Distal part of sacrotuberous ligament, and posterior part of tuberosity of ischium
Origin of Short Head
Lateral lip of linea aspera, proximal two thirds of upracondylar line, and lateral intermuscular septum
Insertion
Lateral side of head of fibula, lateral condyle of tibia, deep fascia on lateral side of leg
Action
The long and short heads of the Biceps femoris flex and laterally rotate the knee joint
In addition, the long head extends and assists in lateral rotation of the hip joint
Nerve to Long Head
Sciatic (tibial branch) L5, S1–3
Nerve to Short Head
Sciatic (peroneal branch) L5, S1–2
Patient
Prone
Fixation
The examiner should hold the thigh firmly down on the table
Test
Flexion of the knee between 50° and 70° with the thigh in slight lateral rotation, and the leg in slight lateral rotation on the thigh
Pressure
Against the leg proximal to the ankle in the direction of knee extension. Do not apply pressure against the rotation component
Straight head from anterior inferior iliac spine. Reflected head from groove above rim of acetabulum
Origin of Vastus Lateralis
Proximal part of intertrochanteric line, anterior and inferior borders of greater trochanter, lateral lip of gluteal tuberosity, proximal one half of lateral lip of linea aspera, and lateral intermuscular septum
Origin of Vastus Intermedius
Anterior and lateral surfaces of proximal two thirds of body of femur, distal one half of linea aspera, and lateral intermuscular septum
Origin of Vastus Medialis
Distal one half of intertrochanteric line, medial lip of linea aspera, proximal part of medial supracondylar line, tendons of Adductor Longus and Adductor Magnus, and Medial Intermuscular Septum
Insertion
Proximal border of patella and through patellar ligament to tuberosity of tibia
Nerve
Femoral L2–4
Patient
Sitting with knees over side of table, holding on to table
Fixation
The examiner may hold the thigh firmly down on the table, or, because the weight of the trunk is usually sufficient to stabilize the patient during this test, the examiner may put a hand under the distal end of the thigh to cushion that part against table pressure
Test
Extension of the knee joint without rotation of the thigh
Pressure
Against the leg above the ankle, in the direction of flexion
Anterior superior iliac spine and superior half of notch just distal to spine
Insertion
Proximal part of medial surface of tibia near anterior border
Action
Flexes, laterally rotates, and abducts the hip joint
Flexes and assists in medial rotation of the knee joint
Nerve
Femoral L2–3
Patient
Supine
Fixation
None necessary on the part of the examiner
The patient may hold on to the table
Test
Lateral rotation, abduction, and flexion of the thigh, with flexion of the knee
Pressure
Against the anterolateral surface of the lower thigh, in the direction of hip extension, adduction and medial rotation, and against the leg in the direction of knee extension
The examiner must resist the multiple action test movement by a combined resistance movement
Anterior part of external lip of iliac crest, outer surface of anterior superior iliac spine, and deep surface of fascia lata
Insertion
Into ilitotibial tract of fascia lata at junction of proximal and middle thirds of thigh
Actions
Flexes, medially rotates, and abducts the hip joint; tenses the fascia lata; and may assist in knee extension
Nerve
Superior gluteal L4–5, S1
Patient
Supine
Fixation
The patient may hold on to the table
Quadriceps action is necessary to hold the knee extended
Usually no fixation is necessary by the examiner, but if there is instability and the patient has difficulty in maintaining the pelvis firmly on the table, then one hand of the examiner should support the pelvis anteriorly on the opposite side
Test
Abduction, flexion and medial rotation of the hip with the knee extended
Pressure
Against the leg in the direction of extension and adduction
Do not apply pressure against the rotation component
