1、Knee Anatomy Training,Knee Anatomy,Introduction 介紹 Very little bony stability 少的骨穩(wěn)定 Behaves more like a round ball on flat surface運動主要是球在面上的滑動 Ligaments responsible for stability主要韌帶穩(wěn)定,Knee Anatomy,Looks simple, but most complex. 看似簡單，最復(fù)雜的關(guān)節(jié) More likely to be injured than any other joint in the body

2、 人體中更易受傷的關(guān)節(jié) Largest joint of the body, actually consisting of 4 joints人體大關(guān)結(jié)，有4個關(guān)節(jié)組成 Patellofemoral臏股關(guān)節(jié), Lateral tibio femoral外側(cè)脛股關(guān)節(jié), Medial tibio femoral內(nèi)側(cè)脛股關(guān)節(jié), Tibiofibular脛腓關(guān)節(jié),Knee Anatomy,Basic Structures基本組織 Bones骨 Femur股骨, Tibia脛骨, Fibula腓骨, Patella 臏骨 Muscles/ Tendons 肌肉及肌腱 Quadriceps四頭肌, Hams

3、trings, Calf muscles Ligaments 韌帶 Medial collateral內(nèi)側(cè)副韌帶, Lateral collateral外側(cè)副韌帶, Anterior cruciate前交叉, Posterior cruciate后交叉, Popliteal ligament, Retinaculum Cartilage軟骨 Meniscus半月板, Articular cartilage 關(guān)節(jié)軟骨 Bursae,Knee Bones,Bones Femur股骨 Large/long bone of the thigh 大長骨 Tibia 脛骨 Large bone of th

4、e lower leg. Fibula 腓骨 Small bone of the lower leg. Patella臏骨 “Knee Cap”,Knee Bones: Anterior View,Femur, Tibia, Patella,Patella,No Patella,Knee Bones: Function,Patella臏骨 Patellofemoral groove (front of the femur). Patella tracking can affect the overall function of the knee.臏骨溝，臏骨軌跡影響膝的功能,Patella P

5、atellar Groove,Knee Bones: Lat/med Views,Femur, Tibia, Fibula, Patella,Lateral,Medial,Knee Bones: Posterior View,Femur, Tibia, Fibula,Primary Knee Ligaments主要的膝韌帶,MCL Medial Collateral Lig.,LCL Lateral Collateral Lig.,Knee Ligaments,Medial and Lateral Collateral Ligaments help stabilize the knee by

6、preventing Varus and Valgus forces內(nèi)外側(cè)副韌帶 防止內(nèi)外翻,Varus Towards the Midline,Valgus外翻 Towards the Outside,Valgus內(nèi)翻 Towards the Outside,Knee Ligaments,MCL,LCL,Cruciate Knee Ligaments (cruciate=cross)十字韌帶,Anterior Cruciate Ligament前交叉韌帶 Attaches anterior on the tibia & posterolateral on the femur附著于脛骨前部股骨

7、后部 Prevents anterior movement of the tibia on the femur防止脛骨相對股骨的前移 Checks external rotation of the tibia in flexion曲屈時防止脛骨外旋,Anterior,ACL,Inferior,Superior,Posterior,Knee: Cruciate Ligaments,Knee: ACL,ACL “Footprint前交叉脛骨附著點” Tibial attachment,Anterior,Posterior,Tibial Plateau,Tibial Plateau,Femoral

8、Attachment (Footprint),Posterior Cruciate后交叉韌帶、 Attaches Posterior on the tibia & Antero- medial on the femur.附著于脛骨后股骨前內(nèi) The PCL is a strong fan shaped ligament that is the strongest in the body后叉強大的扇形韌帶 Primary stabilizer against posterior movement of the tibia on the femur防止脛骨后移 Helps check the kn

9、ee in extension防止過伸,Cruciate Knee Ligaments (Cruciate=Cross),PCL,Knee: Cruciates,ACL,PCL,Anterior View,Posterior View,Knee,Hinge joint - flexion & extension.鉸鏈式關(guān)節(jié)-屈和伸 Flexion is achieved by contracting the hamstring muscles in the back of the leg.通過收縮大腿后部肌肉屈曲關(guān)節(jié) The Extensor Mechanism sits in front o

10、f the knee joint.伸膝裝置在膝關(guān)節(jié)前 The extensor mechanism is made up of the patella, the patellar tendon, the quadriceps tendon and the quadriceps muscles.伸膝裝置由臏骨、臏腱、股四頭肌、股四頭肌腱組成,Knee Muscles,Muscles肌肉、 Quadriceps股四頭肌 Vastus lateralis外側(cè)束, Vastus intermedius中間束, & Vastus medialis內(nèi)側(cè)束 Hamstrings Sartorius, Gra

11、cilis, Semimembranosus, Semitendinosis, & Biceps femoralis縫匠肌、股薄肌、半腱肌肉、半膜肌、二頭肌 Calf Muscles小腿肌肉 Gastrocnemius, Soleus, Popliteus, Pes Anserine muscle attachment is into the medial tibia. 腓腸肌、比目魚肌,Knee: Muscles,Quadriceps股四頭肌,Vastus Medialis,Vastus Lateralis,Vastus Intermedius,Knee: Muscles,Quadricep

