2TerminologyTibial Tuberosity: Boney protrusion where the patellar tendon inserts.Femoral Condyles: Distal end of the femur.Intercondyler Notch: An indentation in the distal femur where the anterior cruciate descends.Quadriceps Femoris Muscle group: attach to the patella through the quadriceps tendon.
3TerminologyPes Anserine:“foot of a bird”, the insertion of the semitendinosis, sartorius, and gracilis to the anteromedial tibiaUnhappy Triad (Terrible Triad): Tearing of the anterior cruciate ligament, medial collateral ligament and the medial meniscus.Varus Stress: Stress applied to the medial aspect of the knee.Valgus Stress: Stress applied to the lateral aspect of the knee.
4Terminology Direct trauma: A blow or fall on the knee. Indirect trauma: violent contracture of the quadricepsDistal pulses: pulses in the foot. The dorsalis pedis and the posterior tibial pulse.Chondromalacia: A degenerative condition in which there is a wearing away of the cartilage on posterior patella.Subchondral: Below the cartilage.
5Bones Of The Knee Femur Tibia Fibula Patella Femur Patella Fibula
6Condyles of the KneeLateral CondyleMedial Condyle
10Primary and Secondary Motions of The Knee 1. Primary MotionsFlexionExtension2. Secondary MotionsInternal RotationExternal RotationGliding Motion (a little)
11Quadriceps Strongest muscle group in the body Vastus Medialis Vastus IntermediusVastus LateralisRectus FemorisResponsible for knee extension
12Hamstrings Biceps Femoris (long and short head) Semimembranosus SemitendinosusResponsible for knee flexion
13Bursa Fluid sac acting as a cushion and lubricant in areas of friction Suprapatellar - under patella (running)Perpatellar - on top of patella (direct blow)Anserine - below knee (running)
14Medial Collateral Ligament Sprain MOI: occurs most often in violently adducted and internally rotated knees.Path: a tear or sprain in the MCLS/S: swelling, pain, loss of stability, popping noise, (+) valgus stress test on MCL (may vary depending on degree of injury)Tx: RICE, rehab-light weights, straight leg raises, whirl pool (if available), crutches for discomfort and degree of injury, MCL taping
15Lateral Collateral Ligament Sprain MOI: blow to inside of the knee (varus force)Path: partial to complete tear of ligamentS/S: pain on lateral side of knee, swelling, positive varus stress testTx: RICE, crutches and referral to physician
16Anterior Cruciate Ligament Sprain (ACL) MOI: twisting of the knee, hyperextension of the knee, forward movement of the tibia on the femurPath: Stretching or tearing of the ACL; secondary injuries: medial meniscus tear and medial collateral ligament sprainTerrible Triad: ACL pathology WITH secondary injuriesS/S: A pop followed by immediate disability, pain, rapid swelling at the joint, feels like knee is coming apartTx: RICE, crutches, refer to doctor.
17Meniscus Tear MOI: sudden twisting and compression Path: tear of the meniscusS/S: locking, swelling, pain, giving wayTx: RICE, crutches, refer to doctor.
18Patellar Subluxation or Dislocation MOI: athlete plants their foot and changes direction.Path: the quadriceps muscles attempt to pull in a straight line and in a result pulls the patella laterally.
19Patellar Subluxation or Dislocation Cont. S&S: Complete loss of knee function; pain and swellingTx: immobilize in the position it is in, place ice around the joint, see physician, use crutches.
20Patellar FracturesMOI: caused by direct or indirect trauma. Forcible muscle contraction, falling, jumping, and running can also cause a fracture.Path: a severe pull of the patellar tendon against the femur when knee is semi flexed resulting in a fractureS/S: causes hemorrhage and joint effusion, resulting in generalized swelling.An indirect fracture causes capsular tearing, separation of bone. Tearing of the quadriceps tendon is also a sign.Direct fracture involves bone separation.
21Patellar Fracture Cont. Tx: a cold wrap should be applied, followed by elastic compression wrap, splinting, crutches and Doctor referral.
22Knee DislocationThe most Serious knee injury is the dislocation of the tibiofemoral joint. THIS IS AN EMERGENCY!
23Knee Dislocation Cont.MOI: Direct blow to the anterior proximal tibia, forceful twisting, lateral blow to the knee.S/S: Grossly displaced tibia, sever pain, swelling, and may have absence of distal pulses.Tx: Calm athlete down, splint, and immediate transport to the hospital. Check distal pulses.