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KNEE Flashcards

1
Q

KNEE - ROM

A
  • Flexion - 150
  • Extension - 0 to -5
  • Internal rotation - 5
  • External rotation - 5
  • Knee must be flexed 90 to assess rotation
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2
Q

KNEE - MYOTOMES

A
  • Hip flexion - L1, L2, L3 - femoral nerve
  • Knee extension - L3, L4 - femoral nerve
  • Knee flexion - L4, L5, S1, S2 - sciatic nerve
  • Ankle dorsiflexion - L4, L5 - deep peroneal nerve
  • Ankle inversion - L4, L5 - tibial nerve, deep peroneal nerve
  • Ankle eversion - L5, S1 - superior peroneal nerve
  • Big toe extension - L5, S1 - deep peroneal nerve
  • Big toe flexion - L5, S1 - tibial nerve
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3
Q

KNEE - ORTHO TESTS - SCREENING

A
  • SCREENING - Heel walk, toe walk; Disco test
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4
Q

KNEE - ORTHO TESTS - PATELLA

A
  • PATELLA - Ballottment; Bulge/sweep; Noble test; Medial/lateral apprehension test, Clarks test
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5
Q

KNEE - ORTHO TESTS - PLICA SYNDROME

A
  • PLICA SYNDROME - Stutter test, Houston’s plica test
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6
Q

KNEE - ORTHO TESTS - MENISCUS

A
  • MENISCUS - McMurray’s test, Apley’s compression, Apley’s distraction
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7
Q

KNEE - ORTHO TESTS - LIGAMENT STRESS

A
  • LIGAMENT STRESS - Valgus/varus stress test, anterior/posterior drawer test, Lachman’s test
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8
Q

KNEE - JOINT TYPE

A
  • Modified hinge - tibiofemoral (largest and most complex joint in the body)
  • Gliding - patellofemoral
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9
Q

KNEE - ARTICULAR SURFACES

A
  • Tibiofemoral - concave (tibial plateau) on convex (femoral condyles)
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10
Q

KNEE - MAIN MUSCLE ACTIONS - FLEXION

A
  • FLEXION - semitendinosus, semimembranosus, biceps femoris (hamstrings)
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11
Q

KNEE - MAIN MUSCLE ACTIONS - EXTENSION

A
  • EXTENSION - vastus medialis, vastus lateralis, vastus intermedius, rectus femoris (quadriceps)
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12
Q

KNEE - MAIN MUSCLE ACTIONS - INTERNAL ROTATION

A
  • INTERNAL ROTATION (tibia) - popliteus with pes anseurine muscles (knee flexed)
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13
Q

KNEE - MAIN MUSCLE ACTIONS - EXTERNAL ROTATION

A
  • EXTERNAL ROTATION (tibia) - biceps femoris
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14
Q

KNEE - RESTING POSITION

A

Tibiofemoral: flexion - 25

Patellofemoral: full extension (straight leg)

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15
Q

KNEE - CLOSED PACKED POSITION

A

Tibiofemoral: full extension and external tibial rotation

Patellofemoral: full flexion

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16
Q

KNEE - NORMAL END FEEL

A

FLEXION - soft tissue or bony approximation

EXTENSION - elastic/firm

SLR - elastic

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17
Q

KNEE - ABNORMAL END FEEL

A

Boggy = joint effusion; ligamentous pathology

Springy block = loose body (displaced meniscus)

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18
Q

KNEE - OPEN KINEMATIC CHAIN

A

Tibiofemoral

  • Flexion - tibia rolls and glides posterior on femur
  • Extension - tibia rolls and glides anterior on femur

Patellofemoral

  • Flexion - inferior patella glide on femur
  • Extension - superior patella glide on femur
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19
Q

KNEE - CLOSED KINEMATIC CHAIN

A

Tibiofemoral

  • Flexion - femur rolls and glides posterior on femur (squatting)
  • Extension - femur rolls and glides anterior on femur (moving from seated to standing)
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20
Q

