Rectus Femoris: Difference between revisions
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== Description == | == Description == | ||
Rectus femoris is a bulk of muscle located in the middle at the anterior compartment of the thigh and the only muscle in quadriceps group of muscle the crosses the hip<ref name=":0">Drake, RL, Vogl, W, Mitchell, AW, Gray, H. Gray's anatomy for Students 2nd ed. Philadelphia : Churchill Livingstone/Elsevier, 2010</ref>. It overlies the [[Vastus Intermedius]] and superiormedial part to the [[Vastus Lateralis|Vastus lateralis]] and [[Vastus Medialis|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<ref name=":1">Moore, KL, Dalley, AF, Agur, AM. Clinically oriented anatomy. 7<sup>th</sup> ed. Baltimore, MD: Lippincott Williams & Wilkins, 2014</ref>. It is 2 way acting muscle as it crosses over the hip and the knee joint; thus, it contributes to 90° of knee flexion and assist the [[Iliacus|iliopsoas]] in hip fexion<ref name=":2"> | Rectus femoris is a bulk of muscle located in the middle at the anterior compartment of the thigh and the only muscle in quadriceps group of muscle the crosses the hip<ref name=":0">Drake, RL, Vogl, W, Mitchell, AW, Gray, H. Gray's anatomy for Students 2nd ed. Philadelphia : Churchill Livingstone/Elsevier, 2010</ref>. It overlies the [[Vastus Intermedius]] and superiormedial part to the [[Vastus Lateralis|Vastus lateralis]] and [[Vastus Medialis|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<ref name=":1">Moore, KL, Dalley, AF, Agur, AM. Clinically oriented anatomy. 7<sup>th</sup> ed. Baltimore, MD: Lippincott Williams & Wilkins, 2014</ref>. It is 2 way acting muscle as it crosses over the hip and the knee joint; thus, it contributes to 90° of knee flexion and assist the [[Iliacus|iliopsoas]] in hip fexion<ref name=":2">Page, P, Frank, CC, Lardner, R. Assessment And Treatment Of Muscle Imbalance: The Janda Approach. Sheridan Books, USA; 2010. </ref><ref name=":0" />. A short rectus femoris may contribute to a high riding patella in relation to the opposite knee. A short rectus femoris is suggested by knee flexion less than 80°or by marked prominence of a superior patellar groove<ref name=":3">Miller, A, Heckert, KD, Davis, BA.The 3-Minute Musculoskeletal & Peripheral Nerve Exam. New York: Demos Medical Publishing. 2009; p.116-117</ref>[[File:Rectus femoris.png|thumb]] | ||
==== '''Origin''' ==== | ==== '''Origin''' ==== | ||
Rectus Femoris originates from anterior inferior iliac spine(AIIS) and the ilium just superior to the acetabulum<ref name=":0" /> | Rectus Femoris originates from anterior inferior iliac spine(AIIS) and the ilium just superior to the acetabulum<ref name=":0" /> | ||
Revision as of 16:06, 27 June 2018
Description[edit | edit source]
Rectus femoris is a bulk of muscle located in the middle at the anterior compartment of the thigh and the only muscle in quadriceps group of muscle the crosses the hip[1]. It overlies the Vastus Intermedius and superiormedial part to the 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 2 way acting muscle as it crosses over the hip and the knee joint; thus, it contributes to 90° of knee flexion and assist the iliopsoas in hip fexion[3][1]. A short rectus femoris may contribute to a high riding patella in relation to the opposite knee. A short rectus femoris is suggested by knee flexion less than 80°or by marked prominence of a superior patellar groove[4]
Origin[edit | edit source]
Rectus Femoris originates from anterior inferior iliac spine(AIIS) and the ilium just superior to the acetabulum[1]
Insertion[edit | edit source]
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].
Function[edit | edit source]
- Rectus Femoris acts with iliopsoas to brings about thigh flexion at the hip joint especially if the knee is flexed[2].
- Together with other muscles that are part of the Quadriceps femoris, it facilitate knee flexion.
- Rectus femoris is more efficient in movement combining hip hyperextension and knee flexion or from a position of knee extension and hip flexion, example of such movement combination is in soccer ball kick off[2][3].
- During gait, as a hip flexor, it acts with the iliopsoas during the preswing(Toe off) phases and acts as an extensor of the thigh in terminal swing phase of walking and also, as a muscle in the quadriceps group it generate force needed for loading(foot flat phase) in stance phase[5].
Innervation[edit | edit source]
The Rectus Femoris muscle is innervated by the Femoral nerve, originating from lumbar nerve 2, 3, and 4 nerve roots.
Blood Supply[edit | edit source]
Blood is supplied to the Rectus Femoris via descending branch of the lateral circumflex femoral (LCF) artery
A branch of the femoral vein serves as the venous drainage route
Assessment[edit | edit source]
Power[6][edit | edit source]
The power test for the Rectus Femoris is done in sitting with the hip and knee flexed to 90° for grade 5, 4 and 3 while for grade 2, 1 and 0, it is done in Side-lying with test limb uppermost and knee flexed to 90° position.
The therapist is situated at the side of the leg to be tested with the patient in supine lying, one hand placed under the knee of the lower limb being tested, and the other hand wrapped around the leg superior to the ankle given downwards pressure at the direction of the bended knee. The patient is asked to extend the knee against resistance.
Grade 5 is given if the patient is able to extend and maintain position at end range against maximal resistance.
Grade 4 is given if the patient is able to extend and maintain position at end range against moderate resistance.
Grade 3 is given if the patient is able to extend and maintain position at end range against no resistance except gravity.
The therapist stands behind the patient lying sideways with the limb being tested uppermost and flexed to 90°, one hand is place immediately superior to the malleoli while the other hand is placed at the underside of the thigh proximal to the knee. The patient is asked to straighten the limb.
Grade 2 is given if the patient is able to extend the knee and maintain position at end range.
For grade 1 and 0, the starting position is the same for grade 3 assessment but the hand placement of the therapist changes; one hand is placed under the knee while the other hand is placed at anterior part of the thigh immediately above the knee for easy palpation to the quadriceps and patella tendon. The patient is asked to push down the knee towards the therapist.
Grade 1 is given if therapist is able to feel contraction of the muscle and grade 0 is given if no contraction is palpable.
Other Test[7][edit | edit source]
In Rectus femoris injury :
- FABER (Patrick's test) illicit no pain
- Pain is felt in resisted hip flexion
- Ely’ test illicit pain on tightness
- Knee ROM is reduced below 80° in shortness of Rectus femoris or prominence of patella grove is noted.
Recent Related Research (from Pubmed)[edit | edit source]
> https://www.ncbi.nlm.nih.gov/pubmed/29252783>
References[edit | edit source]
- ↑ 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
- ↑ 2.0 2.1 2.2 Moore, KL, Dalley, AF, Agur, AM. Clinically oriented anatomy. 7th ed. Baltimore, MD: Lippincott Williams & Wilkins, 2014
- ↑ 3.0 3.1 Page, P, Frank, CC, Lardner, R. Assessment And Treatment Of Muscle Imbalance: The Janda Approach. Sheridan Books, USA; 2010.
- ↑ 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
- ↑ https://en.wikipedia.org/wiki/Rectus_femoris_muscle
- ↑ Hislop, HJ, Montgomery,J. Daniels and Worthingham's Muscle Testing: Techniques of Manual Examination. 8th ed. Missouri: Saunders Elsevier, 2007; p201-204
- ↑ Reider, B. The orthopaedic physical exam/Bruce Reider.-2nd ed. Elsevier Saunders, USA; 2005
