ABMP: Kinesiology (cont. 2)

The Head, Neck, and Jaw

Terminology

Angle of the mandible - Located at the posterior portion of the base of the mandible; provides an attachment site for the masseter.

Anterior scalene - Anterior-most scalene muscle that elevates ribs during inhalation, flexes the neck, laterally flexes the neck to the same side, and rotates the head and neck to the opposite side. It attaches the transverse processes of C3–C6 to the first rib.

Articular disc (temporomandibular joint) - The articular disc is a thin, oval plate made from fibrous connective tissue and found between the condyle of the mandible and the mandibular fossa.

Atlanto-axial joint - The atlanto-axial joint is classified as a synovial pivot joint. It is formed by the articulation of the anterior arch of the atlas and the odontoid process of the axis (atlanto-odontoid joint), and by the articulations of the inferior facets of the atlas (C1) and the superior facets of the axis (C2). It allows flexion, extension, lateral flexion, and rotation.

Atlanto-occipital joint - The atlanto-occipital joint is classified as a condyloid synovial joint. It is formed by the articulations of the superior facets of the atlas (C1) and the occipital condyles, and allows flexion, extension, lateral flexion, and rotation.

Cervical intervertebral joints - Joints between the vertebrae of the cervical spine.

Cervical spine - A segment of the spinal column related to the neck and comprised of seven vertebrae named C1–C7.

Clenching - Conscious or subconscious contraction of the muscles that close the jaw.

Condyle (mandible) - A round bump on a bone where it forms a joint with another bone. The condyle of the mandible is just anterior to the ear canal and connects with the temporalis at the temporomandibular joint.

Coronal suture - Joint between the frontal and parietal bones that runs transversely across the skull and is held together by a thin layer of fibrous tissue.

Coronoid process (mandible) - A flattened triangular projection located anterior to the condyle of the mandible that serves as an attachment site for the temporalis muscle.

Deviation (jaw) - Shifting the jaw laterally.

Ethmoid bone - Bone of the cranium between the two orbits and superior to the nasal bone.

External auditory meatus - The external opening to the ear.

External occipital protuberance - A bony prominence on the posterior inferior surface of the occiput.

Fossa - A depression in a bone that accommodates a muscle or other anatomical structure.

Frontal bone - A bone of the skull commonly called the forehead.

Frontalis - Muscle of the forehead contiguous with the occipitalis; raises the eyebrows.

Grinding - Conscious or subconscious contraction of the jaw muscles accompanied by movement of the jaw that grinds the upper teeth against the lower.

Hyoid bone - A horseshoe-shaped bone located in the anterior midline of the neck between the base of the tongue and above the thyroid cartilage.

Inferior facets - Protrusion on the body of a vertebra that articulates with the superior facet of the vertebra beneath it.

Lacrimal bones - Two bones posterior to the nasal bones that form the medial border of the eye sockets.

Levator scapulae - The muscle from the superior angle of the scapula to the transverse processes of C1–C4; it elevates and downwardly rotates the scapula, laterally flexes and rotates the head and neck to the same side, and extends the head and neck.

Ligamentum nuchae - Large elastic ligament that extends from the spinous process of C7 to the external occipital protuberance.

Mandible - The skeletal structure of the lower jaw that is the only moveable bone of the skull.

Masseter - The primary muscle of mastication that elevates the mandible and attaches to the zygomatic arch; strongest muscle in the body relative to its size.

Mastoid process - Protrusion of the temporal bone directly behind the earlobe that is an attachment site for the sternocleidomastoid and other muscles.

Maxilla - Bone of the face superior to the mouth. There are two maxilla bones forming the upper jaw and palate of the mouth. The two halves are fused at the intermaxillary suture to form the upper jaw.

Mental foramen - A circular opening that allows for passage of nerves and blood vessels, and is located on the anterior surface of the mandible.

Middle scalene - Bilateral neck muscle that elevates the ribs during inhalation, laterally flexes the neck to the same side, and rotates the head and neck to the opposite side. Found lateral to the anterior scalene, it is the largest of the three scalenes.

Nasal bone - The skeletal structure of the nose.

Nuchal lines (occipital bone) - Superior and inferior ridges creating four curved lines on the external surface of the occipital bone. These lines extend from the external occipital protuberance to the ears and mastoid process, serving as attachment sites for many neck muscles.

Occipitalis - A muscle that arises on the superior attachment of the galea aponeurotica over the occiput and attaches on the inferior attachment of the galea aponeurotica and the superior nuchal line. It anchors the galea aponeurotica to the base of the cranium to secure it against the pull of the frontalis.

Occiput - Bone of the posterior cranium that joins with the atlas (C1).

Omohyoid - A strap-like muscle located on the anterior neck that depresses the hyoid. It consists of two bellies separated by an intermediate tendon.

Parietal bones - Two bones of the human skull (left and right) which, when joined together, form the sides and roof of the cranium.

Posterior scalene - Muscle of the lateral neck that connects to the second rib; elevates the ribs during inhalation, laterally flexes the neck to the same side when the ribs are fixed, and rotates the head and neck to the opposite side.

Ramus of the mandible - A flat, wide, vertically oriented portion of the mandible which has two processes along its superior border. One is the flat, wide mandibular condyle located posteriorly to the pointed coronoid process which provides the attachment site for the temporalis.

Skull - The skeletal structure of the cranium.

Sphenoid - A butterfly-shaped bone that serves as a bridge between the cranium and facial bones.

Splenius capitis - Muscles of the upper back and posterior neck that rotate the head to the same side, and laterally flex and extend the head and neck. The muscle originates on the nuchal ligament and the spinous processes of C7–T4 and inserts on the mastoid process of the temporal bone and the occipital bone.