KNEE - PATELLFEMORAL LOADING PATTERNS

A
  • Walking - 0.3x body weight
  • Up strairs - 2.5x bodyweight
  • Down stairs - 3.5x bodyweight
  • Squatting - 7x body weight
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21
Q

KNEE - CONDITIONS - ACL TEAR

A

Hx - direct trauma with valgus or hyperextension stress, audible ‘pop’; playing sport with quick stops or sharp cutting on non-slip surface (b-ball or soccer)
S&S - severe joint effusion +ve anterior drawer; +ve Lachman tes
DDx - often associated with MCL and medial meniscus injury

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22
Q

KNEE - CONDITIONS - MCL TEAR

A

Hx - direct trauma with valgus stress, audible ‘pop’, medial knee pain
S&S - local tenderness to palpation; +ve valgus stress test
DDx - often associated with ACL and medial meniscus injury

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23
Q

KNEE - CONDITIONS - LCL TEAR

A

Hx - direct trauma with varus stress, audible ‘pop’ lateral knee pain
S&S - local tenderness to palpation, +ve varus stress test
DDx - ITB friction rub

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24
Q

KNEE - CONDITIONS - PCL TEAR

A

Hx - direct trauma with posterior or anterior stress, audible ‘pop’
S&S - +ve posterior drawer, +ve reverse Lachman’s
DDx - often associated with ACL and meniscus injury

