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Posterior Abdominal Muscles Quadratus Lumborum O: 12th rib & transverse processes T12L5 I: iliac fossa, posterior iliac crest N: T12-L4 A: 1. Contracts 12th rib to iliac crest 2. extension: both sides 3. bending: one side Blood Supply: Lumbar arteries & lumbar branch of iliolumbar a. Psoas Major O: Lumbar vertebrae, transverse processes & IVdiscs T12-L5 I: Lesser trochanter N: Ventral Rami L1-L3 A: Flexes hip Blood supply: Lumbar branch of iliolumbar a. Psoas Minor O: T12- L1 I: Pectinate Line N: Lumbar plexus A: flexes lumbar vertebrae *absent in 40% Iliacus O: superior 2/3 of iliac fossa, ala of sacrum, anterior sacroiliac ligament I: Lesser trochanter N: Femoral L2-L4 A: flexes Hip Blood supply: medial femoral circumflex, iliolumbar a. (iliac branch) Iliopsoas Psoas Major & Iliacus **chief flexor of the hip/thigh iliopsoas test- indicator of appendicitis Posterior Thigh Biceps Femoris – Long Head *hamstring muscle O: Ischial Tuberosity & Sacrotuberus ligament (distal) I: Head of Fibula N: Tibial Div. of Sciatica N (L5-S2) A: 1. Flex knee 2. Extends hip ** 3. knee external rotation Biceps Femoris- Short Head *hamstring muscle O: Linea Aspera (lateral) I: Head of Fibula N: Common Fibular div. of Sciatica N (L5-S2) A: 1. Flex knee 2. knee external rotation Semitedinosus *hamstring muscle O: Ischial tuberosity I: medial tibia (pes ancerinus) N: Tibial Division of Sciatic N. (L5-S2) A: 1. Extends Hip 2. Flexes Knee 3. internal rotation of knee Semimembranosus *hamstring muscle O: ischial tuberosity I: posterior medial condyle of tibia & posterior capsule N: Tibial Div. of Sciatic N. (L5-S2) A: 1. Extends hip 2. Flexes knee **deep to semitendinosus ** some fibers loop back to form the oblique popliteal lig. (aids posterior stability of the knee) Adductor Magnus *hamstrings * O: Inferior pubic ramus, ischial ramus, ischial tuberosity I: Medial Epicondyle femur N: Tibial Div of Sciatic N. (L4) A: 1. ADDucts hip 2. extends hip ** Popliteus O: Lateral Condyle femur I: Posteriomedial tibia N: tibial (L4- S1) A: 1. Dynamic stabilizer of knee with knee internal rotation 2. Assists with flexion Plantaris O Lateral condyle of femur & oblique popliteal ligament I: medial aspect of Achilles tendon N: Tibial N. (L4-S1) A: 1. Dynamic stabilizer of knee with knee internal rotation 2. Assists with flexion Flash worksheet- Foot Extensor Digitorum Brevis (dorsum) O: dorsal anterior calcaneous I: extensor digitorum longus tendons & toes 2,3,4 ( EDL tendons) N: Lateral Branch of deep fibular (peroneal) N. A: 1. Extend MTP joints for toes 2,3,4 Blood supply: dorsalis pedis a. Extensor Hallucis Brevis (dorsum) O: Dorsal anterior calcaneous I: Base of proximal phalanx of Great toe N. Lateral branch of deep fibular (peroneal) N. A: Extends Great toe Blood supply: dorsalis pedis a. ABductor Hallucis (first layer) plantar O: calcaneus and plantar aponeurosis I: proximal phalanx of great toe N: Medial Plantar N. ( S2, S3) A: ABducts great toe Blood supply: Medial plantar a. Flexor Digitorum Brevis (first layer) plantar O: Calcaneus and plantar aponeurosis I: proximal phalanx of toes 2-4 N: Medial Plantar N. ( S2, S3) A: Flex Toes Blood Supply: Deep Dorsal a.