A 23 year old rugby player presents to the ED complaining of ongoing thigh pain following a match 3 days ago. Imaging has been arranged which shows a traumatic injury to the rectus femoris. The rectus femoris muscle acts primarily to produce which of the following movements:
The quadriceps femoris is made up of four individual muscles; the rectus femoris, the vastus medialis, the vastus intermedius (deep to the rectus femoris) and the vastus lateralis which all insert onto the patella by the common quadriceps femoris tendon. Because the vastus muscles insert into the margins of the patella as well as into the quadriceps femoris tendon, they stabilise the position of the patella during knee joint movement.
Muscle | Function | Innervation |
---|---|---|
Rectus femoris | Flexion at hip and extension at knee | Femoral nerve |
Vastus lateralis | Extension at knee | Femoral nerve |
Vastus medialis | Extension at knee | Femoral nerve |
Vastus intermedius | Extension at knee | Femoral nerve |
The quadriceps femoris muscles are the main extensors of the leg at the knee joint. The rectus femoris crosses both the knee and the hip joint (in contrast to the vastus muscles which only cross the knee joint), and therefore also assists in flexion of the thigh at the hip joint.
The quadriceps femoris muscles are innervated by the femoral nerve.
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Biochemistry | Normal Value |
---|---|
Sodium | 135 – 145 mmol/l |
Potassium | 3.0 – 4.5 mmol/l |
Urea | 2.5 – 7.5 mmol/l |
Glucose | 3.5 – 5.0 mmol/l |
Creatinine | 35 – 135 μmol/l |
Alanine Aminotransferase (ALT) | 5 – 35 U/l |
Gamma-glutamyl Transferase (GGT) | < 65 U/l |
Alkaline Phosphatase (ALP) | 30 – 135 U/l |
Aspartate Aminotransferase (AST) | < 40 U/l |
Total Protein | 60 – 80 g/l |
Albumin | 35 – 50 g/l |
Globulin | 2.4 – 3.5 g/dl |
Amylase | < 70 U/l |
Total Bilirubin | 3 – 17 μmol/l |
Calcium | 2.1 – 2.5 mmol/l |
Chloride | 95 – 105 mmol/l |
Phosphate | 0.8 – 1.4 mmol/l |
Haematology | Normal Value |
---|---|
Haemoglobin | 11.5 – 16.6 g/dl |
White Blood Cells | 4.0 – 11.0 x 109/l |
Platelets | 150 – 450 x 109/l |
MCV | 80 – 96 fl |
MCHC | 32 – 36 g/dl |
Neutrophils | 2.0 – 7.5 x 109/l |
Lymphocytes | 1.5 – 4.0 x 109/l |
Monocytes | 0.3 – 1.0 x 109/l |
Eosinophils | 0.1 – 0.5 x 109/l |
Basophils | < 0.2 x 109/l |
Reticulocytes | < 2% |
Haematocrit | 0.35 – 0.49 |
Red Cell Distribution Width | 11 – 15% |
Blood Gases | Normal Value |
---|---|
pH | 7.35 – 7.45 |
pO2 | 11 – 14 kPa |
pCO2 | 4.5 – 6.0 kPa |
Base Excess | -2 – +2 mmol/l |
Bicarbonate | 24 – 30 mmol/l |
Lactate | < 2 mmol/l |