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61 Cards in this Set

  • Front
  • Back
Ilium landmarks
ASIS- ilio psoas attachment
AIIS- rectuc femorus attaches
Pubis landmarks
tubercle- attachment of the inguinal ligament and rectus abdominus
symphysis- shock absorber
Ischium landmarks
ischial spine
ischial tuberoscity- attachment of hamstrings (posterior tilt)
When the trunk is flexed forward the hamstrings generate more maximal force
Femur osteology
femoral head
femoral neck
lesser trochanter- iliopsoas
greater trochanter
Angle of inclination- 125 degree angle of femoral head to shaft
Coxa valga- more than 125 degrees
Coxa vera- less than 125 degrees

Torsion Angle- can have 10-15 degrees of anteversion
Acetabulum contents
Contains fat, ligaments, vessels, terres ligament
Has a labrum to deepen the cavity
Naturally projects laterally, anteriorly, and inferiorly
Hip ligaments
Iliofemoral- restricts extension
Pubofemoral- restricts abduction
Ischiofemoral- restricts- internal rotation
Flexion and extension at hip
Hip can be flexed 120 degrees with knee bent, but hamstings restrain it in extension.
Have about 20 hip extension with knee bent, but extension of knee limits because of the rectus femoris
Abduction and Adduction at the hip
Abduction is limited by the pubofemoral ligament and adductor muscles.
When the hip abductors are damaged you must rely on the IT Band for support.
Internal and external rotation at hip
Internal-limited by the ischiofemoral ligament and the piriformis muscle
External- limited by the iliofemoral ligament.
Internal gives a posterior glide and external gives a anterior glide.
Hip flexor muscles
iliopsoas, sartoriu, rectus femoris, tensor fascia latae, adductor longus
Femoral on pelvic flexion- abs counter the tilt of the pelvis
Pelvic on femoral- anterior tilt of pelvis by any hip flexor
Hip adductoin muscle
Adductor magnus- also an extensor
adductor longus- flexor or extensor too

Most also work as INTERNAL ROTATORS
Hip extensor muscles
gluteus minimus, gluteus medius, biceps femoris, semitendonousus, semimembranousus, and adductor magnus
Pelvic on femoral- posterior tilt of pelvis
Femoral on pelvic- upward acceleration like going up stairs
Hip abductor muscles
gluteus minimus, tensor fascia latae, gluteus medius
Hip abductors in gait - Exam question
Hip abductor keep the pelvis level during gait to keep it from dropping down too much.
Activate abductors on the opposite as the body weight is falling while in stride.
With weak abductors, use a cane on the opposite side to create a torque opposite of the body weight and has a long moment arm.
Hip external rotators
piriformis, obturator, gemellus
A shortened pisiformis can impact the sciatic nerve.
Hip pathology and things to know
Commonly have fracture affecting the old along with arthritis.
Need to understand clockwise and counter clockwise moments, use of canes, and advise about loads
Joints in the knee joint
tibiofemoral joint- medial and lateral compartment
patellofemoral
Distal femur landmarks
Intercondylar groove- patella articulates with the femur
Interconylar notch- passage for the ACL and PCL
Medial and lateral epiconyles- attachment for the collateral ligaments
Proximal fibula landmarks
Fibula is relatively non-weight bearing.
The head of the fibula is where LCL and biceps femoris attach.
Proximal tibia landmarks
Tibial plateau with articular cartilage- the medial surface is concave and the lateral surface is convex.
Tibial tuberosity- the attachment site of the patellar tendon, which attaches to the quadriceps femoris.
Patella landmarks
Patella is a sesamoid bone- embedded in tendon (quads)
The base is the superior portion.
The apex is the inferior portion and attachment for the patellar ligament.
The posterior part of the patella has a verical ridge, facets, and thick articular cartilage.
INCREASES THE INTERNAL MOMENT ARM.
Knee joint alignment
The femur is naturally oriented medially.
Genu valgum- when knees meet in the middle
Genu varum- when knees bow away from each other.
Knee menisci
On the medial and lateral parts of the joint
Functions
- stability
- disperse forces
- reduce compression
The blood supply is good bad at the center so it is hard to heal here.
amount of tibiofemoral movement
sagittal plane- 130-140 flexion and little hyperextension

horizantal plane- internal and external rotation, 40-50 total rotation with about 2 times the amount of external as internal
Femoral on tibial movement
roll and glide are in opposite directions
tibial on femoral movement
extension- roll and glide in the same direction forward

flexoin- roll and glide in the same direction posterior
Screw home mechanism of the tibia
To get full extension the tibia must rotate externally to lock into place. Happens with about 10 degrees of er.
Must internally rotate to unlock in flexion.
This occurs because of the slight lateral pull of the quadriceps and because it gives the greatest amount of congruency.
The movement of the patella in patellofemoral joint
In full extension the patella rests above the interconylar groove.
At 20 degrees of flexion the inferior portion contacts the femur.
At 60-90 degrees of flexion there is the greatest contact.
At 135 degrees of flexion the superior portion is in contact with the femur.
General ACL and PCL info
Both are named based on where they attached to the tibia. ACL attaches to the anterior tibia, goes throught the interconylar notch and attaches to the posterior femur. The PCL is opposite.
ACL resists anterior translation of the tibia relative to the femur along with rotations and hyperextension
PCL resists posterior translation of tibia, hyperflexion, and severe hyperextension.
ACL injury mechanisms
1. a valgus force on a planted foot
2. a rotational force on a planted foot.
3. hyperextension of the knee
4. a combination including hyperextension
ACL injury in women
Women tend to land in more knee extension, internal rotation, and valgus position. This makes them more prone to ACL injury.
Women also are quads dominant in their legs.
Can train to prevent this by training the hamstrings, softening the landing, training the hip abductors, training the hip ER's.
MCL and LCL info
MCL- flat ligament on medial side, attaches to the medial meniscus, limits valgus motion, extension, and axial rotation

