EXAM #1 Flashcards

(512 cards)

1
Q

Study of the Science of Movement

A

Kinesiology

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2
Q

Kinesiology includes the _
- Bones
- Ligaments
- Joints
- Muscles
- Tendons

A

musculoskeletal system

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3
Q

Muscles work in combinations or in groups to
move joints and bones to produce _ _

A

human movement

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4
Q

_ muscles
_ bones
_ joints

A
  • 600+
  • 206
  • many
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5
Q

Plane of motion:
Bisects body into right and left
halves
- Also called Anteroposterior or
AP plane

A

Sagittal plane

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6
Q

Plane of motion:
Divides body into front and back
- Also called the Coronal plane

A

frontal plane

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7
Q

Generally, motion in this plane is called flexion and extension
- Bicep curl

A

sagittal plane

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8
Q

Generally, adduction and abduction movements occur in this plane of motion
- lateral raise

A

frontal plane

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9
Q

Planes of motion:
Divides the body horizontally into superior and inferior halves
- Also called Horizontal plane
- Latin, “lying across”

A

transverse plane

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10
Q

Generally, rotational movements such as pronation, supination and spinal rotation movements occur in this plane of motion
- cervical (neck) rotation

A

transverse plane

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11
Q

Movement in one plane produces joint motion or _ _ _

A

axis of rotation

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12
Q

Plane: sagittal
Axis of rotation: _

A

lateral

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13
Q

Plane: frontal
Axis of rotation: _

A

anteroposterior

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14
Q

Plane: transverse
Axis of rotation: _

A

vertical

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15
Q

Axis of Rotation occurs _ _ from the plane that motion occurs

A

90 degrees

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16
Q

Anatomical directional terms:
in front of or the front surface of

A

anterior

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17
Q

Anatomical directional terms:
Located in front and below

A

anteroinferior

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18
Q

Anatomical directional terms:
In front of the body, away from the middle line

A

anterolateral

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19
Q

Anatomical directional terms:
located in front and toward the middle

A

anteromedial

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20
Q

Anatomical directional terms:
From front to back

A

anteroposterior

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21
Q

Anatomical directional terms:
located in front and above

A

anterosuperior

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22
Q

Anatomical directional terms:
situated in or directed toward the hind part of the body

