Chapter 10 the Knee Joint

Total Page:16

File Type:pdf, Size:1020Kb

Chapter 10 the Knee Joint The Knee Joint • Knee joint – largest joint in body Chapter 10 – very complex The Knee Joint – primarily a hinge joint Manual of Structural Kinesiology Modified for Prentice WE: Arnheim’s principles of athletic training , ed 12, New R.T. Floyd, EdD, ATC, CSCS York, 2006, McGraw-Hill; from Saladin, KS: Anatomy &physiology: the unity of forms and function , ed 2, New York, 2001, McGraw- Hill. © 2007 McGraw-Hill Higher Education. All rights reserved. 10-1 © 2007 McGraw-Hill Higher Education. All rights reserved. 10-2 Bones Bones • Enlarged femoral condyles articulate on • Fibula - lateral enlarged tibial condyles – serves as the attachment for • Medial & lateral tibial condyles (medial & knee joint lateral tibial plateaus) - receptacles for structures femoral condyles – does not articulate • Tibia – medial with femur or patella – bears most of weight – not part of knee joint Modified from Anthony CP, Kolthoff NJ: Textbook of anatomy and physiology , ed 9, St. Louis, 1975, Mosby. © 2007 McGraw-Hill Higher Education. All rights reserved. 10-3 © 2007 McGraw-Hill Higher Education. All rights reserved. 10-4 Bones Bones • Patella • Key bony landmarks – sesamoid (floating) bone – Superior & inferior patellar poles – imbedded in quadriceps – Tibial tuberosity & patellar tendon – Gerdy’s tubercle – serves similar to a pulley – Medial & lateral femoral in improving angle of condyles pull, resulting in greater – Upper anterior medial tibial mechanical advantage in surface – Head of fibula knee extension Modified from Anthony CP, Kolthoff NJ: Textbook of anatomy and physiology , ed 9, St. Louis, 1975, Mosby. © 2007 McGraw-Hill Higher Education. All rights reserved. 10-5 © 2007 McGraw-Hill Higher Education. All rights reserved. 10-6 1 Bones Bones • Three vasti muscles of quadriceps originate • Semimembranosus inserts posteromedially on on proximal femur & insert on patellar medial tibial condyle superior pole • Biceps femoris inserts primarily on fibula head – insertion is ultimately on tibial tuberosity via • Popliteus originates on lateral aspect of lateral patella tendon femoral condyle • Iliotibial tract of tensor fasciae latae inserts • Tibial collateral ligament originates on medial on Gerdy’s tubercle aspect of upper medial femoral condyle & inserts on medial tibial surface • Sartorius, gracilis, & semitendinosus insert just below the medial condyle on upper • Fibula collateral originates on lateral femoral condyle very close to popliteus origin & inserts anteromedial tibial surface on fibular head © 2007 McGraw-Hill Higher Education. All rights reserved. 10-7 © 2007 McGraw-Hill Higher Education. All rights reserved. 10-8 Joints Joints • Knee joint proper (tibiofemoral joint) • Ligaments provide static stability – classified as a ginglymus joint • Quadriceps & hamstrings contractions produce • Sometimes referred to as trochoginglymus dynamic stability joint internal & external rotation occur during • Articular cartilage surfaces on femur & tibia flexion • Some argue for condyloid classification • Menisci form cushions between bones • Patellofemoral joint – attached to tibia – arthrodial classification – deepen tibial fossa – gliding nature of patella on femoral – enhance stability condyles © 2007 McGraw-Hill Higher Education. All rights reserved. 10-9 © 2007 McGraw-Hill Higher Education. All rights reserved. Modified from Anthony CP, Kolthoff NJ: Textbook of anatomy and 10-10 physiology , ed 9, St. Louis, 1975, Mosby. Joints Joints • Medial meniscus forms receptacle for medial – Either or both menisci may be torn in femoral condyle, Lateral meniscus receives several different areas from a variety lateral femoral condyle of mechanisms, resulting in varying – Thicker on outside border & taper down very thin degrees of problems to inside border – Can slip about slightly, but held in place by • Tears often occur due significant various small ligaments compression & shear forces during – Medial meniscus - larger & more open C rotation while flexing or extending appearance during quick directional changes in – Lateral meniscus - closed C configuration running © 2007 McGraw-Hill Higher Education. All rights reserved. 10-11 © 2007 McGraw-Hill Higher Education. All rights reserved. 