Lower Extremity THIGH MUSCULATURE, KNEE AND ANKLE OSTEOLOGY.
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Transcript of Lower Extremity THIGH MUSCULATURE, KNEE AND ANKLE OSTEOLOGY.
Lower ExtremityTHIGH MUSCULATURE, KNEE AND ANKLE OSTEOLOGY
Objectives
Describe the gross anatomy for each system (circulatory, muscular, nervous, and skeletal) in the lower extremity.
Integrate the systems to discuss the lower extremity stability and mobility functions.
Analyze common injuries in the lower extremities.
For each muscle, describe how the attachment sites result in an action around a joint.
For each muscle, identify the innervation (peripheral nerve and nerve roots).
There are 4 genicular arteries that supply the hip joint
A. True
B. False
True
False
50%50%
Gluteus medius is an internal rotator when the hip is flexed
A. TrueB. False
True
False
50%50%
Your patient has trendelenburg gait when body weight is shifted to the R Leg. Which muscle is probably weakest?
A. R Gluteus MediusB. L Gluteus MediusC. R Gluteus MinimusD. L Gluteus Minimus
25% 25%25%25%
Soft spots
Femoral Triangle Borders:
Problems?
Adductor Canal Borders:
Adductors
Large moment arm for adduction
Small moment arm for internal hip rotation
Obturator nerve
Clinical Relevance
Groin injury or “pulled groin”
Gracilis muscle transplant
Your patient has damage to the obturator nerve. Which muscle would be unaffected?A. Adductor longusB. Adductor brevisC. PectineusD. Hamstring portion of
adductor magnusE. Adductor portion of
adductor magnusAdducto
r longu
s
Adductor b
revis
Pectineu
s
Hamstring p
ortion of a
dductor .
..
Adductor p
ortion of a
dductor m
...
20%20% 20%20%20%
https://www.youtube.com/watch?v=RTV5Yo3E7VQ
Bursae & Bursitis
Prepatellar
Infrapatellar Superficial
Deep
Suprapatellar
Pes anserine
MCL
Iliotibial
What’s wrong with this picture?
A. Nothing
B. The ligaments shown are wrong
C. The patella is out of place
D. The knee doesn’t bend that way
E. There is a ligament missing
A. B. C. D. E.
20% 20% 20%20%20%
Knee rotation and the locked position
Locked position: Full extension & 10 degrees
external rotation
All ligaments taught, maximal joint contact
Clinical Relevance
Genu varum & genu valgum
Patellofemoral syndrome
Patellar dislocation
Bursitis & popliteal cysts
Knee replacement
O’Donoghue Triad
Your patient suffered a lateral blow to the knee with the foot planted while playing soccer. Which of the following is least likely to have suffered damage?
A. ACLB. PCLC. MCLD. Medial meniscusE. Lateral meniscus
ACLPCL
MCL
Medial m
eniscus
Later
al menisc
us
20% 20% 20%20%20%
While rollerblading, your patient ran into a short wall. Which of the following is most likely damaged?
A. ACLB. PCLC. MCLD. Medial meniscusE. Lateral meniscus
ACLPCL
MCL
Medial menisc
us
Later
al menisc
us
20% 20% 20%20%20%
Quadriceps
Rectus Femoris
Vastus Lateralis
Vastus Medialis
Vastus intermedius
Clinical Relevance
Contusions
Avulsion fractures
Hematomas
Charley horse
Hamstrings
Biceps Femoris Long head
Short head (not a hamstring)
Semitendinosus
Semimembranosus
What is the muscle highlighted on the left?
A. Biceps femoris long head
B. Biceps femoris short head
C. SemitendinosusD. Semimembranosu
s
Biceps f
emoris lo
ng hea
d
Biceps f
emoris sh
ort head
Semite
ndinosus
Semim
embran
osus
25% 25%25%25%
What is the muscle highlighted on the right?
A. Biceps femoris long head
B. Biceps femoris short head
C. SemitendinosusD. Semimembranosu
s
Biceps f
emoris lo
ng hea
d
Biceps f
emoris sh
ort head
Semite
ndinosus
Semim
embran
osus
25% 25%25%25%
Popliteal fossa
Task:
Borders: Superomedial
Superolateral
Inferomedial
Inferolateral
Floor
Roof
Identify each of the numbers
Break
Ankle joint
Hinge joint with 3 articular surfaces: Medial surface of fibula -> talus
Inferior tibia -> trochlea of talus
Lateral surface of medial malleolus -> talus
Ligaments – ankle joint
Deltoid ligament 4 parts
Fibular collateral ligaments 3
Tibiofibular ligaments
Clinical relevance
Eversion and inversion sprains and fractures