KneeAnatomyTrainingKneeAnatomyIntroduction介紹Verylittlebonystability少的骨穩定Behavesmorelikearoundballonflatsurface運動主要是球在面上的滑動Ligamentsresponsibleforstability主要韌帶穩定KneeAnatomyLookssimple,butmostcomplex.看似簡單，最復雜的關節Morelikelytobeinjuredthananyotherjointinthebody人體中更易受傷的關節Largestjointofthebody,actuallyconsistingof4joints人體大關結，有4個關節組成Patellofemoral臏股關節,Lateraltibiofemoral外側脛股關節,Medialtibiofemoral內側脛股關節,Tibiofibular脛腓關節KneeBonesBonesFemur股骨Large/longboneofthethigh大長骨Tibia脛骨Largeboneofthelowerleg.Fibula腓骨Smallboneofthelowerleg.Patella臏骨“KneeCap”KneeBones:AnteriorViewFemur,Tibia,PatellaPatellaNoPatellaKneeBones:FunctionPatella臏骨Patellofemoralgroove(frontofthefemur).Patellatrackingcanaffecttheoverallfunctionoftheknee.臏骨溝，臏骨軌跡影響膝的功能PatellaPatellarGrooveKneeBones:PosteriorViewFemur,Tibia,FibulaPrimaryKneeLigaments主要的膝韌帶MCLMedialCollateralLig.LCLLateralCollateralLig.KneeLigamentsMedialandLateralCollateralLigamentshelpstabilizethekneebypreventingVarusandValgusforces內外側副韌帶防止內外翻VarusTowardstheMidlineValgus外翻TowardstheOutsideValgus內翻TowardstheOutsideCruciateKneeLigaments(cruciate=cross)十字韌帶AnteriorCruciateLigament前交叉韌帶Attachesanterioronthetibia&posterolateralonthefemur附著于脛骨前部股骨后部Preventsanteriormovementofthetibiaonthefemur防止脛骨相對股骨的前移Checksexternalrotationofthetibiainflexion曲屈時防止脛骨外旋AnteriorACLInferiorSuperiorPosteriorKnee:CruciateLigamentsKnee:ACLACL“Footprint前交叉脛骨附著點”TibialattachmentAnteriorPosteriorTibialPlateauTibialPlateauFemoralAttachment(Footprint)Knee:CruciatesACLPCLAnteriorViewPosteriorViewKnee

Hingejoint-flexion&extension.鉸鏈式關節-屈和伸

Flexionisachievedbycontractingthehamstringmusclesinthebackoftheleg.通過收縮大腿后部肌肉屈曲關節TheExtensorMechanismsitsinfrontofthekneejoint.伸膝裝置在膝關節前Theextensormechanismismadeupofthepatella,thepatellartendon,thequadricepstendonandthequadricepsmuscles.伸膝裝置由臏骨、臏腱、股四頭肌、股四頭肌腱組成Knee:MusclesQuadriceps股四頭肌VastusMedialisVastusLateralisVastusIntermediusKnee:MusclesQuadricepsVastusMedialis股內側肌RectusFemoris股中間肌VastusLateralis股外側肌Knee:QuadricepsMechanism

It’sthemotor

thatdrivesthekneejoint,andallowsustowalk.Composedofthepatellartendon,thepatella,andthequadricepsmusclesonthefrontofthethigh.走路的發動機由臏股、臏腱、股四頭肌、股四頭肌腱組成Thepatellaworkslikeafulcrum,andincreasestheforceexertedbythequadricepsmusclesasthekneestraightens.WhentheQuadricepsMusclescontract,thekneestraightens.Whentheyrelax,thekneebends.

