1. Mrs. Marr

2. Injuries Remember that most injuries fall into basic categories : –Contusions –Sprains Ligaments –Strains Muscles –Fractures –Chronic vs. Acute

3. Bones of the Lower Limb Pelvis (hip): 3 bones that have grown together Shaped differently in males than females Ilium you can feel it at the top of your hips Ischium 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 Thighbone Knee: Patella- knee bone Joint- Femur and Tibia Lower 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 foot Cuboid- cubed shaped Navicular- shaped like a little boat Cuneiforms (3)- wedge shaped, between Navicular & 1 st 3 metatarsal

5. Hip and Pelvis Anatomy

6. 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 –LCL These ligaments connect the Tibia and Femur and provide the structural integrity to the knee. Meniscus –Medial and Lateral Muscles –Quads (4) –Hamstrings (3)

7. Knee Ligament Structure

8. Cadaver Knee PCL ACL LCL MCL MM LM Patella Tendon Patella

9. Transverse Cross View of the Knee

13. KNEE MUSCLES

15. Hamstring

19. ADDUCTORSADDUCTORS

20. Muscles

21. Evaluation History –Asking what where when how –Getting athlete comfortable Observation –Look for any abnormalities Palpation –KNOW YOUR ANATOMY! Special Tests –ROM –Stress tests

22. Ober Test IT Band Tightness Positive Test: The leg will not drop there is tightness Negative Test: The leg drops easily

23. Lachman’s Test (ACL) Alternative ACL Test –Anterior Drawer –Modified Lachman’s –Forward translation of the Femur on the Tibia

25. Posterior Sag (PCL) Can also be done with heel resting on chair Look for sag of the Tibia/ Backward translation of the Tibia

26. Stress Test Valgus Varus MCL LCL

27. Surgery

28. OTHER Wound Care Put gloves on –Universal Precautions Clean the wound Antibiotic cream Cover Wrap on

29. NAME THIS INJURY

30. KNEE DISLOCATION

32. Femur Fracture

33. Surgery Scars

35. Tibia FX & Dislocation (Rotation)

37. What will you have to know…

42. Are you ready?

47. Review Ankle, Lower leg and Foot

51. Review and LAB… NEXT SLIDES

52. Knee Anatomy Label the structures 1.Femur 2.Tibia 3.Fibula 4.MCL 5.LCL 6.ACL 7.PCL 8.Medial Meniscus 9.Lateral Meniscus 10.Name the action the Quadriceps perform on the knee when contracted.________________ 11.Name the action the Hamstrings perform on the knee when contracted._________________

53. Can You Label the structures ? 1.Femur 2.Sacrum 3.Ilium 4.Illiac Crest 5.Coccyx 6.Femoral Head 7.Pubis 8.Ischium 9.Psoas Major 10.Illiacus 11.Rectus Femoris 12.Vastus Lateralis 13.Sartorius 14.Gracilis 15.Gluteus Max 16.Tibialis Anterior 17.Gastrocnemius 18.Patellar Tendon 19.Achilles Tendon 20.TFL/ IT Band

54. KNEE/Hip Lab KNEE/Hip Lab Label and Palpate Label the Lower Limb –Bones –Ligaments –Tendons/ Muscles YES 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