Sternocleidomastoid - Lateral anterior neck muscle that flexes the neck, laterally flexes the neck and head to the same side, and rotates the neck to the opposite side.

Styloid process of the temporal bone - Fang-like protrusion from the temporal bone which serves as an attachment site for several muscles and ligaments.

Submandibular fossa - Depression on the underside of the mandible that serves as an attachment site for the suprahyoid muscles and the anterior belly of the digastric muscle.

Suboccipitals - Eight small muscles that are deep in the posterior neck and provide stabilization and subtle movements of the head. The suboccipitals include rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis superior, and obliquus capitis inferior.

Sutures - Joints between cranial bones held together by a thin layer of fibrous tissue.

Temporal bone - Cranial bones on the lateral anterior aspect of the cranium.

Temporal lines of the parietal bones - Horizontal ridges superior to the ears that serve as an attachment site for the temporalis muscle.

Temporalis - Muscle on the temporal aspect of the cranium that elevates and retracts the mandible.

Temporomandibular joint (TMJ) - The temporomandibular joint is classified as a synovial modified hinge joint. It is formed by the articulation of the temporal bone and the mandible. It allows elevation, depression, protraction, retraction, left and right deviation, anterior glide, and posterior glide.

Trapezius - Large muscle of the upper back; upper fibers bilaterally extend the head and neck; unilaterally, they laterally flex and rotate the head and neck to the same side, elevate and upwardly rotate the scapula; middle fibers adduct and stabilize the scapula; lower fibers depress and upwardly rotate the scapula.

Vomer - Small facial bone that forms the inferior portion of the nasal septum.

Zygomatic arch - The cheekbone formed by the zygomatic process of the temporal bone and the temporal process of the zygomatic bone.

Zygomatic bone - Facial bone forming the arch of the cheeks.

Practice Quiz

1. An abnormal, forced closure of the jaw is called:

a. tension

b. TMJ syndrome

c. grinding

d. clenching

2. Where is the frontalis muscle?

a. the anterior neck

b. the mouth

c. the forehead

d. the sternum

3. The vertical part of the mandible is called the:

a. pars verticalis

b. ramus

c. coronoid process

d. mandibular angle

4. The joints between the articular processes of adjacent vertebrae are called the:

a. intervertebral discs

b. sacral joints

c. intervertebral joints

d. menisci

5. The bridge of the nose is formed mainly by the:

a. lacrimal bone

b. nasal bones

c. frontal bone

d. ethmoid bone

6. The cranial bone that contains the mastoid process and the structures of the middle and inner ear is the:

a. occipital bone

b. cochlear bone

c. temporal bone

d. sphenoid bone

7. The strap muscle that connects the scapula to the hyoid bone is the:

a. chondrohyoid

b. scapulohyoid

c. sternohyoid

d. omohyoid

8. Which ligament attaches the superior trapezius to the spinous processes of the cervical vertebrae?

a. cervical spinal ligament

b. ligamentum nuchae

c. thoracolumbar ligament

d. supraspinous ligament

9. While performing a postural assessment on your client, you observe forward-head posture and kyphosis of the spine. Your client reports frequent headaches (2–3 times per week) and intermittent tingling and numbness in the hands and fingers, specifically in the region of the thumb and forefinger. Which muscle or group of muscles would be of primary focus in an effective treatment plan?

a. middle trapezius

b. suboccipitals

c. pectoralis major

d. scalenes

10. The anterior of two projections from the superior end of the mandibular ramus is the:

a. mental eminence

b. mandibular condyle

c. articular process

d. coronoid process

11. The most superficial muscle of the upper back and neck is the:

a. trapezius

b. splenius capitis

c. epicranius

d. latissimus dorsi

12. What is the origin of the serratus anterior muscle?

a. transverse processes of T1-T12

b. ribs 1-9

c. ribs 3-5

d. lateral border of the sternum

13. The muscle of the jaw that covers the ramus of the mandible and attaches to the zygomatic arch is the:

a. mandibularis

b. temporalis

c. levator anguli oris

d. masseter

14. The facial bone forming the arch of the cheeks is the:

a. maxilla

b. zygomatic bone

c. sphenoid bone

d. temporal bone

15. The fibrocartilage structure shaped to improve the fit between the bones of a synovial joint is the:

a. synovial capsule

b. amphiarthrotic disc

c. articular disc

d. symphysisth

16. What type of joints are the temporomandibular joints?

a. amphiarthrotic

b. synovial hinge

c. ball and socket

d. synarthrotic

17. The joint between the first cervical vertebra and the second cervical vertebra is called the:

a. atlanto-axial joint

b. intercervical joint

c. atlanto-occipital joint

d. axio-atlantal joint

18. The muscle from the superior angle of the scapula to the transverse processes of C3–C5 is the:

a. anterior scalene

b. levator costarum

c. middle scalene

d. levator scapulae

19.

20.

21.

Practice Quiz Answer Key

1. D

2. C

3. B

4. C

5. B

6. C

7. D

8. B

9. D

10. D

11. A

12. B

13. D

14. B

15. C

16. B

17. A

18. D

19.

20.

21.

The Pelvis and Hip

Terminology

Acetebulum (pelvis) - A concave surface of the pelvis that articulates with the head of the femur and inserts into the pelvis to form the hip joint.

Adductor brevis - A muscle of the medial thigh, situated deep to the pectineus and adductor longus, that adducts and medially rotates the hip and attaches to the uppermost part of the linea aspera.

Adductor longus - A superficial muscle of the medial thigh that adducts and medially rotates the hip and has an easily palpated tendon at the pubic tubercle.

Adductor magnus - The largest of the medial thigh muscles that adducts, medially rotates, and extends the hip.

Anterior inferior iliac spine - Bony prominence on the anterior inferior surface of the iliac spine.