10-12 2 Joints Joints • Anterior & posterior cruciate ligaments • Posterior cruciate – cross within knee between tibia & femur ligament (PCL) injuries – vital in respectively maintaining anterior & – not often injured posterior stability, as well as rotatory stability – mechanism of direct • Anterior cruciate ligament (ACL) injuries contact with an opponent – one of most common serious injuries to knee or playing surface – mechanism often involves noncontact rotary • Fibular (lateral) forces associated with planting & cutting, collateral ligament (LCL) hyperextension, or by violent quadriceps – infrequently injured Modified from Anthony CP, Kolthoff NJ: Textbook of anatomy and contraction which pulls tibia forward on femur physiology , ed 9, St. Louis, 1975, Mosby. © 2007 McGraw-Hill Higher Education. All rights reserved. 10-13 © 2007 McGraw-Hill Higher Education. All rights reserved. 10-14 Joints Joints • Tibial (medial) collateral ligament (MCL) • Synovial cavity – maintains medial stability by resisting – supplies knee with synovial fluid – lies under patella and between surfaces of tibia & valgus forces or preventing knee from femur being abducted – "capsule of the knee” – injuries occur commonly, particularly in • Infrapatellar fat pad contact or collision sports – just posterior to patellar tendon – mechanism of teammate or opponent may – an insertion point for synovial folds of tissue fall against lateral aspect of knee or leg known as “plica” • an anatomical variant that may be irritated or causing medial opening of knee joint & inflamed with injuries or overuse of the knee stress to medial ligamentous structures © 2007 McGraw-Hill Higher Education. All rights reserved. 10-15 © 2007 McGraw-Hill Higher Education. All rights reserved. 10-16 Joints Joints • Bursae • Extends to 180 degrees (0 – more than 10 degrees of flexion) bursae in & • Hyperextension of 10 degrees or around knee > not uncommon – some are • Flexion occurs to about 140 connected to degrees synovial cavity – they absorb • With knee flexed 30 degrees or > shock or prevent – internal rotation 30 degrees occurs friction – external rotation 45 degrees occurs © 2007 McGraw-Hill Higher Education. All rights reserved. 10-17 © 2007 McGraw-Hill Higher Education. All rights reserved. 10-18 3 Joints Movements • Knee “screws home” to fully extend due to the • Flexion shape of medial femoral condyle – As knee approaches full extension tibia must – bending or decreasing externally rotate approximately 10 degrees to angle between femur & achieve proper alignment of tibial & femoral leg, characterized by heel condyles moving toward buttocks – In full extension • close congruency of articular surfaces • Extension • no appreciable rotation of knee – straightening or – During initial flexion from full extension increasing angle between • knee “unlocks” by tibia rotating internally, to a femur & lower leg degree, from its externally rotated position to achieve flexion © 2007 McGraw-Hill Higher Education. All rights reserved. 10-19 © 2007 McGraw-Hill Higher Education. All rights reserved. 10-20 Movements Muscles • Quadriceps muscle group • External rotation – extends knee – rotary movement of leg – located in anterior laterally away from midline compartment of thigh • Internal rotation – consists of 4 muscles – rotary movement of lower • rectus femoris leg medially toward midline • vastus lateralis • Neither will occur unless • vastus intermedius • vastus medialis flexed 20-30 degrees or > © 2007 McGraw-Hill Higher Education. All rights reserved. 10-21 © 2007 McGraw-Hill Higher Education. All rights reserved. 10-22 Muscles Muscles • Q angle • Q angle – Central line of pull for entire – Higher Q angles generally quadriceps runs from ASIS to the predispose people in varying center of patella degrees to a variety of potential – Line of pull of patella tendon runs knee problems including lateral from center of patella to center of patellar subluxation or dislocation, tibial tuberosity patellar compression syndrome, – Angle formed by the intersection of chondromalacia, and ligamentous these two lines at the patella is the injuries Q angle – For people with above normal Q angles, it is particularly important – Normally, angle will be 15 degrees to maintain high levels of strength or less for males & 20 degrees or & endurance in vastus medialis so less in females as to counteract lateral pull of – Generally, females have higher vastus lateralis angles due to a wider pelvis © 2007 McGraw-Hill Higher Education. All rights reserved. 