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