Download Free Medical The Knee-Anatomy and Injuries PowerPoint Presentation

The Knee-Anatomy and Injuries PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical presentation on Orthopaedics, which is titled "The Knee: Anatomy and Injuries", to know about knee anatomy and injuries.

Tags : Orthopaedics, Knee, Anatomy, Injuries

Published on : Aug 18, 2021 | Views : 1819 | Downloads : 7

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

Unit 5: Understanding Athletic-Related Injuries to the Lower Extremity The Knee: Anatomy and Injuries Sports Medicine Mr. Smith
Slide 2-

Knee
Slide 3-

Hinge Joint Knee movement Flexion Extension Slight Rotation Gliding Knee stability depends on ligaments, joint capsule, and muscles. Mechanics of the Knee
Slide 4-

Joint Capsule
Slide 5-

Medial and lateral condyles Medial condyle is longer than the lateral condyle. Trochlea – groove that receives the patella. Articular cartilage Bones of the Knee (Femur)
Slide 6-

Tibial plateau Tibial plateau has two shallow concavities (facets) that articulate with the medial and lateral condyles. Tibial tuberosity Main weight bearing bone (95 – 97%). Tibia
Slide 7-

Tibial Plateau
Slide 8-

Largest sesamoid bone in the body. Articulates in the groove between the femoral condyles. Provides a better line of pull for the quadricep muscles. Patella
Slide 9-

Patella Tracking
Slide 10-

Lateral collateral ligament and muscle attachment. Non – Weight bearing bone. Located on lateral aspect. Minimal knee function. Fibula
Slide 11-

Femur and tibia Femur and patella Tibia and fibula Knee Articulations
Slide 12-

Ligaments of the Knee
Slide 13-

Attachment: femur – intersurface of lateral condyle. Attachment: Tibia – Anterior tibial plateau. Prevents excessive anterior movement and internal rotation of the tibia. Anterior Cruciate Ligament (ACL)
Slide 14-

Extension / Tight Flexion / Relaxed Very vascular Usually surgically replaced if torn. ACL
Slide 15-

Attachment: Femur -Anterior portion of the lateral surface of the medial condyle. Tibia – Posterior medial tibial plateau. Prevents excessive posterior movement of the tibia on the femur. Prevents hyperextension of the knee Posterior Cruciate Ligament (PCL)
Slide 16-

Attachment: Femur – superior epicondyle. Tibia – Medial aspect / medial meniscus. Resists valgus forces. Resists external rotation of the tibia. Medial Collateral Ligament (MCL)
Slide 17-

Attachment: Femur – lateral epicondyle. Fibula: Fibular head Extracapsular Resists varus forces. Aided by popliteal muscle / IT-band Lateral Collateral Ligament (LCL)
Slide 18-

Meniscus
Slide 19-

Medial (C- shape) and lateral (O-shape) meniscus. Located on tibial plateau. Primary function – shock absorber. Deepens articular facets Increase surface contact. Helps stabilize knee Meniscus
Slide 20-

Meniscus
Slide 21-

3 vascular zones Red – Red Zone- outer 1/3 which has good blood supply. Red – White Zone- middle 1/3 which has minimal blood supply. White – White Zone- inner 1/3 which is avascular (no blood supply) Meniscus
Slide 22-

Bursa’s are fluid filled sac’s . Reduce friction between anatomical structures. Two dozen bursa’s within the knee. Prepatellar most often injured. Bursa's of the Knee
Slide 23-

Bursa's of the Knee
Slide 24-

Muscles of the Knee
Slide 25-

Quadricep Muscle Group
Slide 26-

Extensors of the knee. Stabilizers of the knee. Vastus medialis (VMO) – important for patellar tracking. Vastus intermedialis Vastus Lateralis Rectus femoris – Knee extension / Hip flexion. Quadriceps
Slide 27-

Patellar Tendon – Common tendon for the quadriceps muscle group. Attachment: Tibial tuberosity. Houses the patella. Patellar Tendon
Slide 28-

Hamstring Muscle Group
Slide 29-

Flexors of the knee. Extensors of the hip. Prevents anterior tibial movement / Aids ACL. Hamstrings
Slide 30-

Other Structures of the Knee
Slide 31-

Gracilis – Aids in knee flexion. Sartorius – Aids in knee flexion / longest muscle in the body. Gastrocnemius – Aids in knee flexion / primary ankle plantar flexor. Other Structures Con't
Slide 32-

Lateral side of knee. Assist LCL in the lateral stability of the knee. IT - Band
Slide 33-

I-T Band Friction
Slide 34-

Knee Injuries
Slide 35-

Chondromalcia
Slide 36-

Mechanism – Compression and rotation femur / tibia. Can be associated with ligament injury (MCL). Meniscus Injuries
Slide 37-

Signs & Symptoms - Joint effusion (Swelling) - Clicking or locking. - Loss of ROM - Diagnosis is often difficult. Meniscus injuries
Slide 38-