10-23 © 2007 McGraw-Hill Higher Education. All rights reserved. 10-24 4 Muscles Muscles • Hamstring muscle group • Two-joint muscles – responsible for knee flexion – most effective when either origin or – located in posterior compartment of thigh insertion is stabilized to prevent movement – consists of 3 muscles in direction of the contacting muscle • semitendinosus - medial, internal rotator – To a degree, muscles are able to exert • semimembranosus - medial, internal rotator greater force when lengthened than when • biceps femoris - lateral, external rotator shortened • Popliteus assist medial hamstrings in – Hamstring muscles & rectus femoris are biarticular (two-joint) muscles knee internal rotation © 2007 McGraw-Hill Higher Education. All rights reserved. 10-25 © 2007 McGraw-Hill
Recommended publications
  • An Intramuscular Injection Is an Injection Given Directly Into The
    Depo Lupron and Testosterone are both given by intramuscular injection. The following is a guideline on their administration. Eileen Durham, RN, NP Version 12 Jan 2010 Description Intramuscular (IM) injections are given directly into the central area of selected muscles. There are a number of sites that are suitable for IM injections; there are three sites that are most commonly used in this procedure described below. The volume of viscosity of the medication to be injected determines the site that should be used. IM injections cause stretching of the muscle fiber so the larger the muscle used the less discomfort. Intramuscular Injection Sites Depo Lupron Depo Lupron 3 month preparation should only be injected into the Gluteus medius due to the viscosity and volume of the medication approx. 1.5 – 2 cc. Depo Lupron 1 month preparation can be injection into the vastus lateralis or the gluteus medius. Testosterone Testosterone administered to adolescents and adults can be injected into any of the sites listed below, as long as the volume is 1 cc or less. For a volume of 1.5 use the vastus lateralis or Gluteus medius, if the volume is 2 cc you must you the largest muscle the Gluteus medius. If the volume is greater then 2 cc you must divide the dose and give 2 injections as the maximum volume in the Gluteal muscle is 2 cc. Testosterone administered to infants and toddlers use only the anteriolateral aspect of the thigh. Deltoid muscle The deltoid muscle located laterally on the upper arm can be used for intramuscular injections.
    [Show full text]
  • Vastus Medialis: a Reappraisal of VMO and VML
    J. Phys. Ther. Sci. 24: 475–479, 2012 Vastus Medialis: a Reappraisal of VMO and VML EMILY J SKINNER1), PHILIP J ADDS1) 1) Division of Biomedical Sciences (Anatomy), St. George’s, University of London: Cranmer Terrace, London SW17 0RE, U.K. TEL: +44 208-7255208, E-mail: [email protected] Abstract. [Purpose] The morphology and innervation pattern of the vastus medialis (VM) were investigated to determine if there was an anatomical distinction between the oblique (VMO) and longus (VML) parts. [Subjects and Methods] Forty lower limbs were dissected. The innervation pattern was observed in 39 specimens. Muscle length and fibre angles of 14 specimens were recorded. [Results] In 22 specimens there was a distinct separation between the VML and VMO (change in fibre angle, fibrofascial plane, vasculature or nerve branch). The mean fibre angle of VMO was 52°, and the mean VML fibre angle was 5° (relative to the shaft of the femur). Ten limbs (25.6%) had separate innervation to the VML. The separation between VMO and VML was found to be more proximal than expected, with the VMO on average accounting for 70% of the VM, in contrast to the much more distal point of separation reported elsewhere, leading us to raise the possibility that VML and vastus intermedius may have been misidentified in some previous studies. [Conclusions] In conclusion the VML/VMO division (when present) is much more proximal than has been previously reported, and there is no consistent pattern of innervation to the two parts of the muscle. Key words: Fibre angle, Vastus medialis, VML, VMO (This article was submitted Nov.