- plantar metatarsal aa. Abductor Digiti Minimi (first layer) Plantar O: Calcaneous and plantar aponeurosis I : Proximal phalanx 5th toe N: Lateral Plantar N. – superficial branch (S2, S3) A: ABduct 5th toe Blood Supply: Lateral Plantar a. Quadratus Plantae (second layer) Plantar O: Calcaneous I: posteriolateral margin of tendon of FLD N: Lateral Plantar N. (S2, S3) A: Assists flexor digitorum longus (straightens its torque vectors) Blood Supply: Lateral Plantar a. Lumbricals (second layer) Plantar O: FDL tendons I: dorsal hood, lateral 4 digits N: Medial: Medial plantar N. (S2, S3) Lateral 3: Superficial branch of Lateral Plantar N. (S2, S3) A: 1. Flex MTP Blood supply: medial and lateral plantar a. Flexor Hallucis Brevis (third layer) Plantar 2 Heads O: Cuboid, lateral cuneiform and posterior tibialis tendon I: proximal phalanx of great toe N: Medial Plantar N. (S2, S3) A: Flexes great toe Blood Supply: Medial plantar a Adductor Hallucis (third layer) Plantar 2 heads! O: Oblique head: from base of 2nd, 3rd, & 4th Metatarsals & sheath of peroneus longus Transverse head: from joint capsules of 3rd, 4th, & 5th MTP’s and deep transverse MT ligaments I: both insert together as a tendon onto the lateral aspect of the proximal phalanx of the great toe N: Lateral Plantar N. Blood Supply: Lateral plantar a. Flexor Digiti Minimi (third layer) Plantar O: 5th Metatarsal I: proximal phalanx of 5th toe N: lateral plantar N. ( superficial branch) (S2, S3) A: Little toe MTP flexion Blood Supply: lateral plantar a. Dorsal Interosseous m. (fourth layer) Dorsum/plantar O: adjacent sides of metatarsals 1-5 I: 1st: medial side of proximal phalanx of 2nd metetarsal 2-4: lateral side of proximal phanalges 2-4 N: Lateral Plantar N. (terminal branch of tibial n. ) A: ABduct & flex metatarspohalangeal joints 2-4 Blood Supply: Deep plantar a. & dorsal plantar a. ** DAB Plantar interosseous m. (fourth layer) plantar O: Medial Metetarsals 3, 4, 5 I: Medial Proximal phalanges 3, 4, 5 N: Lateral Plantar N. A: ADDucts metatarspohalangleal joints 3-5 Blood Supply: Deep plantar a. ** PAD Gluteal Region Muscles Gluteus Maximus O: ilium, dorsal sacrum, coccyx & sacrotuberous ligament I: ITB & gluteal tuberosity N: inferior gluteal n (L5, S1, S2) A: 1. extends & laterally rotates hip 2. ABducts hip 3. inferior fibers can ADDuct hip Gluteus Medius O: Ilium I: Greater trochanter N: Superior Gluteal (L5, S1) A: 1. Open chain- ABducts hip 2. closed chain- stabilizes pelvis 3. anterior fibers- flexion and internal rotation 4. posterior fibers- extension and external rotation Gluteus Minimus O: Ilium I: anterior border of Greater Trochanter N: superior Gluteal n. (L5, S1) A: 1. ABduction 2. Medial/internal rotation 3. Weakly assists with hip flexion Piriformis O: Anterior surface of sacrum & sacrotoberous ligament I: Superior Border of Greater Trochanter N: Nerve to Piriformis- ventral rami S1, S2 A: 1. Laterally rotates & Extends Hip 2. Assists in ABduction (when hip is flexed) Obturator Internus O: Pelvic Surface Obturator membrane & Ischium I: Medial Surface of Greater Trochanter N: Nerve to Obturator internus (L5-S1) A: 1. Laterally rotates hip 2. assists with ABduction (when hip is flexed!! ) Superior Gemellus O: ischial spine I: medial surface of greater trochanter N: nerve to obturator internus (L5-S1) A: 1. Laterally rotates hip 2. assists with ABduction (when hip is flexed!) Inferior Gemellus O: ischial tuberosity I: medial surface