TCM Database — "Select Joints and Ligaments"

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Select Joints and Ligaments Shoulder Joint Articular Capsule Rotator Cuff = Combination of ligaments Coracohumeral ligament coracoid process --> greater tubercle of humerus Glenohumeral ligament 3 extensions from glenoid cavity --> lesser tubercle and anatomical neck of humerus Transverse humeral ligament Narrow sheet from greater tubercle --> lesser tubercle of humerus Glenoid labrum Narrow rim of fibrocartilage around glenoid cavity Bursae: Subscapular Subdeltoid Subacromial Subcoracoid Elbow Joint Articular capsule Ulnar collateral ligament medial epicondyle of humerus --> coronoid process and olecranon of ulna Radial collateral ligament lateral epicondyle of humerus --> annular ligament (ligament of radialannular pivot joint) and radial notch of ulna Hip Joint Articular capsule Iliofemoral ligament anterior inferior illiac spine --> intertrochanteric line of femur Pubofemoral ligament pubic rim of acetabulum -> neck of femur Ligament of the head of the femur fossa of acetabulum --> fovea capitis of the femur head Acetabular labrum ring of cartilage on acetabulum Transverse ligament of the acetabulum connected with head of the femur and the articular capsule Knee Joint Articular Capsule Medial and Lateral Patellar Retinacula Fused tendons of insertion of the quadriceps femoris muscle and the fascia lata Patellar Ligament patella --> tibial tuberosity Oblique popliteal ligament intercondylar fossa of femur --> head of the tibia Arcuate popliteal ligament lateral condyle of femur --> styloid process of head of the fibula Tibial collateral ligament medial condyle of the femur --> medial condyle of the tibia Fibular collateral ligament lateral condyle of the femur --> later side of the head of the fibula Intracapsular ligaments Anterior Cruciate Ligament (ACL) anterior section of intercondyle area of tibia --> lateral condyle of femur Posterior Curciate Ligament (PCL) posterior section of intercondyle area of tibia and lateral meniscus --> medial condyle of femur Artivular Discs (Menisci) Medial and Lateral Bursae: Prepatellar bursa - between patella and skin Intrapatellar bursa - superior part of tibia and patellar ligament Suprapatellar bursa - inferior part of femur and deep suface of quadriceps femoris.

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Femur Pelvis HIP JOINT Femoral Head in Acetabulum Acetabular
Anatomy of the Hip Joint Overview The hip joint is one of the largest weight-bearing HIP JOINT joints in the body. This ball-and-socket joint allows the leg to move and rotate while keeping the body Femoral head in stable and balanced. Let's take a closer look at the acetabulum main parts of the hip joint's anatomy. Pelvis Bones Two bones meet at the hip joint, the femur and the pelvis. The femur, commonly called the "thighbone," is the longest and heaviest bone of the body. At the top of the femur, positioned on the femoral neck, is the femoral head. This is the "ball" of the hip joint. The other part of the joint – the Femur "socket" – is found in the pelvis. The pelvis is a bone made of three sections: the ilium, the ischium and the pubis. The socket is located where these three sections fuse. The proper name of the socket is the "acetabulum." The head of the femur fits tightly into this cup-shaped cavity. Articular Cartilage The femoral head and the acetabulum are covered Acetabular with a layer of articular cartilage. This tough, smooth tissue protects the bones. It allows them to labrum glide smoothly against each other as the ball moves in the socket. Soft Tissues Several soft tissue structures work together to hold the femoral head securely in place. The acetabulum is surrounded by a ring of cartilage called the "acetabular labrum." This deepens the socket and helps keep the ball from slipping out of alignment. It also acts as a shock absorber.
