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Anatomy of MSK

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Popliteal Region
Batas
Isi
Dibentuk oleh =
1. the popliteal surface of the femur superiorly
2. the posterior aspect of the joint capsule of the knee joint centrally
3. the investing popliteus fascia covering the popliteus muscle inferiorly
Posterior Compartment of Leg
Terbagi menjadi dua macam kompartemen
Superficial dan profundus
SUPERFICIAL MUSCLE GROUP IN POSTERIOR COMPARTMENT
triceps surae dibentuk oleh gastrocnemius (caput lateral dan medial) dan soleus
~berfungsi elevating the heel and thus depressing the forefoot
*generating as much as 93% of the plantarflexion force.
~berfungsi menjaga manusia berdiri tegak, lurus
~berfungsi mengangkat, mendorong, dan mempercepat saat berjalan, melompat,
atau berdiri
calcaneal tendon dibentuk oleh gastrocnemius and soleus
*the most powerful (thickest and strongest) tendon in the body
*semakin ke bawah semakin tebal dan sempit
Panjang tendon calcanei = 15 cm
*meskipun dua m. membentuk satu tendon, namun befungsi sendiri-sendiri
Fungsi m. gastrocnemius = untuk melompat
Fungsi m. soleus = untuk berjalan
Bagaimana cara melakukan tes terhadap otot triceps surae?
1. Kaki plantar flexi, misal standing on the toes
2.
If normal, the calcaneal tendon and triceps surae can be observed and palpated.
A subcutaneous calcaneal bursa
Berada diantara skin and the calcaneal tendon
~berfungsi allows the skin to move over the taut tendon (kulit ikut bergerak saat
tendon tertaut kencang)
deep bursa of the calcaneal tendon atau retrocalcaneal bursa
Berada diantara (located between) the tendon and the calcaneus,
allows the tendon to glide over the bone.
Raises heel during walking = meninggikan tumit saat berjalan
Steadies leg on foot = menstabilkan kaki
*semua berfungsi plantarflexi
*ada yang dapat menggerakkan knee joint dan ankle joint secara bersamaan (m.
gastrocnemius)
*ada yang bisa melakukan plantarflexi sendirian = m. soleus
Gastrocnemius
~Secara spesial berfungsi (contractions of the gastrocnemius) produce rapid
movements during running and jumping
~ intermittently during symmetrical standing
*capable of acting on both the knee and the ankle joint, but it cannot exert its full power on
both joints at the same time
~most effectively when the knee is extended (extension of knee joint)
~maximum activated when sprint start
Soleus
tendinous arch of soleus = a tendinous arch
~ popliteal artery and tibial nerve exit the popliteal fossa
~ popliteal artery simultaneously bifurcating into its terminal branches, the anterior
and posterior tibial arteries
* can be palpated on each side of the gastrocnemius when the individual is standing on their
tiptoes.
* act with the gastrocnemius in plantarflexing the ankle joint
* acts alone when the knee is flexed
* antigravity muscle = predominant plantarflexor for standing and strolling
* capable of sustained contraction because = Composed largely of red, fatigue-resistant,
slow-twitch (type 1) muscle fibers, it is a strong
but relatively slow
* during symmetrical standing, the soleus is continuously active.
Plantaris
*is absent in 5–10% of people
*occasionally suddenly ruptures with a painful pop during activities such as racquet sports\
* the plantaris tendon can be removed for grafting (during reconstructive surgery of the
tendons of the hand) without causing disability
~Function acts with the gastrocnemius but is insignificant as either a fl exor of the
knee or a plantarfl exor of the ankle.
~Function as receptors for proprioception (has a high density of muscle spindles)
DEEP MUSCLE GROUP IN POSTERIOR COMPARTMENT
*berfungsi sebagai plantarflexi, namun hanya menyumbang 7% gerakan
* When the calcaneal tendon is ruptured, these muscles cannot generate the power
necessary to lift the body’s weight (i.e., to stand on the toes).
*terdapat m. yang saling silang = m. flexor hallucis longus (dari fibula) dan
flexor digitorum longus (dari tibia)
Popliteus
Berfungsi = ~insignificant as a flexor of the knee joint per se (flexi knee)
~to assist the posterior cruciate ligament (PCL) during partly knee flexed =
*preventing anterior displacement of the femur on the inclined tibial plateau
popliteus bursa
berada = deep to the popliteus tendon
Berfungsi =
~to rotate the femur laterally 5° on the tibial plateaus, releasing the knee from its
close-packed or locked position so that flexion can occur.
* When standing with the knees locked in the fully extended position
Flexor Hallucis Longus (FHL)
*a powerful flexor of all of the joints of the great toe
*membantu gait
Terletak di =
1.
2.
3.
4.
5.
posterior to the distal end of the tibia
occupies a shallow groove on the posterior surface of the talus
continuous with the groove on the plantar surface of the sustentaculum tali
The tendon then crosses deep to the tendon of the fl exor digitorum longus in the
sole of the foot.
As it passes to the distal phalanx of the great toe, the FHL tendon runs between two
sesamoid bones in the tendons of the flexor hallucis brevis
*dilindungi oleh two sesamoid bones
Bagaimana cara test FHL?
1.
2.
the distal phalanx of the great toe is flexed against resistance
if normal, the tendon can be seen and palpated on the plantar aspect of the great toe
as it crosses the joints of the toe.
Flexor Digitorum Longus.
Tibialis Posterior.
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