A

Caudal

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23
Q

Anatomical directional terms:
of or relating to the head

A

Cephalic

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24
Q

Anatomical directional terms:
Having to do with the opposite side of the body

A

Contralateral

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25
Anatomical directional terms: away from the surface or further into the body
deep
26
Anatomical directional terms: posterior and superior in position or direction
Posterosuperior
27
Anatomical directional terms: lying flat with the face downward
Prone
28
Anatomical directional terms: lying on the back
Supine
29
Anatomical directional terms: a part of the body that is closer to the center of the body than another part
Proximal
30
Anatomical directional terms: on the surface or shallow
Superficial
31
Anatomical directional terms: toward the head end of the body; upper
Superior
32
Anatomical directional terms: the front part of the body
Ventral
33
Anatomical directional terms: relating to the palm of the hand or the sole of the foot
Volar
34
Anatomical directional terms: a part of the body that is farther away from the center of the body than another part
Distal
35
Anatomical directional terms: situated on or toward the upper side of the body, equivalent to the back, or posterior
Dorsal
36
Anatomical directional terms: away from the head; lower
Inferior
37
Anatomical directional terms: On the same side of the body as another structure or a given point
Ipsilateral
38
Anatomical directional terms: to the side of, or away from, the middle of the body
Lateral
39
Anatomical directional terms: toward the middle or center
Medial
40
Anatomical directional terms: situated at or toward the hind part of the body
Posterior
41
Anatomical directional terms: Situated back and below
Posteroinferior
42
Anatomical directional terms: Situated on the side and toward the posterior aspect
Posterolateral
43
Anatomical directional terms: located on or near the dorsal midline of the body or a body part
Posteromedial
44
Bones: - cylindrical shaft - protruding ends - function: serve as levers - Ex: femur, humerus
long
45
Bones: - cube-shaped, solid bones - function: shock absorption - Ex: metatarsals, metacarpals
short
46
Bones: - curved surface - can be thick or thin - function: protection - Ex: cranium
flat
47
Bones - serve a variety of purposes - include bones of entire spine, ischium, pubis, and maxilla
irregular
48
Bones: - Small bones embedded within the tendon of a musculoskeletal unit that provide protection - Called “free-floating” because they do not attach to other bones - Also serve to improve mechanical advantage of musculotendinous unit - Ex: patella, ribs
sesamoid
49
Articulation of two or more bones - classified by structure or function - enable movement to occur
joints
50
Types of joints
- synovial - syndesmosis - fibrous
51
Joints: Joined together by connective tissue - generally immovable - Ex: Sacroiliac joint, Sternoclavicular
fibrous joints
52
Joints: joined together by hyaline cartilage or fibrocartilage - Allows very slight movement - Ex: Costochondral joints of the ribs, Intervertebral discs
cartilaginous joints
53
Joints: Freely moveable - Contain a joint capsule - Contain synovial fluid - Generally they are diarthrodial - Ex: Knee, Shoulder
synovial joints
54
Joint classification Structure: fibrous Function: _
Synarthrodial
55
Joint classification Structure: Cartilaginous Function: _
Amphiarthrodial
56
Joint classification Structure: Synovial Function: _
Diarthrodial
57
Joints: - immovable - Ex: cranial sutures, socket of a tooth
synarthrodial joints
58
Joints: Slightly moveable - Three types 1. Syndesmosis: joint held together by strong ligamentous structures 2. Symphysis: joint separated by a fibrocartilage pad 3. Synchronosis: joint separated by hyaline cartilage
Amphiarthrodial joints
59
Joints: Freely moveable - Contain a joint capsule (sleeve-like covering) - Joint capsule surrounds the bony ends - Contain synovial fluid: lubricate the joint cavity - Ex: knee, shoulder
Diarthrodial joints
60
Joint classification by motion: Motion in one plane
1 degree of freedom
61
Joint classification by motion: Motion in two planes
2 degrees of freedom
62
Joint classification by motion: Motion in three planes
3 degrees of freedom
63
Joints: Two flat, bony surfaces - Butt against each other - Permits limited gliding movement - 1 degree of freedom - Ex: Carpal bones of the wrist
arthrodial (gliding joint)
64
Joints: Also called biaxial ball and socket joints - Bones permit movement in two planes without rotation (2 degrees of freedom) - Ex: Wrist between the radius and proximal row of the carpal bones
condyloidal joint
65
Joints: Also called multiaxial ball and socket joint - Permits movement in all three planes (3 degrees of freedom) - Ex: Hip and shoulder joints
enarthrodial joint
66
Joints: Also called a hinge joint - One plane of motion - Wide range of motion within that plane - Ex: Elbow, knee
ginglymus joint
67
Joints: Also called a saddle joint - Found only in the thumb - Permits ball-and-socket movement, except for rotation
sellar joint
68
Movement in joints: - Can be limited or wide-ranging - Some movements are relatively specific to a joint - Some movements describe motion at _ joints
several
69
General joint motions: - Lateral movement away from the midline of the body - Frontal plane motion
Abduction
70
General joint motions: - Movement medially toward the midline of the trunk - Frontal plane motion
Adduction
71
General joint motions: - Circular movement of a limb that delineates an arc - Combination of flexion, extension, abduction and adduction
Circumduction
72
General joint motions: - Bending movement of a limb - Results in a decrease joint angle by moving bones together - Usually occurs in the sagittal plane
Flexion
73
General joint motions - Straightening movement of a limb - Results in an increase joint angle by moving bones apart - Usually occurs in the sagittal plane
Extension
74
General joint motions: - Rotary movement around a longitudinal axis of a bone - Movement is away from the midline of the body - Transverse plane motion
External Rotation
75
General joint motions: - Rotary movement around the longitudinal axis of a bone - Movement is towards the midline of the body - Transverse plane motion
Internal Rotation
76
_ muscles in the human body _ of total body weight
- 600+ - 40-50%
77
- Responsible for movement of the body and joints - Provide protection, posture and support - Provide a major portion of body heat - Many different shapes and sizes - Different fiber types and arrangements
muscles
78