    [Show full text]
  • Bacterial Meningitis and Multiple Abscess Formation in the Iliopsoas
    Yamada et al. Renal Replacement Therapy (2018) 4:22 https://doi.org/10.1186/s41100-018-0163-x CASEREPORT Open Access Bacterial meningitis and multiple abscess formation in the iliopsoas, erector spinae, and vastus lateralis muscle in a maintenance hemodialysis patient treated with continuous epidural anesthesia for herpes zoster-related pain control: a case report and review of the literature Shunsuke Yamada1, Narihito Tatsumoto1, Noriko Nakamura1, Kosuke Masutani1, Toshiro Maeda2, Takanari Kitazono1 and Kazuhiko Tsuruya1,3* Abstract Background: Infection is the second leading cause of mortality in patients who undergo maintenance hemodialysis. In this population, impairment in both cellular and humoral immunity contributes to the increased incidence of infection and infection-related hospitalization. However, these artificial devices occasionally enhance the risk of deep organ infection including muscle abscess, frequently leading to disability and mortality in hemodialysis patients. Case presentation: A 54-year-old male undergoing maintenance hemodialysis was hospitalized because of the acute onset pain in the back and bilateral legs and declining consciousness which started at 7 days after the treatment of herpes zoster-related neuralgia with continuous epidural anesthesia. Physical examination revealed purulent discharge from the insertion site of the catheter. Serum biochemical tests showed increased inflammatory response and malnutrition. Magnetic resonance imaging revealed meningitis and multiple abscesses in the iliopsoas, erector spinae, gluteus medius, and vastus lateralis muscles, where conventional antibiotic treatment often fails to cure. Staphylococcus aureus was detected in the cerebrospinal fluid. Combination of intravenous antibiotics treatment and aggressive open surgical drainage of the muscle abscesses finally cured meningitis and multiple deep muscle abscesses in this patient.
    [Show full text]
  • Skier Tibia (Leg) Fractures
    Skier Tibia (Leg) Fractures In years past, the prototypical ski fracture was sustained at the lower part of the outside of the leg in the region of the ankle. However, in the past 10 years, with the advent of the modern ski boots and improvements in binding, the most commonly seen lower leg skier fracture is the tibia (or shinbone) fracture. 10% of these fractures are associated with a collision. Thus, 90 % are associated with an isolated fall or noncontact type of injury, which is generally the result of binding malfunctions and inappropriate release. The most common mechanism leading to a tibia (leg) fracture is a forward fall. Risk factors for sustaining a skier tibia fracture include: beginners or novice skiers, less than 20 years of age, higher outdoor temperatures, and increased snow depth. Non-risk factors include ski lengths, icy conditions, and male versus female sex. The modern ski boot very closely resembles an extremely well padded short leg cast in the treatment of many orthopaedic lower extremity fractures. It of course goes to a much higher level than the former shorter boot top-level varieties. The binding release and designs have been based on the fracture strength of the adult tibia (shin) bone at the top of the modern ski boot. The treatment of most skier leg fractures includes a closed reduction and cast application for variable periods of time, with or without weight bearing allowed. However, severe misalignments of the bones can lead to later bony prominences that may be incompatible with snug, rigid, high fitting ski boots.