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25
KNEE - CONDITIONS - CHONDROMALACIA PATELLAE
Hx - prior trauma, retropatellar pain, worse with prolonged walking, going down stairs, crepitus/grinding in knee S&S - +ve patella grind, abnormal tracking DDx - condition is effectively patellofemoral DJD, meniscuc tear, knee DJD
26
KNEE - CONDITIONS - MENISCUS TEAR
Hx - painful click or snapping, deep joint line pain, joint locking S&S - local tenderness to palpation; +ve McMurray’s, +ve Apley’s compression/distraction; +ve Thessaly test DDx - MCL & ACL tear (may occur in conjunction)
27
KNEE - CONDITIONS - OSGOOD-SCHLATTER DISEASE
Hx - active pre-teens/teens - insidious onset after intense activity S&S - focal tenderness, swelling, red, pain with PROM, pain brought on by activity, will be able to point to the pain DDx - osteochondroma
28
KNEE - CONDITIONS - ITB FRICTION TEST
Hx - recent increase in running distance, intensity, frequency or duration, lateral knee pain S&S - local tenderness, +ve Noble test, +ve Ober’s DDx - LCL tear, pes planes and genu varum may predispose to condition
29
KNEE - CONDITIONS - PLICA SYNDROME
Hx - pain over lateral or medial condyle, snapping sensation S&S - tender band or cord from patella to condyle, +ve active stutter, Houston’s test DDx - ITB friction rub, arthroscopy is the gold standard for diagnosis
30
KNEE - ORTHO TESTS - ANTERIOR DRAWER TEST
- Pt supine - Knee bent 90 - Examiner stabilises foot by sitting on foot and places thumbs over the anterior knee joint line - Examiner pulls the tibia anteriorly
31
KNEE - ORTHO TESTS - ANTERIOR DRAWER TEST - POSITIVE TEST
**ACL sprain** - Pain **ACL rupture** - Excessive motion
32
KNEE - ORTHO TESTS - ANTERIOR DRAWER TEST - SN & SP
**SN**: 54 **SP**: 97
33
KNEE - ORTHO TESTS - APLEY'S COMPRESSION TEST
- Pt prone - Knee flexed 90 - Examiner applies downward force on the foot and rotates internally/externally
34
KNEE - ORTHO TEST - APLEY'S COMPRESSION TEST - POSITIVE TEST
**Meniscal damage** - Pain or crepitus with compression and rotation, which is relieved by knee distraction
35
KNEE - ORTHO TEST - APLEY'S COMPRESSION TEST - SN & SP
**SN**: 13-16 **SP**: 86-100
36
KNEE - ORTHO TEST - APLEY'S DISTRACTION
- Pt prone - Knee flexed 90 - Examiner stabilises pt thigh by placing knee over the pt’s distal posterior thigh - Examiner then applies long axis distraction above the malleoli at the ankle (pulls up) - Examiner then internally and externally rotates the knee
37
KNEE - ORTHO TEST - APLEY'S DISTRACTION - POSITIVE TEST
**Capsule/ligamentous lesion at the knee, collateral ligament sprain** - Pain with distraction **Meniscal lesion** - Decreased pain following distraction
38
KNEE - ORTHO TEST - APLEY'S DISTRACTION - SN & SP
**SN**: 13-16 **SP:** 86-100
39
KNEE - ORTHO TEST - CLARKE'S SIGN
- Pt supine with leg straight - Examiner compresses the quadriceps muscle 2cm (1 inch) above the superior pole of the patella - Pt is then instructed to contract the quadriceps muscle
40
KNEE - ORTHO TEST - CLARKE'S SIGN - POSITIVE TEST
**Chrondromalacia patella, degeneration of the patellofemoral joint** - Retropatellar pain
41
KNEE - ORTHO TEST - EGE'S TEST
- Pt standing - Feet approx 30cm apart and legs maximally internally rotated - Pt attempts a full squat - Repeat with pt legs externally rotated
42
KNEE - ORTHO TEST - EGE'S TEST - POSITIVE TEST
**Lateral meniscus tear** - Pain, inability to perform test, audible clicking or crepitus with internal rotation **Medial meniscus tear** - Pain, inability to perform test, audible clicking or crepitus with external rotation
43
KNEE - ORTHO TEST - EGE'S TEST - SN & SP
**SN**: 64-67 **SP**: 81-90
44