Muscle terms: - Pertaining usually to muscles within or belonging solely to the body part on which they act - Ex: small intrinsic muscles of the hand
Intrinsic
79
Muscle terms: - Pertaining usually to muscles that arise or originate outside of the body part on which they act - Ex: Forearm muscles that attach to distal end of humerus and insert on the fingers
Extrinsic
80
Muscle terms; The specific movement of the joint resulting from a concentric (shortening) contraction of a muscle which crosses the joint - Ex: The Biceps Brachii has the action of flexion at the elbow - Usually action of a joint is caused by a group of muscles working together - A particular muscle may cause more than one action either at the same joint or a different joint
action
81
Muscle terms: - The segment of the nervous system defined as being responsible for providing a stimulus to muscle fibers within a specific muscle or portion of the muscle - A particular muscle may be innervated by more than one nerve - A particular nerve may innervate more than one muscle
Innervation
82
Muscle terms: - Also called origin - Generally considered the least moveable part - Usually the part that attaches closest to midline/center of body
Proximal Insertion
83
Muscle terms; - Also called the insertion - Generally considered the most moveable part - Usually the part that attaches farthest from midline/center of the body
Distal Insertion
84
Types of muscle contractions: - Tension is developed within the muscle, but the joint angle remains constant - Static contractions
Isometric
85
Types of muscle contractions: - Involve the muscle developing tension to either cause or control joint movement - Dynamic Contraction: Causes the joint angle to change
Isotonic
86
Types of muscle contractions: - Involves the muscle developing tension as it shortens - Occurs when the muscle develops enough force to overcome applied resistance - Can be thought of as causing movement against gravity or resistance - Described as positive contractions - Results in the joint angle being changed in the direction of the applied muscular force
Concentric
87
Types of muscle contractions: - Involves the muscle lengthening under tension - Occurs when the muscle gradually lessons in tension to control the descent of the resistance - Control movement with gravity or resistance - Called negative contractions - Results in a change in the joint angle in the direction of the resistance or external force
Eccentric
88
Role of Muscles: - Muscles that, when contracting concentrically, cause joint motion through a specified plane of motion - Known as prime movers
Agonist
89
Role of Muscles: - Muscles that are usually located on the opposite side of the joint from the agonist - Have the opposite concentric action - Known as contralateral muscles - Work in cooperation with agonistic muscles by relaxing and allowing movement
Antagonist
90
Role of Muscles: - Muscles that surround the joint or body part - Contract to fixate or stabilize the area to enable another limb or body to exert force or move - Proximal Stability ->> Distal Mobility
Stabilizers
91
Role of Muscles: - Muscles that assist in the action of agonists - Not necessarily the prime movers for the action - Known as guiding muscles - Assist in refining movement
Synergist
92
Comprised of – Distal tibia – Distal fibula – Talus
ankle
93
Ankle: Fibula and Tibia make a _
mortise
94
Ankle: Held together by a _ _
interosseous membrane
95
Ankle: ends of tibia and fibula form _ - Latin - little hammer
malleoli
96
Compse of 3 sections: 1. hindfoot - talus & calcaneous 2. midfoot - 3 cuneiforms, navicular, cuboid 3. forefoot - metatarsals & phalanges
foot
97
Foot: 7 bones - greek - taros, any flat surface
tarsals
98
Foot: - greek - meta, after
metatarsals
99
Foot: - greek - phalanx, line of battle
phalanges
100
4 main joints of the foot/ankle complex
1. ankle (talocrural) 2. subtalar 3. tarsometatarsal 4. metatarsalphalangeal
101
Ankle has _ motions
2
102
Ankle: 50 degrees of motion
plantarflexion
103
Ankle: 30 degrees of motion
dorsiflexion
104
Ankle: neutral position
0 degrees
105
Ankle: Motise allows _ to pass through
talus
106
Ankle: - wider anteriorly - narrower posteriorly
talus
107
Ankle: - tight position at end range _ - loose at end range _
- dorsiflexion - plantarflexion
108
Ankle: - often fractured in dislocations of the ankle - has upward arterial supply - prone to necrosis with severe injury (avascular necrosis) - "snowboarder's fracture"
talus
109
Ankle Joint: - "below the ankle" - formed between the talus & calcaneus - "calcaneum" - latin - heel
subtalar joint
110
Subtalar joint: 30 degrees
inverison
111
Subtalar joint: 10 degrees
inversion
112
subtalar joint - in the middle - "optimally aligned foot" - best stress distribution
neutral position
113
Ankle joint: - 3 cuneiforms & cuboid with metatarsals - helps regulate positions of the foot - springs, shocks
Tarsometatarsal Joint
114
Ankle joint: - “MTP” - 5 joints - Primarily flexion and extension - Hinge to allow heel to rise while toes stabilize – gait
Metatarsophalangeal Joint
115
6 main movements of the ankle/foot complex
1. plantarflexion 2. Dorsiflexion 3. Inversion 4. Eversion 5. Pronation 6. Supination
116
Ankle movements: combination of eversion & dorsiflexion
pronation
117
Ankle movements: combination of inversion & plantarflexion
supination
118
Ankle ligaments: - roughly _
60
119
4 main ankle/foot complex ligaments
1. Interosseus membrane 2. Deltoid ligament 3. Anterior Talofibular Ligament 4. Plantar calcaneonavicular ligament
120
Ankle ligaments: - tibia to fibula - force distribution - shock attenuation - high ankle sprain
interosseus membrane
121
Ankle ligaments: - connects tibia to talus, calcaneus, and navicular - strong - bone often fails before ligaments ruptures
deltoid ligament
122
Ankle ligaments: - "ATF" or "ATFL" - fibula to talus - most often sprained - plantarflexion and inversion injury
anterior talofibular ligament
123
Ankle ligaments: - aka "spring" ligament - helps support medial longitudinal arch - helps to prevent over-pronation
plantar calcaneonavicular ligament
124
- longitudinal (medial, lateral) - transverse - function: add stability and shock absorption - supported by ligaments, shapes of bones, tendons, muscles
arches
125
Ankle/foot complex muscles: 5 main plantar flexors
1. gastrocnemius 2. plantaris 3. soleus 4. flexor hallucis longus 5. flexor digitorum longus
126
Ankle/foot complex muscles: proximal attachment = posterior condyles of femur
Gastrocnemius
127
Ankle/foot complex muscles: Distal attachment = common insertion via achilles tendon
Gastrocnemius
128
Ankle/foot complex muscles: Action = plantarflexes foot
Gastrocnemius
129