    [Show full text]
  • Assessment, Management and Decision Making in the Treatment Of
    Pediatric Ankle Fractures Anthony I. Riccio, MD Texas Scottish Rite Hospital for Children Update 07/2016 Pediatric Ankle Fractures The Ankle is the 2nd most Common Site of Physeal Injury in Children 10-25% of all Physeal Injuries Occur About the Ankle Pediatric Ankle Fractures Primary Concerns Are: • Anatomic Restoration of Articular Surface • Restoration of Symmetric Ankle Mortise • Preservation of Physeal Growth • Minimize Iatrogenic Physeal Injury • Avoid Fixation Across Physis in Younger Children Salter Harris Classification Prognosis and Treatment of Pediatric Ankle Fractures is Often Dictated by the Salter Harris Classification of Physeal Fractures Type I and II Fractures: Often Amenable to Closed Tx / Lower Risk of Physeal Arrest Type III and IV: More Likely to Require Operative Tx / Higher Risk of Physeal Arrest Herring JA, ed. Tachdjian’s Pediatric Orthopaedics, 5th Ed. 2014. Elsevier. Philadelphia, PA. ISOLATED DISTAL FIBULA FRACTURES Distal Fibula Fractures • The Physis is Weaker than the Lateral Ankle Ligaments – Children Often Fracture the Distal Fibula but…. – …ligamentous Injuries are Not Uncommon • Mechanism of Injury = Inversion of a Supinated Foot • SH I and II Fractures are Most Common – SH I Fractures: Average Age = 10 Years – SH II Fractures: Average Age = 12 Years Distal Fibula Fractures Lateral Ankle Tenderness SH I Distal Fibula Fracture vs. Lateral Ligamentous Injury (Sprain) Distal Fibula Fractures • Sankar et al (JPO 2008) – 37 Children – All with Open Physes, Lateral Ankle Tenderness + Normal Films – 18%: Periosteal
    [Show full text]
  • Applications of the Pedicled Vastus Lateralis Flap for Patients with Complicated Pressure Sores
    Spinal Cord (1997) 35, 437 ± 442 1997 International Medical Society of Paraplegia All rights reserved 1362 ± 4393/97 $12.00 Applications of the pedicled vastus lateralis ¯ap for patients with complicated pressure sores AB Schmidt1, G Fromberg1 and M-H Ruidisch2 1Abt. fuÈr Plastische-, Hand-, Kiefer- und rekonstruktive Mikrochirurgie, BG Unfallklinik Murnau; 2Abt. fuÈr RuÈckenmark- und WirbelsaÈulenverletztungen, BG Unfallklinik Murnau, Germany The vastus lateralis muscle- or musculocutaneous ¯ap is a well established tool in the surgery of pressure sores of the pelvic region. Its size, its constant large axial vascular pedicle originating from the lateral circum¯ex femoral artery, and its ability to carry quite a large skin island from the distal lateral region of the upper thigh makes this ¯ap a very versatile one in the management of dicult situations. The vastus lateralis ¯ap allows the simultaneous closure of defects in the trochanteric and sacral region, a technique which has not been described previously. A pedicled vastus lateralis ¯ap may be the only remaining local salvage procedure for defects due to obstruction of internal and external iliac arteries and aortobifemoral bypass surgery. This is another application which has not yet been described in the medical literature. The outcome of a series of 38 vastus lateralis ¯aps and the complications are shown. The follow-up period ranged from 3 months to 4 years. One ¯ap was lost. More complications were seen at the donor site than at the reconstructed defect. In patients who may be able to walk or stand at a later date, potential impairment of these functions has to be considered.
    [Show full text]
  • Muscle Activation and Kinematic Analysis During the Inclined Leg Press Exercise in Young Females
    International Journal of Environmental Research and Public Health Article Muscle Activation and Kinematic Analysis during the Inclined Leg Press Exercise in Young Females Isabel Martín-Fuentes 1 , José M. Oliva-Lozano 1 and José M. Muyor 1,2,* 1 Health Research Centre, University of Almería, 04120 Almería, Spain; [email protected] (I.M.-F.); [email protected] (J.M.O.-L.) 2 Laboratory of Kinesiology, Biomechanics and Ergonomics (KIBIOMER Lab.), Research Central Services, University of Almería, 04120 Almería, Spain * Correspondence: [email protected]; Tel.: +34-950214429 Received: 24 October 2020; Accepted: 20 November 2020; Published: 23 November 2020 Abstract: Knee joint muscle activation imbalances, especially weakness in the vastus medialis oblique, are related to patellofemoral pain within the female population. The available literature presents the leg press as an exercise which potentially targets vastus medialis oblique activation, thus reducing imbalances in the quadriceps muscles. The main aim of the present study was to compare thigh muscle activation and kinematic parameters under different conditions during the inclined leg press exercise in a young female population. A cross-sectional study was conducted on 10 young, trained females. Muscle activation of the vastus medialis oblique, vastus lateralis, rectus femoris and gluteus medialis was analyzed under five different inclined leg press conditions, modifying the feet rotation (0–45◦ external rotation) and the stance width (100–150% hip width) on the footplate. All the conditions were performed at two different movement velocities: controlled velocity (2” eccentric–2” concentric) and maximal intended velocity. Mean propulsive velocity, maximum velocity and maximum power were also assessed. The results show that both controlled velocity conditions and maximal intended velocity conditions elicited a similar muscle activation pattern with greater activation during the concentric phase (p < 0.001, ηp2 = 0.96).
