膝关节解剖2.pptxVIP

Arthrex 内部培训资料膝关节解剖基础Arthrex China骨膝包含4块骨头股骨胫骨腓骨髌骨 股骨外侧髁和内侧髁组成关节的上面.髁间凹 ACL 和 PCL 在此位置内上髁和外上髁髌骨沟Anterior and posterior views of right femur胫骨胫骨平台包括内侧髁面和外侧髁面髁间嵴胫骨内侧髁和外侧髁胫骨结节鹅足Anterior view of Left Tibia骨性标志Anterior view of left knee内上髁，外上髁胫骨结节腓骨头 鹅足髌腱屈曲伸直膝关节的运动膝关节的运动内旋外旋(A) normal, (B) Varus, and (C) Valgus deformities of the knee外翻和内翻胫骨股骨关节滑液髁状铰链关节包括:股骨髁 胫骨近端.胫股关节运动小腿屈曲/伸直0-100 伸直130-1400 屈曲小腿的小幅度旋转(Note: 0-10? extension is “normal” value. Hyperextension can be seen due to anatomic variance. 130-1400 flexion may not be seen due to muscular development/anatomic variance)髌股关节滑动关节伸膝过程中，增加股四头肌的杠杆作用包括:髌骨人体最大的籽骨 股骨滑车Lateral and anterior views of right kneeSuperior view of right knee髌股关节Anterior view of right knee髌骨位置固定通过:股四头肌腱髌腱内侧髌股韧带外侧支持带膝的韧带Anterior Cruciate Ligament (ACL)从胫骨前内侧到股骨外侧髁的内侧面主要限制胫骨前移对旋转稳定亦有帮助Anterior view of left knee膝的韧带Posterior Cruciate Ligament (PCL)胫骨后侧到股骨内侧髁限制胫骨后移Posterior view of left knee膝的韧带Medial Collateral Ligament (MCL)膝内表面的宽，厚韧带包含在关节囊中限制外翻MCLAnterior view of right kneeValgus Stress Test- Inward pressure is placed on lateral surface of knee to check stability of MCL 膝的韧带Lateral Collateral Ligament (LCL)薄，铅笔状的韧带关节囊外结构限制内翻 Lateral view of right kneeVarus Stress Test- Outward pressure is placed on medial surface of the knee to check the stability of the LCL半月板纤维软骨结构，通过加深关节面有利于关节稳定和吸收冲击震荡 内侧半月板“C-型”与ACL和MCL有连接损伤常见于三联征 (ACL, MCL, MM tear)外侧半月板“O-型”后外角与关节囊之间存在“腘裂孔”半月板损伤常见Anterior and superior views of right knee膝的肌肉屈曲Hamstrings 股二头肌Biceps Femoris 半膜肌Semimembranosus 半腱肌Semitendinosis股薄肌Gracilis缝匠肌Sartorius腓肠肌Gastrocnemius腘肌Popliteus伸直股四头肌股直肌Rectus Femoris股外侧肌Vastus Lateralis股内侧肌Vastus Medialis股中间肌Vastus Intermedius膝关节的运动膝关节屈曲时，胫骨内旋肌肉:腘肌.半膜肌半腱肌 膝关节屈曲时，胫骨外旋肌肉股二头肌重要的胫骨止点PosteriorAnteriorMedial view of left knee鹅足缝匠肌，股薄肌和半腱肌在胫骨的止点Anterior Cruciate Lig. (ACL)由2束组成根据在胫骨的相对位置进行的命名.2束分别是:前内束 (AM)后外束 (PL)各束功能不同.前内束防止胫骨前移.屈曲紧张，伸直松弛后外束控制胫骨内旋. 伸直紧张，屈曲松弛 A) Shows anterior view of right knee in flexion, B) Anterior view of right knee flexed with thigh externall