Ankle/foot complex muscles: proximal attachment = proximal posterior tibia along soleal line
soleus
130
Ankle/foot complex muscles: soleus _ _: common insertion via achilles tendon
distal attachment
131
Ankle/foot complex muscles: soleus action
plantarflexes foot
132
Ankle/foot complex muscles: proximal attachment = distal posterior femur
plantaris
133
Ankle/foot complex muscles: distal attachment = posterior calcaneus
plantaris
134
Ankle/foot complex muscles: plantaris action
plantarflexes foot
135
Ankle/foot complex muscles: Proximal attachment = distal 2/3 of posterior fibula
flexor hallicus longus
136
Ankle/foot complex muscles: distal attachment = base of the distal phalanx of the great toe, plantar surface
flexor hallicus longus
137
Ankle/foot complex muscles: flexor hallicus longus action
plantarflexes foot and big toe (hallicus)
138
Ankle/foot complex muscles: proximal attachment = distal 1/2 of the posterior tibia
flexor digitorum longus
139
Ankle/foot complex muscles: distal attachment = base of distal phalanges of digits 2-5, plantar surface
flexor digitorum longus
140
Ankle/foot complex muscles: flexor digitorum longus action
plantarflexes foot and toes 2-5
141
Ankle/foot complex muscles: 3 main dorsiflexors
1. tibialis anterior 2. extensor digitorum longus 3. extensor hallicus longus
142
Ankle/foot complex muscles: proximal attachment = superior 2/3 of anterolateral tibia
tibialis anterior
143
Ankle/foot complex muscles: distal attachment = base of 1st metatarsal of the 1st digit, also 1st cuneiform
tibialis anterior
144
Ankle/foot complex muscles: tibialis anterior action
dorsiflexes foot and inverts foot
145
Ankle/foot complex muscles: proximal attachment = superior 3/4 of the fibula, anterior surface
extensor digitorum longus
146
Ankle/foot complex muscles: distal attachment = via common tendon along the dorsal surfaces of phalanges 2-5
extensor digitorum longus
147
Ankle/foot complex muscles: extensor digitorum longus action
dorsiflexes foot and toes 2-5
148
Ankle/foot complex muscles: proximal attachment = middle anterior surface of the fibula
extensor hallicus longus
149
Ankle/foot complex muscles: distal attachment = dorsal surface of the great toe (distal phalanx)
extensor hallicus longus
150
Ankle/foot complex muscles: extensor hallicus longus action
dorsiflexes foot and big toe (hallicus)
151
Ankle/foot complex muscles: 3 everters
1. peroneus longus 2. peroneus brevis 3. peroneus tertius
152
Ankle/foot complex muscles: proximal attachment = head and proximal 1/2 of fibula, lateral side
peroneus longus
153
Ankle/foot complex muscles: distal attachment = crosses plantar surface of the foot to attach to 1st cuneiform and 1st metatarsal
peronus longus
154
Ankle/foot complex muscles: peroneus longus action
everts foot
155
Ankle/foot complex muscles: proximal attachment = distal 1/2 of the lateral side of the fibula
peroneus brevis
156
Ankle/foot complex muscles: distal attachment = tuberosity of the lateral side of the 5th metatarsal
peroneus brevis
157
Ankle/foot complex muscles: peroneus brevis action
everts foot
158
Ankle/foot complex muscles: proximal attachment = distal 1/3 of the anterior surface of the fibula
peroneus tertius
159
Ankle/foot complex muscles: distal attachment = dorsal surface of the base of the 5th metatarsal
peroneus tertius
160
Ankle/foot complex muscles: peroneus tertius action
everts foot
161
Ankle/foot complex muscles: 2 inverters
1. tibialis anterior 2. tibialis posterior
162
Ankle/foot complex muscles: proximal attachment = lateral side of the posterior tibia proximally
tibialis posterior
163
Ankle/foot complex muscles: distal attachment = navicular tuberosity, three cuneiforms, cuboid
tibialis posterior
164
Ankle/foot complex muscles: tibialis posterior action
inverts foot
165
Ankle/foot complex muscles: intrinsic muscles of the foot
way too many of them
166
Ankle/foot complex injuries: most common orthopedic injury
ankle sprain
167
Ankle/foot complex injuries: ankle sprain - Inversion with plantarflexion - Tear to _ - Severe inversion may fracture distal fibula
ATF
168
Ankle/foot complex injuries: ankle sprain – Eversion - Tear to _ _ - Rare
deltoid ligament
169
Ankle/foot complex injuries: - Inflammation of plantar fascia - Fascia tears usually near its calcaneus attachment - Main Complaint: Pain worst with first few steps in the morning
plantar fasciitis
170
Ankle/foot complex injuries: - microtearing - slow to heal - restriction in dorsiflexion range of motion
plantar fasciitis
171
Ankle/foot complex injuries: - plantar fasciaotomy - can cause _ _
collapsed foot
172
Ankle/foot complex injuries: caused by excessive inversion
fibular fracture
173
Ankle/foot complex injuries: fibular fracture - ambulation is often still possible - _ of body weight on fibula - _ on tibia - surgical options: - open reduction and internal fixation
- 15% - 85%
174
Ankle/foot complex injuries: - 1-2in above attachment to calcaneus - "critical zone of avascularity" - pronation increases length on achilles tendon
anchilles tendonitis
175
Red means _ white means _
- oxygen - no oxygen
176
Ankle/foot complex injuries: - violent start or stop - over age 30 - audible "pop" or "snap"
achilles tendon rupture
177
Ankle/foot complex injuries: - Anterior Tibialis tension - Repetitive microtrauma to tibia and its muscular attachments - Microtears to the tibialis posterior muscle or soleus muscle (medial tibial pain) - Microtears to the peroneal muscles (lateral tibial pain)
shin splints
178
ankle/foot complex injuries: - excess pronation - poor shock absorption - poor foot alignment - sudden increase in activity levels - muscle imbalances - poo warm-up - poor conditioning - tight achilles tendon - toe running * torsion on tibia bone
shin splint causes
179
ankle/foot complex injuries: - pull on achilles tendon on calcaneal insertion - in growing children - pain in heel
sever's disease
180
ankle/foot complex injuries: - increased pronation - wringing out effect on the post tib tendon
posterior tibial tendonitis
181
ankle/foot complex injuries: - following fracture or dislocation - inverted arterial supply - no muscular attachments
talar avascular necrosis
182
ankle/ foot complex health (3)
- flexibility - strength - relaxation
183
Knee: - largest joint in the body structural: _ functional: _
- synovial joint - diarthrodial joint
184
Knee: needs to provide _, _, and _
- stability - mobility - shock absorption
185
4 Knee bones:
- femur - tibia - fibula - patella
186
Knee bones: classification - long bone
femur
187
Knee bones: classification - sesamoid bone
patella
188
Knee bones: - aka knee cap - embedded in the quadriceps tendon - function: to increase force of the quadriceps muscle
patella
189
2 Knee joints:
1. tibiofemoral 2. patellofemoral
190
Knee joints: - synovial - diarthrodial - functions as a hinge
tibiofemoral joint
191
Knee joints: - flexion and extension - some internal and external rotation
tibiofemoral joint
192
5 Knee ligaments
1. MCL 2. LCL 3. PCL 4. ACL 5. MPFL
193
Knee ligaments: - medial knee - femur to tibia - thick and white * think large LA freeway
medial collateral ligament (MCL)
194
Knee ligaments: protects against lateral blows to the knee
medial collateral ligament (MCL)
195
Knee ligaments: - lateral - femur to tibia - thin and narrow * think small portland street
lateral collateral ligament (LCL)
196
Knee ligaments: protects against medial forces to the knee
lateral collateral ligament (LCL)
197
Knee ligaments: - femur to anterior tibia - protects excessive anterior tibial movement * think hands in pockets
anterior cruciate ligament (ACL)
198
Knee ligaments: - femur to posterior tibia - protects posterior tibial movement
posterior cruciate ligament (PCL)
199
medial patellofemoral ligament dislocation
dislocated knee cap
200
Knee ligaments: - patella to medial femoral condyle - helps stabilize the patella - if ruptured may lead to patellar dislocations
medial patellafemoral ligament
201
4 Knee movements
1. flexion 2. extension 3. internal rotation 4. external rotation
202
Knee movements: - flexion - sagittal plane movement - _ degrees
155
203
Knee movements: - extension - sagittal plane movement - _ degrees
0 to -20
204
Knee movements: - transverse plane movement - named by tibia
internal & external rotation
205
Knee muscles: - extensors - quadriceps - made up of 4 distinct parts: _, _, _, and _
1. rectus femoris 2. vastus lateralis 3. vastus intermedius 4. vastus medialis
206
Knee muscles: Origin = iliac spine
rectus femoris
207
Knee muscles: rectus femoris insertion
tibial tuberosity
208
Knee muscles: rectus femoris action
extends the knee
209
Knee muscles: origin = lateral femur
vastus lateralis
210
Knee muscles: vastus lateralis insertion
tibial tuberosity
211
Knee muscles: origin = medial femur
vastus medialis
212
Knee muscles: vastus medialis insertion
tibial tuberosity
213
Knee muscles: vastus medials action
knee extension
214
Knee muscles: vastus laterlis action
knee extension
215
Knee muscles: origin = femur
vastus intermedius
216
Knee muscles: vastus intermedius insertion
tibial tuberosity
217
Knee muscles: vastus intermedius action
knee extension
218
Knee flexors (2)
1. hamstrings 2. popliteus
219
Knee muscles: hamstrings composed of 3 muscles: _, _, and _
- biceps femoris - semimembranosis - semitendinosis
220
Knee muscles: biceps femoris origin
ischial tuberosity
221
Knee muscles: insertion = lateral condyle of tibia and head of fibula
biceps femoris
222
Knee muscles: biceps femoris action
knee flexion
223
Knee muscles: semimebranosis origin
ischial tuberosity
224
Knee muscles: semimebranosis insertion
proximal medial tibia
225
Knee muscles: semimebranosis action
knee flexion
226
Knee muscles: semitendinosis origin
ischial tuberosity
227
Knee muscles: semitendinosis insertion
proximal medial tibia
228
Knee muscles: semitendinosis action
knee flexion
229
Knee muscles: popliteus origin
posterior lateral femur
230
Knee muscles: popliteus insertion
medial tibia
231
Knee muscles: popliteus action
knee internal rotation and knee flexion
232
Knee muscles: - tibia _ _ on the femur - happens when knee extends - due to shape of bones and meniscus - called screw-home mechanism
externally rotates
233
Knee muscles: - popliteus "unlocks" the knee - popliteus _ _ the knee
internally rotates
234
- MCL sprain - osteoarthritis - total knee replacement - patellofemoral pain - patellar tendinitis/osis - Osgood schlatter - meniscal tear - ACL tear
knee injuries
235
Knee injuries: - can be minor to major (grad I, II, III) - MOI: lateral stress/force to knee (usually in weight-bearing - tests & measures: medial ligamentous stress test - rehabilitation: bracing, ROM, strengthening - surgery: rarely required
MCL sprain
236
Knee injuries: "terrible triad"
- MCL - ACL - medial meniscus
237
Knee injuries: - MOI: insidious onset caused by breakdown and eventual loss of joint cartilage - causes: usually no known cause, often associated with inactivity - signs & symptoms: pain and stiffness of joint, usually effect medial knee compartment - rehabilitation: ROM and strengthening - surgery: TKA or hemi TKA
osteoarthritis (OA)
238
Knee injuries: symptoms - 1. sharp or burning pain 2cm prox. to lat. joint line 2. symptoms develop after reproducible distance run 3. pain with walking or sitting (severe cases)
IT Band Syndrome
239
Knee injuries: Tests/Measures: 1. pain with palpation 2. positive Noble’s test (apply pressure to lat femoral epicondyle as extend knee) (+) is pain at 30 degrees flexion 3. positive Ober’s test
IT Band Syndrome
240
Knee injuries: - symptom: lateral knee pain - typical patient: runners, cyclists, weight lifters
IT band syndrome
241
Knee injuries: End stage operation - Done for pain relief - Can replace full knee or medial/lateral side only - If one sided- does not correct varus or valgus deformity - Replace posterior patella - 1-2 year recovery
Total knee replacement
242
Knee injuries: MOI: usually repetitive stressful activity of knee, multitracking of the patella - signs & symptoms: pain around patella - rehabilitation: full knee ROM, hip strengthening
patellofemoral pain syndrome
243
Knee: Large _ may be predisposing factor for developing patellofemoral pain - Increased incidence in females vs males
Q angle
244
Knee injuries: - MOI: sports and activity involving frequent jumping, also called "jumper's knee" - signs & symptoms: pain, usually below patella to insertion of patellar tendon - treatment: full knee ROM, eccentric quadricep strengthening, healing could take weeks to years
patellar tendinitis/osis
245
itis =
inflammation
246
osis =
degeneration
247
Knee injuries: - MOI: Running or jumping activity during rapid bone growth - Higher frequency in athletes: 20% - Signs & Symptoms: Pain,swelling, and tenderness at tibial tuberosity - treatment: full knee ROM. hip and hamstring strengthening, limit quadricep activity - usually resolves after growth spurt (11-12 females, 13-14 males)
Osgood-Schlatter disease
248
Greek - meniskos meaning crescent
meniscus
249
meniscus functions
- stability - shock absorption - lubrication - proprioception
250
meniscus anatomy: _ - wedge - attached to tibia
fibrocartilage
251
Meniscus anatomy: - C shaped - aslo attaches to transverse ligament - coronary ligaments - MCL and capsule
medial meniscus
252
Meniscus anatomy: - circular - transverse ligament - coronary ligaments - no connection to the LCL - more mobile
lateral meniscus
253
