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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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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
slide7

Patellar Tendon

Tuberosity

slide9

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.