Anterior sacroiliac ligament - Ligament that connects the sacrum to the ilium on the anterior aspect of the sacrum.

Anterior super iliac spine - Bony prominence on the anterior superior surface of the iliac spine.

Coccyx - A small bone that articulates with the sacrum and usually consists of four fused vertebrae that form the terminus of the spinal column.

Coxofemoral joint - Another term for the joint between the coxae and the femur (hip joint).

Femoral neck - The narrowed portion of the femur between the body and the head.

Femur - A bone in the leg extending from the pelvis to the knee; it is the longest, largest, and strongest in the body.

Gluteal tuberosity (femur) - A small ridge on the posterior femur distal to the greater trochanter that serves as an attachment site for the lower fibers of the gluteus maximus.

Gluteus maximus - The largest and most superficial of the three gluteal muscles that extends, laterally rotates, and abducts the hip; lower fibers adduct the hip. Known as the largest muscle in human body.

Gluteus medius - One of three gluteal muscles (deep to, and partially covered by, the gluteus maximus) that abducts, flexes, extends, and medially and laterally rotates the hip.

Gluteus minimus - The smallest and deepest of the three gluteal muscles. Situated immediately beneath the gluteus medius, it abducts, medially rotates, and flexes the hip.

Greater trochanter (femur) - The larger lateral projection between the shaft and the neck of the femur; serves as the attachment site for the gluteus medius, gluteus minimus, and the deep rotator muscles.

Hip joint - A general term for the coxofemoral joint that is formed by the head of the femur and the acetabulum of the pelvis.

Iliac crest - The superior ridge of the ilium that serves as an attachment site for many muscles. It stretches posteriorly from the anterior superior iliac spine (ASIS) to the posterior superior iliac spine (PSIS).

Iliac tubercle - The widest point of the iliac crest; serves as an attachment site for the iliotibial tract/band.

Iliacus - This muscle—deep to abdominal organs—flexes, laterally rotates, and adducts the hip, and fills the iliac fossa.

Iliofemoral ligament - Thick ligament that connects from the anterior inferior iliac spine to the intertrochanteric line of the femur.

Iliolumbar ligament - Extends from the transverse process of the 5th lumbar vertebra to the posterior iliac crest; helps to stabilize L5 on the sacrum.

Ilium - The two large wings of the pelvis, which articulate with the sacrum posteriorly.

Interosseous sacroiliac ligament - A ligament deep to the posterior sacroiliac ligament that stabilizes the sacroiliac joint.

Intertrochanteric crest (femur) - A bony ridge located on the posterior side of the head of the femur that runs obliquely downward and medially from the summit of the greater trochanter to the lesser trochanter.

Intertrochanteric line (femur) - A raised surface on the anterior femur running between the greater and lesser trochanters that marks where the articular capsule of the coxal joint attaches. The iliofemoral ligament (the largest ligament of the human body) attaches above the line which strengthens the capsule of the hip joint.

Ischial spine (ischium) - A projection of the ischium just inferior to the greater sciatic notch.

Ischial tuberosity (ischium) - The most inferior protuberance of the ischium and the common origin of the hamstring.

Ischiofemoral ligament - Attaches from the ischial aspect of the acetabulum to the superior portion of the neck of the femur.

Ischium - The posterior inferior portion of the pelvis that articulates with the ilium and the pubis.

Labrum - A ring of fibrocartilage forming a lip, edge, or brim around the edge of an articular joint. Examples include the glenoid labrum in the shoulder joint and the acetabular labrum in the hip joint.

Lesser trochanter (femur) - A smaller prominence on the posterior medial aspect of the femur, inferior and medial to the greater trochanter between the shaft and neck of the femur; serves as an attachment site for the psoas and iliacus muscles.

Ligamentum teres - Ligament inside the joint capsule of the hip that connects from the acetabular notch to the fovea capitis of the femoral head.

Linea aspera (femur) - The ridge that runs vertically along the center of the posterior aspect of the femur.

Obturator foramen - An opening formed by the superior and inferior rami of the pubis and ischium.

Pectineus - Muscle of the groin/inner thigh that adducts, medially rotates, and assists to flex the hip; smallest of the hip adductors.

Pelvis - Bowl-like structure formed by the two fused coxae and the sacrum.

Piriformis - Deep muscle of the hip that runs from the anterior sacrum to the greater trochanter, and laterally rotates the hip and abducts the thigh when the hip is flexed.

Posterior inferior iliac spine (ilium) - A projection on the posterior margin of the ilium that is situated below the posterior superior iliac spine.

Posterior sacroiliac ligament - Ligament that connects the sacrum to the ilium on the posterior portion of the sacrum.

Posterior superior iliac spine (ilium) - A projection on the posterior margin of the ilium that is situated above the posterior inferior iliac spine.

Psoas - Psoas major is a muscle deep to abdominal contents; flexes, laterally rotates, and adducts the hip. Psoas minor is present in roughly 40% of the population; assists in upward rotation of the pelvis, in opposition to psoas major. The psoas attaches to the lumbar vertebrae and inserts on the lesser trochanter.

Pubic symphysis joint - The fibrocartilaginous joint between the two coxae (also called the symphysis pubis).

Pubic tubercle - Small, horn-shaped prominences on the upper medial pubis that serve as attachment sites for the adductor longus muscle and the inguinal ligament.

Pubis - The anterior inferior portion of the coxae.

Pubofemoral ligament - This ligament is attached, above, to the obturator crest and the superior ramus of the pubis; below, it blends with the capsule and with the deep surface of the vertical band of the iliofemoral ligament.

Quadratus group - The four muscles of the quadriceps group: rectus femoris (extends the knee and flexes the hip), vastus medialis, vastus lateralis, and vastus intermedius (all vastus muscles extend the knee).

