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AT Exam 3 - AT Exam 3 The Knee Anatomy Bones 8:40:00 AM o...

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AT Exam 3:  The Knee 25/03/2008 07:40:00 Anatomy Bones: o Tibia/tibial plateau o Fibula o Femur * medial/lateral Condyles & epicondyles o Patella o Tibial Tuberosity o Fibular Head o Epicondyles: o Condyles: Joints: o Hinge Joint - tibiofemoral o Patella -femoral Joint o Tibiofibular Joint * Distal * Proximal Ligaments o Anterior Cruciate Ligament  (ACL): prevents anterior movement of tibia  on femur o Posterior Cruciate Ligament  (PCL): prevents posterior movement of tibia  on femur
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o Medial Collateral Ligament  (MCL): protects from valgus stress o Lateral Collateral Ligament  (LCL): protects joints from varus stress  Meniscus o Fibrocartilage - cushion/shock absorbers - Medial & Later components (attachments on tibia) - Mostly  avascular  (not a lot of blood  supply) * divided into 3 parts:  1. Red-Red: [outer] more vascular (not as high risk) 2. Red-White: [middle] Little blood supply  3. White-White: [inner] No blood supply (not going to  heal) More Anatomy o Joint Capsule/Synovial Membrane: Holds and Protects knee (MCL &  LCL)  o Bursa: in b/w structures * subject to injury  * deep infrapatella bursa o Patella Tendon o Iliotibial Band (ITB): lateral thigh  * crosses knee joint * inserts on lateral side of tibia  Musculature
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Quadriceps: (Quadriceps Femoris) o Vastus Lateralis o Vastus Medialis o Rectus Femoris Hamstrings o Semi-membranosus (medial) o Semi-teninosis (medial) o Biceps femoris: inserts on fibular head, runs laterally Adductors: inner thigh/groin o Insert on hip Abductors: outer thigh/hip Gastrocnemius: origin above the knee joint Soleus: origin below knee joint Knee Movement:  Flexion (foot to butt): Hamstrings Extension (kick foot out): Quad Femoris Internal rotation: semimembranosus & semitendinosis (muscles attaching on  medial side) External rotation: Biceps Femoris Terminology Genu Varum:  bow legs Genu Valgum:  knock knees—knees toward midline
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Genu Recurvatum:  Hyperextension—straight-legged Assessing Knee Injuries H     istory O.P.S. o Acute: popping, crunching, lock up? o Chronic: locking/clicking in knee, stairs hurt *meniscus tear: grinding, clicking o Critical points: *Locking, clicking = meniscus *Knee giving out = ACL/PCL injury mainly  H. O bservation P.S. o Swelling o Atrophy o Ambulation o ROM o Obvious deformities o Bilateral comparison H. O. P alpation S o Proper athlete positioning—knee on table, feet on table (stable) o LCL: cross legs-palpate lig.  o MCL: (origin-medial femoral epicondyle) insertion-medial tibial flare o Quads, Hamstings
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H. O. P. S pecial tests o Varus Stress Test * tests LCL stability * looking for laxity, pain, swelling
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  • Spring '08
  • KIT
  • Anterior Cruciate Ligament, Posterior Cruciate Ligament, Medial collateral ligament, LATERAL COLLATERAL LIGAMENT, valgus stress

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