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CHAPTER 9 KNEE INJURIES Slide 2 4 bones in the tibiofemoral joint Tibia Femur Fibula Patella BONES OF THE KNEE Slide 3 Shin bone Major weight bearing bone in the body. Named after a Greek aulos flute Parts to know: Medial Condyle Medial Tibial Plateau Lateral Condyle Lateral Tibial Plateau Intercondylar Eminence Tibial Tuberosity Gerdys Tubercle Shaft of the Tibia Anterior Crest Medial Malleolus Fibular Notch TIBIA Anterior ViewPosterior View Slide 4 Thigh bone Strongest bone in the body. Longest bone in the body. Parts to know: Greater Trochanter Head of the Femur Neck of the Femur Lesser Trochanter Shaft of the Femur Linea Aspera Lateral Condyle of the Femur Lateral Epicondyle of the Femur Medial Condyle of the Femur Medial Epicondyle of the Femur Patellar Surface Popliteal Surface Intercondylar Fossa FEMUR Anterior view Posterior view Slide 5 Largest sesamoid bone in the body. Enclosed in quadriceps femoris tendon. Illustration is of the right patella Parts to know: Base Apex Medial Facet Lateral Facet PATELLA Slide 6 Ligaments of the Knee Anterior Cruciate Ligament (ACL) Posterior Cruciate Ligament (PCL) Medial Collateral Ligament (MCL) Lateral Collateral Ligament (LCL) Meniscus of the Knee Medial Meniscus Lateral Meniscus LIGAMENTS AND CARTILAGE OF THE KNEE Slide 7 Flexion Extension Medial Rotation Lateral Rotation RANGE OF MOTION Slide 8 Rectus Femoris Origin Anterior Inferior Iliac Spine (AIIS) Insertion Tibial Tuberosity via the patellar tendon Action Extend the knee Flex the hip MUSCLES OF THE KNEE Slide 9 Vastus Lateralis Origin Lateral lip of linea aspera, gluteal tuberosity, and greater trochanter. Insertion Tibial Tuberosity via the patellar tendon. Action Extend the knee. MUSCLES OF THE KNEE Slide 10 Vastus Intermedius Origin Anterior and lateral shaft of the femur. Insertion Tibial Tuberosity via the patellar tendon. Action Extend the knee. MUSCLES OF THE KNEE Slide 11 Vastus Medialis Origin Medial lip of the linea aspera. Insertion Tibial tuberosity via the patellar tendon. Action Extend the knee. MUSCLES OF THE KNEE Slide 12 Semimembranosus Origin Ischial tuberosity. Insertion Posterior aspect of medial condyle of tibia. Action Flex the knee Medially rotate the flexed knee Extend the hip Assist in medially rotating the hip Tilt the pelvis posteriorly MUSCLES OF THE KNEE Slide 13 Semitendinosus Origin Ischial tuberosity. Insertion Proximal, medial shaft of the tibia at pes anserinus. Action Flex the knee Medially rotate the flexed knee Extend the hip Assist to medially rotate the hip Tilt the pelvis posteriorly MUSCLES OF THE KNEE Slide 14 Biceps Femoris Origin Long head: Ischial tuberosity. Short head: Lateral lip of the linea aspera. Insertion Head of the fibula. Action Flex the knee Laterally rotate the flexed knee Long head: extend the hip Long head: Assist to laterally rotate the hip Tilt the pelvis posteriorly MUSCLES OF THE KNEE Slide 15 Sartorius Origin Anterior Superior Iliac Spine (ASIS) Insertion Proximal, medial shaft of the tibia at the pes anserinus Action Flex the hip Laterally rotate the hip Abduct the hip Flex the knee Medially rotate the flexed knee MUSCLES OF THE KNEE Slide 16 Sartorius (posterior view) MUSCLES OF THE KNEE