Ramus of the ischium - A projection of the ischium that is contiguous with the inferior ramus of the pubis and helps to form the obturator foramen.

Sacroiliac joint - Two compound joints (one on each side) consisting of an anterior synovial gliding joint (formed between the surface of the sacrum and ilium) and a posterior syndesmosis joint (formed between the sacrum and ilium) that allow for nonaxial gliding movements.

Sacroiliac ligament - A strong ligament with five ligamentous bands arising from each sacral segment that binds both the front (anterior sacroiliac ligament) and the back (posterior sacroiliac ligament) sides of the sacrum to the ilium.

Sacrospinous ligament - Along with the sacrotuberous ligament, this ligament stabilizes the sacroiliac joint; connects from anterior portion of the sacrum to the ischium.

Sacrotuberous ligament - Along with the sacrospinous ligament, this ligament stabilizes the sacroiliac joint; connects from the anterior portion of the sacrum to the ischium.

Sacrum - Along with the sacrospinous ligament, this ligament stabilizes the sacroiliac joint; connects from the anterior portion of the sacrum to the ischium.

Tensor fascia latae - Small, superficial muscle on the lateral upper thigh that flexes, medially rotates, and abducts the hip, and stabilizes the knee.

Practice Quiz

1. The pubic symphysis is a ____ joint.

a. synovial joint

b. saddle joint

c. condyloid

d. fibrocartilaginous

2. Which of the following laterally rotates the hip?

a. rectus femoris

b. quadratus lumborum

c. vastus lateralis

d. quadratus femoris

3. A small ridge distal to the greater trochanter that serves as an attachment site for the lower fibers of the gluteus maximus is the:

a. anterior inferior iliac spine

b. gluteal tuberosity

c. ischial ramus

d. ischial tuberosity

4. The strongest ligament of the hip joint, running from the anterior inferior iliac spine (AIIS) to the intertrochanteric line is the:

