This injury is what many people refer to as a hip flexor strain. Fun facts about the quadriceps and rectus femoris did you know that the rectus femoris is the strongest and leanest muscle in the human body. Check syringe to make sure you have right amount of r with no air bubbles. Make sure to properly measure your medication, identify the patient, and always wash the hands before injecting the patient. Draw an imaginary line from the posterior superior iliac spine iliac crest to the greater trochanter of the femur. The rectus femoris muscle is one of four quadriceps muscles in the anterior compartment of the thigh. Intramuscular site dorsogluteal upper outer quadrant of buttocks landmarks. The rectus femoris tendon is detached from the top of the knee cap. The rectus femoris is the only one of the quadriceps muscles to cross the hip joint, which allows it to act as a hip flexor and a knee. If youve ever pulled a muscle, you are probably familiar with the rice method of treating the injury. Once that is removed, the rectus femoris is easily visible. Pain in the front and center of the knee, particularly when walking downstairs or downhill, or when wearing high heels. Im injections can be made into either the anterior or posterior aspect of the thigh or the lumbar epaxial musculature.
It is responsible for knee extension and hip flexion. This is the muscle that primarily extends the leg, straightening and stabilizing the knee by virtue of its strong attachments around the front and sides of the joint and to the tibia below it. Surgical treatment of proximal ruptures of the rectus. Landmarks for intramuscular injection sites and how to determine site dorsogluteal. Rectus femoris tear presenting as an unusual cause of a. Insert the needle at a 90degree angle into the middle third of the muscle, parallel to the skin surface. Hip pain without injury photo quiz american family. Rectus femoris the rectus femoris muscle is one of the four quadriceps muscles that sits in the middle of the front of the thigh. Find the lateral quadriceps muscle for the vastus lateralis, or the anterior thigh for the rectus femoris. Insert the needle at a 90degree angle into the middle third of the muscle, parallel to the skin. Calcium hydroxyapatite crystal deposition is usually selflimiting 4,5. Rectus femoris avulsions are described in pediatric and adolescent populations as avulsions of the anteroinferior iliac spine.
Pain and progressive less vision eventually coupled with increasing spots. Of the four muscles that comprise this group, the rectus femoris is the most commonly strained and also has the most complex anatomy. The others are the vastus medialis, the vastus intermedius deep to the rectus femoris, and the vastus lateralis. Rectus femoris muscle an overview sciencedirect topics. Sites of the thigh rectus femoris and vastus lateralis the uptake of drugs from the thigh region is slower than from the arm but faster than from the buttock, thus facilitating better drug serum concentrations than is possible with the gluteal muscles. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Strains can occur when kicking a ball and the knee is in some way restricted. Unlike the other quadriceps muscles, the rectus femoris originates from the anterior inferior iliac spine. Rectus femoris muscle musculus rectus femoris attachments of rectus femoris. However, proximal ruptures of the rectus femoris diagnosed by mri are not common and do not exceeding 1% of quadriceps injuries 1215. Strains are common in soccer players and also occur in football and other sports where kicking or sudden jumping is required.
The rectus femoris rf has a regionspecific functional role. Biceps femoris and rectus femoris how to dissect a fetal pig. Proximal avulsion or rupture of the rectus femoris is an uncommon injury with limited published data. In our three cases, calcific tendinitis developed in the reflected head of. The rectus femoris and lower back pain corewalking. A healthy young woman presented with a 2month history of an enlarging right anterior thigh subcutaneous mass. Nur 104 pharmacology injection sites flashcards quizlet. Surgical treatment of chronic proximal rectus femoris rupture. Its actually composed of four main muscles, one of which is the rectus femoris. Left hip pain after kicking the ball in a soccer match.
Rectus femoris rupture information sinew therapeutics. It is distinct from the other quadriceps muscles vastus medialis, vastus intermedius, vastus lateralis in that crosses both the hip and knee joints 1. Anatomically safe sites for intramuscular injections. However, the main disadvantage is that injections in the rectus femoris site may. Easy option 1 standing, flex the knee to bring the foot towards the buttocks and place upon a low table or chair back. It is possible to observe their presence in sports activities requiring strong, repeated, and eccentric loading with maximal lengthening in lower limbs such as during sprinting and kicking.
Rectus femoris injection anesthesiologypain management. A muscle in the quadriceps, the rectus femoris muscle is attached to the hip and helps to extend or raise the knee. Efficacy of botulinum toxin injections in the rectus femoris to treat. Tefloncoated emg guidance for confirmation of injection into the rectus femoris muscle in addition to utilizing standardized injection landmarks, the solution will. In contrast, calcific tendinitis of the rectus femoris is a rare disease first recognized in 1967 by king and vanderpool. Insert needle into n vial and immediately invert vial and slowly withdraw n insulin to equal total of both r and n needed. The rectus femoris goes from the hip to the knee and can. Patellar tendon advancements and distal femoral extension osteotomies. The rectus femoris is responsible for both hip flexion and knee extension. Dermatologists should be aware of a tear of the rectus femoris muscle presenting as a subcutaneous mass to defer biopsy and properly refer for imaging and orthopedic evaluation. Which landmark serves as an attachment site for the rectus femoris. We present a repair of a patient with an 8month injury. Watch and learn how simple it is do an intramuscular injection in the deltoid, rectus femoris, vastus lateralis, dorsal or ventral gluteal.
Acute rectus femoris calcific tendinitis case reports. The rectus femoris attaches from the pelvis to just below the knee on the patellar tendon. Rectus femoris muscular, musculoskeletal anatomyzone. This how to video demonstrates how to administer an intramuscular injection. It is commonly caused by forceful movement when the muscle is in a contracted position.