of Greater Trochater N: Nerve to Quadratus Femoris (L5-S1) A: 1. Laterally rotates hip 2. Assists with ABduction (when hip is flexed!!) Quadratus Femoris O: Lateral border of Ischial tuberosity I: Intertrochanteric Crest N: Quadratus Femoris N. (L5- S1) A: Laterally rotates hip Obturator Externus *medial thigh m. * O: rami of pubis & ischium & external surface of Obturator membrane I: trochanteric fossa of femur N: Obturator N (L3-4) A: 1. Lateral/external rotator of the thigh 2. ADDucts hip Flash Worksheet - Leg Anterior Compartment Ankle Dorsiflexors & Toe Extensors Tibialis Anterior O: lateral tibial condyle & ½ lateral surface of tibia I: medial cuneiform & base of 1st metatarsal N: Deep Fibular (Peroneal) N. (L4-S1) A: 1. Ankle dorsiflexion 2. Foot inversion (powerful) Blood Supply: Anterior Tibial a. Extensor Hallucis Longus O: Middle ½ anterior surface of fibula & interosseous membrane I: base of distal phalanx N: Deep Fibular (Peroneal) N. (L4-S1) A: 1. Great toe extension 2. Ankle dorsiflexion Blood supply: Tibial a. Extensor Digitorum Longus O: lateral tibial condyle & ¾ of media lsurface of fibula & interosseous membrane I: middle phalanx of lateral 4 toes N: Deep Fibular (Peroneal) N. (L4-S1) A: 1. PIP Extension of lateral 4 toes 2. Ankle Dorsiflexion Blood Supply: Tibial a. Fibularis (Peroneus) Teritus O: Inferior 1/3 anterior surface of fibula I: dorsal shaft of 5th metatarsal N: Deep Fibular (Peroneal) N. (L4-S1) A: 1. Ankle dorsiflexion 2. foot eversion Blood Supply: tibial a. *may be absent, very small m. Lateral Compartment Ankle Plantarflexors & Foot Evertors Fibularis (Peroneus) Longus O: Fibular head and lateral surface of fibula I: base of 1st metatarsal * medial cuneiform N: Superficial Fibular (Peroneal) N. (L5S2) A: 1. Subtalar eversion 2. Weak ankle plantarfleion Blood Supply: fibular a. Fibularis (Peroneus) Brevis O: distal lateral surface of fibula I: base of 5th Metatarsal N: Superficial Fibular (Peroneal) N. (L5S1) A: 1. Subtalar eversion 2. Weak ankle plantarflexion Blood Supply: fibular a. Posterior Compartment Ankle Plantarflexors & Toe Flexors Gastrocnemius (Superficial) *2 heads O: femoral condyles (medial & lateral) I: calcaneal tuberosity (Achilles tendon) N: Tibial N. (S1, S2) A: 1. Plantar Flex ankle 2. Flex knee Blood Supply: sural a. Soleus (Superficial) O: Posterior tibia & fibula I: Calcaneal Tuberosity (Achilles tendon) N: Tibial N. (S1, S2) A: 1. Stablilizes knee indirectly by stabilizing tibia 2. Ankle plantar flexion Blood Supply: sural a. Plantaris (Superficial) O: Lateral Supracondylar line of femur & oblique popliteal ligament I: Calcaneal Tuberosity (Achilles tendon) N: Tibial N. (L5, S1) A: Dynamic stabilizer of the knee Blood Supply: sural a. Tibialis Posterior (Deep) O: Interosseous Membrane & Posterior tibia & Fibula I: Navicular tuberosity & fibrous expansion of cuneiforms, cuboid and bases of 2nd, 3rd, & 4th metatarsals N: Tibial N. (L4, L5, S1) A: 1. Plantar flexes foot 2. Foot inversion 3. Eccentricly controls against dorsiflexion and eversion/pronation Blood Supply: posterior tibial a. Flexor Digitorum Longus (Deep) O: Tibia an posterior tibialis muscle fascia I: distal phalanges of lateral 4 toes N: Tibial N. (L5, S1, S2) A: 1. Ankle, MTP & IP flexion 2. Foot inversion Blood Supply: posterior tibial a. Flexor Hallucis Longus (Deep) O: Distal 2/3 of posterior fibula I: base of distal phalanx of great toe N: Tibial N. (L5, S1, S2) A: 1. MTP and Hallux IP joint flexion 2. Ankle plantarflexion 3. Foot inversion Blood Supply: posterior tibial a. Popliteus (Deep) O: lateral Femoral condyle I: tibia’s soleal line (posteriomedial tibia) N: Tibial N. (L4-S1) A: 1. Dynamic knee stabilizer 2. Assists with knee flexion 3. Internal (medial) rotator of tibia on femur Blood Supply: popliteal a. Anterior and Medial Thigh Muscles Anterior Thigh Tensor Fasciae Latae m. O: Iliac crest and ASIS I: ITBand N: superior Gluteal N. (L4-S1) A: 1. Hip flexion 2. hip ABduction 3. Hip internal/medial rotation 4. Helps stabilize knee in extension Blood Supply: Superior gluteal a. & lateral circumflex femoral Sartorius m. O: ASIS I: Medial Tibia (pes ancerinus) N: Femoral N. (L2, L3) A: 1. Hip flexion 2. Hip ABduction 3. Hip external rotation 4. Knee flexion Blood Supply: femoral a. Rectus Femoris (Quadriceps femoris m) O: 1. AIIs 2. superior rim of acetabulum I: Tibial tuberosity (Patellar tendon) N: femoral N. (L2,34) A: 1. Extends knee 2. Flexes hip Blood Supply: femoral & lateral circumflex femoral a. Vastus Lateralis (Quadriceps femoris m) O: Greater trochanter & lateral lip of linea aspera I: Tibial tuberosity (Patellar tendon) N: Femoral N (L2,3,4) A: Extends knee Blood Supply: femoral a. Vastus Intermedius (Quadriceps femoris) O: Anterior & lateral Femur I: Tibial tuberosity N: Femoral N. (L2,3,4) A: Extends Knee Blood Supply: femoral a. ** lies deep to Vastus Rectus! Vastus Medialis (Quadriceps femoris m) O: intertrochanteric line & medial lip of linea aspera I: Tibial tuberosity N: Femoral N (L2,3,4) A: Extends Knee Blood Supply: femoral a. Medial Thigh Muscles Pectineus (Superficial) O: Superior Ramus of Pubis I: femur just inferior to lesser trochanter N: femoral N. & sometimes obturator (L2,3,4) A: 1. Flexes hip 2. ADDucts hip Blood Supply: profunda femoral & medial femoral circumflex a. *forms floor of femoral triangle with iliopsoas m. Adductor Longus (Superficial) O: Pubis- Inferior to Pubic crest I: linea aspera (middle 1/3) N: Obturator N. (L2,3,4) A: 1. ADDucts hip 2. assists with hip extension, flexion and rotation Blood Supply: profunda femoral & medial femoral circumflex a. Gracilis (Superficial) O: Body and Inferior Ramus of Pubis I: Superior medial tibia (pes ancerinus) & satorius & semitendinosis N: Obturator n. (L2, L3) A: 1. ADDucts hip 2. Flexes & interally rotates knee Blood supply: profunda femoral & medial femoral circumflex a. Adductor Brevis (Deep) O:Pubis- Body and Inferior ramus I: Proximal Linea Aspera N: Obturator N. (L2,3,4) A: 1. ADDucts hip 2. Assists with hip flexion and rotation Blood Supply: profunda femoral & medial femoral circumflex a. Adductor Magnus (Deep portion) O: inferior pubic ramus, ischial ramus, ischial tuberosity I: Linea aspira N: Obturator N. A: Adducts hip Blood Supply: profunda femoral & medial femoral circumflex a. Adductor Magnus (upper, minimus) O: inferior pubic ramus, ischial ramus, ischial tuberosity I: linea aspira N: obturator A: 1. Adducts hip 2. Externally rotates hip Blood supply: profunda femoral & medial femoral circumflex a. ** note other adductor magnus on posterior thigh worksheet All have the same ORIGIN. Changes: insertions, innervations and actions!!! Gluteal Muscles