KNEE - ORTHO TEST - LACHMAN'S TEST
- Pt supine with knee bent 15-30 - Lachman’s anterior - Examiner stabilises pt femur with one hand - Examiner pulls the tibia anteriorly with the other hand - Lachman’s posterior - Examiner stabilises pt femur with one hand - Examiner pushes the tibia posteriorly with the other hand
45
KNEE - ORTHO TEST - LACHMAN'S TEST - POSITIVE TEST
**ACL sprain** - Pain with normal anterior translation **ACL rupture** - Pain with increased anterior translation **PCL sprain** - Pain with normal posterior translation **PCL rupture** - Pain with increased posterior translation
46
KNEE - ORTHO TEST - LACHMAN'S TEST - SN & SP
**SN**: 63-99 **SP**: 42-100
47
KNEE - ORTHO TEST - MCMURRAY'S TEST
- Pt supine or side lying - Hip flexed 90 and knee flexed 90 - Examiner stabilises pt knee over distal quads and grips pt heel with the other hand - Examiner applies long axis compression - Examiner then rotates the tibia internally while applying a varus force and straighten leg - Repeat by rotating the tibia externally while applying a valgus force and straighten leg
48
KNEE - ORTHO TEST - MCMURRAY'S TEST - POSITIVE TEST
**Meniscal lesion** - Pain or crepitus - Valgus force with external rotation = **lateral meniscus** - Varus force with internal rotation = **medial meniscus**
49
KNEE - ORTHO TEST - MCMURRAY'S TEST - SN & SP
**SN**: 16-67 **SP**: 69-98
50
KNEE - ORTHO TEST - NOBLE COMPRESSION TEST
- Pt supine or side lying - Examiner applies lateral to medial pressure over pt lateral epicondyle with thumb - Examiner slowly passively flexes and extends the leg 3-4 times
51
KNEE - ORTHO TEST - NOBLE COMPRESSION TEST - POSITIVE TEST
**ITB syndrome** - Pain over the lateral femoral epicondyle - Palpable tendon snapping
52
KNEE - ORTHO TEST - BALLOTTMENT'S TEST
- Pt supine with leg straight - Examiner strokes the medial side of the patella while simultaneously stroking the lateral side of the patella downward (both going towards the patella) - Repeat 2-3 times - Apply gentle pressure to the patella palpating for motion
53
KNEE - ORTHO TEST - BALLOTTMENT'S TEST - POSITIVE TEST
**Internal derangement, ligament sprain or rupture, vascular damage, fracture** - Fluid accumulation at the inferior medial border of the patella **Intra-articular knee swelling** - Increased motion or spongy joint feel
54
KNEE - ORTHO TEST - POSTERIOR DRAWER TEST
- Pt supine - Knee bent 90 - Examiner places thumbs over the anterolateral and anteromedial knee joint line - Examiner pushes the tibia posteriorly
55
KNEE - ORTHO TEST - POSTERIOR DRAWER TEST - POSITIVE TEST
**PCL sprain or rupture** - Pain - Increased motion
56
KNEE - ORTHO TEST - POSTERIOR DRAWER TEST - SN & SP
**SN**: 22-100 **SP**: 99
57
KNEE - ORTHO TEST - VALGUS STRESS TEST
- Pt supine with legs straight - Examiner stabilises medial ankle and applies a lateral to medial (valgus) force at the knee - Repeat again with the knee flexed to 25 degrees
58
KNEE - ORTHO TEST - VALGUS STRESS TEST - POSITIVE TEST
**MCL sprain** - Pain **MCL rupture** - Increased motion/gapping
59
KNEE - ORTHO TEST - VALGUS STRESS TEST - SN & SP
**SN**: 86-100 **SP**: 100
60
KNEE - ORTHO TEST - VARUS STRESS TEST
- Pt supine with legs straight - Examiner stabilises lateral ankle and applies a medial to lateral (varus) force at the knee - Repeat again with the knee flexed to 25 degrees
61
KNEE - ORTHO TEST - VARUS STRESS TEST - POSITIVE TEST
**LCL sprain** - Pain **LCL rupture** - Increased motion/gapping
62
KNEE - ORTHO TEST - VARUS STRESS TEST - SN & SP
**SN**: 0-89 **SP**: 48-100
63
KNEE - DEFORMITIES OF THE KNEE