The cause of these tendinous tears is still unknown, and a wide range of risk factors have been suggested within the. With the diagnosis of rectus femoris calcific tendinitis, injection therapy was planned. There are also leg locks and pins that specifically take advantage of tight quads. Intramuscular injection guidelines becton dickinson. The rectus femoris muscle is one of the four quadriceps muscles of the human body. Identifying injection sites mcgrawhill professional. All four parts of the quadriceps muscle attach to the patella knee cap by the quadriceps tendon the rectus femoris is situated in the middle of the front of the thigh. Andreas serner 8th muscletech networ slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Rupture of the rectus femoris tendon, which is located at the top of the muscle close to the hip, can occur as a result of explosive loads or overuse of that muscle. Vastus lateralis and rectus femoris sites find the lateral quadriceps muscle for the vastus lateralis, or the anterior thigh for the rectus femoris. Rectus femoris anatomy the quadriceps muscle group is vital for athletes who participate in sports that require running, jumping and kicking. Proximal rectus femoris avulsion injury radiology case.
The vastus intermedius muscle, lies beneath the rectus femoris. Standardized criteriabased rehabilitation for rectus femoris injuries experiencies from aspetar sports medicine hospital. Soft tissue palpation revealed exquisite tenderness of the right biceps femoris muscle. Discussion rectus femoris reflected head calcification is a rare condition which causes hip pain and discomfort. Andreas serner rectus femoris injuries experiencies. Proximal rectus femoris tendon avulsions are rare and account for approximately 1. The straight head of the rectus femoris originates at the anterior inferior iliac spine and the reflected head at the ilium above the acetabulum. Sites for intramuscular injections include the ventrogluteal, vastus lateralis, and. In this article, dr ralph rogers discusses what it is, how it happens and the best way to. Nonoperative treatment of a complete distal rectus femoris. Severe limitation in hip movements may be associated with constitutional symptoms like fever, acute inflammatory features, and elevated acute phase reactants. Anatomy of the rectus femoris the quadriceps is the large muscle group on the front of the thigh. Anatomy of the rectus femoris muscle everything you need to know. The femoris rectus is the quadriceps femoris muscle that is most frequently involved in stretch lesions.
Injections into the caudal thigh, specifically the biceps. Remove your fingers and insert the needle at a 90degree angle. Hip and thigh bony landmarks, muscle pics, and facts. Palpation of bony landmarks revealed an elevated anterior superior iliac spine. Malignancies such as juxtacortical chondroma, chondrosarcoma and synovial sarcoma must be considered but ct allows proper. Surgical treatment of rectus femoris injury in soccer. Palm placed on greater trochanter and index finger towards anterior superior iliac spine and middle finger spreads posteriorly away from index finger following the iliac crest forming a triangle. Did you know that the rectus femoris is the only quad that isnt actually attached to the femur thigh bone but. It is the topmost muscle of the thigh and is the most anterior muscle in the quadricep. To locate the landmark for the deltoid muscle, expose the upper arm and find. Rectus femoris is a muscle which belongs to the group of quadriceps muscles and is one of the powerful muscles in that group. Although conservative treatments may lead to acceptable results, it is common for patients to display lower muscle.
So, as you can imagine, it is placed on a huge stretch when an athlete goes into a position of hip extension and knee flexion kind of like this. The tendon is then transferred and reattached to a muscle semitendonosis on the inside back of the leg, just above the knee. The rectus femoris is the most anterior muscle of the quadriceps group and is also the only muscle of the group to act upon both the hip and the knee when it contracts due to its origin and insertion stretching. This allows the rectus femoris muscle to bend flex the knee instead of straighten extend the knee. Note that this instructional video is intended for. A muscle that does not get its notorious due when it comes to lower back pain is the rectus femoris, one of the four quadriceps muscles. Rectus femoris tendinopathies are not particularly frequent occurrences in sports traumatology. In the mri findings, calcification was noted in the right rectus femoris tendon, showing thickening with a small amount of fluid collection and edematous change of peripheral soft tissue fig. Successful treatment of rectus femoris calcification with.
It is commonly injured as the tendon at the front of the hip or in the muscle belly of the thigh. Arthroscopic treatment of chronically painful calcific. The anatomical safety of intramuscular injections at the deltoid and. Difficulty extending the hip or fully flexing the knee. A rectus femoris is a common injury among athletes. The structure indicated is the rectus femoris of the quadriceps group of thigh muscles the rectus femoris is one of the muscles that makes up the quadriceps femoris, and is contained in the anterior compartment of the thigh.
The muscles of the anterior compartment are all innervated by the femoral nerve and serve generally to extend the leg at the knee joint. Tear of the rectus femoris direct head surgical repair. The ventrogluteal site, rectus femoris and vastus lateralis location are the preferred location for large volume deep muscle im injections. Shawl signmacular erythema of the posterior shoulders and neck. Which pair of bony landmarks can usually be identified by two small dimples at the base of the lower back. The treatment and rehabilitation of rectus femoris strains closely resemble that of many other muscles strains and injuries. All of the quadriceps muscles vastus lateralis, medialis, intermedius and the rectus femorisextend the knee, but rectus femoris, the only one that connects to the pelvis, also flexes the hip. The rectus femoris is one of the quadriceps muscles of the thigh. Rehabilitation protocols after singleevent multilevel surgery. Draw an imaginary line from the posterior superior iliac spine iliac crust to the greater trochanter of the femur. Intramuscular injections offer some benefits over other types of delivery methods, such as oral, intravenous injections into a vein, and subcutaneous injections into fatty tissue under the skin. The rectus femoris cannot be seen without removing some of the tesnor fasciae latae.