Knee
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Knee PowerPoint PPT Presentation


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Knee. Terminology. Tibial Tuberosity: Boney protrusion where the patellar tendon inserts. Femoral Condyles: Distal end of the femur. Intercondyler Notch: An indentation in the distal femur where the anterior cruciate descends.

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Knee

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Knee

Knee


Terminology

Terminology

  • Tibial Tuberosity: Boney protrusion where the patellar tendon inserts.

  • Femoral Condyles: Distal end of the femur.

  • Intercondyler Notch: An indentation in the distal femur where the anterior cruciate descends.

  • Quadriceps Femoris Muscle group: attach to the patella through the quadriceps tendon.


Terminology1

Terminology

  • PesAnserine:“foot of a bird”, the insertion of the semitendinosis, sartorius, and gracilis to the anteromedial tibia

  • Unhappy Triad (Terrible Triad): Tearing of the anterior cruciate ligament, medial collateral ligament and the medial meniscus.

  • Varus Stress: Stress applied to the medial aspect of the knee.

  • Valgus Stress: Stress applied to the lateral aspect of the knee.


Terminology2

Terminology

  • Direct trauma: A blow or fall on the knee.

  • Indirect trauma: violent contracture of the quadriceps

  • Distal pulses: pulses in the foot. The dorsalispedis and the posterior tibial pulse.

  • Chondromalacia: A degenerative condition in which there is a wearing away of the cartilage on posterior patella.

  • Subchondral: Below the cartilage.


Bones of the knee

Bones Of The Knee

  • Femur

  • Tibia

  • Fibula

  • Patella

Femur

Patella

Tibia

Fibula


Condyles of the knee

Condyles of the Knee

  • Lateral Condyle

  • Medial Condyle


Knee

Patellar Tendon

Tuberosity


Knee

Cartilage known as Menisci


Knee

Cruciate ligaments form an “X”

http://www.kneeguru.co.uk/KNEEnotes/cruciate-ligament

http://www.kneeguru.co.uk/KNEEnotes/node/829


Primary and secondary motions of the knee

Primary and Secondary Motions of The Knee

1. Primary Motions

  • Flexion

  • Extension

    2. Secondary Motions

  • Internal Rotation

  • External Rotation

  • Gliding Motion (a little)


Quadriceps

Quadriceps

  • Strongest muscle group in the body

    • VastusMedialis

    • VastusIntermedius

    • VastusLateralis

    • Rectus Femoris

  • Responsible for knee extension


Hamstrings

Hamstrings

  • Biceps Femoris (long and short head)

  • Semimembranosus

  • Semitendinosus

  • Responsible for knee flexion


Bursa

Bursa

Fluid sac acting as a cushion and lubricant in areas of friction

  • Suprapatellar - under patella (running)

  • Perpatellar - on top of patella (direct blow)

  • Anserine - below knee (running)


Medial collateral ligament sprain

Medial Collateral Ligament Sprain

  • MOI: occurs most often in violently adducted and internally rotated knees.

  • Path: a tear or sprain in the MCL

  • S/S: swelling, pain, loss of stability, popping noise, (+) valgus stress test on MCL (may vary depending on degree of injury)

  • Tx: RICE, rehab-light weights, straight leg raises, whirl pool (if available), crutches for discomfort and degree of injury, MCL taping


Lateral collateral ligament sprain

Lateral Collateral Ligament Sprain

  • MOI: blow to inside of the knee (varus force)

  • Path: partial to complete tear of ligament

  • S/S: pain on lateral side of knee, swelling, positive varus stress test

  • Tx: RICE, crutches and referral to physician


Anterior cruciate ligament sprain acl

Anterior Cruciate Ligament Sprain (ACL)

  • MOI: twisting of the knee, hyperextension of the knee, forward movement of the tibia on the femur

  • Path: Stretching or tearing of the ACL; secondary injuries: medial meniscus tear and medial collateral ligament sprain

    • Terrible Triad: ACL pathology WITH secondary injuries

  • S/S: A pop followed by immediate disability, pain, rapid swelling at the joint, feels like knee is coming apart

  • Tx: RICE, crutches, refer to doctor.


Meniscus tear

Meniscus Tear

  • MOI: sudden twisting and compression

  • Path: tear of the meniscus

  • S/S: locking, swelling, pain, giving way

  • Tx: RICE, crutches, refer to doctor.


Patellar subluxation or dislocation

Patellar Subluxation or Dislocation

  • MOI: athlete plants their foot and changes direction.

  • Path: the quadriceps muscles attempt to pull in a straight line and in a result pulls the patella laterally.


Patellar subluxation or dislocation cont

Patellar Subluxation or Dislocation Cont.

S&S: Complete loss of knee function; pain and swelling

Tx: immobilize in the position it is in, place ice around the joint, see physician, use crutches.


Patellar fractures

Patellar Fractures

  • MOI: caused by direct or indirect trauma. Forcible muscle contraction, falling, jumping, and running can also cause a fracture.

  • Path: a severe pull of the patellar tendon against the femur when knee is semi flexed resulting in a fracture

  • S/S: causes hemorrhage and joint effusion, resulting in generalized swelling.

    • An indirect fracture causes capsular tearing, separation of bone. Tearing of the quadriceps tendon is also a sign.

    • Direct fracture involves bone separation.


Patellar fracture cont

Patellar Fracture Cont.

  • Tx: a cold wrap should be applied, followed by elastic compression wrap, splinting, crutches and Doctor referral.


Knee dislocation

Knee Dislocation

  • The most Serious knee injury is the dislocation of the tibiofemoral joint. THIS IS AN EMERGENCY!

  • http://emedicine.medscape.com/article/1250829-overview


Knee dislocation cont

Knee Dislocation Cont.

  • MOI: Direct blow to the anterior proximal tibia, forceful twisting, lateral blow to the knee.

  • S/S: Grossly displaced tibia, sever pain, swelling, and may have absence of distal pulses.

  • Tx: Calm athlete down, splint, and immediate transport to the hospital. Check distal pulses.


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