臏骨為增加股四頭肌肉力量的支點，收縮伸膝，放松屈膝PatellarTendonQuadricepsTendonKnee:HamstringMusclesSartorius縫匠肌Gracilis股薄肌Semimembranosis半腱肌Semitendonosis半膜肌BicepsFemoris股二頭肌Knee:HamstringMusclesPesAnserineAttachmentofthe鵝足Hamstringtendons(SartoriusshownhereontheMedialTibialTuberosity)MedialAttachmentsKneeLigamentsLateral&MedialRetinaculumMedialRetinaculumMedialsupportforPatellarTrackingLateralRetinaculumLateralsupportforPatellarTrackingVastusMedialisVastusLateralisKnee:TendonsTendonsQuadricepsTendonQuadricepsTendonconnectstheQuadricepsMusclestothePatella四頭肌腱連接四頭肌和臏骨PatellarTendonPatellarTendonconnectsthePatellatotheTibia.臏腱連接臏韌帶和脛骨ThePatellaisaboneembeddedwithintheQuadricepsandPatellarTendonslyingovertheFemoralbone.Alsoknownasa“sesamoid”bone.臏骨存在于股四頭肌內，又成為籽骨Knee:TendonsQuadricepsTendonPatellarTendonKnee:MeniscalCartilageMeniscus(plural=menisci)半月板Thearticularsurfacesbetweenthefemurandtibiaarenotcongruent.Theyareclosestinfullextension.Howeverthisspacemustbefilledbythemeniscus.股骨和脛骨關節面不是匹配的，在屈曲位是最接近的。空間被半月板填充Bothmenisciarethickerattheirperipheryandthinnertowardsthemiddle.Theybothmoveinflexionandextension.兩個半月板都是四周厚中間薄，在屈伸時都是運動的Thelateralmeniscusisnotfirmlyattachedtothecollateralligamentortothetibiaasisthemedialmeniscus.Thus,itislesspronetodistortionandinjury.外側半月板不像內側半月板那樣同側副韌帶或脛骨緊密附著Knee:MeniscalCartilageMeniscus,ACL/PCLAttachmentsThelateralmeniscusis”O“shapedandgenerallyofequalthickness.外側半月板o形，等厚。Themedialmeniscusis”C“shapedandisthickerposteriorlythananteriorly.內側半月板c形，后側比前側厚

LateralMedialLateralMedialKneeThemenisciserveseveralfunctions

半月板裝置的幾個功能A.Lubrication潤滑B.Nutrition營養C.Shockabsorbers震蕩吸收D.Spreadstress傳導壓力E.Decreasearticularcartilagewear減少關節軟骨磨損F.Makejointspacesmorecongruent填充關節間隙G.Preventhyperextension防止過伸Themeniscusactuallywrapsaroundtheupperbonetofillthespacebetweentheroundfemurandtheflattibia.Knee:MeniscusMeniscusCrescent-shapedfibrocartilage半月形纖維軟骨

Collagenfibersarrangedlongitudinallyandradially膠原纖維成經向放射裝

Triangularincrosssection橫截面呈三角形KneeMeniscusThemenisciarerelativelyavasculartowardstheirinner1/3,somewhatvascularintheirmiddle1\3,&vascularintheirouter1/3.Theyareheldinplacebythecoronaryligaments半月板內1/3為白區，中1/3為紅白區，外1/3為紅區。中間被冠狀韌帶連接。Themeniscipossessnonerves,thusthereisnopainunlessacoronaryligament(tibialattachment)hasbeendamaged.Thereisseldomabloodyeffusion,however,youmightfindsynovialswelling.半月板沒有神經，因而沒有疼痛直到冠狀韌帶損傷。很少有血液滲出，但是能看到關節液增長BloodsupplyperipherallyNobloodsupplyproximal.ArticularKnee:Cartilage關節軟骨Coversendsofbones(joint)覆蓋骨末端endsofthefemur,thetopofthetibia,top

ofthefibulaandthebackofthepatella股骨末端、脛骨及腓骨上端、臏骨背面White,shinymaterial,tough,rubbery白色、有光澤、有彈性的、有硬度的

Consistency.?”thickFunctionabsorbshock吸收震蕩providesmoothsurface(facilitatemotion)提供表面的潤滑Knee:ArticularCartilageArticularcartilageproducesawonderfullubrication關節軟骨產生關節液mechanismwithalmostzerofriction,whichhelpsusarticulateourjointsduringdailyactivi