Rectus Femoris

Original Editor - Uchechukwu Chukwuemeka Top Contributors - Uchechukwu Chukwuemeka and Abbey Wright

Description

Rectus femoris.png

Rectus femoris is a bulk of muscle located in the superior, anterior middle compartment of the thigh and is the only muscle in the quadriceps group that crosses the hip[1].

It is superior and overlying of the vastus intermedius muscle and superior-medial part of Vastus lateralis and Vastus medialis.

The word rectus is a latin word connoting “straight”. Thus the rectus femoris received its name because it runs straight down the thigh[2].

It is a two way acting muscle as it crosses over the hip and knee joint; therefore, it contributes to 90° of knee flexion and assists iliopsoas in hip flexion[3][1].

A short rectus femoris may contribute to a higher positioned patella in relation to the contralateral side. A markedly shortened rectus femoris is suggested by knee flexion of less than 80°or by marked prominence of superior patellar groove[4]

Anatomy

Origin

Rectus Femoris originates from anterior inferior iliac spine(AIIS) and the part of alar of ilium superior to the acetabulum[1]

Insertion

Rectus Femoris together with vastus medialis, vastus lateralis and vastus intermedius joins the quadriceps tendon to insert at the patella and tibial tuberosity (via patellar ligament)[4].

Nerve supply

Rectus Femoris is innervated by the femoral nerve, originating from lumbar nerve 2, 3, and 4 nerve roots

Bloody supply

Blood is supplied to the Rectus Femoris via descending branch of the lateral circumflex femoral (LCF) artery.

Function

Actions

Hip flexion

Knee extension

  • Together with other muscles that are part of the Quadriceps femoris, it facilitates knee extension.
  • In terminal swing phase rectus femoris acts as an extensor of the knee, as a muscle in the quadriceps group, it generate force needed for loading(foot flat phase) in stance phase[5].
  • Rectus femoris is more efficient in movement combining hip hyper-extension and knee flexion or from a position of knee extension and hip flexion. For example kicking a soccer ball[2][3]

Assessment

Palpation

Rectus femoris can be palpated as it is the most superior of the quadriceps muscles. Start palpation at AIIS, rectus femoris can be felt until its insertion into the quadriceps tendon. Asking the patient to isometrically contract quadriceps will help to identify the muscle belly.

Strength[6]

To assess muscle strength for the Rectus Femoris (including rest of the quadriceps group) position the patient in sitting with the hip and knee flexed to 90°  for grade 5, 4 and 3 while grade 2, is assessed in side-lying with test limb uppermost and knee flexed to 90° position.

[7]

Other Tests[8]

In Rectus femoris injury :

  • FABER (Patrick's test) - illicit no pain
  • Pain is felt in resisted hip flexion[9]
[11]

References

  1. 1.0 1.1 1.2 Drake, RL, Vogl, W, Mitchell, AW, Gray, H. Gray's anatomy for Students 2nd ed.  Philadelphia : Churchill Livingstone/Elsevier, 2010
  2. 2.0 2.1 2.2 Moore, KL, Dalley, AF, Agur, AM. Clinically oriented anatomy. 7th ed. Baltimore, MD: Lippincott Williams & Wilkins, 2014
  3. 3.0 3.1 Page, P, Frank, CC, Lardner, R. Assessment And Treatment Of Muscle Imbalance: The Janda Approach. Sheridan Books, USA; 2010. 
  4. 4.0 4.1 Miller, A, Heckert, KD, Davis, BA.The 3-Minute Musculoskeletal & Peripheral Nerve Exam. New York: Demos Medical Publishing. 2009; p.116-117
  5. Rectus femoris muscle [Internet]. En.wikipedia.org. 2018 [cited 15 October 2018]. Available from: https://en.wikipedia.org/wiki/Rectus_femoris_muscle
  6. Hislop, HJ, Montgomery,J.  Daniels and Worthingham's Muscle Testing: Techniques of Manual Examination. 8th ed.  Missouri: Saunders Elsevier, 2007; p201-204
  7. Physiotutors. MRC Scale|Muscle strength grading. Available from: https://www.youtube.com/watch?v=LjlqP1uMUo0 [last accessed: 30.11.2015]
  8. Reider, B. The orthopaedic physical exam/Bruce Reider.-2nd ed. Elsevier Saunders, USA; 2005
  9. Mendiguchia J, Alentorn-Geli E, Idoate F, Myer GD. Rectus femoris muscle injuries in football: a clinically relevant review of mechanisms of injury, risk factors and preventive strategies. Br J Sports Med. 2013 Apr 1;47(6):359-66.
  10. Huri G, Dubin JM, Ozgonen K, Kaya D, Doral MN. A Unique Rectus Femoris Injury in an Adolescent Professional Soccer Player: A Case Report. JBJS case connector. 2014 Oct 1;4(4):e115.
  11. KenHub - Learn human anatomy, Quadriceps Femoris Muscle - Origin, Insertion and Function - Human Anatomy | Kenhub. Available from: https://www.youtube.com/watch?v=1Av_KKvCcVI&t=8s [last accessed 20.07.2014]