Kinesiology Chapter 8

Kinesiology Chapter 8 - Chapter 8 – The Lower Extremity...

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Unformatted text preview: Chapter 8 – The Lower Extremity: Chapter 8 – The Lower Extremity: The knee, ankle, and foot • The Knee Joint Femoral condyles Tibial plateau with medial and lateral meniscus Patella 2 joints: femoral­tibial joint patello­femoral joint Concave vs Convex rule Concave vs Convex rule • • • • • When is it concave on convex? When is it convex on concave? Capsular Pattern: flexion > extension Open pack position: 30 degrees of flexion Close pack position: full knee flexion The femoral condyles The femoral condyles • lateral femoral condyle: broader and more prominent than medial femoral condyle Femur and patella Femur and patella • from above, femur slants inward – called obliquity of the femoral shaft • patella is a large sesamoid bone which increases the mechanical advantage of the quadriceps Meniscus Meniscus • menisci: medial and lateral, they sit on the tibial plateau medially and laterally • lateral forms an incomplete circle • medial forms a large letter C, – anchored to the MCL and semimembranosus posteriorly, – more prone to injury Ligaments: ACL, PCL, MCL, LCL Ligaments: ACL, PCL, MCL, LCL • • • • MCL: checks extension and lateral rotation LCL: checks extension and medial rotation ACL: prevents forward translation of tibia PCL: prevents backward translation of tibia Q­angle: Q­angle: • normal is 11 degrees for men and about 16 for women; what happens to knees with higher than normal; class demonstration Screw home mechanism Screw home mechanism • the tibia externally rotates about 20 degrees on the fixed femur; femur internally rotates; terminal rotation of the knee Muscles Muscles • flexors, extenders, rotators; • Popliteus: unlocks the knee, rotates the knee inward and helps flex the knee Pathology: Pathology: • • • • • • • • • • • Pes anserine bursitis Patella tendonitis Patellofemoral syndrome Chondromalacia patella ACL tear PCL tear MCL/LCL sprain/strain Meniscal tears ITB band syndrome Muscle tears Stroke causing genu recurvatum • Osgood Schlatter Disease PFS PFS • Bracing for PFS: chopat strap, knee brace with lateral patella buttress Unhappy Triad Unhappy Triad Chapter 8 – The Lower Extremity: Chapter 8 – The Lower Extremity: Ankle and Foot • 2 functions: support and propulsion • Structure of the Ankle: Talocrural Joint Subtalar Joint Midfoot Joint • Bones: Metatarsals, Cunieforms, Cuboid, Navicular • Ligaments: Deltoid and Lateral Ligaments MIDFOOT MIDFOOT • Proximal end of the second metatarsal is tightly recessed between first and third cuneiforms • This mortise configuration effectively locks entire tarsometarsal complex, – Preventing medial or lateral translation Lisfranc injury Lisfranc injury • because 2nd metatarsal is the longest metatarsal proximally, it will often be fractured at its base, with the other metatarsals dislocated; • dorsal capsule of Lisfranc's joint, lacking sufficienct re­inforcement, will not be able to support the load and will therefore collapse, resulting in dorsal fracture dislocation of the metatarsal bases; Ankle and Foot Ankle and Foot • Concave vs Convex Rule with PF/DF • Capsular Pattern: – Talocrural ­ plantarflexion more limited than dorsiflexion • Close Pack and Loose Pack position: – Close Pack: Weightbearing DF – Loose Pack: 30 degrees of PF Ligaments Ligaments • Most commonly injured Ankle Ligament? Why does the ankle sprain more so in the inversion direction? Palpation of the ATFL 2 Arches in the foot: longitudinal and transverse arches Movements: Movements: • Ankle or Talocrural Joint: DF vs PF • Subtalar: Supination vs Pronation • Combined movements? – Supination: adduction, inversion – Pronation: abduction, eversion Foot Posture Foot Posture • • • • Subtalar neutral Pronated foot Supinated foot Class lab Muscles: Muscles: • Tibialis Anterior • Peroneous Longus: common strained with type of injury? Muscles Muscles • Gastroc/Soleus: how can you isolate the soleus for stretching and strengthening? • Tibialis Posterior: commonly gets injured how? • Plantar Fascia: functions? Pathology: Pathology: Shin splints Stress fractures Ankle sprain/strain Fractures of the ankle ORIF Closed reduction Achilles Tendonitis Plantar Fasciitis Posterior Tibialis Tendonitis Foot Drop Shin splints Shin splints Also known as medial tibial stress syndrome exercise induced pain in mid leg contributing factors include varus hindfoot, excessive forefoot pronation, genu valgum, excessive femoral anteversion or toeing in, & external tibial torsion • excessive or unbalanced pronation may be a cause of shin splints; • • • ...
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