a. pubofemoral ligament

b. sacrotuberous ligament

c. iliotrochanteric ligament

d. iliofemoral ligament

5. What part of the iliopsoas attaches at the anterior portion of the 12th thoracic vertebra and all lumbar vertebrae?

a. iliacus

b. psoas major

c. psoas minor

d. psoas intermedius

6. Which is not true of the sacroiliac ligament?

a. is it very strong

b. it has five ligamentous bands arising from each sacral segment

c. it is anterior to the sacrum and ilium

d. it has anterior and posterior bands

7. The intertrochanteric crest:

a. connects the femoral condyles

b. is the insertion of the gluteus medius

c. runs from the greater to the lesser trochanter

d. is on the anterior proximal femur

8. The ilium is the:

a. lower half of the pelvic bone

b. posterior part of the lower pelvis

c. upper half of the pelvic bone

d. a section of the small intestine

9. A projection on the posterior margin of the ilium that is situated above the posterior inferior iliac spine is the:

a. posterior superior iliac spine

c. iliac tubercle

c. posterior inferior iliac spine

d. iliac spine

10. If you were a Roman anatomist, what might you call the pubic symphysis?

a. symphysis pubis

b. symphysis publius

c. symphysis surae

d. nero

11. The gluteal tuberosity is the femoral attachment of the:

A:Gluteus medius

B:Gluteus maximus

C:Vastus medialis

D:Biceps femoris

12. The movement of the femur in the frontal plane away from the midline of the body is called:

A:Adduction

B:Rotation

C:Abduction

D:Lateral flexion

13. Which two muscle groups are oppositionally hypertonic in the postural deviation of posterior pelvic tilt?

A:Hamstrings and abdominals

B:Hamstrings and gluteals

C:Hip adductors and abdominals

D:Hip flexors and spine extensors

14. The ligament that is completely inside the hip joint is the:

A:Acetabular ligament

B:Annular ligament

C:Ligamentum nuchae

D:Ligamentum teres

15. The ischial tuberosity:

A:Is a sharp spine on the posterior ischium

B:Is the proximal attachment of the adductor longus

C:Is the common origin of the hamstrings

D:Connects the ischium to the pubis

16. What is the only muscle that crosses the sacroiliac joint?

A:Gluteus minimus

B:Quadratus femoris

C:Obturator internus

D:Piriformis

17. The most heavily ligamented joint in the human body is the:

A:Knee joint

B:Hip joint

C:Ankle joint

D:Sacroiliac joint

18. The movement of the femur in the frontal plane toward the midline of the body is called:

A:Abduction

B:Adduction

C:Lateral flexion

D:Rotation

19. The hip flexor that fills the iliac fossa and sits deep to the abdominal organs is the:

A:Psoas major

B:Internal obturator

C:Gluteus minimus

D:Iliacus

20. The lesser trochanter is:

A:On the lateral femur

B:An attachment for the gluteus maximus

C:An attachment for the iliopsoas

D:On the anterior femur

21. Lateral rotation:

A:Occurs in the frontal plane

B:Occurs at the sacroiliac joint

C:Is movement of the posterior surface of the femur away from the midline

D:Is movement of the anterior surface of the femur away from the midline

22. Where is the iliac tubercle found?

A:Iliac crest

B:Iliac fossa

C:Superior gluteal line

D:Gluteal fossa

23. The fibrocartilaginous joint between the two coxae at the midline is the:

A:Pubic symphysis joint

B:Femoroacetabular joint

C:Ischiopubic ramus

D:Intercoxal joint

24. The sharp, bony projection on the posterior superior ischium is the:

A:Styloid process

B:Ischial spine

C:PSIS

D:Ischial tuberosity

25. The bowl-shaped structure formed by the two pelvic bones and the sacrum is the:

A:Iliac fossa

B:Gluteal cavity

C:Obturator fossa

D:Pelvis

26. What is the insertion of the iliopsoas?

A:Inferior borders of ribs 9–12

B:Greater trochanter of the femur

C:Vertebral bodies of all lumbar vertebrae

D:Lesser trochanter of the femur

27. The large foramen in the lower half of the pelvis is the:

A:Sacral foramen

B:Pelvic foramen

C:Ischial hiatus

D:Obturator foramen

28. The ligament connecting the lower lumbar vertebrae to the ilium is the:

A:Iliospinous ligament

B:Iliolumbar ligament

C:Sacroiliac ligament

D:Interspinous ligament

29. Which joint is partly fibrous and partly synovial:

A:Tibiofibular joint

B:Sacroiliac joint

C:Interosseous membrane

D:Hip joint

30. The sacroiliac joint is which type of joint?

A:Condyloid

B:Gliding

C:Saddle

D:Cartilaginous

31. The deep six lateral rotators all insert on some portion of the:

A:Greater trochanter of the femur

B:Iliac crest

C:Coccyx

D:Lateral border of the sacrum

32. The smallest of the hip adductors is the:

A:Pectineus

B:Quadratus femoris

C:Gluteus minimus

D:Adductor brevis

33. The rough line on the shaft of the posterior femur is the:

A:Arcuate line

B:Linea alba

C:Intertrochanteric line

D:Linea aspera

34. The muscle that runs from the anterior sacrum to the greater trochanter is the:

A:Internal obturator

B:Sciaticus

C:Piriformis

D:Quadratus femoris

35. The small bone composed of fused vertebrae attached to the caudal end of the sacrum is the:

A:Pubis

B:Sacral promontory

C:Sacral crest

D:Coccyx

36. The psoas major flexes, laterally rotates, and ____ the hip.

A:Abducts

B:Adducts

C:Depresses

D:Elevates

37. The fibrocartilage lip that enlarges and deepens a joint socket is the:

A:Annulus fibrosus

B:Symphysis

C:Labrum

D:Articular disc

38. The ligament that wraps over the neck of the femur and attaches deep to the iliofemoral ligament is the:

A:Ligamentum teres

B:Ischiofemoral ligament

C:Acetabulofemoral ligament

D:Pubofemoral ligament

39. The largest muscle in the human body is considered to be the:

A:Gluteus maximus

B:Adductor magnus

C:Latissimus dorsi

D:Vastus lateralis

40. The largest hip adductor is the:

A:Adductor magnus

B:Gluteus maximus

C:Adductor longus

D:Sartorius

41. The largest bone in the human body is considered to be the:

A:Pelvic bone

B:Tibia

C:Skull

D:Femur

42. The pubis is the:

A:Anterior inferior portion of the coxae

B:Superior half of the pelvic bone

C:Anterior superior part of the pelvic bone

D:Posterior one-third of the pelvic bone

43. Which muscle is the prime mover of flexion of the hip?

A:Rectus abdominis

B:Iliopsoas

C:Vastus intermedius

D:Rectus femoris

Practice Quiz Answer Key

1. D

2. D

3. B

4. D

5. B

6. C

7. C

8. C

9. A

10. A

11. B

12. C

13. A

14. D

15. C

16. D

17. D

18. B

19. D

20. C

21. D

22. A

23. A

24. B

25. D

26. D

27. D

28. B

29. B

30. B

31. A

32. A

33. D

34. C

35. D

36. B

37. C

38. B

39. A

40. A

41. D

42. A

43. B

44.

45.

46.

47.

48.

49.

50.

The Thigh and Knee

Terminology

Adductor tubercle (femur) - Prominence on the distal medial end of the femur that serves as an attachment site for the adductor magnus.

Anterior cruciate ligament - A ligament that connects the anterior intercondylar surface of the tibia to the posterior medial surface of the lateral femoral condyle; prevents anterior displacement of the tibia, posterior displacement of the femur, and hyperextension of the knee.

Biceps femoris long head - Superficial hamstring muscle that originates on the ischial tuberosity and inserts on the head of the fibula and lateral condyle of the tibia; it flexes the knee, laterally rotates the flexed knee, extends and laterally rotates the hip, and tilts the pelvis posteriorly.

Biceps femoris short head - Deep hamstring muscle that originates on the lateral lip of the linea aspera and joins the long head to insert on the head of the fibula and lateral condyle of the tibia; it flexes the knee, laterally rotates the flexed knee, extends and laterally rotates the hip, and tilts the pelvis posteriorly.

Femur - A bone in the leg extending from the pelvis to the knee; it is the longest, largest, and strongest in the body.

Fibula - The more lateral long bone of the lower leg.

Fibular collateral ligament - This ligament runs from the lateral epicondyle of the femur to the head of the fibula, stabilizing the knee joint from excessive lateral movement; also called the lateral collateral ligament.

Gerdy's tubercle - This projection of bone on the lateral aspect of the proximal tibia serves as an attachment site for the iliotibial tract/band; also called the tibial tubercle.

Gracilis - Inner thigh muscle that adducts and medially rotates the hip, and flexes and medially rotates the knee. It originates on the inferior pubic ramus and inserts on the pes anserinus.

Head of the fibula - The superior end of the fibula.

Lateral condyle (femur) - The protuberance at the distal lateral end of the femur bone.

Lateral epicondyle (femur) - The roughened surface just superior to the lateral condyle of the femur.

Linea aspera (femur) - The ridge that runs vertically along the center of the posterior aspect of the femur.

Medial condyle (femur) - The protuberance at the distal medial end of the femur bone.

Medial epicondyle (femur) - The roughened surface just superior to the medial condyle of the femur.

Menisci - Fibrocartilaginous discs attached to the tibial condyles that aid in weight distribution, reduce joint friction, and help the round femoral condyles sit comfortably on the flat tibial plateaus.

Patella - The kneecap.

Patellar ligament - The distal portion of the common tendon of the quadriceps femoris, which is continued from the patella to the tibial tuberosity.