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Elbow Checklist
Workbook Musculoskeletal Ultrasound September 26, 2013 Shoulder Checklist Long biceps tendon Patient position: Facing the examiner Shoulder in slight medial rotation; elbow in flexion and supination Plane/ region: Transverse (axial): from a) intraarticular portion to b) myotendinous junction (at level of the pectoralis major tendon). What you will see: Long head of the biceps tendon Supraspinatus tendon Transverse humeral ligament Subscapularis tendon Lesser tuberosity Greater tuberosity Short head of the biceps Long head of the biceps (musculotendinous junction) Humeral shaft Pectoralis major tendon Plane/ region: Logitudinal (sagittal): What you will see: Long head of biceps; fibrillar structure Lesser tuberosity Long head of the biceps tendon Notes: Subscapularis muscle and tendon Patient position: Facing the examiner Shoulder in lateral rotation; elbow in flexion/ supination Plane/ region: longitudinal (axial): full vertical width of tendon. What you will see: Subscapularis muscle, tendon, and insertion Supraspinatus tendon Coracoid process Deltoid Greater tuberosity Lesser tuberosity Notes: Do passive medial/ lateral rotation while examining Plane/ region: Transverse (sagittal): What you will see: Lesser tuberosity Fascicles of subscapularis tendon Supraspinatus tendon Patient position: Lateral to examiner Shoulder in extension and medial rotation Hand on ipsilateral buttock Plane/ region: Longitudinal (oblique sagittal) Identify the intra-articular portion of biceps LH in the transverse plane; then
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Compiled for Lower Limb
Updated: December, 9th, 2020 MSI ANATOMY LAB: STRUCTURE LIST Lower Extremity Lower Extremity Osteology Hip bone Tibia • Greater sciatic notch • Medial condyle • Lesser sciatic notch • Lateral condyle • Obturator foramen • Tibial plateau • Acetabulum o Medial tibial plateau o Lunate surface o Lateral tibial plateau o Acetabular notch o Intercondylar eminence • Ischiopubic ramus o Anterior intercondylar area o Posterior intercondylar area Pubic bone (pubis) • Pectineal line • Tibial tuberosity • Pubic tubercle • Medial malleolus • Body • Superior pubic ramus Patella • Inferior pubic ramus Fibula Ischium • Head • Body • Neck • Ramus • Lateral malleolus • Ischial tuberosity • Ischial spine Foot • Calcaneus Ilium o Calcaneal tuberosity • Iliac fossa o Sustentaculum tali (talar shelf) • Anterior superior iliac spine • Anterior inferior iliac spine • Talus o Head • Posterior superior iliac spine o Neck • Posterior inferior iliac spine • Arcuate line • Navicular • Iliac crest • Cuboid • Body • Cuneiforms: medial, intermediate, and lateral Femur • Metatarsals 1-5 • Greater trochanter • Phalanges 1-5 • Lesser trochanter o Proximal • Head o Middle • Neck o Distal • Linea aspera • L • Lateral condyle • L • Intercondylar fossa (notch) • L • Medial condyle • L • Lateral epicondyle • L • Medial epicondyle • L • Adductor tubercle • L • L • L • L • 1 Updated: December, 9th, 2020 Lab 3: Anterior and Medial Thigh Anterior Thigh Medial thigh General Structures Muscles • Fascia lata • Adductor longus m. • Anterior compartment • Adductor brevis m. • Medial compartment • Adductor magnus m. • Great saphenous vein o Adductor hiatus • Femoral sheath o Compartments and contents • Pectineus m. o Femoral canal and ring • Gracilis m. Muscles & Associated Tendons Nerves • Tensor fasciae lata • Obturator nerve • Iliotibial tract (band) • Femoral triangle: Boundaries Vessels o Inguinal ligament • Obturator artery o Sartorius m. • Femoral artery o Adductor longus m.
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Acetabular Labral Tears: Resection Vs
Acetabular Labral Tears: Resection vs. Repair In the past decade, significant advances have been made in the diagnosis and treatment of non-arthritic intra-articular hip pathologies, including acetabular labral tears. Tears of the acetabular labrum have been identified as a source of hip pain and mechanical symptoms, and as a possible instigator of premature hip degeneration. Arthroscopic management of labral tears has evolved from simple resection of the torn labral portion to advanced repair techniques for tears Mara L. Schenker, MD1 associated with large bony deformities. While arthroscopic technology has evolved to allow the labrum to be repaired, Marc J. Philippon, MD2 scientific evidence demonstrating the benefits of labral repair over resection have lagged. 1 Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA In the past decade, significant advances have quicker rate of cartilage consolidation in the 2 Steadman Philippon Research Institute, been made in the diagnosis and treatment of absence of a labrum. They further demonstrated Vail, CO non-arthritic intra-articular hip pathologies, that resection of the labrum causes the femoral including acetabular labral tears. Tears of the head to lateralize, shifting the load bearing surface acetabular labrum have been identified as a of the joint shifts to the acetabular rim, thereby source of hip pain and mechanical symptoms, causing increases in femoroacetabular contact and as a possible instigator of premature hip pressures6. Although some have suggested degeneration1. Arthroscopic management of that labral resection may lead to premature labral tears has evolved from simple resection osteoarthritis, one in vivo study failed to show the of the torn labral portion to advanced repair relationship at 24 months after labral resection7.
