In the name of god. Knee. By: Tofigh Bahraminia Graduate Student of the Pathology Sports and corrective actions. Heat: Dr. Babakhani. Nov.

Transcription

1 In the name of god Knee By: Tofigh Bahraminia Graduate Student of the Pathology Sports and corrective actions Heat: Dr. Babakhani Nov

2 Anatomy-Bones Bones Femur Medial/lateral femoral condyles articulate tibia. Tibia Tibial plateau is flat-articulates femoral condyles. Fibula Articulates tibia. Patella Sesamoid bone protects anterior joint. Inclouded in quadriceps/patellar tendon. 2

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5 Anatomy-Joints Joints Tibiofemoral. Hinge joint with synovial. Patellofemoral. Superior Tibiofibular. 5

6 Anatomy-Meniscus Meniscus Medial and lateral. Fibrocartilaginous disks. Thicker on outside than inside (poor blood supply). Lie on top of tibial plateau. Increase stability. Make condyles fit better. Shock absorbers. 6

7 Transverse genual ligament. Minescofemoral ligament. 7

8 Anatomy-Ligaments ACL-anterior cruciate ligament Runs from anterior tibia to posterior femur. Prevents anterior displacement of tibia on fixed femur. Prevents femur from moving posterior during weight bearing. Stabilizes tibia against excessive internal rotation. 8

9 Ligaments PCL-posterior cruciate ligament Runs from posterior tibia to anterior femur_ Medial condyle. Prevents posterior displacement of tibia on fixed femur. Prevents femur from moving anterior during weight bearing. Both ACL and PCL cross or wrap around each other taut when in extension and looser when in flexion. 9

10 PCL Ligaments 10

11 Ligaments MCL-medial collateral ligament Attaches on the medial femoral epicondyle & anteromedial tibia. Prevents portion of joint capsule. Two parts-superficial and deep. Deep portion attaches to medial meniscus. Stabilizes against valgus stress applied to lateral aspect of joint capsule. 11

12 MCL-medial collateral ligament 12

13 Ligaments LCL-lateral collateral ligament Attaches to lateral femoral epicondyle and head of fibula. Stabilizes against varus stress when force is applied to medial aspect of joint. Both the MCL and LCL are tightest during full extension of knee and relaxed during flexion. 13

14 LCL-lateral 14

15 Oblique popliteal ligament. Arcuate popliteal ligament. 15

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17 Ligaments 17

18 Muscles Quadriceps Rectus femoris, vastus lateralis, vastus medialis, vastus intermedius. Knee extension, hip flexion Hamstrings Biceps femoris, semimembranosus, semitendinosus. Knee flexion, hip extension 18

19 Muscles Gracilis Knee flexion, hip adduction. Sartorius Knee flexion, hip flexion, hip external rotation. Popliteus Knee flexion. Gastrocnemius Knee flexion. 19

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21 Motions of the Knee A. Flexion - bending or decreasing the angle of the knee characterized by the heel moving toward the buttocks. B. Extension - The opposite of flexion. Straightening or increasing the angle between the femur and the lower leg. 21

22 Knee Flexion 22

23 Knee Extension 23

24 Motions of the knee C. External rotation - rotary movement of the lower leg laterally away from the midline. D. Internal rotation - Rotary movement of the lower leg medially toward the midline. 24

25 Bursas of the knee anterior Name location Subcutaneous prepatellar Deep infraptellar Subcutaneous infrapatellar Betweenthe patellar and skin Between proximal tibia and patellar ligament Between tibial tuberosity and skin suprapatellar Between distal femur and quadriceps tendon 25

26 Posterior name gastrocnenius biceps popliteal gastrocnemius semimembranous location Between lateral head of gastrocenemius muscle and capsule Between fibular collateral ligament and biceps tendon Between popliteus tendon and lateral femoral condyle Between medial head of gastrocnemius muscle and capsule Between tendon of semimembranosus mascle and tibia 26

27 lateral iliotibial name Fibular collateral ligament location Under the iliotibial band at its distal attachment Under the fibular collateral ligament nex to the bone 27

28 Medial Anserine Name Location Under the sartorius, gracilis, and semitendinosus tendons 28

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40 The Q angle, or patellofemoral angle, is the angle between the quadriceps muscle, primarily the rectus femoris muscle and the patellar tendon. It is determind by drawing a line from the anterior superior iliac spine (ASIS) to the midpoint of the patella. and from the tibial tuberosity to the midpoint of the tuberosity to the midpoint of the patella. The angle formed by the intersecting of these lines represents the Q angle. This angle Ranges from 13 to 18 degrees in normal individuals in knee extension and tends to be greater in females. 40

41 Common knee pathologies Jumpers knee. Iliotibial track friction syn. Prepatellar bursitis. Popliteal (Bakers) cyst. Patellofemoral oveload (Chondromalacia patella). osgood- Schlatter. Osteoarthritis. Cruciate ligament tear. Meniscus tear. Fractured patellar bons. Valgus deformity And knee parenthesis. 41

42 Meniscus tear 42

43 The ACL torn The ACL intact 43

44 Popliteal (Bakers) cyst 44

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47 Refreance حرکت شناسی CLINICAL KINESIOLOGY and ANATOMY )فیزیولوژی مفاصل ( دکتر علی اصغر رواسی اصول حرکت شناسی ساختاری دکتر وهللا دبیدی روشن حرکت شناسی دکتر تند نویس حرکت شناسی دکتر حمید طباطبایی حرکت شناسی دکتر رحمان سوری 47

48 Thank you for your atention 48