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Brachial plexus. The Knee. PSE4U. Bones. Femur Tibia Fibula Patella. Ligaments. Medial Collateral Lateral Collateral. Ligaments. Anterior Cruciate Posterior Cruciate. Meniscus. Medial meniscus Lateral meniscus. Bursa(e). - PowerPoint PPT Presentation

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Knee and Thigh

Brachial plexus

The Knee PSE4U

BonesFemurTibiaFibulaPatella

LigamentsMedial CollateralLateral Collateral

LigamentsAnterior CruciatePosterior Cruciate

MeniscusMedial meniscusLateral meniscus

Bursa(e)A bursa is a fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body.

MusclesQuadricepsFunction is knee extension.

Vastus medialisVastus intermediusVastus lateralisRectus femoris

MusclesHamstringsfunction is knee flexion.

SemitendinosusSemimemranosusBiceps femoris

TendonsQuadriceps tendonPatellar ligament Hamstring tendons

Knee InjuriesQuadricep strainHamstring strainContusionPatellar/Quadriceps tendonitisPatellar/Quadriceps tendon ruptureOsgood-Slatter diseaseBursitisMeniscal tearMCL/LCL sprainACL/PCL sprain

Quadriceps strainGrade 1: Tightness in the thigh, Unable to walk properly. Probably not much swelling. Grade 2:Probably cannot walk properly. The athlete may notice swelling. Straightening the knee against resistance causes pain. Unable to fully bend the knee. Grade 3:Unable to walk properly without the aid of crutches. In severe pain. Bad swelling appearing immediately. Expect to be out of competition for 3 to twelve weeks.

12Results from repeated overuse (kicking) or over stretching of the muscle.Hamstring StrainGrade 1:Might have tightness in the thigh. May be able to walk properly. Probably won't have much swelling. Grade 2:Bending the knee against resistance causes pain. Might be unable to fully straighten the knee. Some swellingGrade 3:Unable to walk properly without the aid of crutches. In severe pain. Bad swelling appear immediately.

ContusionCaused by a direct blow to the muscle. Most likely to occur in the quadriceps.

Hyperextended kneeIn this injury, your knee extends beyond its normally straightened position so that it bends back on itself.

Quadriceps TendonitisA person experiencing quadriceps tendonitis will have particular pain straightening the lower leg, or decelerating when walking. The major point of pain coming from above the kneecap. Patellar TendonitisWhat is patellar tendonitis? Patellar tendonitis, also called jumper's knee, is inflammation in the band of tissue (the patellar tendon) that connects the kneecap (patella) to the shinbone (tibia). How does it occur? The most common activity causing patellar tendonitis is too much jumping. Other repeated activities such as running, walking, or bicycling may lead to patellar tendonitis. All of these activities put repeated stress on the patellar tendon, causing it to be inflamed. Patellofemoral SyndromeGradual onset of anterior knee pain or pain around the patellaMore common in adolescents, young adults and females are more prone than malesOften aggravated by sports such as running, volleyball and basketballThere is quite a bit of disagreement in the sport medicine community as to its causeJumpers Knee

Factors Contributing to PFSOveruse/Overload: repeated weight bearing impact, landing from jumpsBiomechanical Instability: flat feet (pronation) causes internal rotation of tibia and femur which stresses the PF jointhigh arches puts undue stress on PF jointQ-angle?MusclesMuscle weakness or imbalance (especially quadriceps and hamstrings)Patellar tendon rupture

Patellar dislocationWhat is a dislocated patella? A dislocated patella occurs when the kneecap (patella) pops out from its normal position. This can occur as the result of force or, is more often related to a developmental condition that leads to an improper alignment of the kneecap with the thighbone (femur). This is sometimes called "unstable kneecap."

Patellar fractureDislocated Knee

Osgood-Slatter diseaseOsgood-Schlatter (OS) disease is one of the most common causes of knee pain in the adolescent.

During periods of rapid growth, stress from contraction of the quadriceps is transmitted through the patellar tendon onto a small portion of the partially developed tibial tuberosity. Osgood-Slatter disease

BursitisHousemaid or Carpet layers knee. This is caused by direct trauma.

Meniscal tearOne may tear the meniscus by twisting the knee, pivoting, cutting or decelerating. In athletes, meniscal tears often happen in combination with other injuries such as a torn ACL (anterior cruciate ligament). Meniscal tearSigns and SymptomsPain and clicking while walking or bending knee.Pain and clicking while going upstairs.Remedies: RICE with medication, or surgery.Meniscal tears

Meniscal injury tests

Medial Collateral injuryWhat causes Medial Collateral Ligament Sprain?By far the most common cause of medial collateral ligament sprain is a blow or sudden impact to the outside (lateral) of the knee joint. This causes the outside of the knee to collapse inward toward the midline of the body and the inside of the knee (where the medial collateral ligament is located) to widen and open up. This opening up stretches the ligament, which results in the injury.32Show videoMedial Collateral injuryWhat are the Signs & Symptoms of Medial Collateral Ligament Sprain?

The most common symptom of a MCL injury is pain around the inside of the knee joint. Also common is bruising and swelling.Collateral Ligament Tests

Lateral Collateral sprainApply everything from an MCL injury, except the mechanism of injury is a direct blow from the medial side of the knee.Anterior Cruciate sprainHow is the anterior cruciate ligament injured?

The ACL or anterior cruciate ligament is injured either through twisting the knee or through an impact to the side of the knee - often the outside.

36Show video.

Anterior Cruciate sprainSigns and Symptoms

Pain at time of the injury.Athlete and/or people in the area will hear a pop.Swelling. In the later stages when the swelling has decreased there may be instability in the joint. For a partial rupture pain may be felt on the Anterior Drawer test where the tibia is pulled.The Q-AngleQ-angle stands for the quadriceps angleThe Q angle is formed by two lines drawn:From the Anterior Superior Illiac Spine (ASIS) through the centre of the patellaFrom the tibial tuberosity through the centre of the patellaResearch indicates that a Q-angle greater than 20 increases the risk of knee injuriesMeasuring Your Q-AngleFind a friendLocate the ASIS, tibial tuberosity and the centre of the patellaCreate two lines to form your Q-angleUse a protractor to measure your Q angleReport your results on the board

Q angle

Unhappy TriadMedial Meniscus tearMedial Collateral ligament tearAnterior Cruciate ligament tear

Female Anterior Cruciate injuryNCAA study showed that women suffered ACL injuries four times more often in basketball; three times more often in gymnastics; and two-and-a-half times more often in soccer. Posterior Cruciate sprainMechanism of injuryPCL tears can occur when a football or soccer player falls on a bent knee. Motor vehicle accidents are another common cause of injury to the PCL. When the driver or passenger strikes the bent knee just below the kneecap (patella) against the dashboard, the force can tear the PCL and damage other ligaments, bones and muscles. PCL Injury

Posterior Cruciate sprainSigns and symptoms Marked, immediate swelling (within three hours of the injury) Difficulty walking after the injury Painful to move the knee Occasionally, a feeling of instability, or the knee "giving way"