Meniscus anatomy: - less mobile - MCL and joint capsule - semimembranosus to posterior horn
medial meniscus
254
Meniscus anatomy: medial meniscus _ mainly in the anterior and posterior horns
mechanoreceptors
255
Meniscus anatomy: - no LCL attachment - more mobile - "bend not break"
lateral meniscus
256
- medial and lateral geniculate arteries - perimeniscal plexus - joint capsule
meniscus circulation
257
- torsion - excessive - flexion - extension - translation - open or closed chain - contact or non-contact
meniscus injury
258
- joint line pain - catching, popping, locking - +/- swelling - special tests = McMurray's - Apley's - rule out other areas ( knee and referred)
meniscus diagnosis
259
Meniscus treatment: - repair - difficulty, time consuming during surgery and recovery - debridement - 40% less thick under meniscus - more trauma
surgical
260
lateral compartment articular _ deterioration following partial meniscectomy
rapid
261
joint kinematics - therapeutic exercise - unloaded motion - CPM study - synovial flush - oxygen - envelope of function - the body wants to heal itself - full ROM
Meniscus treatments
262
ACL anatomy: named for _ side
tibial
263
ACL anatomy: ACL bundles
- anteromedial bundle - posterolateral bundle
264
ACL biomechanics: ACL provides the main check at _ degrees for anterior tibial movement
20-45
265
ACL biomechanics: most _ through the ACL at 20-45 degrees
force
266
ACL biomechanics: rotation - excessive _ tibial movement - excessive _ rotary tibial movement
- anterior - medial
267
ACL bundle biomechanics: AM bundle controls _ stability
anterior
268
ACL bundle biomechanics: PL bundle controls _ stability
rotational
269
ACL bundle biomechanics: Extended knee - AM and PL are _ - _ has more force through it
- parallel - AM
270
ACL bundle biomechanics: Flexed knee - AM and PL are _ - _ has more force through it
- crossed - PL
271
ACL injuries: Occur when bones of the leg _ _ _ _ under full body weight
twist in opposite directions
272
2 way ACL injuries occur
1. non-contact 2. contact
273
ACL bone bruise: Which has a larger bone bruise contact or non-contact?
non-contact
274
ACL bone bruise: patients with bone bruise has a significantly _ _ than patients without bone bruise
poorer function
275
ACL to reconstruct or not: Whose decision is it?
patient
276
ACL to reconstruct or not: what is our role?
- education - present the research
277
ACL to reconstruct or not: How to determine the need to reconstruct
- clinical instability - sport
278
ACL to reconstruct or not: it may be the severity of the injury itself that leads to the _ _
poor sequela
279
ACL reconstruction graft choices: - poor primary repair - too stretched out - graft choices: _, _, and _
- allograft - autograft - double bundle
280
ACL reconstruction graft choices: - autograft - tendon graft is harvested from the patellar tendon
patellar tendon graft
281
ACL reconstruction graft choices: - autograft - tendon graft is harvested from lateral hamstring tendon
hamstring tendon graft
282
ACL reconstruction: prior to surgery - no swelling - equal ROM - no quad lag SLR (straight leg raise) - without these; _ _ - possibility of _
- difficulty results - arthrofibrosis
283
ACL reconstruction graft choices: - less pain - less trauma - earlier weight bearing - quicker motion return - better cosmesis - faster surgery - less motion loss
allograft pros (cadaver)
284
ACL reconstruction graft choices: - infection - whose tendon? - site incorporation - stretches out? - cost - availability
allograft cons
285
ACL reconstruction graft choices: - less infection risk - better graft incorporation - slows patient down
autograft pros
286
ACL reconstruction graft choices: BPTB (bone patellar tendon bone) is the _
gold standard
287
ACL reconstruction graft choices: - more pain - arthrofibrosis - slower to fully weight bear - patellar fracture - patellofemoral articular lesions - knee extension weakness - pain while kneeling - decreased hamstring strength - patellofemoral pain
autograft cons
288
ACL reconstruction graft choices: - think door hinges - shared work
double bundle
289
ACL reconstruction graft choices: - footprints - bundles - tunnel - A La Carte (Fu)
double bundle concepts
290
ACL reconstruction graft choices: who is not a good double bundle canidate?
- too small a footprint - patient is still growing - severe arthritis present - multiple ligament injury
291
what causes an ACL injury? _ movement of the knee
valgus
292
when can an ACL injury happen in non-contact sports?
- jumping - landing - running and stopping abruptly
293
ACL injuries most prevalent in
females 15-19 years old
294
After an ACL injury, it is highly predictable that the athlete will most likely suffer the same injury in the future - usually will occur in the _ _
opposite knee
295
ACL injuries: - females have an _ times higher incidence rate of ACL injury than males - _: women have wider hips than men
- 8 - Q-angle
296
knocked knees - knees go in
valgus
297
Bowed knees - knees go out
varus
298
What makes you vulnerable to an ACL tear?
quadricep/hamstring ratio imbalance
299
It is estimated that _ of ACL injuries are sustained through non-contact mechanisms
70%
300
ACL injuries: what can we do? - implement a _ _ _ _ for players to warm up, not just stretching - overhead squats - lunges - high knees - butt kickers
strength training/neuromuscular training program
301
Hip bones: - right and left halves - made of three bones: ilium, ischium, pubis - separate bones at birth, during growth and development - fused at maturity
pelvis
302
Hip bones: - classification: long bone - function: lever - longest bone in the body
femur
303
Hip bones: - extension of the spinal column - 5 fused vertebrae - located posteriorly between the two pelvic bones
sacrum
304
Hip bones: sacrum - _ _: formed by junction of pelvis and sacrum
sacroiliac (SI) joint
305
Hip bones: - classification: flat bone - function: protection
ilium bone
306
Hip bones: - classification: irregular bone - function: protection
pubic bone
307
Hip bones: - classification: irregular bone - function: protection - not pubic bone
ischium bone
308
Hip joint: - large stable joint - structural: _ _ - functional: _ _ _ _
- synovial joint - ball and socket joint
309
Hip joint: consists of: - ball = _ - socket = _
- head of femur - acetabulum of pelvis
310
Hip joint provides
stability, mobility, shock absorption and, protection
311
Hip joint: - aka _ _ - three degrees of freedom 1. frontal plane motion 2. sagittal plane motion 3. transverse plane motion
femoroaoacetabular joint
312
Hip joint: - spherical - smooth surface
femoral head - "ball"
313
Hip joint: Femoral head - covered by _ _ - cartilage that covers the ends of bones that form joints - shock absorption - joint nutrition
