Knee (Tibiofemoral) Joint. Bones of the Knee Joint Femur -Longest and strongest bone in the body...
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Transcript of Knee (Tibiofemoral) Joint. Bones of the Knee Joint Femur -Longest and strongest bone in the body...
![Page 1: Knee (Tibiofemoral) Joint. Bones of the Knee Joint Femur -Longest and strongest bone in the body Lateral and medial epicondyles -The widest points of.](https://reader030.fdocuments.in/reader030/viewer/2022032523/56649d845503460f94a6bc5e/html5/thumbnails/1.jpg)
Knee (Tibiofemoral) Joint
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Bones of the Knee Joint•Femur
-Longest and strongest bone in the body
• Lateral and medial epicondyles-The widest points of the femur at the knee-Round prominences above lateral and medial condyles-Will be attachments for thigh and leg muscles and knee ligaments
•Medial and Lateral Condyles-distal end of the femur-smooth round surfaces inferior to medial and lateral epicondyles
• Intercondylar Fossa-Groove separating the medial and lateral condyles
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Bones of the Knee Joint
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Bones of the Knee Joint•Tibia
-Larger bone of the lower leg-Only weight bearing bone of crural region
-If tibial fracture occurs, what may a patient not be able to do?
• Medial and Lateral Condyles-Articulate with medial and lateral condyles of the femur-Insertion points for leg muscles
• Intercondylar Eminence-ridge separating medial and lateral condyles of tibia
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Bones of the Knee Joint•Tibial Tuberosity
-can be palpated just below the patella-An attachment for the powerful leg muscles that extend the knee
*****Important for muscle insertions (Quads)
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Bones of the Knee Joint•Fibula
-Slender lateral bone of lower leg-Stabilizes the ankle, but does not bear any of the bodies weight
•Head-Proximal end of fibula-This Portion is thicker and broader than the distal end
•Patella-roughly triangular sesamoid bone embedded in the tendon of the knee
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Knee Ligaments• Fibular or lateral collateral ligament
• Extends from the lateral epicondyle of femur to the lateral surface of the head of fibula
• Tibial or medial collateral ligament• Extends from medial epicondyle of femur to medial condyle and superior, medial part of
tibia
• Oblique popliteal ligament• Expansion of tendon of semimembranosus • Strengthens joint capsule posteriorly
• Arcuate popliteal ligament• Arises from posterior aspect of the fibular head• Passes over the popliteus tendon and covers posterior surface of knee joint
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Knee Ligaments and cartilage• Anterior cruciate ligament (ACL)• Posterior cruciate ligament (PCL)
• ACL is the weaker of the two• Cross like an X
• Medial Meniscus• Adheres to tibial collateral ligament
• Lateral Meniscus• Popliteus tendon separates it from theLateral collateral ligament
• Transverse Ligament• Attaches the lateral portion of the menisci
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Patellar Ligament and Quadriceps Femoris Tendon
• Patellar ligament is an extension of the quadriceps femoris tendon
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Knee Bursae• Prepatellar bursa• Suprapatellar bursa• Deep infrapatellar bursa • Subcutaneous infrapatellar bursa
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Clinical Concerns
• Torn ACL • Can be partial or complete• Common sports injury for soccer, basketball and football players• Can result from changing direction rapidly, stopping quickly, direct contact,
and landing a jump incorrectly• Disrupts stability of knee, requires surgery
ACL Reconstruction
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The muscles of the patellar joint:
• Rectus Femoris:• Origin: Anterior inferior iliac spine• Insertion: Tibial tuberosity• Action: Hip flexion, knee extension• Nerve: Femoral nerve• Roots: L2-L4
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Vascular supply for the Rectus femoris:
• Lateral circumflex femoral artery
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Nerve innervation Rectus femoris:
• Femoral nerve• L2-L4
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Vastus intermedialis, lateralis, and medialis:• Origin: anterior femur( VI) and Linea aspera (VLAnd VM)• Insertion: Tibial tuberosity via patellar tendon• Action: Knee extension• Nerve: Femoral nerve• Roots: L2-L4• Vascular supply: Lateral circumflex
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Biceps femoris
• Origin: • Long head: Ischial tuberosity• Short head: Lateral lip of linea aspera
• Insertion: Fibular head• Action:
• Long head: Extends hip and flex knee• Short head: Flex knee
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Vascular Supply:
• Inferior gluteal artery
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Nerve Innervation
• Long head: Tibial division of sciatic nerve• Short head: Common peroneal nerve• Roots: L5, S1, and S2
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Semimembranosus:
• Origin: Ischial tuberosity• Insertion: Posterior surface of medial condyle of tibia• Action: Extend hip and flex knee• Nerve: Sciatic nerve• Roots: L5, S1, and S2• Vascular supply: Inferior gluteal artery
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Popliteus:
• Origin: Lateral condyle of femur• Insertion: Posteriorly on medial condyle of tibia• Action: Initiates knee flexion• Nerve: tibial nerve• Roots: L4-5, S1
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Vascular supply to popliteus:
• Popliteal artery• Popliteal vein
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Semitendinosus:
• Origin: Ischial tuberosity• Insertion: Anteromedial surface of proximal tibia• Action: Extend hip and flex knee• Nerve: Sciatic nerve• Roots: L5, S1, and S2
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Vascular supply to semitendinosus:
• Deep femoral artery
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Gastrocnemius:
• Origin: Medial and lateral condyles of femur• Insertion: Posterior calcaneus• Action: Knee flexion, ankle plantar flexion• Nerve: Tibial nerve • Roots: S1-2• Vascular supple: popliteal artery
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Other nerves to know:• Deep fibular
• Superficial fibular
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Other arteries we need to know:
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Other veins to know:
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Surface Anatomy: Posterior
• Popliteal fossa• Medial and lateral head of gastrocnemius• Semitendinous tendon• SemimembranosusTendon• Soleus• Biceps fermoris tendon
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Surface Anatomy: Anterior
• Patella• Vastus medialis • Vastus lateralis