LCL- round cord ligament, attaches to the head of the fibula and the lateral epicondyle, limits verus motion/frontal plane, extension and axial rotation.
Knee flexion and extension muscles
flexion- hamstrings, popliteus, gastrocnemeus, plantaris, and adductor longus

extension- quadriceps femoris- 4 heads that together cause sagittal plane movement
Internal and external knee rotation muscles
internal- adductor muscles, semimembranousus, semitendonousus, popliteus

external- biceps femoris
limitations to hip flexion and extension
extension- with knee extended limited by the Y ligament, with flexed limited by the quads

flexion- knee extended limited by hamstrings, knee flexed limited by the gluteus max and hip joint capsule
stresses felt at knee (exam question)
With a valgus force there is tension on the MCL, and compression on the lateral meniscus and lateral articular cartilage.
With a verus force there is tension on the LCL and compression on the medial meniscus and medial articular cartilage.
Ankle/foot regions
Ankle- talocrural joint
mid-foot- tarsal bones, navicular, cuboid, and cuneforms 1,2, and 3
rear-foot- calcaneous, and talus
forefoot- metatarsals, and phalanges
Calcaneous and talus landmarks
Talus- head is the front and the trochlea is the top
calcaneous- calcaneal tuberosity is posterior part that attaches to the achilles, the sustenacular talus is a medial projection that shelves the talus
Navicular, cuboid, and cuneiforms landmarks
navicular- tuberosity on medial surface that attaches to the tibialis anterior muscle, "navicular drop" the amount of drop because of pronation at the navicular
Cuboid- articulates with most of the tarsals
Cuneiforms- contribute to the transverse arch
Metatarsal landmarks
base-proximal ends
shaft- concave on plantar surface to contribute to longitudinal arch
The 5th metatarsal has a styloid process that serves as the attachment for the peroneus brevis muscle (everter)
Amounts of foot/ankle movements
plantar flexion and dorsiflexion-
saggital
25 dorsiflexion, 45 plantar

inversion and eversion
frontal plane
30 inversion, 10 eversion

abduction and adduction
in the horizontal plane
about 30 each
Foot suppination and pronation info
Supination- need plantar flexion, inversion, and adduction to create rigid position good for push off

Pronation- need dorsiflexion, eversion, and abduction to create a relaxed state, limited by the tibialis posterior
Talocrural joint info
The capsule is reinforced by the collateral ligaments.
Ligaments- deltoid (medial), 3 lateral collateral
Mainly the anterior talofibular ligament is injured because there is no boney protection and hard to unweight foot
Roll and glide are in opposite directions
Subtalar joint info
Formed by the calcaneous and the talus.
Allows movement at the foot without movement at the ankle
Foot arches
Anterior transverse arch
medial longitudinal arch- plantar fascia contributes to it
lateral longitudinal arch
Anterior compartment muscles
tibialis anterior, flexor digitorum longus, flexor hallicus longus, peronues tertius,
All lead to dorsifelxion
Innervated by the deep peroneal nerve
Muscles of the lateral compartment
Peroneus longus and brevis
Lead to evert
Innervated by the superficial peroneal nerve.
Muscles of the posterior compartment
superficial- gastrocnemeus, soleus, plantaris
plantar flex the foot
deep- tibialis posterior, flexor digitorum longus, flexor hallicus longus
help invert
Innervated by the tibial nerve
Cerebral cortex info
Area of highest level of control
Involved in choosing a course of action
Contains Primary Motor Cortex to send commands
Contains Somatosensory cortex
Spinal cord infor
lowest level of perception and action along with receptors
Initially processes infor
Involved in basic reflexes of flexion and extension
Brainstem info
Involved in postural control and locomotion.
contains vestibular nuclei
Control output to neck, face, and eyes
All descending pathways originate here
Muscle Spindle receptors
Located in the belly of skeletal muscle.
Consist of specialized intrafusal fiber that can be stretched.
Responds to changes in muscle length and rate of stretch.
Stretch reflex loop
Alpha motor neurons are stimulated by the spinal cord, which receives a signal from the spindles
Causes agonist to contract and inhibits antagonist
Plyometrics info
These are powerful explosive movements where there is rapid stretching followed by shortening of muscles.
In the short term, in little time, stretch reflex and elastic energy cause spring forward.
Over time have an increase in power and strength because of muscular hypertrophy.
Golgi tendon organs
Located in the tendon muscle junctions.
Sensitive to active and passive tension.
Inhibits own muscle and excite antagonist.
Joint receptors
Numerous types.
Located in the joint capsule.
Signal extreme joint positions
Three balance systems
1. vestibular system
2. vision
3. proprioreceptors
Vestibular system
Provides info of where head is and sudden changes in it.
Important for keeping eyes stable and coordinating responses
Plasticity
The ability to show modification.
Changes in the efficiency or strength of synaptic connections.
A change in the organization and number of connections
mechanisms of plasticity
sensory and motor pathways
redundancy
Stages of learning
1. cognitive phase- understanding, develop strategies, improvements are large, performance inconsistency

2. associative phase- subtle adjustments, improvements gradual

3. autonomous phase- largely automatic, requires less attention