1. 17-1 Kinesiology for Manual Therapies Chapter 17 The Knee Joint McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

2. 17-2 Learning Outcomes o 17-1 Define key terms. o 17-2 Identify on a human skeleton selected bony features of the knee joint. o 17-3 Describe the cartilaginous and ligamentous structures of the knee joint. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

3. 17-3 Learning Outcomes (cont.)  17-4 Draw and label on a skeletal chart the muscles, including origins and insertions, and ligaments of the knee joint.  17-5 Palpate the superficial knee joint structures and muscles, including origins and insertions, on a partner. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

4. 17-4 Learning Outcomes (cont.)  17-6 Demonstrate all the active and passive movements of the knee joint with a partner.  17-7 Name and explain the actions and importance of the quadriceps and hamstring muscles. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5. 17-5 Learning Outcomes (cont.)  17-8 List and organize the muscles that produce the movements of the knee joint and list their antagonists.  17-9 Practice flexibility and strengthening exercises for each muscle group. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

6. 17-6 Introduction  The knee joint affects posture through the position of the hip joint.  The knee joint is vulnerable to injuries.  The bone’s structure is designed to provide mobility and weight bearing. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

7. 17-7 Bones  The tops of the medial and lateral tibial condyles are known as the medial and lateral tibial plateaus.  The tibia bears most of the body’s weight in the knee joint.  The fibula serves for an attachment site for muscles and ligaments. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

8. 17-8 Bones (cont.)  The patella is a sesamoid bone.  Key bony landmarks include the tibial tuberosity, Gerdy’s tubercle, the medial and lateral femoral condyles, and the medial tibial condyle. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

9. 17-9 Bones (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

10. 17-10 Bones (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

11. 17-11 Joints  The knee joint is the tibiofemoral joint and is classified as a ginglymus joint because it acts like a hinge performing flexion and extension.  Ligaments provide stability for the knee joint and the medial and lateral menisci (cartilage) cushion the joint. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

12. 17-12 Joints (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

13. 17-13 Ligaments of the Knee Joint  The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) are named because they cross within the knee between the tibia and femur.  The ACL is often injured.  The medial knee has the tibial medial collateral ligament (MCL) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

14. 17-14 Ligaments of the Knee Joint (cont.)  The lateral side of the knee the fibular collateral ligament (LCL) joins the fibula to the femur.  A plica is an anatomical variant among some individuals that may be irritated or inflamed with injuries or overuse of the knee. There are over 10 bursae in the knee. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

15. 17-15 Movements McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

16. 17-16 Movements (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

17. 17-17 Movements (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

18. 17-18 Muscles McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19. 17-19 Muscles (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

20. 17-20 Muscles (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

21. 17-21 Muscles (cont.) Q Angle McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

22. 17-22 Nerves  The femoral nerve innervates the knee extensors.  The knee flexors are innervated by the tibial division of the sciatic nerve. The biceps femoris short head is supplied by the peroneal nerve. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

23. 17-23 Individual Muscles of the Knee Joint – Anterior - Quadriceps  The quadriceps consist of the rectus femoris, the vastus lateralis, vastus intermedius, and the vastus medialis.  They all attach to the patella by the patellar tendon to the tuberosity of the tibia. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

24. 17-24 Individual Muscles of the Knee Joint (cont.) – Anterior – Rectus Femoris McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

25. 17-25 Individual Muscles of the Knee Joint (cont.) – Anterior – Rectus Femoris McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

26. 17-26 Individual Muscles of the Knee Joint (cont.) – Anterior – Vastus Lateralis McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

27. 17-27 Individual Muscles of the Knee Joint (cont.) – Anterior – Vastus Lateralis McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

28. 17-28 Individual Muscles of the Knee Joint (cont.) – Anterior – Vastus Intermedius McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

29. 17-29 Individual Muscles of the Knee Joint (cont.) – Anterior – Vastus Intermedius McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

30. 17-30 Individual Muscles of the Knee Joint (cont.) – Anterior – Vastus Medialis McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

31. 17-31 Individual Muscles of the Knee Joint (cont.) – Anterior – Vastus Medialis McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

32. 17-32 Individual Muscles of the Knee Joint – Posterior – Hamstrings Semitendinosus McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

33. 17-33 Individual Muscles of the Knee Joint (cont.) – Posterior – Hamstrings Semitendinosus McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

34. 17-34 Individual Muscles of the Knee Joint (cont.) – Posterior – Hamstrings Semimembranosus McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

35. 17-35 Individual Muscles of the Knee Joint (cont.) – Posterior – Hamstrings Semimembranosus McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

36. 17-36 Individual Muscles of the Knee Joint (cont.) – Posterior – Hamstrings Biceps Femoris McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

37. 17-37 Individual Muscles of the Knee Joint (cont.) – Posterior – Hamstrings Biceps Femoris McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

38. 17-38 Individual Muscles of the Knee Joint (cont.) – Posterior Popliteus McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

39. 17-39 Individual Muscles of the Knee Joint (cont.) – Posterior Popliteus McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

40. 17-40 Chapter Summary The bones, joints, ligaments, movements, muscles, and nerves of the knee joint are explored in this chapter. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

41. 17-41 Chapter Summary (cont.)  Individual muscles of the knee joint are reviewed in depth with regard to palpation, origin, insertion, action, and innervation.  Each muscle includes information with clinical notes, muscle specifics, clinical flexibility and strengthening. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

42. 17-42 Chapter Review  The Chapter Review is divided into true and false, short answers, and multiple choice questions.  The questions are designed for the students to test their knowledge.  Worksheets are at the end of the text as an aid for learning. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

43. 17-43 Explore and Practice  Students should utilize the questions and charts at the end of the chapter to help focus on the content of the chapter. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved