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Lower Extremity 2FINAL

Lower Extremity 2FINAL - Hamstrings Posterior Thigh Biceps...

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Biceps femoris O: long head - ischial tuberosity short head - linea aspera (lateral) I: long head - head of fibula both heads - lateral tibial condyle A: both - flex leg long head - extend thigh Semitendinosus O: ischial tuberosity I: proximal medial tibia A: extend hip, flex leg Hamstrings - Posterior Thigh
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Semimembranosus O: ischial tuberosity I: posterior aspect of medial tibial condyle A: extend hip, flex leg Hamstrings - Posterior Thigh
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Hip (Femoral) Fractures ‘broken hip’ usually femoral neck fracture (weakest part of femur) collisions, elderly poor healing potential (avascular necrosis Hip Osteoarthritis degeneration of joint cartilage narrowed joint space, growth of bone in and around joint (osteophytes) Hip Injuries and Disease
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Subcapital (where neck joins head) fracture of the femoral neck. A, Notice the compressed trabeculation and resulting radiodense band on the inferior margin of the femur (arrowheads) and cortical disruption on the distracted superior margin of the fractured femur (arrow) .
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Hip Bursitis (Greater Trochanteric Pain Syndrome) Iliotibial Band Syndrome Snapping Hip Syndrome Hip Dislocations Hip Pointer - ASIS direct blow, bruised soft tissue, bone Avulsions - ischial tuberosity - lesser trochanter Hip Injuries and Disease
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Bursitis Sprung Pelvis
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Like the elbow, the primary function of the knee is to lengthen and shorten the limb (helps hip position foot) Example: 1) knee shortens lower extremity to allow foot to clear ground during swing phase of gait; 2) lengthens lower extremity toward ground for stance phase Role of telescoping knee is complicated by: 1. Knee is weight bearing 2. Located between the 2 longest bones (femur, tibia) 3. Motion of foot on ground causes twisting motion of tibia and hence knee Pure hinge joint won’t cut it. Need complex 3-D motion. Knee (Genu)
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Knee (Genu) Tibiofemoral joint Patellofemoral joint
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KNEE JOINT COMPLEX Largest joint in body Type: Compound, Diarthroidial and effectively ginglymus (hinge) a) Condylar (modified hinge)- Two large convex condyles of femur articulate with nearly flat tibial plateaus (primary joint - tibiofemoral joint) b) Patella articulates with patella surface of femur (patellofemoral joint) Tibiofemoral joint large surface area of femoral condyles allows sagittal plane motion stability from body weight, lig’s, capsule, menisci, forces
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KNEE JOINT Capsule - encloses medial and lateral tibiofemoral joints, patellofemoral joint (does not cover anterior surface -quadriceps covers) Menisci are circular rims of fibrocartilage discs in knee joint Menisci anchored to intercondylar tibial region Lateral – is an incomplete circle Medial – “C” shaped Thick peripheral borders & taper to a thin inner edge Mensci Function to reduce compression stress reduce friction, guide motion 2200 joint contact by almost 3x shock absorbers, deformation torn meniscus?
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Ligaments of the Knee Lateral (fibular) collateral lig - runs from femur to fibula and limits varus stresses and motion of knee Medial collateral lig - from femur to tibia (also attached to medial meniscus) and limits valgus stress Genu valgum - knock-knee Genu varum - bow-leg Base Apex
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Ligaments of the Knee Fig 8.5
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Movements Fig 8.6 Flexion Extension Internal rotation External rotation
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Movements Tibiofemoral joint Lateral rotation Medial rotation Tibiofemoral joint Flexion Extension
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Anterior Posterior
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