Patellofemoral joint - A synovial joint formed between the posterior surface of the patella and the intercondylar groove of the femur that allows gliding movements of the patella along the femur. With the tibiofemoral joint, it is located within the joint capsule of the knee.

Pes anserinus - The conjoined tendons of three muscles (sartorius, gracilis, and semitendinosus) that insert onto the medial aspect of the tibial tuberosity; also called a "goose foot."

Posterior cruciate ligament - A ligament that connects the posterior intercondylar surface of the tibia to the lateral aspect of the medial femoral condyle. It restricts posterior displacement of the tibia and anterior displacement of the femur.

Rectus femoris - The longest, most superficial quadriceps muscle that extends the knee and flexes the hip.

Sartorius - Longest muscle in the body, extending from pelvis to lower leg; flexes, laterally rotates, and abducts the hip.

Semimembranosus - The most medial of the three hamstring muscles that flexes the knee, medially rotates the flexed knee, extends and medially rotates the hip, and tilts the pelvis posteriorly. It originates on the ischial tuberosity and inserts on the posterior medial tibial condyle.

Semitendinosus - One of the three hamstring muscles notable for the length of its tendon insertion on the pes anserinus. It flexes the knee, medially rotates the flexed knee, and extends the hip.

Sesamoid bone - A bone embedded within a tendon or a muscle. The largest sesamoid bone is the patella found within the quadriceps tendon, but sesamoid bones can be found on joints throughout the body including the hands, feet, and wrist. Oftentimes, sesamoid bones form in response to strain by creating a smooth surface for tendons to slide over, increasing the tendon's ability to transmit muscular forces.

Shaft of the femur - The main, long portion of the femur bone; the body.

Tibia - The larger, more medial weight-supporting bone of the lower leg.

Tibial collateral ligament - This ligament runs from the proximal medial epicondyle of the femur to the medial surface of the tibia; it stabilizes the knee to prevent excessive medial movement and anterior displacement of the tibia; also called the medial collateral ligament.

Tibial condyles - Inferior to the tibial plateau, two round projections on the tibia serve as insertion sites for the distal hamstring tendons. The medial tibial condyle is the insertion site for the semimembranosus muscle, while the lateral tibial condyle is the insertion site for the biceps femoris muscle (which also inserts on the fibula).

Tibial plateau - Medial and lateral flattened portions on the proximal end of the tibia.

Tibial tubercle - This projection of bone on the lateral aspect of the proximal tibia serves as an attachment site for the iliotibial tract/band; also called Gerdy's tubercle.

Tibial tuberosity - The superficial protuberance on the anterior proximal shaft of the tibia; serves as an attachment site for the patellar ligament.

Tibiofemoral joint - A synovial hinge joint commonly called the knee (it shares the same joint capsule as the patellofemoral joint), formed between the condyles of the tibia and the condyles of the femur that allows flexion and extension. With the patellofemoral joint, it is located within the joint capsule of the knee.

Trochlear groove (femur) - A concave region of the distal anterior femur that accommodates the patella. Also called the trochlear notch.

Vastus intermedius - The smallest of the four quadriceps muscles—located between the vastus lateralis and vastus medialis—that extends the knee.

Vastus lateralis - The largest and strongest of the four quadriceps muscles—located on the lateral aspect of the anterior thigh—that extends the knee.

Vastus medialis - One of the four quadriceps muscles—located medially in the thigh—that extends the knee.

Practice Quiz

1. Which term best describes rotation of the anterior surface of the tibia away from the midline of the body?

a. medial rotation

b. abduction

c. internal rotation

d. lateral rotation

2. Which head of the hamstrings does not originate at the ischium, but rather from the posterior femur?

a. short head of the biceps femoris

b. semimembranosus

c. long head of biceps femoris

d. semitendinosus

3. Which term best describes a ligament that runs from the medial epicondyle of the femur to the proximal medial tibia?

a. posterior cruciate

b. anterior cruciate

c. tibial collateral

d. popliteal

4. Which is the largest and strongest of the four quadriceps?

a. rectus femoris

b. vastus lateralis

c. vastus intermedius

d. vastus medialis

5. Which term best describes rotation of the anterior surface of the tibia toward the midline of the body?

a. lateral rotation

b. abduction

c. external rotation

d. medial rotation

6. Which term could be used to refer to the knee joint?

a. synovial modified hinge joint

b. ball-and-socket joint

c. ellipsoid joint

d. synovial modified gliding joint

7. What is the rough, low ridge along the posterior femur and serves as an attachment site for the hip adductors?

a. pectineal line

b. linea aspera

c. adductor tubercle

d. ischial tuberosity

8. Which term refers to the prominence at the superior end of the fibula?

a. shaft of fibula

b. body of fibula

c. head of the fibula

d. fibula malleolus

9. Which term refers to the proximal expansion of the tibia?

a. tibial tuberosity

b. medial tibial condyle

c. medial tibial epicondyle

d. tibial plateau

10. Which term refers to the thigh bone that is considered to be the largest bone of the human body?

a. tibia

b. femur

c. fibula

d. patella

11. Which muscle is considered to be the longest muscle in the human body?

A:Gracilis

B:Adductor longus

C:Sartorius

D:Rectus femoris

12. Your client sustained an injury while playing soccer when he had to make a sudden forward stop that forced his knee into hyperextension. Which ligament of the tibiofemoral joint most likely took the brunt of the damage due to the sudden force placed upon it?