Slide 17 Gracilis Origin Inferior ramus of the pubis Insertion Proximal, medial shaft of the tibia at pes anserinus Action Adduct hip Medially rotate hip Flex the knee Medially rotate the flexed knee MUSCLES OF THE KNEE Slide 18 Popliteus Origin Lateral condyle of the femur Insertion Proximal, posterior aspect of the tibia Action Medially rotate the flexed knee Flex the knee MUSCLES OF THE KNEE Slide 19 Gastrocnemius Origin Condyles of the femur, posterior surfaces Insertion Calcaneus via the Achilles tendon Action Flex the knee Plantar flex the ankle MUSCLES OF THE KNEE Slide 20 Plantaris Origin Lateral supracondylar line of the femur. Insertion Calcaneus via the Achilles tendon Action Plantar flexion of the ankle Flexion of the knee MUSCLES OF THE KNEE Slide 21 Tensor Fascia Latae and the Iliotibial Band Origin Iliac crest, posterior to the ASIS Insertion Iliotibial tract (which then inserts on the tibial tubercle on the lateral aspect of the proximal tibia) Action Flex the hip Medially rotate the hip Abduct the hip MUSCLES OF THE KNEE Slide 22 Valgus Test Varus Test Anterior Drawer Lachmans Test Posterior Drawer Test Godfreys Test/Posterior Sag Test McMurrays Test Apleys Compression Test Apleys Distraction Test Patellar Apprehension Test Patellar Grind Test/Clarkes Sign ASSESSMENT TESTS Slide 23 Ligament Sprain MCL LCL ACL PCL Jumpers Knee Osgood-Schlatter Disorder Quadriceps Strain Hamstrings Strain Patellar Subluxation/Dislocation Chondromalacia patella Meniscal Injuries Bursitis Iliotibial Band Friction Syndrome Osteochondritis Dissecans KNEE INJURIES & CONDITIONS Slide 24 Etiology MCL Injury Pathology Treatment MEDIAL COLLATERAL LIGAMENT SPRAIN Slide 25 Etiology LCL Injury Pathology Treatment LATERAL COLLATERAL LIGAMENT SPRAIN Slide 26 Etiology ACL Injury Pathology Treatment ANTERIOR CRUCIATE LIGAMENT SPRAIN Slide 27 Etiology PCL Injury Pathology Treatment POSTERIOR CRUCIATE LIGAMENT SPRAIN Slide 28 Etiology Pathology Treatment JUMPERS KNEE (PATELLAR TENDINITIS) Slide 29 Etiology Patella Tendon Rupture Injury Pathology Treatment PATELLA TENDON RUPTURE Slide 30 Etiology Pathology Treatment OSGOOD-SCHLATTER DISEASE/SHINDING-LARSEN- JOHANSSON DISEASE Slide 31 Etiology Quad injury Pathology Treatment QUADRICEPS STRAIN Slide 32 Etiology Hamstring Injury Pathology Treatment HAMSTRINGS STRAIN Slide 33 Etiology Patellar Dislocation Pathology Treatment Patellar Reduction PATELLAR SUBLUXATION/DISLOCATION Slide 34 Etiology Pathology Treatment CHONDROMALACIA PATELLA Slide 35 Etiology Pathology Treatment MENISCAL INJURIES Slide 36 Etiology Pathology Treatment BURSITIS Slide 37 Etiology Obers Test Pathology Treatment RUNNERS KNEE ILIOTIBIAL BAND FRICTION SYNDROME Slide 38 Etiology Pathology Treatment OSTEOCHONDRITIS DISSECANS Slide 39 FOR YOUR QUIZ Students should be able to: Label the parts of the bones for the knee joint including the femur, tibia, patella and fibula. Label the muscles that are involved with the knee joint. Label the ligament and meniscal structures of the knee. Identify the different knee assessment tests and what they are used for. Identify the different knee injuries and conditions and be able to define them. Identify the different bones and their respective parts on the models of the bones.