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Acetabular Labral Tears with Underlying Chondromalacia: a Possible Association with High-Level Running
Acetabular Labral Tears With Underlying Chondromalacia: A Possible Association With High-Level Running Carlos A. Guanche, M.D., and Robby S. Sikka, B.A. Purpose: The use of hip arthroscopy has helped delineate intra-articular pathology and has enabled clinicians to further elucidate the factors responsible for injuries, such as running. The subtle development of degenerative changes may be a result of repetitive impact loading associated with this sport. This study presents a population of runners with common pathologic acetabular changes. Type of Study: Case series. Methods: Eight high-level runners with an average age of 36 years (range, 19 to 45 years) were seen for complaints of increasing hip pain with running without any history of macrotrauma. All of the patients had either run several marathons (4), were triathletes (1), Olympic middle distance runners (1), or had run more than 10 miles per week for longer than 5 years (2). Plain radiographic analysis revealed no degenerative changes and an average center-edge (CE) angle of 36.7° (range, 28° to 44°). Results: All patients underwent hip arthroscopy with labral debridement. In 6 patients (75%), a chondral injury of the acetabular cartilage underlying the labral tear was noted. In addition, 3 patients had ligamentum teres disruptions. Conclusions: It is possible that the development of these tears is the result of subtle instability, which may be exacerbated by running, eventually leading to labral tearing and possible ligamentum teres disruption. While perhaps con- currently, subtle acetabular dysplasia may play a role. Although this study does not conﬁrm an association between running and the development of labral tears or chondral lesions in the hip, it certainly questions whether there is an injury pattern common to this population, a “runner’s hip.” Level of Evidence: Level IV.
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Folia Morphol. Vol. 70, No. 2, pp. 61–67 Copyright © 2011 Via Medica R E V I E W A R T I C L E ISSN 0015–5659 www.fm.viamedica.pl Human ligaments classification: a new proposal G.K. Paraskevas Department of Anatomy, Medical School, Aristotle University of Thessaloniki, Greece [Received 24 January 2011; Accepted 22 March 2011] A high concern exists among physicians about surgically important ligaments such as cruciate and collateral ligaments of the knee, patellar ligament, tibiofibular syndesmosis, collateral ligaments of the ankle, and coracoclavicular ligament. However, the classification of the ligaments is insufficient in the literature, due to their origin from connective tissue. A new classification is proposed, based on various parameters such as the macroscopic and microscopic features, the function and the nature of their attachment areas. (Folia Morphol 2011; 70, 2: 61–67) Key words: ligaments, classification, Nomina Anatomica INTRODUCTION connective tissue surrounding neurovascular bundles There was always some confusion concerning the or ducts as “true ligaments” [4]. classification of ligaments of the human body, presu- The “false ligaments”, could be subdivided in the mably due to their origin from the connective tissue following categories: that is considered a low quality tissue compared to oth- a) Splachnic ligaments, which are further subdivid- ers. Moreover, orthopaedists are focused only on surgi- ed into “peritoneal” (e.g. phrenocolic ligament), cally important ligaments. For these reasons there is an “pericardiac” (e.g. sternopericardial ligaments), absence of a well-designated classification system that “pleural” (e.g. suprapleural membrane), and subdivides the ligaments into subgroups according to “pure splachnic ligaments” (e.g.
