Mrs. Marr

Injuries• Remember that most

injuries fall into basic categories :– Contusions– Sprains

• Ligaments

– Strains• Muscles

– Fractures

– Chronic vs. Acute

Bones of the Bones of the Lower LimbLower Limb

Pelvis (hip): 3 bones that have grown togetherShaped differently in males than

femalesIlium you can feel it at the top of

your hipsIschium you sit on the boney tips Pubis located above your groin

Sacrum: back of hips, attached to ilium, base of the spine, 5 fused vertebrae

Coccyx: 4 bones at end of sacrum Acetabulum: Socket for the Femur

(Ball and Socket joint)Upper Leg:

Femur ThighboneKnee: Patella- knee bone

Joint- Femur and TibiaLower Leg: 2 bones

Tibia- weight bearing Fibular- non weight bearing

Ankle/Foot: Bottom of your toes 7 tarsal Bones

Talus: Ankle Bone Calcaneus (Heel Bone)

Largest/strongest bone in your footCuboid- cubed shapedNavicular- shaped like a little boatCuneiforms (3)- wedge shaped,

between Navicular & 1st 3 metatarsal

Hip and Pelvis Anatomy

Knee Anatomy• Hinge Joint

– Knee Flexion• Hamstrings

– Knee Extension• Quadriceps

• Bones– Femur– Tibia– Patella

• Fibula is not really in the knee complex

• Ligaments (4)– ACL– PCL– MCL– LCLThese ligaments connect

the Tibia and Femur and provide the structural integrity to the knee.

• Meniscus– Medial and Lateral

• Muscles– Quads (4)– Hamstrings (3)

Knee Ligament Structure

Cadaver KneePCL

ACL

LCL MCL

MM

LM

Patella Tendon

Patella

Transverse Cross View of the Knee

KNEE MUSCLES

Hamstring

ADDUCTORS

Muscles

Evaluation• History

– Asking what where when how

– Getting athlete comfortable

• Observation– Look for any

abnormalities

• Palpation– KNOW YOUR ANATOMY!

• Special Tests– ROM– Stress tests

Ober Test IT Band Tightness

Positive Test: The leg will not drop there is tightness

Negative Test:The leg drops easily

Lachman’s Test (ACL)

• Alternative ACL Test– Anterior Drawer – Modified Lachman’s

– Forward translation of the Femur on the Tibia

Posterior Sag (PCL)• Can also be done with

heel resting on chair• Look for sag of the Tibia/

Backward translation of the Tibia

Stress Test Valgus Varus

MCL LCL

Surgery

OTHERWound Care

• Put gloves on– Universal

Precautions

• Clean the wound• Antibiotic cream• Cover • Wrap on

NAME THIS INJURY

KNEE DISLOCATION

Femur Fracture

Surgery Scars

Tibia FX & Dislocation (Rotation)

What will you have to

know…

Are you ready?

Ilium

Illiac Crest

FemurIschial TuberosityPubic

Tubercle

FemoralHead

Sacrum

Coccyx

Ischium

Pubis

Sacroiliac JT

I lliacus Muscle

Psoas ( Major)

MUS CLES OF THE HI P

Rectus Femoris Sartorius

Illiac Crest

Vastus Lateralis

Vastus Medialis

Gracilis

Adductor Longus

Pectineus

Lateral FemoralCondyle

Tibia

Patellar Tendon

Patella

Tibialis Anterior

Peroneus

ExtensorDigitorum

Extensor Hallucis Longus

Fibular Head

Calcaneus

Gluteus MaximusGluteus Medius

AchillesTendon

Gastrocnemius

Semimembranosus

PopitealFossa

BicepsFemoris

Semiteninosus

Medial Malleolus

Lateral Malleolus

Gracilis

AdductorMagnus

Vastus Lateralis

Greater Trochanter(Femur)

Hamstrings (Semiteninosus,Semimembranosus, Biceps Femoris)

Hip Flexors (Illopsoas, Rectus Femoris,Tens or Fac iae LataePec tineus ,G rac ilis , Sartor ius )

Tensor FaciaeLatae

Quadriceps (Rectus Femoris,Vastus Lateralis,Vastus Intermedius, Vastus Medialis)

Lateral JointLine

Medial Joint Line

Groin/Anterior Thigh (Adductors,Pectineus, Gracilis)

Plantar Fascia

ReviewAnkle, Lower leg and Foot

Talus

Calcaneus

Navicular

Cuboid

CuneiformBones (3)

Metatarsals

Phalanges

Tibia

Fibula

Anterior Tib-Fib Lig

Calcaneus

Talus

Navicular

Cuboid

PosteriorCalcano-Fibular

Anterior Talo-Fibular Lig.

Calcano-FibularLigament

Metatarsals

Phalanges

Lateral View of Left Lower Limb (Bones)

Femoral Head

Femur

Tibia

Fibula

Calcaneus

Fibular Head

Patella

Cuneiforms

Phalanges

Lateral Malleolus

Femoral Condyle

Review and

LAB…

NEXT SLIDES

Knee AnatomyLabel the structures

1. Femur2. Tibia3. Fibula4. MCL5. LCL6. ACL7. PCL8. Medial Meniscus9. Lateral Meniscus10. Name the action the Quadriceps

perform on the knee when contracted.________________

11. Name the action the Hamstrings perform on the knee when contracted._________________

Can You Label the structures ?

1. Femur2. Sacrum3. Ilium4. Illiac Crest5. Coccyx6. Femoral Head7. Pubis8. Ischium9. Psoas Major10. Illiacus11. Rectus Femoris12. Vastus Lateralis13. Sartorius14. Gracilis15. Gluteus Max16. Tibialis Anterior17. Gastrocnemius18. Patellar Tendon19. Achilles Tendon20. TFL/ IT Band

KNEE/Hip LabKNEE/Hip LabLabel and Palpate

• Label the Lower Limb– Bones– Ligaments– Tendons/ MusclesYES YOU NEED TO MARK ON THEIR LEGS !

• Palpate and get a feel for the Knee and Hip– Always compare~ Touch BOTH Knees.

• SM II- Practice special tests-Knee– Anterior Drawer Test– Lachman’s/Modified Lachman’s Test– Varus Stress Test– Valgus Stress Test

• DON’T FORGET ABOUT THE ANKLE,FOOT, TOESDON’T FORGET ABOUT THE ANKLE,FOOT, TOES