    [Show full text]
  • The Role of and Relationship Between Hamstring and Quadriceps Muscle Myofascial Trigger Points in Patients with Patellofemoral Pain Syndrome
    The role of and relationship between Hamstring and Quadriceps muscle myofascial trigger points in patients with patellofemoral pain syndrome. By Karen Louise Frandsen Smith A mini-dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic at the Durban University of Technology I, Karen Louise Frandsen Smith, declare that this dissertation is representative of my own work in both conception and execution (except where acknowledgements indicate to the contrary). _______________________ ________________ Karen Louise Frandsen Smith Date Approved for Submission _______________________ ________________ Dr Brian Kruger (supervisor) Date M. Tech. Chiro., C.C.S.P. Dedication I dedicate this work to everyone who loves me and have supported me throughout these years of studying and all the difficult times. It is thanks to you that I have reached my dream. Dad, you would be so proud. i Acknowledgements Thank you to the DUT staff, patients, and supervisor, Dr Brian Kruger for making this happen. Thanks to my class mates for making the years fly by, and creating lifelong memories. This dissertation would not have been completed without supportive, generous and helpful people. Special thanks to you, Dr Danella Lubbe for motivating me and thank you so much Dr Charmaine Korporaal for “picking me up” and helping me finish. Endless gratitude goes to you Damon, Cherine, Mom and Viggo. You are / were all my anchors in the storm, and without your belief in me, I would be nowhere. ii Abstract Purpose: Patellofemoral Pain Syndrome is a common condition in all age groups, with a multi- factorial etiology.
    [Show full text]
  • Quadriceps and Hamstrings Coactivation in Exercises Used in Prevention And
    bioRxiv preprint doi: https://doi.org/10.1101/574210; this version posted March 11, 2019. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY 4.0 International license. 1 Quadriceps and hamstrings coactivation in exercises used in prevention and 2 rehabilitation of hamstring strain injury in young soccer players 3 Gonzalo Torres1¶; David Chorro1¶; Archit Navandar2¶; Javier Rueda1¶; Luís 4 Fernández3¶; Enrique Navarro1*¶ 5 6 1Faculty of Sport Sciences, Universidad Politécnica de Madrid, Madrid, Madrid, Spain. 7 2Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Madrid, Spain. 8 3Medical Services of Atlético de Madrid, Club Atlético de Madrid, Madrid, Madrid, 9 Spain. 10 11 12 *Corresponding author 13 E-mail: [email protected] (EN) 14 15 ¶These authors contributed equally to this work. 16 17 18 19 20 21 22 23 24 bioRxiv preprint doi: https://doi.org/10.1101/574210; this version posted March 11, 2019. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY 4.0 International license. 25 Abstract 26 This study aimed to study the co-activation of hamstring-quadriceps muscles 27 during submaximal strength exercises without the use of maximum voluntary isometric 28 contraction testing and compare (i) the inter-limb differences in muscle activation, (ii) the 29 intra-muscular group activation pattern, and (iii) the activation during different phases of 30 the exercise.