articular cartilage
314
Hip joint: - also lined by hyaline articular cartilage - needs to support entire body weight
acetabulum
315
Hip joint: - fibrocartilage - deepens the socket - provides more stability - provides proprioception
acetabulur labrum
316
Hip movements: - hip flexion - normal ROM: _ degrees - large variability in "normal" ROM - sagittal plane motion
0-130
317
Hip movements: movement of the femur straight anterior toward the pelvis
hip flexion
318
Hip movements: movement of the femur straight posteriorly away from the pelvis
hip extension
319
Hip movements: - hip extension - normal ROM: _ degrees - sagittal plane motion
0-30
320
Hip movements: movement of the femur laterally to the side away from midline
hip abduction
321
Hip movements: - hip abduction - normal ROM: _ degrees - frontal plane motion
0-45
322
Hip movements: movement of the femur medially towards the midline
hip adduction
323
Hip movements: - hip adduction - normal ROM: _ degrees - frontal plane motion
0-30
324
Hip movements: rotary movement of the femur medially around its longitudinal axis towards the midline
hip internal rotation
325
Hip movements: - hip internal rotation - also called medial rotation - normal ROM: _ degrees - transverse plane motion
0-45
326
Hip movements: rotary movement of the femur laterally around its longitudinal axis away from the midline
hip external rotation
327
Hip movements: - hip external rotation - also called lateral rotation - normal ROM: _ degrees - transverse plane motion
0-50
328
3 main hip ligaments
1. iliofemoral ligament 2. ischiofemoral ligament 3. pubofemoral ligament
329
Hip ligaments: - strong ligaments - function: _
stability
330
Hip ligaments: - Ilium to femur - Anterior to Hip Joint - Prevents abduction and external rotation
Iliofemoral Ligament
331
Hip ligaments: - Connects the ischium to the femur - Triangular band of strong fibers - Posterior side of hip joint - Limits medial rotation
Ischiofemoral Ligament
332
Hip ligaments: - Pubis to Femur - Anterior to Hip Joint - Limits abduction
Pubofemoral Ligament
333
Hip muscles: - psoas (major & minor) - iliacus - rectus femoris - sartorius - tensor fascia latae (TFL) - adductor longus
hip flexors
334
Hip muscles: - hip flexor - origin = T12-L5 vertebrae
psoas major/minor
335
Hip muscles: - hip flexor - insertion = lesser trochanter of femur
psoas major/minor
336
Hip muscles: psoas major/minor action
hip flexion
337
Hip muscles: - hip flexor - origin = inner part of ilium
iliacus
338
Hip muscles: - hip flexor - iliacus insertion = _
lesser trochanter of femur
339
Hip muscles: iliacus action
hip flexion
340
Hip muscles: - hip flexor - origin = iliac spine
rectus femoris
341
Hip muscles: - hip flexor - insertion = tibial tuberosity
rectus femoris
342
Hip muscles: rectus femoris actions
hip flexion, knee extension
343
Hip muscles: - hip flexor - origin = anterior ilium
sartorius
344
Hip muscles: - hip flexor - insertion = upper medial tibia
sartorius
345
Hip muscles: sartorius action
hip flexion
346
Hip muscles: - hip flexor - origin = anterior iliac crest
tensor fascia latae (TFL)
347
Hip muscles: - hip flexor - insertion = IT band
tensor fascia latae (TFL)
348
Hip muscles: tensor fascia latae (TFL) actions
hip flexion, hip abduction
349
Hip muscles: - hip flexor - origin = anterior pubis
adductor longus
350
Hip muscles: - hip flexor - insertion = proximal medial femur
adductor longus
351
Hip muscles: adductor longus actions
hip flexion, hip adduction
352
4 main hip extensor muscles
1. gluteus maximus 2. semimembranosis 3. semitendonosis 4. biceps femoris
353
Hip muscles: - hip extensor - origin = Posterior ilium & Sacrum
Gluteus Maximus
354
Hip muscles: - hip extensor - insertion = Greater trochanter of femur & IT band
Gluteus Maximus
355
Hip muscles: gluteus Maximus actions
hip extension, hip ER
356
Hip muscles: - hip extensor - origin = Ischial tuberosity
Semimembranosis
357
Hip muscles: - hip extensor - insertion = Proximal medial tibia and Fibula
Semimembranosis
358
Hip muscles: Semimembranosis actions
Hip extension, Knee flexion
359
Hip muscles: - hip extensor - origin = Ischial tuberosity
Semitendinosis
360
Hip muscles: - hip extensor - insertion = Proximal medial tibia
Semitendinosis
361
Hip muscles: Semitendinosis actions
Hip extension, Knee flexion
362
Hip muscles: - hip extensor - origin = Ischial tuberosity
Biceps femoris
363
Hip muscles: - hip extensor - insertion = Lateral condyle of tibia & Head of fibula
Biceps femoris
364
Hip muscles: Biceps femoris actions
Hip extension, Knee flexion
365
3 main hip abductor muscles
1. gluteus medius 2. gluteus minimus 3. tensor fascia latae (TFL)
366
Hip muscles: - hip abductors - origin = lateral ilium
gluteus medius
367
Hip muscles: - hip abductors - insertion of gluteus medius
greater trochanter of femur
368
Hip muscles: - hip abductors
369
Hip muscles: - hip abductors
370
Hip muscles: gluteus medius actions
hip abduction, hip IR (anterior fibers), hip ER (posterior fibers)
371
Hip muscles: - hip abductors - origin = lateral ilium (below glute med)
gluteus minimus
372
hip muscles: - hip abductors - insertion of gluteus minimus
greater trochanter of femur
373
hip muscles: gluteus minimus actions
hip abduction, hip IR (anterior fibers), hip ER (posterior fibers)
374
5 main hip adductor muscles
1. adductor longus 2. adductor brevis 3. adductor magnus 4. pectinius 4. gracilis
375
Hip muscles: - Hip Adductors Adductor Longus - origin = Anterior pubis
Adductor Longus
376
Hip muscles: - Hip Adductors - insertion = Proximal medial femur
Adductor Longus
377
Hip muscles: Adductor Longus actions
hip adduction, hip flexion
378
Hip muscles: - Hip Adductors - origin = Anteroinferior pubis
Adductor Brevis
379
Hip muscles: - Hip Adductors - insertion = Proximal medial femur
Adductor Brevis
380
Hip muscles: adductor brevis action
hip adduction
381
Hip muscles: - hip adductors - origin = Pubis, ischium, and ischial tuberosity
Adductor Magnus
382
Hip muscles: - hip adductors - insertion = Posterior and medial femur
Adductor Magnus
383
Hip muscles: Adductor Magnus action
Hip Adduction
384
Hip muscles: - Hip Adductors - origin = Pubis
Pectineus
385
Hip muscles: - Hip adductors - insertion Upper medial femur
Pectineus
386
Hip muscles: Pectineus actions
Hip flexion, also adduction of hip & internal rotation
387
Hip muscles: - Hip Adductors - Gracilis origin  I: Medial tibia  A: Hip adduction, hip internal rotation
pubis
388
Hip muscles: - Hip Adductors - gracilis insertion
Medial tibia
389
Hip muscles: Gracilis actions
Hip adduction, hip internal rotation
390
5 main hip internal rotator muscles
1. gracilis 2. pectinius 3. gluteus medius (anterior fibers) 4. gluteus minimus (anterior fibers) - TFL
