Your SlideShare is downloading. ×
4
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
373
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
12
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide
  • I: Between the lesser trochanter and the lineaaspera
  • Important landmark in fitting above the knee prosthetics
  • Often described as performing hamstring functions
  • Transcript

    • 1. + ESS 3092: KINESIOLOGY Week 12
    • 2. + Review 3
    • 3. + Name the thigh adductors: 4
    • 4. 5
    • 5. + Pectineus  Origin  The superior ramus of the pubis, between the pubic tubercle and the iliopubic eminence  Insertion  Pectineal line on the posterior aspect of the femur  Location  Deep  Action  Hip adduction  Hip internal rotation (weak)  Hip flexion (weak) 6
    • 6. + Adductor Brevis  Origin  The body and the inferior ramus of the pubis  Insertion  Pectineal line and the proximal half of the linea aspera  Location  Deep  Medial  Posterior to pectineus  Action  Hip adduction  Hip internal rotation (weak)  Hip flexion (weak) 7
    • 7. + Adductor Longus  Origin  The intersection of the pubic crest and symphysis  Insertion  Medial lip of the linea aspera  Location  Medial  Superficial  Action  Hip adduction  Hip flexion 8
    • 8. + Adductor Magnus  Origin  Inferior ramus of the pubis  Insertion  Linea aspera to the adductor tubercle  Location  Medial  Deepest of the adductors  Action  Hip extension  Hip adduction (role unknown) 9
    • 9. + Gracilis  Origin  Thin aponeurosis from the medial surface of the inferior body of the pubis  Insertion  Proximal aspect of the medial surface of the tibia  Location  Medial  Most superficial of the adductors  Action  Hip adduction  Knee flexion  Knee internal rotation 10
    • 10. + The Knee Joint 11
    • 11. + The Knee Joint Bones & bony landmarks Joint Structure  Ligaments & menisci Movements Muscles surrounding the joint & attachments
    • 12. + Patella
    • 13. Patella The largest sesamoid bone
    • 14. + Knee Joint Vulnerable to injury Provides stability and mobility  Extended – joint surfaces congruent  Flexed – requires capsule, ligaments, muscles 3 articulations 1)Tibiofemoral (knee) 2) Patellofemoral= gliding joint 3) Superior tibiofibular
    • 15. + Degrees of Freedom a) Medial/lateral translation b) Longitudinal rotation c) Anterior/posterior translation 16 d) Tibial and femoral rotation e) Varus/Valgus f) Flexion/extension
    • 16. + Knee Malalignment (Varus ans Valgus)  Hip, knee and ankle should remain in line  Varus moves load medially and increases risk of AO, weight is a confounder increasing risk of AO 5x  Valgus moves load laterally. Less risk of AO compared to varus, but still a factor in AO, minisci, and ligament damage. 17
    • 17. + Knee Joint  Bursae (>10)  Absorb shock or prevent friction  Synovial cavity (capsule)  Lies under patella & between surfaces of tibia & femur  Infrapatellar fat pad  Posterior to patellar tendon  Osteoarthritis:  Breakdown of articular cartilage– decreased blood supply so does not self- regenerate
    • 18. + Tibiofemoral Joint  Lateral condyle (c)  Flatter, larger surface area  More superior than (b)  ↑ stability  Aligned w/ femur  Medial condyle (b)  Convex  Aligned w/ tibia  Fits snug with tibia (concave) Posterior Anterior c b
    • 19. + Tibiofemoral Joint Menisci form cushions between bones  Attached to tibia  Enhance stability  Thicker outside border & taper Medial  Larger & more open C Lateral  Closed C configuration
    • 20. + Tears due to:  Compression & shear forces during rotation while flexing or extending  Quick directional changes in running Menisectomies ↑ friction 50 % (leads to osteoarthritis)
    • 21. + Knee Joint Supporting Ligaments Cruciate ligaments: (2) ACL & PCL  Cross w/in knee between tibia & femur  Maintain anterior & posterior stability & rotatory stability
    • 22. + Cruciate Ligaments Posterior Cruciate Ligament (PCL)  From posterior middle tibia to anterior medial femoral condyle.  Limits posterior movement of tibia on femur  PCL injury = direct contact injury Anterior Cruciate Ligament (ACL)  From (anterior) intercondylar eminences of tibia to lateral femoral condyle  Limits anterior movement of tibia on femur  Common injury to knee  Injury mechanism often involves noncontact rotary forces  Planting & cutting  Hyperextension  Violent quadriceps contraction (pulls tibia forward on femur)
    • 23. + ACL Injury Theories why females tear ACLs 2-7x more than males: 1. ↑ Q-angle in 2. Neurological: when stimulate back of knee, contract quads, contract hamstrings. 3. Strength differences: is stronger than 4. Hormonal: ↑ Estrogen => ↑ elasticity => ↑ tearing
    • 24. +  Lateral (fibular) Collateral Ligament (LCL)  Supports knee against varus forces (medial bending)  Laterally directed force  Medial (tibial) Collateral Ligament (MCL)  supports knee against valgus forces (lateral bending)  Injuries (contact) are common: more exposed/vulnerable Knee Joint Supporting Ligaments
    • 25. + LCL and MCL
    • 26. + Q Angle Assessment of  Lower extremity alignment  Patella position Most efficient angle for quadriceps to function is ~10º  Males: 10-14º  Females: 15-17º Genu valgum (knock kneed)  > 17º = excessive Genu varus (bowlegged)  Negative ↑ Q angle => ↑ stress on MCL
    • 27. + Joint Movements Flexion (145º ROM)  accompanied by internal rotation (tibia on femur) Extension (<180º ROM)  accompanied by external rotation (tibia on femur)
    • 28. + Joint Movements  External rotation  rotary movement of leg laterally away from midline  Internal rotation  rotary movement of lower leg medially toward midline  Knee must be flexed ≥ 20-30º for motion 30º 45º
    • 29. + Knee Musculature

    ×