Meniscus MRI
Slide 39-

Meniscus Tear
Slide 40-

ppt slide no 40 content not found
Slide 41-

Surgical treatment - Procedure depends on location and severity of tear. - Resection (Total removal of tear) - Stitch or tack. Treatment
Slide 42-

Tack Repair
Slide 43-

ppt slide no 43 content not found
Slide 44-

- Indicated only for minor tears. - RICE (Control Swelling) - Maintain ROM / Strength - Non surgical treatment can result in further damage Non Surgical Treatment
Slide 45-

Arthriis Arthritis
Slide 46-

Common in sports. Mechanism – External rotation of tibia, knee in valgus position, foot fixed. Signs & Symptoms Feeling pop Knee feels unstable Joint effusion Positive testing ACL Injuries
Slide 47-

RICE (Control Swelling) Immobilizer / Crutches Refer to physician Rehabilitation (Strengthening & ROM) Non Surgical Treatment
Slide 48-

MRI of ACL NORMAL ACL ACL TEAR
Slide 49-

Arthroscopic surgery Various grafts can be used for repair. Patellar tendon (Autograft) Hamstring (semitendinosus / Gracillis) Cadaver (Allograft) Surgical Treatment
Slide 50-

ppt slide no 50 content not found
Slide 51-

ppt slide no 51 content not found
Slide 52-

ppt slide no 52 content not found
Slide 53-

ppt slide no 53 content not found
Slide 54-

Patellar Tendon (autograft)
Slide 55-

ppt slide no 55 content not found
Slide 56-

ppt slide no 56 content not found
Slide 57-

ppt slide no 57 content not found
Slide 58-

ppt slide no 58 content not found
Slide 59-

ppt slide no 59 content not found
Slide 60-

Intercondyler Notch
Slide 61-

Notch Plasty
Slide 62-

Injured less frequent Mechanism: - Fall on anterior aspect of bent knee with foot plantar flexed. - Hyperextension PCL Injuries
Slide 63-

PCL MRI
Slide 64-

Signs / Symptoms - Experience “Pop” - Effusion (swelling) - Tenderness posterior aspect of knee - Knee feels unstable - Positive special test PCL Injuries
Slide 65-

MCL / LCL Injuries MCL injuries are usually caused by a lateral to medial blow to the knee. Also known as a valgus force. LCL injuries are usually caused by medial to lateral blow to the knee. Also known as a varus force.
Slide 66-

Mechanism of Injury - direct blow from the lateral side (Valgus Stress) - severe rotation of the tibia - can be a combination of both MCL Injuries
Slide 67-

MRI OF MCL TEAR
Slide 68-

1st degree - ligamentous fibers are stretched - joint is stable during valgus stress test - little or no joint effusion - may be some joint stiffness and medial joint line tenderness - almost full range of motion MCL Sprains
Slide 69-

2nd degree sprain - partial tear of the ligament - slight to moderate laxity during valgus stress test - there is little joint effusion - moderate to severe joint stiffness with loss of ROM MCL Sprains
Slide 70-

3rd degree sprain - Complete tear - severe laxity revealed with valgus stress test - moderate joint effusion - loss of ROM MCL Sprains
Slide 71-

1st degree – RICE, Rehab to increase strength, ROM. 2nd degree – RICE, Immobilize, Crutch, 24 hours. Re-evaluate. Refer to physician 3rd degree – RICE, Immobilize, Crutch. Refer to physician Treatment of MCL Sprains
Slide 72-

Not very common in athletics. Occurs by a medial blow to knee which produces a varus stress LCL Injuries
Slide 73-

Patellar Dislocation
Slide 74-

Knee Dislocation
Slide 75-

Knee Dislocation
Slide 76-

ppt slide no 76 content not found
Slide 77-

Assessing the Knee Joint
Slide 78-

HISTORY What did you feel, hear, …. Was there a pop or snap? Did you get hit by another player? Was your foot planted? Did this happen without being hit? Exactly where does you knee hurt, and be specific? Have you hurt this knee before, when, what was the injury?
Slide 79-

HISTORY When did you first notice the condition? Is there swelling or recurrent swelling? What activity hurts the most? Does it ever catch or lock? Do you fell as if the knee is going to give way, or has it already done so? Does it hurt to go up and down stairs?
Slide 80-

Observation Does the athlete have a limp, or is it easy to walk? Cant the athlete be full weight bearing? Is the athlete able to perform a half-squat to extension? Cant the athlete do up and down stairs?
Slide 81-

Testing for Knee Joint Instability Testing helps one get a better idea of the stability of the joint and an informed decision can be made about playing status. Many tests may point to ligamentous damage, while others will help detect meniscus damage. Knowing these test and how to perform them takes practice and time to understand the degrees of damage done to the knee.
Slide 82-

Test for patellar dislocations Positive sign is guarding, and pain. Patellar Apprehension
Slide 83-

Tests for torn meniscus Positive sign is popping, clicking or pain. Apley’s Compression/Distraction - Tests for torn meniscus - Compression signs same as McMurray - Distraction sign is reduction of pain. McMurray Meniscal Test
Slide 84-

