Cheatography
                https://cheatography.com
            
        
        
    
                   
                            
    
                    Upper leg muscles - Hamstrings, Adductors, Abductors, Quads
                    
                 
                    
        
        
            
    
        
                                    This is a draft cheat sheet. It is a work in progress and is not finished yet.
                    
        
                
        
            
                                
            
                
                                                | Hamstrings
                        
                                                                                    
                                                                                            | Consists of: |  
                                                                                            | - Bicep Femoris |  
                                                                                            | - Semimembranosus |  
                                                                                            | -Semitendinosus |  Bicep Femoris
                        
                            Origin: Long head: inferomedial upper area of the ischial tuberosity and sacrotuberous ligamentShort head: lateral lip of linea aspera
 Insertion: Head of the fibula
 NS:  Long head: Tibial nerve Short head: Common fibular nerve
 Action:  Flexes know joint, laterally rotates knee joint when knee is flexed, long head extends hip joint
 Semimembronous
                        
                            Origin: Ischial TuberosityInsertion: Medial condyle of femur
 NS: Tibial part of sciatic nerve (L5 -S2)
 Actions: Extends hip and flexes knee
 Semitendinosus
                        
                            Origin: Tuberosity of the ischiumInsertion: Per anserinus
 NS: Sciatic (tibial L5-S2)
 Action: Flexion of knee, extension of the hip joint
 Sartorius
                        
                            Origin: ASIS Insertion: Anteromedial surface of the proximal tibia (pes anserinus)
 NS: Femoral nerve L2-L3
 Action: Flexion, Abduction and lateral rotation of the hip and flexion of the knee
 Sartorius TrPs
                        
                            - Usually superficial sharp/tingling pain- Rarely seen alone as a myofascial pain producer
 - Sleeping/lying with hips and knees flexed can cause TrPs in this muscle
 - Active during seated cycling
 - Consider this muscle in patients with meralgia paraesthetica along with quads and iliacus
 Tensor Fascia Lata (TFL)
                        
                            Origin: ASISInsertion: Iliotibial tract
 NS: Superior Gluteal nerve (L4-S1)
 Action: Hip - Flexion, medial rotation, abduction Knee- Lateral rotation Torso - Stabilisation
 TFL TrP
                        
                            - Can be misdiagnosed as tronchanteric bursitis- Running/walking on sloped surfaces increase risk of TrPs
 - Tightness of TFL can lead to a short leg when prone/supine
 - TrPs in anterior glut mini can lead to TrPs in TFL
 - Tight QL, TFL overpower weak/inhibited Glut med - leads to lumbar lordosis - deal with tight muscles first before strengthening glut med
 Quadriceps
                        
                                                                                    
                                                                                            | Consists of: |  
                                                                                            | - Rectus Femoris |  
                                                                                            | - Vastus Intermedius |  
                                                                                            | - Vastus Lateralis |  
                                                                                            | - Vastus medialis |  Rectus Femoris
                        
                            Origin: AIIS and bony ridgeInsertion: Patellar tendon
 NS:  Femoral nerve L2-L4
 Action: Knee extension, Hip flexion
 Rectus Femoris TrPs
                        
                            - Felt deep in knee joint- Wakes pt up at night - pain infront of patella and lower anterior thigh
 - Knee pain + sense of weakness going down stairs
 - Can diminishe the L4 reflex
 - Secondary TrPs in other quad muscles and iliopsoas major
 Vastus Intermedius
                        
                            Origin: Anteriolateral femurInsertion: Patella tendon
 NS: Femoral nerve L2-L4
 Action: Extension of the knee
 Articulus genu - small muscle , usually blends in VI, thought to retract synovial suprapatellar bursa proximal during extension
 Vastus Intermedius TrPs
                        
                            - TrPs cause difficulty straightening the knee- Buckling knee can be TrPs in vastus intermedius and 2 heads of gastrocnemius
 Vastus Lateralis
                        
                            The largest of the quadsOrigin: GT, intertrochanteric line and linea aspera of the femur
 Insertion: Patella tendon
 NS: Femoral nerve L2-L4
 Action: Extends and stabilise knee
 Vastus Lateralis TrP
                        
                            - Lying on affected side can disturb sleep- TrP can cause stuck patella syndrome (patella loses all passive movement - stiff leg and dragging foot)
 - Anterior fibres of Glut mini can cause satellite Trps in VL
 Vastus Medialis
                        
                            Origin: Medial side of femurInsertion: Quads tendon
 NS: Femoral Nerve L2-L4
 Action: Extends knee
 Vastus Medialis TrP
                        
                            - Produce toothache like pain deep in the knee joint that interrupts sleep, pain fades over weeks and then buckling and weakness occurs- Excessive pronation of the foot and Morton's foot can lead to TrPs in this muscle
 Pectineus
                        
                            Location of the Pectineus (black)Origin: Pectineal line of the pubic bone
 Insertion: Pectineal line of the femur
 NS:  Femoral Nerve L2-L3 and accessory obturator L3
 Action: Adduction and flexion of the thigh
 Pectineus - Palpation
                        
                            - Hip slightly flexed and lateral rotated- Pt adducts hip slightly
 - Slide off adductor tendon laterally
 Pectineus TrP
                        
                            - Should be checked for TrPs after treating ilipsoas and adductor TrPs Adductor Brevis
                        
                            Origin:  Anterior surface of inferior Ramus and body of the pubisInsertion: Lesser tronchanter and linea aspera
 NS: Obturator nerve L2-L3
 Action: Adducts thigh, controls leg swing through gait cycle and postural control
 Adductor Longus
                        
                            Origin: Pubic body, below pubic crestInsertion: Middle 1/3 of linea aspera
 NS: Anterior branch obturator nerve L2-L4
 Action:  Adduction of hip, flexion of hip joint
 Adductor Longus TrPs
                        
                                                                                    
                                                                                            | Same as Adductor Brevis |  
                                                                                            | - Common cause of groin pain |  
                                                                                            | - Adductor longus bilateral TrPs can occur in horse riders -  check for lumbar lesions |  Adductor Magnus
                        
                            Origin: Pubis, tuberosity of ischiumInsertion: Linea Aspera and adductor tubercle of femur
 NS: Posterior branch of obturator nerve and sciatic nerve (L2-L4)
 Action:  Both portions adduct hip, hip flexion  (adductor portion) , Ext hip (Hamstring portion)
 Adductor magnus  TrPs
                        
                            - TrP below pubic bone can refer pain into rectum, pubic bone, vagina or bladder - pain is sharp and shooting- Adductor Magnus active when climbing stairs, inactive when descending
 Gracilis
                        
                            Origin:  Ischiopubic RamusInsertion: Tibia (pes anserinus)
 NS: Anterior branch of obturator nerve L2-L3
 Action:  Flexes, medially rotates and adducts hip
 Gracillis TrPs
                        
                            - Can be hot/stinging pain that travels along inside of thigh |