- **Bow legs** - legs that curve outwards at the knee - **Knock knees** - legs that curve inwards at the knee - Can be caused by Rickets, Injury, Infection or an Inherent growth disorder
64
KNEE - LESIONS OF THE MENISCI
- Medial less mobile than lateral, more liable to tearing when subjected to abnormal stresses - Grinding forces split the fibres of the meniscus
65
KNEE - LESIONS OF THE MENISCI - POPULATION AFFECTED
- Pt usually young who sustains a twisting injury to knee - Or elderly - Horizontal tears usually degenerative or due to repetitive minor trauma
66
KNEE - LESIONS OF THE MENISCI - CLINICAL PRESENTATION
- Swelling appears after a few hours or the following day - Sometimes knee gives way spontaneously and is followed by pain and swelling - Pts over 40 may not remember original injury, main complaint will be giving way and locking - On examination joint may be held slightly flexed - Quads wasted - Tenderness on joint line, on medial side in vast majority
67
KNEE - OSTEOCHONDRITIS DISSICANS
- A piece of the bone partially or fully separates from the end of the bone that forms a joint. As the piece of the bone dies, the cartilage covering it cracks, and both may break loose.
68
KNEE - OSTEOCHONDRITIS DISSICANS - CAUSE
- lack of blood supply to the area. - Trauma, either singular impact with the edge of the patella or repeated contact with an adjacent tibial ridge
69
KNEE - OSTEOCHONDRITIS DISSICANS - CLINICAL PRESENTATION
- Intermittent ache or swelling - Later attacks of giving way and the knee feels unreliable - Quads wasted - Joint slightly swollen - Limited ROM - Tenderness localised to femoral condyle
70
KNEE - LOOSE BODIES
- Small fragments of articular cartilage that break off in the knee joint as a result of a knee injury or degeneration. - Loose bodies float around within the knee joint and cause pain, catching, locking, or swelling depending upon where the fragments migrate. - Behind the patella - Injury – chip of bone or cartilage - **Osteochondritis dissecans** – may produce one or two fragments - **Osteoarthritis** – pieces of cartilage or osteophytes
71
KNEE - RECURRENT DISLOCATION OF THE PATELLA
- Due to disruption/stretching of surrounding ligaments, which normally stabilise the joint.
72
KNEE - RECURRENT DISLOCATION OF THE PATELLA - CAUSE
- Repeated dislocation damages articular surfaces of the patella and femoral condyle - This may result in further flattening the condyle and therefore further dislocations
73
KNEE - RECURRENT DISLOCATION OF THE PATELLA - RISK FACTORS
- Generalised ligamentous laxity - Valgus deformity of the knees - External tibial torsion
74
KNEE - RECURRENT DISLOCATION OF THE PATELLA - CLINICAL PRESENTATION
- From time to time knee gives way and P falls - May be accompanied by pain and knee stays in flexion - Dislocation almost always to the lateral side - Usually tenderness on the medial side of the joint - Later the joint becomes swollen
75
KNEE - CHONDROMALACIA PATELLA
- Breakdown of cartilage on the underside of the kneecap - Repetitive mechanical overload of the patellofemoral joint
76
KNEE - CHONDROMALACIA PATELLA - CLINICAL PRESENTATION
- Anterior knee pain (pain under knee-cap) - Symptoms aggravated by activity, climbing stairs or when sitting or standing for a long period of time - Quads wasted - Patella femoral pain is elicited by pressing the patella against the femur and asking P to contract the quads (Clark’s)
77
KNEE - TIBIAL TUBEROSITY 'APOPHYSITIS'
- Pain and swelling of tibial tubercle
78
KNEE - TIBIAL TUBEROSITY 'APOPHYSIYIS' - CLINICAL PRESENTATION
- Tibial tuberosity unusually prominent and tender - Sometimes active extension of the knee against resistance is also painful - X-rays show displacement of tibial apophysis