391
4 main hip external rotators
1. gluteus medius (posterior fibers) 2. gluteus minimus (posterior fibers) 3. gluteus maximus 4. 6 deep external rotators
392
Hip muscles: - Piriformis - Superior gemellus - Inferior gemellus - Obturator internus - Obturator externus - Quadratus femoris
6 deep external hip rotators
393
Hip muscles: - origin = Sacrum and/or ischium
6 deep external hip rotators
394
Hip muscles: - insertion = Greater trochanter
6 deep external hip rotators
395
Hip muscles: 6 deep external rotators actions
Hip external rotation
396
Hip joint injuires = _ _ (usually)
groin pain
397
- Hip Impingement aka Femoroacetabular Impingment - Hip Osteosarcoma (cancerous tumor) - Avascular Necrosis - Slipped Capital Femoral Epiphysis - Hip Fracture - Hip Pointer/Contusion - Stress Fracture - Adductor Strain - Hip Labral Tear - Total Hip Replacement
hip injuries
398
hip injuries: aka femoroacetabular impingement
hip impingement
399
hip injuries: - Disruption of the blood supply - Trauma - Steroid use - Asthma - Alcoholism - Fatty deposits in bloodstream
Avascular Necrosis of the Hip (AVN)
400
Hip injuries: - Pain in groin - Range of motion loss - Treatment - Activity modification - Possible surgery
Avascular Necrosis of the Hip (AVN)
401
Hip injuries: Epiphysis = area at end of long bond that is separated from main part of bone by a growth plate - Most common just after onset of puberty - Males > Females - More common in obese children - Cause: Unknown - Maybe weakening of growth plate due to: * Trauma * Inflammation * Changes in hormone levels
slipped capital epiphysis
402
Hip injuries: - Worsens with activity - Cannot weight bear affected leg - Affected leg is often turned outward in comparison to normal leg - Loss of flexion and IR ROM
slipped capital epiphysis
403
Hip injuries: Treatment: - Surgery: stabilize bone with pins or screws (bone are left with tilt seen at presentation) - Possible Complications: * Chondrolysis (loss cartilage) * Avascular necrosis * Greater risk of osteoarthritis * 1 short limb due to premature closure of the growth plate
Slipped Capital Epiphysis
404
Hip injuries: - Usually to the femoral neck of the femur - Caused by trauma - Falls, car accidents - Usually over 65 - Bones become less dense with age - Women higher risk than men
Hip Fracture
405
Hip injuries: - Pain in groin - Unable to bear weight on leg - Swelling and bruising - Treatment: - Surgery
hip fracture
406
Hip injuries: - Aka contusion - Bruise to the ilium - Pain above groin - Treated with rest, ice, padding
Hip Pointer
407
Hip injuries: - Caused by overuse - Runners - Military - Usually occurs at femoral neck - Pain in groin - Pain with running - Often no pain with walking, sitting
Stress Fractures
408
Hip injuries: - Treatment - Rest - Pool running - Training modification
stress fractures
409
Hip injuries: - Pain in adductors (usually adductor longus) - Excessive motion ○ Soccer ○ Hockey
Adductor (Groin) Strain
410
Hip injuries: - Treatment - Rest, ice - Regain motion - Eccentric loading when able
Adductor (Groin) Strain
411
Hip injuries - Tear of fibrocartilage labrum - Causes ○ Trauma ○ Excessive motion - Hockey - Golf - Gymnastics
Acetabular Labral Tear
412
Hip injuries: - May have no symptoms - May have groin pain - May have catching or popping - Pain with twisting - Motion loss
Acetabular Labral Tear
413
Hip injuries Treatment - Non surgical ○ Motion restoration ○ Neuromuscular control - Surgical ○ Repair ○ Debridement
Acetabular Labral Tear
414
Hip injuries: - Pain in groin due to severe osteoarthritis or trauma - Protective cartilage of the hip erodes
Hip Replacement
415
Hip injuries: Hip Replacement replaces the _ _ _
ball and socket
416
Hip injuries: - End stage operation - Nothing else helped - Patient can’t walk, function, sleep - Good outcome but has risks - Risks ○ Infection ○ Blood clots ○ Death
Hip replacement
417
Hip injuries: Typical Patient Presentation - Anterior Groin Pain - Limited Hip Flexion - Limited Hip Internal Rotation - Positive FAI Test - Pain with Sitting - Pain with Bending - Pain with Twisting - Radiographs ?
femoroacetabular impingement (FAI)
418
Hip injuries: 2 types of femoroacetabular impingements (FAI)
1. cam impingement 2. pincer impingement
419
Hip injuries: femoroacetabular impingement (FAI) - treatment - Improving Techniques - Similar but less invasive
Arthroscopic Surgery
420
Hip injuries: femoroacetabular impingement (FAI) - treatment - restore full motion - restore neuromuscular control
non-surgical treatment
421
Hip injuries: - treatment plan - Carefully restore full ROM - Don’t forget the Spine - Neuromuscular Control - Sport Specific Training - Recheck, Recheck, Recheck
femoroacetabular impingement (FAI)
422
sagittal plane
423
frontal plane
424
transverse plane
425
movement towards midline
adduction
426
abduction
427
extension
428
flexion
429
internal rotation
430
external rotation
431
talus bone
432
subtalar joint
433
tarsometatarsal joint
434
Metatarsophalangeal Joint
435
Interosseus Membrane
436
Deltoid Ligament of Ankle
437
Anterior Talofibular Ligament (ATFL)
438
Plantar Calcaneonavicular Ligament
439
Gastrocnemius
440
Soleus
441
Plantaris
442
Flexor Hallicus Longus
443
Flexor Digitorum Longus
444
Tibialis Anterior
445
Extensor Digitorum Longus
446
Extensor Hallicus Longus
447
Peroneus Longus
448
Peroneus Brevis
449
Peroneus Tertius
450
Tibialis Posterior
451
achilles tendon
452
achilles tendon
453
Sever’s Disease
454
talus fracture
455
femur
456
tibia
457
fibula
458
patella
459
MCL
460
LCL
461
ACL
462
PCL
463
Medial Patellafemoral Ligament reconstruction
464
Tibial Tuberosity
465
Rectus Femoris
466
Vastus Lateralis
467
Vastus Medialis
468
Vastus Intermedius
469
Ischial Tuberosity
470
posterior view
Biceps Femoris
471
Semimebranosis
472
Semitendinosis
473
Popliteus
474
Meniscus
475
IT Band Syndrome
476
Total Knee Replacement
477
Q angle
478
Osgood-Schlatter Disease
479
pelvis
480
Sacrum
481
Ilium Bone
482
Pubic Bone
483
Ischium Bone
484
Hip joint
485
Femoroacetabular Ligaments
486
Iliofemoral Ligament
487
Ischiofemoral Ligament
488
Pubofemoral Ligament
489
Greater Trochanter
490
opposite greater trochanter
Lesser Trochanter
491
Psoas Major/Minor
492
Iliacus
493
Sartorius
494
Tensor Fascia Latae (TFL)
495
Adductor Longus
496
Gluteus Maximus
497
Gluteus Medius
498
Gluteus Minimus
499
Adductor Brevis
500
Adductor Magnus
501
Pectineus
502
Gracilis
503
The 6 deep external rotators
504
Femoroacetabular Impingement
505
Avascular Necrosis of the Hip (AVN)
506
Slipped Capital Epiphysis
507
Hip Fracture
508
Hip Pointer
509
Stress Fracture
510
Acetabular Labral Tear
511
Adductor (Groin) Strain
512
Hip Replacement