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Knee & Thigh Chapter 7

Knee & Thigh Chapter 7. Objectives: UNDERSTAND: Anatomy of the knee & thigh Principles of rehabilitation to the knee & knee Preventive/supportive techniques and devices IDENTIFY: Assessment tests for injuries to the knee and thigh RECOGNIZE: Steps in the evaluation format

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Knee & Thigh Chapter 7

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  1. Knee & ThighChapter 7 Objectives: UNDERSTAND: Anatomy of the knee & thigh Principles of rehabilitation to the knee & knee Preventive/supportive techniques and devices IDENTIFY: Assessment tests for injuries to the knee and thigh RECOGNIZE: Steps in the evaluation format Common injuries to the knee and thigh

  2. Anatomy • The Knee • Largest joint in the body, but structurally very weak. • Unstable bony structure: the femur (longest & strongest bone in the body) sits on top of the smaller tibia (main weight bearing bone of lower leg).

  3. Anatomy • Femur-longest and strongest • Tibia-main weight bearing bone of lower leg • Fibula-non-weight bearing bone of lower leg • Patella-(knee cap) encased in powerful patellar tendon

  4. Ligaments • Medial Collateral (MCL) -secure femur to tibia - connects to the medial meniscus -Reduce Valgus & varus movement (abduction & adduction of tibia and femur) • Lateral Collateral (LCL)-(not as strong) -does not attach to the lateral meniscus -Reduce Valgus & varus movement (abduction & adduction of tibia and femur) • Anterior Cruciate (ACL)-form “X” control anterior & posterior movement of femur on the tibia. • Posterior Cruciate (PCL)

  5. Other structures • Cartilage: (rest on top of tibia, form a cushion for the femur to rest on, and shock-absorption, joint stability, smooth gliding & rotating of the femur and tibia) • Medial Meniscus (cartilage) • Lateral Meniscus (cartilage) • Bursa-closed, fluid-filled sacs, cushion against friction over bone, or where tendon moves over a bone. • Synovial membrane -largesac that lines the inside of the knee joint, helps: tendons, ligaments, and bones. • Fat pads -soft tissue: weight bearing and absorbing impact

  6. Muscles • Quadriceps: Anterior, extend (straighten) lower leg, form patellar tendon (attaches on front of tibia) 1. Rectus femoris 2. vastusmedialis-patellar tracking 3. vastuslateralis 4. vastusmedialis

  7. Muscles • Hamstrings: posterior, flexes the knee, controls the rotary movements of the tibia. 1. Semitendinosus 2. semimembranosus 3. biceps femoris

  8. Muscles & Tendons • VastusMedialis: extension of knee • VastusLateralis: extension of knee • VastusIntermedius: extension of knee • Rectus Femoris: extension of knee, flexion of hip • Gracilis: adduction of hip and flexion of knee • Sartorius: flexion & rotation of hip & knee • Semitendinosus: knee flexion & medial rotation • Semimebranosus: Knee flexion & medial rotation

  9. Muscles & Tendons • Popliteus: flexion of knee & medial rotation • BicepsFemoris: flexion of knee & lateral rotation • Gastrocnemius: knee flexion • Plantaris: knee flexion

  10. Assessment Tests • Test for knee ligament stability: - abduction or valgus stress: medial joint stability -adduction or varus stress: lateral joint stability -anterior drawer: acl -posterior drawer: pcl -Lachman’s: acl

  11. Common Injuries • Ligament sprains: 1st, 2nd, 3rd degrees. -Contusion: direct blow to knee joint -Torsion: feet are fixed and body/injured joint is twisted (most often menisci) -Shearing: force delivered to opposite side of joint • Patellar Tendinitis: Inflammation above/below patella. (pain after exercise, swelling) Ice & rest

  12. Common Injuries • Chondromalacis Patellae: irritation and softening of the cartilage on the posterior aspect of the patella, causing unusual tracking of the patella as it moves. (causes: muscle weakness, imbalance, females: wider pelvic) • Osgood-Schlatter: Adolescents due to rapid growth during growth spurts, swelling below one/both knees. (causes: inflammation of the tibial tubercle, where the patellar tendon attaches) Rest & maybe cast • Muscularstrains: PRICES

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