
Multifidis | Rotatares
166
Most commonly injured nerve in the shoulder
Axillary | Anterior dislocation or fracture of head of the humerus
167
Lungs, GB, heart, diaphragm, spleen and elbows can all refer pain to ...
The shoulder

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