12、s,Vastus Medialis 股內(nèi)側(cè)肌,Rectus Femoris 股中間肌,Vastus Lateralis 股外側(cè)肌,Knee: Quadriceps Mechanism,Its the motor that drives the knee joint, and allows us to walk. Composed of the patellar tendon, the patella, and the quadriceps muscles on the front of the thigh.走路的發(fā)動機由臏股、臏腱、股四頭肌、股四頭肌腱組成 The patella works

13、like a fulcrum, and increases the force exerted by the quadriceps muscles as the knee straightens. When the Quadriceps Muscles contract, the knee straightens. When they relax, the knee bends. 臏骨為增加股四頭肌肉力量的支點，收縮伸膝，放松屈膝,Patellar Tendon,Quadriceps Tendon,Femur,Patella,Patellar Tracking:臏骨軌跡 The Patella

14、r Facets track in the Femoral Groove,Knee: Hamstring Muscles,Sartorius縫匠肌 Gracilis股薄肌 Semimembranosis 半腱肌 Semitendonosis 半膜肌,Biceps Femoris 股二頭肌,Knee: Hamstring Muscles,Pes Anserine Attachment of the鵝足 Hamstring tendons (Sartorius shown here on the Medial Tibial Tuberosity),Medial Attachments,Knee:

15、Hamstring Muscles,Lateral Attachment 外側(cè)附件 Biceps Femoris Attachment to the Fibula股二頭肌肉腓骨附著點,Knee Ligaments,Knee Ligaments,Lateral & Medial Retinaculum,Medial Retinaculum Medial support for Patellar Tracking,Lateral Retinaculum Lateral support for Patellar Tracking,Vastus Medialis,Vastus Lateralis,Kn

16、ee: Tendons,Tendons Quadriceps Tendon Quadriceps Tendon connects the Quadriceps Muscles to the Patella四頭肌腱連接四頭肌和臏骨 Patellar Tendon Patellar Tendon connects the Patella to the Tibia. 臏腱連接臏韌帶和脛骨 The Patella is a bone embedded within the Quadriceps and Patellar Tendons lying over the Femoral bone. Also

17、 known as a “sesamoid” bone.臏骨存在于股四頭肌內(nèi)，又成為籽骨,Knee: Tendons,QuadricepsTendon,Patellar Tendon,Knee: Meniscal Cartilage,Meniscus (plural = menisci)半月板 The articular surfaces between the femur and tibia are not congruent. They are closest in full extension. However this space must be filled by the menis

18、cus.股骨和脛骨關(guān)節(jié)面不是匹配的，在屈曲位是最接近的?？臻g被半月板填充 Both menisci are thicker at their periphery and thinner towards the middle. They both move in flexion and extension. 兩個半月板都是四周厚中間薄，在屈伸時都是運動的 The lateral meniscus is not firmly attached to the collateral ligament or to the tibia as is the medial meniscus. Thus, it

19、 is less prone to distortion and injury.外側(cè)半月板不像內(nèi)側(cè)半月板那樣同側(cè)副韌帶或脛骨緊密附著,Knee: Meniscal Cartilage,Meniscus, ACL/ PCL Attachments The lateral meniscus is ”O(jiān)“ shaped and generally of equal thickness.外側(cè)半月板o形，等厚。 The medial meniscus is ”C“ shaped and is thicker posteriorly than anteriorly.內(nèi)側(cè)半月板c形，后側(cè)比前側(cè)厚,Later

20、al,Medial,Lateral,Medial,Knee,The menisci serve several functions 半月板裝置的幾個功能 A. Lubrication潤滑 B. Nutrition營養(yǎng) C. Shock absorbers震蕩吸收 D. Spread stress傳導(dǎo)壓力 E. Decrease articular cartilage wear減少關(guān)節(jié)軟骨磨損 F. Make joint spaces more congruent填充關(guān)節(jié)間隙 G. Prevent hyperextension防止過伸 The meniscus actually wraps ar

21、ound the upper bone to fill the space between the round femur and the flat tibia.,Knee: Meniscus,Meniscus Crescent-shaped fibrocartilage半月形纖維軟骨 Collagen fibers arranged longitudinally and radially膠原纖維成經(jīng)向放射裝 Triangular in cross section橫截面呈三角形,Knee,Meniscus The menisci are relatively avascular towards

22、 their inner 1/3, somewhat vascular in their middle 13, & vascular in their outer 1/3. They are held in place by the coronary ligaments半月板內(nèi)1/3為白區(qū)，中1/3為紅白區(qū)，外1/3為紅區(qū)。中間被冠狀韌帶連接。 The menisci possess no nerves, thus there is no pain unless a coronary ligament (tibial attachment) has been damaged. There is

23、 seldom a bloody effusion, however, you might find synovial swelling.半月板沒有神經(jīng)，因而沒有疼痛直到冠狀韌帶損傷。很少有血液滲出，但是能看到關(guān)節(jié)液增長,Blood supply peripherally,No blood supply proximal.,Articular Knee:Cartilage關(guān)節(jié)軟骨,Covers ends of bones (joint)覆蓋骨末端 ends of the femur, the top of the tibia, top of the fibula and the back of the patella股骨末端、脛骨及腓骨上端、臏骨背面 White, shiny material, tough, rubbery白色、有光澤、有彈性的、有硬度的 Consistency. ” thick Function absorb shock 吸收震蕩 provide smooth surface (facilitate motion)提供表面的潤滑,Knee: A