Transcript Knee, Ankle Foot presentation OTA

Knee, Ankle, Foot
JAYME BUTLER, ANDRE BOND, MARISSA DAVIS
Surface Anatomy:
Anterior Knee
• Vastus medialis
• Vastus lateralis
• Patella
Surface Anatomy:
Posterior Knee
• Popliteal fossa
• Medial head of Gastronemius
• Lateral head of Gastronemius
• Soleus
Medial and Lateral
Surface Anatomy: Posterior Knee
• Biceps femoris tendon
• Semitendinosus tendon
• Semimembranosus tendon
Surface Anatomy: Foot
• Calcaneal tendon
• Lateral malleolus
• Medial malleolus
Surface Anatomy: Foot
• Site of dorsalis pedis
• Great Saphenous vein
Bones of the Femur:
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Lateral condyle
Lateral epicondyle
Medial condyle
Medial epicondyle
Intercondylar fossa
Bones of the Tibia:
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Lateral condyle
Medial condyle
Tibial tuberosity
Intercondylar eminence
Medial Malleolus
Bones of the Fibula:
• Head
• Fibular notch
• Lateral malleolus
Tarsal Bones:
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Calcaneus
Talus
Navicular
Cuboid
Cuneiforms
Metatarsal Bones:
• Numbered 1-5 (big toe is #1)
Phalangeal Bones:
• Toes numbered 1-5 (big toe is #1)
• Proximal, Middle (Intermediate), Distal
Ligaments: Knee
• Quadriceps femoris tendon
• Patellar ligament
• Tibial collateral ligament
• Fibular collateral ligament
Ligaments: Ankle and Foot
• Interosseous tibiofibular
ligament
• Anterior tibiofibular
ligament
• Posterior tibiofibular
ligament
• Interosseous membrane
Ligaments: Knee
• Anterior cruciate ligament
• Posterior cruciate ligament
• Transverse ligament
Ligament: Ankle and Foot
• Long plantar
ligament
• Short plantar
ligament
• Plantar
calcaneonavicular
ligament (spring)
Ligaments: Ankle and Foot
• Extensor retinacula
• Plantar aponeurosis
Bursae:
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Prepatellar bursa
Deep Infrapatellar bursa
Suprapatellar bursa
Subcutaneous infrapatellar bursa
Cartilage:
• Lateral meniscus
• Medial meniscus
Tendons of the foot:
• Fibularis longus
• Fibularis brevis
• Extensor digitorum
longus
• Extensor hallucis
longus
• Tibialis anterior
• Extensor hallucis
brevis tendon
Tendons of the foot continued:
• Extensor hallucis brevis
tendon
Arches of the foot:
• Longitudinal Arch:
1. Medial
2. Lateral
• Transverse Arch
Rectus Femoris
O: Anterior inferior iliac spine
I: Patella via quadriceps tendon and
tibial
tuberosity via patellar ligament
A: Extension at knee and Flexion at hip
N: Femoral nerve
R: L2-L4
Vastus Intermedius
*Deep to Rectus Femoris
O: Anterior 2/3 of lateral shaft of femur
I: Patella via quadriceps tendon and tibial tuberosity
via patellar ligament
A: Extension at knee
N: Femoral nerve
R: L2-L4
Vastus Medialis
O: Linea aspera of femur
I: Patella via quadriceps tendon and tibial tuberosity via
patellar ligament
A: Extension at knee
N: Femoral nerve
R: L2-L4
Vastus Lateralis
O: Intertrochanteric line of the linea aspera of femur
I: Patella via quadriceps tendon and tibial tuberosity via
patellar ligament
A: Extension at knee
N: Femoral Nerve
R: L2-L4
Biceps Femoris:
Long Head
O: Ischial tuberosity
I: Lateral condyle of tibia and head of fibula
A: Extends hip and flexes knee
N: Tibial nerve
R: L5-S2
Short Head
O: Linea aspera of femur
I: Head of fibula and lateral condyle of tibia
A: Flexes knee and laterally rotates hip
N: Fibular nerve
R: L5-S2
Semitendinosus:
O: Ischial tuberosity
I: Proximal medial shaft of tibia
at Pes Anserinus tendon
A: Flexes knee, rotates flexed knee,
and extends hip
N: Tibial nerve
R: L5-S2
Semimembranosus:
O: Ischial tuberosity
I: Posterior medial condyle of tibia
A: Flexes knee, medially rotates flexed knee,
extends hip
N: Tibial nerve
R: L5-S2
Gastrocnemuis:
O: Lateral head: Lateral condyle of femur
Medial head: Superior to medial condyle of femur
I: Calcaneus via calcaneal tendon
A: Plantar flexes ankle and flexes leg at knee
N: Tibial nerve
R:S1-S2
Soleus:
O: Posterior head of fibula, Posterior medial tibia
I: Calcaneus via calcaneal tendon
A: Plantar flexes ankle
N: Tibial
R: S1-S2
Tibialis Anterior:
O: Lateral condyle, superior 2/3 surface of the
tibia, and interosseous membrane
I: Medial inferior surface of 1st cuneiform and
base of 1st metatarsal
A: Dorsiflexes ankle, inverts foot, and supports
longitudinal arch
N: Deep fibular nerve
R: L4-L5
Fibularis Longus
O: Head and superior 2/3 of lateral fibula
I: Plantar surface of base of 1st metatarsal and 1st
cuneiform
A: Everts foot, weakly plantarflexes ankle, and supports
transverse arch
N: Superficial fibular nerve
R: L5-S2
Fibularis Brevis
O: Lateral inferior 2/3 of fibula
I: Dorsal surface of tuberosity of 5th metatarsal
A: Everts foot, weakly planterflexes ankle, supports
transverse arch
N: Superficial fibular nerve
R: L5-S2
Nerves:
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Femoral nerve
Sciatic nerve
Tibial nerve
Superficial fibular (peroneal)
nerve
• Deep fibular (peroneal)
nerve
Arteries:
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Femoral artery
Popliteal artery
Anterior tibial artery
Posterior tibial artery
Dorsalis pedis
Fibular(peroneal)
Arteries Continued:
• Medial circumflex femoral artery
• Lateral circumflex femoral artery
Arteries Continued:
• Inferior gluteal artery
Veins:
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Femoral vein
Popliteal Vein
Small saphenous
Great saphenous
Veins Continued:
• Anterior tibial
• Posterior tibial
• Fibular
Veins Continued:
• Dorsal venous arch
Veins Continued:
• Plantar arch
Clinical Concerns:
• Torn anterior cruciate ligament (ACLs) are a common knee injury
• Tear or sprain occurs with a sudden change in direction or pivot
against a locked knee
• Pop, followed by pain and swelling of the knee are the most common
symptoms
• Women more likely to tear ACL because of differences in anatomy
and muscle function
• Treatment goals are to return the patient to his or her preinjury level
of function. Arthroscopic surgery may be required to reconstruct the
torn ligament.
• May take six to nine months to return to normal activity after an ACL
injury.