Gluteus Maximus Origin Ilium, dorsal sacrum, coccyx and sacrotuberous ligament Insertion Iliotibial band and Gluteal tuberosity Gluteus Medius Origin Ilium Insertion Greater trochanter Gluteus Minimus Origin Ilium Insertion Anterior border of greater trochanter Innervation Inferior Gluteal n. (L5, S1, S2) Blood Supply Superior and inferior gluteal arteries Innervation Superior gluteal n. (L5, S1) Blood Supply Superior gluteal artery Innervation Superior gluteal n. (L5, S1) Blood Supply Superior gluteal artery Actions -Extends hip -Laterally rotates hip -Abducts hip -Adducts hip (most inferior fibers) Actions -Abducts hip in an open chain -Stabilizes pelvis in a closed chain -Flexion of hip -Medial rotation of hip -Extension of hip -Lateral rotation of hip **Trendelenburg Gait -indicative of a weak gluteus medius Actions -Abducts the hip -Medially rotates the hip -(Flexes the hip) Lateral Rotators of the Hip Piriformis Origin Anterior surface of sacrum, sacrotuberous ligament Insertion Superior border of the greater trochanter Superior Gemellus Origin Ischial spine Insertion Medial surface of greater trochanter Innervation Nerve to the piriformis (ventral rami S1, S2) Actions -Laterally rotates the hip -Extends the hip -Abducts the Blood Supply hip when hip is Sup. and Inf. flexed gluteal arteries, **Landmark lateral sacral for arteries neurovascular structures Innervation Nerve to Obturator Internus (L5, S1) Blood Supply Inferior gluteal artery Actions -Laterally rotate the hip -Abduct the hip when the hip is flexed Inferior Gemellus Origin Ischial tuberosity Insertion Medial surface of greater trochanter Obturator Internus Origin Obturator membrane and ischium Insertion Medial surface of greater trochanter Quadratus Femoris Origin Lateral border of ischial tuberosity Insertion Intertrochanteric crest Origin Innervation Nerve to Quadratus Femoris (L5, S1) Actions -Laterally rotate the hip -Abduct the hip when the hip is flexed Blood Supply Inferior gluteal artery Innervation Nerve to Obturator Internus (L5, S1) Actions -Laterally rotates the hip -Abducts the hip when the hip is flexed Blood Supply Superior gluteal artery Innervation Nerve to Quadratus Femoris (L5, S1) Actions -Laterally rotates the hip Blood Supply Inferior gluteal artery Innervation Actions Obturator Externus Rami of pubis and ischium, external surface of obturator membrane Obturator n. (L3, L4) -Laterally rotates the hip -(Adducts the Blood Supply hip) Obturator a. Insertion Trochanteric fossa Posterior Thigh Muscles Biceps Femoris (Long) Origin Ischial tuberosity and distal sacrotuberous ligament Insertion Head of fibula Biceps Femoris (Short) Origin Lateral portion of linea aspera Insertion Head of fibula Innervation Tibial division of Sciatic n. (L5-S2) Blood Supply Inferior gluteal a. Perforating arteries Popliteal a. Innervation Common Fibular division of Sciatic n. (L5-S2) Blood Supply Inferior gluteal a. Perforating arteries Popliteal a. Actions -Flex the knee -Extends the hip -Knee external rotation Actions -Flex the knee -Knee external rotation Semitendinosus Origin Ischial tuberosity Insertion Medial tibia Semimembranosus Origin Ischial tuberosity Insertion Post. med. condyle of tibia and posterior capsule Adductor Magnus Origin Inferior public ramus, ischial ramus, ischial Innervation Tibial division of Sciatic