A:Anterior cruciate ligament

B:Tibial collatoral ligament

C:Fibular collatoral ligament

D:Posterior cruciate ligament

13. Which is the largest and strongest of the four quadriceps?

A:Rectus femoris

B:Vastus intermedius

C:Vastus medialis

D:Vastus lateralis

14. Which term refers to concave, semicircular fibrocartilaginous discs on the tibial condyles?

A:Intervertebral disc

B:Acetabular labrum

C:Menisci

D:Glenoid labrum

15. Which term best describes the lateral long bone of the leg?

A:Femur

B:Fibula

C:Patella

D:Tibia

16. Which term best describes the weight supporting bone of the leg?

A:Fibula

B:Tibia

C:Navicular

D:Calcaneus

17. Which term refers to the distal portion of the common tendon of the quadriceps femoris, which is continued from the patella to the tibial tuberosity?

A:Medial collateral ligament

B:Medial extensor tendon

C:Patellar ligament

D:Lateral collateral ligament

18. What action do the quadriceps have at the knee?

A:Extension

B:Medial rotation

C:Flexion

D:Lateral rotation

19. What is the quadriceps muscle located medially in the thigh?

A:Vastus intermedius

B:Vastus medialis

C:Rectus femoris

D:Vastus lateralis

20. Which muscle is the longest quadriceps muscle?

A:Vastus intermedius

B:Vastus lateralis

C:Rectus femoris

D:Vastus medialis

Practice Quiz Answer Key

1. D

2. A

3. C

4. B

5. D

6. A

7. B

8. C

9. D

10. B

11. C

12. A

13. D

14. B

15. B

16. B

17. C

18. A

19. B

20. C

21.

The Leg, Ankle, and Foot

Terminology

Ankle - A general term for the region where the leg meets the foot; associated with the talocrural joint (considered the true ankle joint), the subtalar joint, and the distal tibiofibular joint.

Anterior talofibular ligament - Ligament on the anterior aspect of the ankle that connects the talus to the fibula.

Base (toes) - The more proximal end of the toes.

Calcaneofibular ligament - Ligament that connects the calcaneus to the fibula.

Calcaneus - The heel bone of the foot.

Cuboid - One of the seven tarsal bones of the foot.

Cuneiforms - Three wedge-shaped bones in the foot (medial, intermediate, and lateral).

Deep posterior compartment - Compartment in the deep posterior aspect of the leg that contains the popliteus, tibialis posterior, flexor hallicus longus, and flexor digitorum longus muscles.

Deltoid ligament - A collection of several ligaments that originate from the medial malleolus and fan out to attach to the talus, sustentaculum tali on the calcaneus, and the navicular.

Extensor digitorum longus - Muscle of the lower leg that extends the second through fifth toes, dorsiflexes the ankle, and everts the foot.

Extensor hallucis longus - Muscle of the lower leg that extends the first toe, dorsiflexes the ankle, and inverts the foot.

Fibula - The more lateral long bone of the lower leg.

Flexor digitorum longus - Muscle of the lower leg, in the deep posterior compartment, that flexes the second through fifth toes, weakly plantar flexes the ankle, and inverts the foot.

Flexor hallucis longus - Muscle of the lower leg, in the deep posterior compartment that flexes the first toe, weakly plantar flexes the ankle, and inverts the foot.

Flexor retinaculum - A broad band of connective tissue spanning from the medial calcaneus to the medial malleolus.

Foot - Structure below the ankle that supports the weight of the body and enables walking and other movement.

Gastrocnemius - Calf muscle of the lower leg that flexes the knee and plantar flexes the ankle.

Inferior extensor retinaculum - Y-shaped band of connective tissue that begins distal to the lateral malleolus on the calcaneus; one fork attaches to the medial malleolus, the other attaches to the navicular.

Inferior fibular retinaculum - A connective tissue band that anchors the peroneal tendons down at the peroneal tubercle; also called the inferior peroneal retinaculum.

Interosseous membrane - Tough, fibrous membrane between the tibia and fibula.

Interphalangeal joint (foot) - A synovial hinge joint formed between the proximal, medial, and distal phalanges that allows flexion and extension of the toes.

Intertarsal joint - A synovial gliding joint formed between the cuneiforms, navicular, and cuboid bones that contributes to foot stability and mobility.

Lateral longitudinal arch - Arch of the foot located on the lateral aspect, created by the calcaneus, cuboid, and the two lateral metatarsals.

Lateral malleolus (fibula) - Protuberance on the distal end of the fibula.

Leg - Refers to the lower leg, distal to the knee.

Medial longitudinal arch - Arch of the foot located on the medial aspect, created by the calcaneus, talus, navicular, cuneiforms, and medial three metatarsals.

Medial malleolus (tibia) - The protuberance on the distal end of the tibia.

Metatarsals - The five bones of the foot between the toes and the ankles that make up the distal part of the longitudinal arches.

Metatarsophalangeal joint - A synovial ellipsoid joint formed between the metatarsals and the proximal phalanges that allows flexion, extension, abduction (lateral rotation), and adduction (medial rotation).

Middle tibiofibular joint - A syndesmosis joint formed between shafts of the tibia and fibula through the interosseous membrane. Works in combination with the proximal and distal tibiofibular joints to allow gliding movements.

Navicular - A bone on the medial aspect of the ankle.

Peroneus brevis - The shorter of the two muscles of the lateral lower leg that everts the foot and assists in plantar flexion of the ankle. Also commonly called the fibularis brevis.

Peroneus longus - The longer of the two muscles of the lateral lower leg that everts the foot and assists in plantar flexion of the ankle. Also commonly called the fibularis longus.

Phalanges - The bones of the fingers and toes. There are three phalanges (distal, middle, proximal) for each digit, except the thumbs and large toes.

Posterior talofibular ligament - Ligament on the posterior aspect of the ankle that connects the talus to the fibula.

Proximal tibiofibular joint - A synovial gliding joint formed between the proximal articulations of the tibia and fibula. Works in combination with the middle and distal tibiofibular joints to allow gliding movements.