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Blomechanlcs of the ACETABULAR LABRUM By
BlOMECHANlCS OF THE ACETABULAR LABRUM by Stephen John Ferguson A thesis submitted to the Department of Mechanical Engineering in conformity with the requirements for the degree of Doctor of Philosophy Queen's University Kingston, Ontario, Canada March, 2000 copyright Q Stephen John Ferguson, 2000 National Library Bibliothèque nationale 1+1 dca"ada du Canada Acquisitions and Acquisitions et Bibliographie Services services bibliographiques 395 Wellington Street 395. rue Wellington Ottawa ON KIA ON4 Ottawa ON K1A ON4 Canada Canada YOM fi& Votre réference Our lile Notre rdfdmee The author has granted a non- L'auteur a accordé une licence non exclusive licence allowing the exclusive permettant à la National Library of Canada to Bibliothèque nationale du Canada de reproduce, loan, distribute or sell reproduire, prêter, dishibuer ou copies of this thesis in microfom, vendre des copies de cette thèse sous paper or electronic formats. la forme de microfiche/nlm, de reproduction sur papier ou sur format électronique. The author retains ownership of the L'auteur conserve la propriété du copyright in this thesis. Neither the droit d'auteur qui protège cette thèse. thesis nor substantial extracts kom it Ni la thèse ni des extraits substantiels may be printed or othenvise de celle-ci ne doivent être imprimés reproduced without the author' s ou autrement reproduits sans son permission. autorisation. Biomechanics of the Acetabular Labrum Abstract The goal of this research was to determine the fünctional role of the acetabular Iabrum in the normal hip joint, and its possibIe role in the development of osreoarthrosis. Despite clinical evidence of a Iink between labrum patholom and osteoarthrosis, there have been few studies of the function of the acetabular Iabrurn.
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Hip Arthroscopy for Acetabular Labral Tears
Hip Arthroscopy for Acetabular Labral Tears Laith A. Farjo, M.D., James M. Glick, M.D., and Thomas G. Sampson, M.D. Summary: The purpose of this study is to better understand the history, physical examination, imaging, and outcome of arthroscopic debridement of acetabular labral tears. We performed a review of all 290 patients who underwent hip arthroscopy at our institution to identify those who have undergone arthroscopic debridement of an acetabular labral tear. Patients were assessed at follow-up by a physician visit or telephone interview and questioned as to pain, mechanical symptoms, activity level, work status, sports ability, and performance of activities of daily living. Patients were followed-up for a minimum of 1 year or until they underwent total hip arthroplasty (THA). All 28 patients meeting the study criteria were available for follow-up (mean age, 41 years; range, 14 to 70 years) at an average of 34 months after surgery (range, 13 to 100 months). Average duration of symptoms before arthroscopy was 25 months. Eighteen (64%) patients were noted to have mechanical symptoms such as clicking or locking. Ten patients were noted to have a specific inciting event that initiated their symptoms. Magnetic resonance imaging identified the labral tear in 5 of 21 (24%) cases; arthrography identified the tear in 1 of 8 (13%). Of the 28 tears identified, there were 12 radial flap, 5 degenerative, 5 bucket handle, 3 horizontal cleavage, and 3 peripheral longitudinal tears. Seventeen were located anteriorly, 7 were located posteriorly, and 4 were located superiorly. Patients were stratified into two groups based on the presence of significant joint arthritis on radiographs.
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Microinstability of the Hip: a Previously Unrecognized Pathology
Original article Microinstability of the hip: a previously unrecognized pathology Ioanna Bolia 1 The role of the hip joint capsule has gained par - Jorge Chahla 1 ticular research interest during the last years, and Renato Locks 1 its repair or reconstruction during hip arthro - Karen Briggs 1 scopy is considered necessary in order to avoid Marc J. Philippon 1,2 iatrogenic hip microinstability. Various capsular closure/plication techniques have been devel - oped towards this direction with encouraging re - 1 Steadman Philippon Research Institute, Colorado, USA sults. 2 The Steadman Clinic, Colorado, USA Level of evidence: V. KEY WORDS: hip arthroscopy, hip microinstability, hip Corresponding author: dysplasia. Marc J. Philippon, MD Steadman Philippon Research Institute The Steadman Clinic Introduction 181 West Meadow Drive, Suite 400 Vail, Colorado 81657, USA The native hip is a particularly constrained joint with a E-mail: [email protected] powerful suction seal that is imperative for optimal 1,2 function of the joint . The hip capsule is one of the most important static stabilizers of the hip joint 3 and Summary disruption or debridement of the capsule during hip arthroscopy is a potential contributor to postoperative Background : Hip microinstability is an estab - iatrogenic hip instability. Therefore, hip surgeons must lished diagnosis; however, its occurrence is still be thoughtful of hip capsule management as hip debated by many physicians. Diagnosis of hip mi - arthroscopic procedures are increasing exponentially 4. croinstability is often challenging, due to a lack of Unlike other joints in the anatomy, hip instability is specific signs or symptoms, and patients may re - generally defined as extra-physiologic hip motion that main undiagnosed for long periods.