    [Show full text]
  • Bones Can Tell Us More Compiled By: Nancy Volk
    Bones Can Tell Us More Compiled By: Nancy Volk Strong Bones Sometimes only a few bones are found in a location in an archeological dig. VOCABULARY A few bones can tell about the height of a person. This is possible due to the Femur ratios of the bones. It has been determined that there are relationships between the femur, tibia, humerus, and radius and a person’s height. Humerus Radius Here is a little help to identify these four bones and formulas to assist with Tibia determining the height of a person based on bone length. Humerus Femur: Humerus: The thigh is the region of the femur. The arm bone most people call the From the hip bone to the knee bone. upper arm. It is found from the elbow to the shoulder joints. Inside This Packet Radius Strong Bones 1 New York State Standards 1 Activity: Bone Relationships 2 Information for the Teacher 4 Tibia: Radius: The larger and stronger of the two bones The bone found in the forearm that New York State Standards in the leg below the knee bone. extends from the side of the elbow to Middle School In vertebrates It is recognized as the the wrist. Standard 4: Living Environment strongest weight bearing bone in the Idea 1: 1.2a, 1.2b, 1.2e, 1.2f body. Life Sciences - Post Module 3 Middle School Page 1 Activity: Bone Relationships MATERIALS NEEDED Skeleton Formulas: Tape Measure Bone relationship is represented by the following formulas: Directions and formulas P represents the person’s height. The last letter of each formula stands for the Calculator known length of the bone (femur, tibia, humerus, or radius) through measurement.
    [Show full text]
  • Normative Values for Femoral Length, Tibial Length, Andthe Femorotibial
    Article Normative Values for Femoral Length, Tibial Length, and the Femorotibial Ratio in Adults Using Standing Full-Length Radiography Stuart A Aitken MaineGeneral Medical Center, 35 Medical Center Parkway, Augusta, ME 04330, USA; [email protected] Abstract: Knowledge of the normal length and skeletal proportions of the lower limb is required as part of the evaluation of limb length discrepancy. When measuring limb length, modern standing full-length digital radiographs confer a level of clinical accuracy interchangeable with that of CT imaging. This study reports a set of normative values for lower limb length using the standing full-length radiographs of 753 patients (61% male). Lower limb length, femoral length, tibial length, and the femorotibial ratio were measured in 1077 limbs. The reliability of the measurement method was tested using the intra-class correlation (ICC) of agreement between three observers. The mean length of 1077 lower limbs was 89.0 cm (range 70.2 to 103.9 cm). Mean femoral length was 50.0 cm (39.3 to 58.4 cm) and tibial length was 39.0 cm (30.8 to 46.5 cm). The median side-to-side difference was 0.4 cm (0.2 to 0.7, max 1.8 cm) between 324 paired limbs. The mean ratio of femoral length to tibial length for the study population was 1.28:1 (range 1.16 to 1.39). A moderately strong inverse linear relationship (r = −0.35, p < 0.001, Pearson’s) was identified between tibial length and the Citation: Aitken, S.A. Normative corresponding femorotibial ratio.
    [Show full text]
  • Tibial De-Rotational Osteotomies for Tibial Torsion
    Tibial De-Rotational Osteotomies for Tibial Torsion Why does my child need tibial torsion surgery? What happens during the surgery? A lot of young children walk with their toes pointing in or First, the surgeon cracks the tibia and the smaller fibula bone out instead of straight ahead. The most common reason is next to it, usually just above the ankle. Surgically cracking a tibial torsion, a twist in the tibia bone of the lower leg. This bone is also known as an osteotomy. It is similar to breaking twist brings the knee and ankle out of alignment. The feet a bone, except that it is done on purpose. The surgeon respond by turning in (internal tibia torsion) or out (external weakens the tibia bone first by drilling holes through a small tibia torsion). Most of the time, tibial torsion gets better as a surgical opening. The next step is to rotate, or turn, the bone child exercises the leg muscles by walking and running. into correct alignment. The surgeon then places a pin in the bone just below the knee. The pin will be removed once the But when a child has spasticity, a condition in which muscle bone heals. In the meantime, your child will wear a cast that tone is very strong, tibial torsion can get worse instead starts at the pin and covers the leg and foot. The cast keeps of better as the child grows. Surgery helps children with the leg from moving while new bone grows. spasticity who can stand, but cannot walk or run normally because of tibial torsion.
    [Show full text]