Soleus - "Calf" muscle of the lower leg deep to the gastrocnemius that plantar flexes the ankle.

Styloid process of the fifth metatarsal - A bony prominence on the lateral aspect of the base of the 5th metatarsal that serves as an attachment site for peroneus brevis; also referred to as a tuberosity.

Subtalar joint - A complex synovial ellipsoid joint formed by three separate articulations of the inferior talus and the superior calcaneus; allows inversion, eversion, abduction (lateral rotation), and adduction (medial rotation).

Superior extensor retinaculum - Broad band of connective tissue that crosses the anterior ankle proximal to the malleoli.

Superior fibular retinaculum - A connective tissue band that stretches from the lateral malleolus to the calcaneus; also called the superior peroneal retinaculum.

Talocrural joint - A synovial hinge joint commonly referred to as the ankle, formed between the articulations of the tibia, fibula, and talus that allows dorsiflexion and plantar flexion.

Talus - Bone of the ankle that connects with the tibia and fibula to form the talocrural joint.

Tarsal bones - The seven bones of the ankle.

Tarsometatarsal joint - Five synovial gliding joints located between the distal row of tarsal bones and the metatarsal bones; allows dorsiflexion, plantar flexion, inversion, and eversion. The first tarsometatarsal joint (TMT) is located between the first cuneiform and the base of the first metatarsal. The second TMT is between the second cuneiform and the base of the second metatarsal. The third TMT is between the third cuneiform and the base of the third metatarsal. The forth TMT is between the cuboid and the base of the forth metatarsal. The fifth TMT is between the cuboid and the base of the fifth metatarsal.

Tibia - The larger, more medial weight-supporting bone of the lower leg.

Tibialis anterior - Muscle of the anterior lower leg that inverts the foot and dorsiflexes the ankle.

Tibialis posterior - Deep muscle of the posterior lower leg that inverts the foot and plantar flexes the ankle.

Tibiofibular joint - Three articulations (proximal, middle, and distal) located between the tibia and the fibula that allow gliding movements between the fibula and tibia.

Transverse arch - Arch crossing from medial to lateral aspects of the foot, created by the cuboid and cuneiform bones.

Transverse tarsal joint - A compound synovial gliding joint composed of the talonavicular joint (located between the talus and the navicular bone) and the calcaneocuboid joint (located between the calcaneus and cuboid bones); allows pronation and supination. Through its close relationship with the subtalar joint, the transverse tarsal joints also allow inversion, eversion, abduction, and adduction.

Practice Quiz

1. The distal tibiofibular joint is:

a. a synovial pivot joint

b. a syndesmosis joint

c. a symphysis joint

d. another name for the interosseous membrane

2. Which of the following muscles is not in the deep posterior compartment of the leg?

a. flexor digitorum longus

b. flexor hallucis longus

c. soleus

d. tibialis posterior

3. What is the prime mover of plantar flexion at the ankle?

a. tibialis anterior

b. peroneus

c. gastrocnemius

d. soleus

4. What type of joint is the subtalar joint:

a. gliding joint

b. hinge joint

c. symphysis joint

d. condylar joint

5. What is the technical name of the ankle joint?

a. talocrural joint

b. tibiofemoral joint

c. metatarsal joint

d. tibiofibular joint

6. The muscle of the posterior compartment which runs to digits 2–5 is the:

a. flexor pollicus longus

b. flexor digitorum longus

c. flexor digitorum profundus

d. flexor digitorum brevis

7. Which term refers to movement of the intertarsal joints, facing the plantar surface of the foot medially?

a. inversion

b. abdcution

c. eversion

d. pronation

8. Which muscles are responsible for eversion of the foot?

a. deep posteriors

b. peroneals

c. tibials

d. triceps surae

9. Movement at the ankle joint, lowering the distal foot, is called:

a. dorsiflexion

b. inversion

c. plantar flexion

d. extension

10. The fibrous band whose ends both attach to the calcaneus, restraining the peroneus longus and brevis tendons is the:

a. superior fibular retinaculum

b. calcaneal ligament

c. inferior fibular retinaculum

d. flexor retinaculum

11. Which term refers to a movement at the tarsal joints, facing the plantar surface of the foot laterally?

A:Eversion

B:Pronation

C:Abduction

D:Inversion

12. The largest of the tarsals is the:

A:Talus

B:Calcaneus

C:Femur

D:Cuboid

13. The proximal part of the longitudinal arches of the foot consists of these seven bones:

A:Metatarsals

B:Phalanges

C:Tarsals

D:Carpals

14. An anatomical term for the true ankle joint would be the:

A:Tibiofemoral joint

B:Talocrural joint

C:Femoroacetabular joint

D:Cruciform joint

15. The tarsal bone that articulates directly with the tibia is the:

A:Talus

B:Navicular

C:Fibula

D:Calcaneus

16. The fibrous band that runs horizontally from the anterior fibula to the anterior tibia is the:

A:Interosseous membrane

B:Superior extensor retinaculum

C:Inferior extensor retinaculum

D:Transverse tarsal ligament

17. The bones of the toes are the:

A:Tarsals

B:Phalanges

C:Metatarsals

D:Metacarpals

18. How many phalanges are in each foot?

A:12

B:17

C:16

D:14

19. What is the technical name of the ankle joint?

A:Tibiofemoral joint

B:Cruciform joint

C:Femoroacetabular joint

D:Talocrural joint

20. A synovial hinge joint moves in the:

A:Frontal plane

B:Horizontal plane

C:Sagittal and horizontal planes

D:Sagittal plane only

21.

Practice Quiz Answer Key

1. B

2. C

3. D

4. A

5. A

6. B

7. A

8. B

9. C

10. C

11. A

12. B

13. C

14. B

15. A

16. B

17. B

18. D

19. C

20. D

21.