79
KNEE - CHRONIC LIBAMENTOUS INSTABILITY
3 types of tibiofemoral instability: 1. sideways tilt, varus or valgus 2. Excessive glid, forwards or backwards 3. Unstable rotation. - Ligament injury, from strain to ruptures
80
KNEE - PATELLAR TENDINOPATHY
- Common soft tissue injury which can cause pain in the patellar tendon. It can also cause stiffness and weakness around the knee. - Overuse injury, which means it can develop after repeated stress on your patellar tendon.
81
KNEE - PREPATELLAR BURSITIS
- Inflammation of the bursa in the front of the patella. - Occurs when the bursa becomes irritated and produces too much fluid, which causes it to swell and put pressure on the adjacent parts of the knee. - Can result from frequent kneeling or from acute trauma to the anterior knee. E.g. Plumbers, roofers, carpet layers and gardeners.
82
KNEE - MEDIAL/LATERAL COLLATERAL LIGAMENT STRAIN
- Ligaments are stretched but not torn. The MCL is the most commonly injured knee ligament.
83
KNEE - MEDIAL/LATERAL COLLATERAL LIGAMENT STRAIN - CAUSE
- Following trauma - Contact sports - Report of history of twisting injury with pop or snap
84
KNEE - MEDIAL/LATERAL COLLATERAL LIGAMENT STRAIN - CLINICAL PRESENTATION
- Medial knee pain after trauma to the lateral side of the knee or lower leg or a fall with a valgus moment. - Pain may be worse with weight bearing, and an effusion may be present. - There may be a sense of knee instability or “giving way” with high-grade MCL sprains. - Tenderness on medial side of the knee - Most painful when knee is in 20-30deg of flexion
85
KNEE - TORN MENISCUS
- Can be acute or chronic degenerative tears.
86
KNEE - TORN MENISCUS - ACUTE VS CHRONIC CAUSE
- **Acute** - Pt will report a rotational or “twisting” injury to the flexed knee that often results in an audible “pop” with concurrent localised sharp pain. - **Chronic** - older Pts, result of degenerative changes in the meniscus that are typical of aging.
87
KNEE - TORN MENISCUS - CLINICAL PRESENTATION
- Knee catching or locking, resulting in difficulties with flexion and extension. - With large tears, the knee can become locked in flexion and the patient may be unable to straighten the knee - Pain when squatting or pivoting. - Tenderness to palpation along the joint line in the area of the tear
88
KNEE - PES ANSERINE BURSITIS
- Located on the medial side of the knee at the proximal tibia. - Overuse injury, occasionally trauma involved.
89
KNEE - PES ANSERINE BURSITIS - POPULATION AFFECTED
- Common in patients aged 50-80 years who have osteoarthritis of the knees
90
KNEE - PES ANSERINE - CLINICAL PRESENTATION
- Medial-sided knee pain - There is tenderness to palpation at the proximal medial tibia, at the attachment of the pes anserine tendons.
91
KNEE - KNEE EFFUSION
- Swollen knee - Excess fluid collects in or around the knee joint
92
KNEE - BAKER'S CYST
- Fluid-filled growth behind the knee. It causes a bulge and a feeling of tightness - Inflammation of the knee joint, which can occur with various types of arthritis
93
KNEE - BAKER'S CYST - CAUSE
- A knee injury, such as a cartilage tear
94
KNEE - BAKER'S CYST - CLINICAL PRESENTATION
- Swelling behind the knee, and sometimes in the leg - Knee pain - Stiffness and inability to fully flex the knee - The symptoms may be worse after you’ve been active or if you’ve been standing for a long time.
95
KNEE - AROM - FLEXION - MUSCLES ACTIVATED
Semitendinosus Semimembranosus Biceps femoris Popliteus Sartorius
96
KNEE - AROM - FLEXION - TISSUES STRETCHED
Quadriceps Femoral nerve
97
KNEE - AROM - FLEXION - TISSUES COMPRESSED