n. (L5-S2) Blood Supply Inferior gluteal a. Perforating arteries Actions -Extends the hip -Flex the knee -Knee interal rotation Innervation Tibial division of Sciatic n. (L5-S2) Actions -Extends the hip -Flex the knee Blood Supply Profunda femoris a. **Some fibers loop back to form Oblique Popliteal Ligament Innervation Tibial division of Sciatic n. (L4) Actions -Adducts the hip -Extends the hip tuberosity Blood Supply Obturator a. Insertion Medial epicondyle of the femur Popliteus Origin Lateral condyle of the femur Insertion Posteriomedial tibia Innervation Tibial n. (L4-S1) Blood Supply Popliteal a. Actions -Stabilizer of knee during internal knee rotation -Flex the knee Anterior Thigh Muscles Tensor Fascia Latae Origin Iliac crest and ASIS Insertion Iliotibial Band Innervation Actions Superior gluteal -Flex the hip n. (L4-S1) -Abduct the hip Blood Supply -Medially Lateral rotate the hip circumflex -Stabilize femoral a. knee in Superior gluteal extension a. Sartorius Origin ASIS Insertion Medial tibia Iliopsoas Origin Psoas: IV discs of T12-L5 And TVP Iliacus: Iliac crest, iliac fossa, ala of sacrum, SI ligament Innervation Femoral n. (L2,L3) Blood Supply Femoral a. Innervation Anterior rami of L1-L3 Blood Supply Medial femoral circumflex a. Iliolumbar a. Actions -Flex the hip -Abduct the hip -Laterally rotate the hip -Flex the knee Actions -Flex the hip -(Laterally rotates the hip) Insertion Lessor trochanter Rectus Femoris (Quadriceps Femoris) Origin Two heads: AIIS and superior rim Innervation Femoral n. (L2L4) Actions -Extend the knee of acetabulum Insertion Tibial tuberosity Blood Supply Lateral femoral circumflex a. -Flex the hip Vastus Lateralis (Quadriceps Femoris) Origin Innervation Greater trochanter Femoral n. (L2and lateral lip of L4) linea aspera Blood Supply Insertion Femoral a. Tibial tuberosity Actions -Extend the knee Vastus Intermedius (Quadriceps Femoris) Origin Ant. and Lat. femur Innervation Femoral n. (L2L4) Actions -Extend the knee Insertion Tibial tuberosity Blood Supply Femoral a. Origin Intertrochanteric line and medial lip Innervation Femoral n. (L2L4) Vastus Medialis (Quadriceps Femoris) Actions -Extend the knee of linea aspera Insertion Tibial tuberosity Blood Supply Femoral a. Medial Thigh Muscles Pectineus Origin Superior ramus of pubis Insertion Inferior to lesser trochanter Adductor Longus Adductor Brevis Innervation Femoral n. (Obturator n. {L2L4}) Actions -Flex the hip -Adducts the hip Blood Supply Profunda femoral a. Medial femoral circumflex a. Origin Pubis, inferior to pubic crest Innervation Obturator n. (L2L4) Insertion Linea aspera (mid 1/3) Blood Supply Profunda femoral a. Medial femoral circumflex a. Origin Pubis, body and Innervation Obturator n. (L2- Actions -Adducts hip -(Extends the hip) -(Flexes the hip) -(Rotates the hip) Actions -Adducts the hip Gracilis **Obturator Externus and Adductor Magnus are included in the above sections, but are still located in the medial thigh region inf. ramus L4) Insertion Prox. linea aspera Blood Supply Profunda femoral a. Medial femoral circumflex a. Origin Body and inf. ramus of pubis Innervation Obturator n. (L2L3) Insertion Superior med. tibia Blood Supply Profunda femoral a. Medial femoral circumflex a. -(Flex the hip) -(Rotates the hip) Actions -Adducts the hip -Flexes the hip -Medially rotates the hip