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 that 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 of [[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 a 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 flexion<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 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]]
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<ref name=":0">Drake, RL, Vogl, W, Mitchell, AW, Gray, H. Gray's anatomy for Students 2nd ed.  Philadelphia : Churchill Livingstone/Elsevier, 2010</ref>.  
==== '''Origin''' ====
 
It is superior and overlying of the [[Vastus Intermedius|vastus intermedius]] muscle and superior-medial part of [[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 a two way acting muscle as it crosses over the hip and knee joint; therefore, it contributes to 90° of knee flexion and assists [[Iliacus|iliopsoas]] in hip flexion<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 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<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>
 
== Anatomy ==
[[File:Rectus femoris.png|thumb]]
=== '''Origin''' ===
Rectus Femoris originates from anterior inferior iliac spine(AIIS) and the part of alar of ilium superior to the acetabulum<ref name=":0" />
Rectus Femoris originates from anterior inferior iliac spine(AIIS) and the part of alar of ilium superior to the acetabulum<ref name=":0" />


==== '''Insertion''' ====
=== '''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)<ref name=":3" />.
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)<ref name=":3" />.


== '''Function''' ==
=== Nerve supply ===
* Rectus Femoris acts with [[Iliopsoas Bursitis|iliopsoas]] to brings about thigh flexion at the [[Hip|hip joint]] especially if the knee is flexed<ref name=":1" />.
Rectus Femoris is innervated by the femoral nerve, originating from lumbar nerve 2, 3, and 4 nerve roots
* Together with other muscles that are part of the Quadriceps femoris, it facilitates knee extension.
* 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 can be seen in soccer ball kick off<ref name=":1" /><ref name=":2" />.
* During [[Gait Cycle|gait]], as a hip flexor, it acts with the [[Psoas Major|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<ref>https://en.wikipedia.org/wiki/Rectus_femoris_muscle</ref>.


==== '''Innervation''' ====
=== Bloody supply ===
The Rectus Femoris muscle is innervated by the Femoral nerve, originating from lumbar nerve 2, 3, and 4 nerve roots.  
Blood is supplied to the Rectus Femoris via descending branch of the lateral circumflex femoral (LCF) artery.


==== '''Blood Supply''' ====
== '''Function''' ==
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
=== Actions ===
# Hip flexion
* Rectus Femoris acts with [[Iliopsoas Bursitis|iliopsoas]] to produce [[Hip|hip flexion]] especially if the knee is flexed<ref name=":1" />.
* During [[Gait Cycle|gait]], as a hip flexor, it acts with the [[Psoas Major|iliopsoas]] in "Toe off" phase,.
2. 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<ref>https://en.wikipedia.org/wiki/Rectus_femoris_muscle</ref>.
* 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<ref name=":1" /><ref name=":2" />


== Assessment ==
== Assessment ==
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= Resources<ref>Huri G, Dubin JM, Ozgonen K, Kaya D, Doral MN. [https://europepmc.org/abstract/med/29252783 A Unique Rectus Femoris Injury in an Adolescent Professional Soccer Player: A Case Report.] JBJS case connector. 2014 Oct 1;4(4):e115.</ref> =


= Resources =
> https://www.ncbi.nlm.nih.gov/pubmed/29252783>
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{{#ev:youtube|v=1Av_KKvCcVI&t=8s}}<ref>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]</ref>
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= References  =
= References  =


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Revision as of 22:14, 15 October 2018

Original Editor - Uchechukwu Chukwuemeka Top Contributors - Uchechukwu Chukwuemeka, Abbey Wright, Kim Jackson, Wendy Snyders, Oyemi Sillo, Joao Costa, Lucinda hampton, Tony Lowe and Essam Ahmed

Description[edit | edit source]

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[edit | edit source]

Rectus femoris.png

Origin[edit | edit source]

Rectus Femoris originates from anterior inferior iliac spine(AIIS) and the part of alar of ilium 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].

Nerve supply[edit | edit source]

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

Bloody supply[edit | edit source]

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

Function[edit | edit source]

Actions[edit | edit source]

  1. Hip flexion

2. 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[edit | edit source]

Power[6][edit | edit source]

The power test for the Rectus Femoris muscle is done in sitting with the hip and knee flexed to 90°  for grade 5, 4 and 3 while for grade 2, 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 a downwards pressure at the direction of the flexed 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 of the quadriceps and patella tendon. The patient is asked to push down the knee towards the therapist's hand and the plinth.

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[8]


Resources[9][edit | edit source]

[10]

References[edit | edit source]

  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. ↑ 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. ↑ Reider, B. The orthopaedic physical exam/Bruce Reider.-2nd ed. Elsevier Saunders, USA; 2005
  8. ↑ https://www.ncbi.nlm.nih.gov/pubmed/22864009
  9. ↑ 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.
  10. ↑ 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]


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