Popliteal fossa structure - popliteal artery, tibial nerve) Patella compressed into femoral condyles
98
KNEE - AROM - EXTENSION - MUSCLES ACTIVATED
Vastus medialis Vastus lateralis Vastus intermedius Rectus femoris
99
KNEE - AROM - EXTENSION - TISSUES STRETCHED
Semitendinosus Semimembranosus Biceps femoris Popliteus Gastrocnemius Sciatic nerve
100
KNEE - AROM - EXTENSION - TISSUES COMPRESSED
Anterior knee structures
101
KNEE - AROM - INTERNAL ROTATION - MUSCLES ACTIVATED
Semitendinosus Semimembranosus Sartorius Popliteus
102
KNEE - AROM - INTERNAL ROTATION - TISSUES STRETCHED
Biceps femoris Anterolateral joint capsule
103
KNEE - AROM - INTERNAL ROTATION - TISSUES COMPRESSED
Posteromedial joint capsule
104
KNEE - AROM - EXTERNAL ROTATION - MUSCLES ACTIVATED
Biceps femoris
105
KNEE - AROM - EXTERNAL ROTATION - TISSUES STRETCHED
Semitendinosus Semimembranosus Sartorius Popliteus Posteromedial joint capsule
106
KNEE - AROM - EXTERNAL ROTATION - TISSUES COMPRESSED
Anterolateral joint capsule
107
SARTORIUS - ORIGIN
ASIS
108
SARTORIUS - INSERTION
Proximal anteromedial tibia (pes anserine)
109
SARTORIUS - ACTION
Flexion, abduction and lateral rotation of hip joint Flexion of knee joint Anterior pelvic tilt
110
SARTORIUS - INNERVATION
Femoral nerve (L2-L3)
111
SARTORIUS - TRIGGER POINT REFERRAL
Upper muscle - refers pain to the upper anterior thigh and inguinal region Middle muscle - refers pain over ther anterior muscle thigh Lower muscle - refers pain over medial thigh and knee
112
SARTORIUS - STRETCH
Extend, adduct and medially rotate thigh
113
SARTORIUS - STRENGHTNEN
Resisted abduction and flexion Side lying leg raise 45 degree leg raised Figure 8 in air with legs
114
RECTUS FEMORIS - ORIGIN
Anterior heas - ASIS Posterior head - superior to rim of acetabulum (supra-acetabular groove)
115
RECTUS FEMORIS - INSERTION
Tibial tuberosity (via common quadriceps tendon and patella ligament)
116
RECTUS FEMORIS - ACTION
Extension of knee Flexion of hip
117
RECTUS FEMORIS - INNERVATION
Femoral nerve (L2-L4)
118
RECTUS FEMORIS - TRIGGER POINT REFERRAL
Pain is referred over anterior distal thigh and over the patella
119
RECTUS FEMORIS - STRETCH
Lying prone, place something under your flexed knee and pull heel to bum and extend hip
120
RECTUS FEMORIS - STRENGHTEN
Resisted knee extension Squat Lunge Split squat Step up
121
VASTUS LATERALIS - ORIGIN
Lateral lip of linea aspera
122
VASTUS LATERALIS - INSERTION
Tibial tuberosity (via common quadriceps tendon and patella ligament)
123
VASTUS LATERALIS - ACTION
Extension of knee joint
124
VASTUS LATERALIS - INNERVATION
Femoral nerve (L2-L4)
125
VASTUS LATERALIS - TRIGGER POINT REFERRAL
Pain is referred over the lateral thigh, both superiorly from the site of the trigger point
126
VASTUS LATERALIS - STRETCH
Standing, pull ankle to buttock (consider pulling leg medially to further stretch lateral fibres)
127
VASTUS LATERALIS - STRENGTHEN
Resisted knee extension Squat Lunge Split squat Step up
128
VASTUS INTERMEDIUS - ORIGIN
Anterior lateral surface of femur
129
VASTUS INTERMEDIUS - INSERTION
Tibial tuberosity (via common quadriceps tendon and patella ligament)
130
VASTUS INTERMEDIUS - ACTION
Extension of knee
131
VASTUS INTERMEDIUS - INNERVATION
Femoral nerve (L2-L4)
132
VASTUS INTERMEDIUS - TRIGGER POINT REFERRAL
Pain is referred over the anterior thigh in a '3-pronged' area that extends distally along the midline, medially and laterally
133
VASTUS INTERMEDIUS - STRETCH
Standing, pull ankle to buttock
134
VASTUS INTERMEDIUS - STRENGTHEN
Resisted knee extension Squat Lunge Split squat Step up
135
VASTUS MEDIALIS - ORIGIN
Medial lip of linea aspera (intertrochanteric line)
136