Valgus and Varus Stress Tests Purpose: intended to reveal laxity of the medial and lateral collaterals. The athlete lie supine with the leg extended. Apply stress to the knee either medially or laterally
Slide 85-

Valgus Stress Tests The valgus examination in full extension tests the MCL, posteromedial capsule, and the cruciates. The exam at 30 degrees flexion isolates the MCL.
Slide 86-

Tests for MCL stability Positive sign indicates an injury to the MCL Test at 0 and 15 degrees Valgus Stress Test
Slide 87-

ppt slide no 87 content not found
Slide 88-

Varus Stress Tests The examiner reverses hand positions and tests the lateral side with a varus force on the fully extended knee and then with 30 degrees of flexion. With the knee extended, the LCL and posterolateral capsule are examined. At 30 degrees of flexion, the LCL is isolated.
Slide 89-

Tests for LCL stability Positive sign indicates an injury to the LCL Test at 0 and 15 degrees Varus Stress Test
Slide 90-

ppt slide no 90 content not found
Slide 91-

Anterior Cruciate Ligament Tests Anterior Drawer Test Lachman’s Test
Slide 92-

Anterior Drawer Test The tibia’s sliding forward from under the femur is considered a positive anterior drawer sign. If a positive anterior drawer sign occurs, the test should be repeated with the athlete’s leg rotated internally 30 degrees and externally 15 degrees.
Slide 93-

Anterior Drawer Test - Tests for ACL instability / laxity Positive sign is increase in anterior translation. (No end point) Special Tests
Slide 94-

ppt slide no 94 content not found
Slide 95-

ppt slide no 95 content not found
Slide 96-

ppt slide no 96 content not found
Slide 97-

Anterior Cruciate Ligament Tests Lachman’s Test: is considered to be a better test than the drawer test at 90 degrees of flexion.
Slide 98-

Lachman’s Tests The Lachman’s test is administered by positioning the knee in approximately 30 degrees of flexion. One hand of the examiner stabilizes the leg by grasping the distal end of the thigh, and the other hand grasps the proximal aspect of the tibia and attempts to move it anteriorly. A positive Lachman’s test indicated damage to the ACL
Slide 99-

Lachman Test - Test for ACL instbility/laxity Positive sign is increased anterior tibial translation. (No end point) Special Tests
Slide 100-

ppt slide no 100 content not found
Slide 101-

Posterior Cruciate Ligament Tests Posterior Drawer Test: is performed with the knee flexed at 90 degrees and the foot in neutral position. Force is exerted in a posterior direction at the proximal tibial plateau. A positive posterior drawer test indicates damage to the posterior cruciate ligament.
Slide 102-

Posterior Drawer - Test for PCL instability/laxity Positive sign is posterior movement of the tibia. Special Tests
Slide 103-

ppt slide no 103 content not found
Slide 104-

Posterior Cruciate Ligament Tests Posterior Sag Test: With the athlete supine, both knees are flexed to 9- degrees. Observing laterally on the injured side, the tibia will appear to sag posteriorly when compared to the opposite extremity if the posterior cruciate ligament is damaged.
Slide 105-

ppt slide no 105 content not found
Slide 106-

Special Tests
Slide 107-

Prevention of Knee Injuries To avoid injuries to the knee, the athlete must be as highly conditioned as possible, which means total body conditioning that includes strength, flexibility, cardiovascular and muscle endurance, agility, speed and balance. THE MUSCLES around the knee MUST be strong and flexible.
Slide 108-

Prevention of Knee Injuries Athletes participating in a particular sport should acquire a strength ratio between the quadriceps and hamstring muscle groups. Fro example: the hamstring muscles of football players should have 60 to 70 percent of the strength of the quadriceps muscles. The gastrocnemius muscle should also be strengthened to help stabilize the knee. Although maximizing muscle strength may prevent some injuries, it fails to prevent rotary-type injuries.
Slide 109-

Prevention of Knee Injuries Shoe Type: Cleat Length Astro Turf shoes: more grip=more injuries Sneakers are good for artificial surfaces
Slide 110-

Functional and Prophylactic Knee Braces Functional Knee Braces are used to protect grade 1 and 2 sprains of the ACL and MCL, and reconstructed ACL knees. Most of them are bilateral knee braces, meaning there is a hinge on both sides of the brace. These braces have an important part within the athletic community. They will also give the athlete confidence while playing.
Slide 111-

ppt slide no 111 content not found
Slide 112-

Functional and Prophylactic Knee Braces Prophylactic Knee Braces are designed to prevent or reduce the severity of knee injuries. They are worn on the lateral surface of the knee to protect the medial collateral ligament.
Slide 113-

ppt slide no 113 content not found
Slide 114-

ppt slide no 114 content not found
Slide 115-

Knee Injury Treatments Straight Leg Raises
Slide 116-

Knee Injury Treatments Side Leg Raises
Slide 117-

Knee Injury Treatments Side Leg Raises
Slide 118-

Knee Injury Treatments Terminal Knee Extensions
Slide 119-

Knee Injury Treatments Step Ups
Slide 120-

BOSU