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Effect of Acetabular Labral Tears on Proprioceptive Parameters of the Human Hip Joint HIP CENTER David C
Effect of Acetabular Labral Tears on Proprioceptive Parameters of the Human Hip Joint HIP CENTER David C. Holst,,, Allston J. Stubbs MD, Martin L. Tanaka PhD 1. Introduction (dominant or non-dominant for controls and pathologic or 5. Conclusions Acetabular labral cartilage tears are a common cause of hip pain normal for patients) was randomized using a coin toss. A Based on our limited data set, two concepts can be drawn from our in younger, athletic individuals and are associated with the total of 7 trials were completed for each side, with the first early results. First, computer based balance analysis (a development of hip joint arthritis. The pain of labral tears trial on each leg counting as “practice,” and not included in noninvasive test) can successfully differentiate normal subjects and 1 negatively affects patients’ daily activities and athletic goals. final analyses. The force plate measured Center of Pressure symptomatic hip patients based on single leg balance. Second, These labral tears are difficult to diagnose despite the (COP)deviations(Figure2),andthesedatawererecorded patients with labral tears appear to have worse balance in the availability of advanced technology such as MRI scanning. Due to and subsequently processed using custom MATLAB code. affected leg than the unaffected leg. In conclusion, we limited diagnostic tests, arthroscopic hip surgery is often used to Measurements included the area of an ellipse that enveloped recommend continuation of this projectasameanstoestablish confirm cartilage tears of the hip joint. As surgery is invasive, 95% of the data points (COP_EA, measured in mm2)andthe proprioception balance testing as a noninvasive means to assess for improved non-invasive diagnostic tools for this condition are path length of the COP (measured in mm).
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Iliofemoral Ligament
LOWER LIMB Hip Joint: forms the connection between the lower limb & the pelvic girdle Classification: Ball and socket synovial joint Freedom: 3 degree, multiaxial Movement: Flexion, extension, abduction, adduction, medial and lateral rotation and circumduction. Plane: Sagittal (F & E), Frontal (Abd & Add), Transverse (M & L rotation) Axis: Frontal (F & E), Saggital (Abd & Add), Longitudinal (M & L rotation) Static stabiliser: Joint capsule and their ligaments- Pubofemoral ligament, iliofemoral ligament, ischiofemoral ligaments and the actebular labrum (stabilise head of femur into acetabulum) Function: It is designed for stability over a wide range of movement. When standing, the entire weight of the upper body is transmitted through the hip bones to the heads & neck of the femora. Pubofemoral ligament: Attachment: arises from the obturator crest of the pubic bone and passes laterally and inferiorly to merge with the fibrous layer of the joint capsule (textbook) It is the thickened part of the hip joint capsule which extends from the superior ramus of the pubis to the intertrochanteric line of the femur (app) Function: It tightens during both extension and abduction of the hip joint. The pubofemoral ligament prevents overabduction of the hip joint. Stabilizes the hip joint and limits extension and lateral rotation of the hip. Iliofemoral ligament: Attachment: attaches to the anterior inferior iliac spine and the acetabular rim proximally and the intertrochanteric line distally Function: Said to be the body’s strongest ligament, the iliofemoral ligament specifically prevents hyperextension of the hip joint during standing by screwing the femoral head into the acetabulum and it is the main ligament that reinforces and strengthen the joint.
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Slide 1 Manual Therapy for the Hip and Lower Quarter
Slide 1 ___________________________________ Manual Therapy for the Hip and Lower Quarter ___________________________________ Techniques and Supporting Evidence ___________________________________ Mitchell Barber Scarlett Morris ___________________________________ PT, MPT, CMT, OCS, FAAOMPT PT, DPT, CMT, OCS ___________________________________ ___________________________________ ___________________________________ Slide 2 ___________________________________ Disclosures: ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 3 ___________________________________ Session 1: The Hip ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 4 ___________________________________ The Hip Hip Anatomy ___________________________________ o Synovial ball-and socket joint o The head of the femur points in an ___________________________________ anterior/medial/superior direction o The acetabulum faces lateral/inferior/anterior ___________________________________ o Anteversion angle of the neck is 10-15 degrees ___________________________________ ___________________________________ ___________________________________ Slide 5 ___________________________________ The Hip Hip Anatomy ___________________________________ o Femoral
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