VASTUS MEDIALIS - INSERTION
Tibial tuberosity (via common quadriceps tendon and patella ligament)
137
VASTUS MEDIALIS - ACTION
Extension of knee
138
VASTUS MEDIALIS - INNERVATION
Femoral nerve (L2-L4)
139
VASTUS MEDIALIS - TRIGGER POINT REFERRAL
Pain is referred over the medial thigh, both superiorly and inferiorly from the site of the trigger point May produce 'tooth-like' pain deep in the knee joint
140
VASTUS MEDIALIS - STRETCH
Standing, pull ankle to buttock (consider pulling leg laterally to further stretch medial fibres)
141
VASTUS MEDIALIS - STRENGTHEN
Resisted knee extension Squat Lunge Split squat Step up
142
SEMITENDINOSUS - ORIGIN
Ischial tuberoisty
143
SEMITENDINOSUS - INSERTION
Proximal anterior medial tibia (pes anserine)
144
SEMITENDINOSUS - ACTION
Flexion of knee Extension of hip Medial rotation of knee (tibia) when knee is flexed
145
SEMITENDINOSUS - INNERVATION
Sciatic nerve, tibial division (L5-S2)
146
SEMITENDINOSUS - TRIGGER POINT REFERRAL
Generally pain is referred upward to the lower gluteal region Pain can also be referred inferiorly over the upper medial calf
147
SEMITENDINOSUS - STRETCH
Standing, extend back, anteriorly tilt pelvis and flex thighs, externally rotate hips to further stretch medial fibres
148
SEMITENDINOSUS - STRENGTHEN
Resisted hip extension or knee flexion Leg curls Straight-leg dead-lift
149
SEMIMEMBRANOSUS - ORIGIN
Ischial tuberosity
150
SEMIMEMBRANOSUS - INSERTION
Medial tibial condyle (posterior medial aspect)
151
SEMIMEMBRANOSUS - ACTION
Flexion of knee Extension of hip Medial rotation of knee (tibia) when knee is flexed
152
SEMIMEMBRANOSUS - INNERVATION
Sciatic nerve, tibial division (L5-S2)
153
SEMIMEMBRANOSUS - TRIGGER POINT REFERRAL
Generally pain is referred upward to the lower gluteal region Pain can also be referred inferiorly over the upper medial calf
154
SEMIMEMBRANOSUS - STRETCH
Standing, extend back, anteriorly tilt pelvis and flex thighs, externally rotate hips to further stretch medial fibres
155
SEMIMEMBRANOSUS - STRENGTHEN
Resisted hip extension or knee flexion Leg curls Straight-leg dead-lift
156
BICEPS FEMORIS - ORIGIN
Long head - ischial tuberosity Short head - lateral lip of linea aspera
157
BICEPS FEMORIS - INSERTION
Head of fibula
158
BICEPS FEMORIS - ACTION
Flexion of the knee (long and short head) Extension of hip joint (long head) Laterally rotation of the knee (tibia) when the knee is flexed
159
BICEPS FEMORIS - INNERVATION
Sciatic nerve (long head = tibial division (L5-S2)) (short head = common peroneal division (S1-S2))
160
BICEPS FEMORIS - TRIGGER POINT REFERRAL
Generally pain is referred upward to the lower lateral gluteal region Pain can be referred inferiorly over the upper lateral popliteal fossa and calf
161
BICEPS FEMORIS - STRETCH
Standing, extend back, anteriorly tilt pelvis and flex thighs, internally rotate hips to further stretch lateral fibres
162
BICEPS FEMORIS - STRENGTHEN
Resisted hip extension or knee flexion Leg curls Straight leg deadlift
163
POPLITEUS - ORIGIN
Lateral femoral condyle
164
POPLITEUS - INSERTION
Proximal posterior tibia
165
POPLITEUS - ACTION
Unlocks knee from an extended position Lateral rotation of femur on tibia or medial rotation of tibia on femur Flexion of knee
166
POPLITEUS - INNERVATION
Tibial nerve (L4-S1)
167
POPLITEUS - TRIGGER POINT REFERRAL
Generally refers pain over the back of the knee and upper calf Popliteus trigger points dont occur on their own and usually occur in conjunction with trigger points in the gastrocnemius or biceps femoris
168
POPLITEUS - STRETCH
With posterior knee straight, lean body forward

ANATOMY (10 decks)

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