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Knee Acute Collateral Ligament Instability

The lateral collateral ligament (LCL) originates on the lateral epicondyle of the femur and is inserted into the head of the fibula. Injuries to the lateral side of the knee joint are considered as an injury to the complex rather than a single injury to the LCL (which is relatively rare). Again, the complex can be considered to consist of three layers the first layer includes the ilio-tibial tract and superficial portion of the biceps femoris the second layer includes the extracapsular lateral collateral ligament itself and the third layer includes the joint capsule and arcuate ligament, as well as the popliteal tendon.

Labeling Exercise 201

Muscle Labeling Exercises

Adductors of thigh Biceps brachii Brachioradialis Deltoid Extensor carpi External oblique Flexor carpi Gastrocnemius Intercostals Internal oblique Masseter Orbicularis oculi Orbicularis oris Pectoralis major Peroneus longus Quadriceps femoris Rectus abdominis Sartorius Serratus anterior Soleus

Anterior Inferior Acetabular Hip Paralabral Cyst

Iliopsoas Bursa Aspiration Technique

Rectus femoris avulsion in an athlete. (A) Coronal inversion recovery, and (B) axial T2, fat-suppressed images demonstrate avulsion of the origin of the biceps femoris from the left anterior inferior iliac spine. Note prominence of avulsed tendon (arrows) with surrounding soft-tissue edema and hemorrhage.

Steps Of Muscle Contraction

Sarcoplasmic Reticulum Cycles

Which has a single nucleus, skeletal muscle fibers have many nuclei because they develop through the fusion of many individual cells. A muscle such as your biceps (which bends your arm) is composed of many muscle fibers bundled together by connective tissue. In skeletal muscle, the arrival of an action potential at a neu-romuscular junction causes an action potential in a muscle fiber. The spread of that action potential through the T tubule system of the muscle fiber causes a minimum unit of contraction, called a twitch. A twitch can be measured in terms of the tension, or force, it generates (Figure 47.7a). A single action potential stimulates a single twitch, but the ultimate force generated by a muscle can vary enormously depending on how many muscle fibers are in its motor units. In muscles responsible for fine movements, such as those of the fingers, a motor neuron may innervate only one or a few muscle fibers, but in a muscle that produces large forces, such as the biceps, a...

The Anatomic Arrangement of Muscle Is a Prime Determinant of Function

Antagonistic Pairs Levers

Triceps Biceps Antagonistic pairs and the lever system of skeletal muscle. Contraction of the biceps muscle lifts the lower arm (flexion) and elongates the triceps, while contraction of the triceps lowers the arm and hand (extension) and elongates the biceps. The bones of the lower arm are pivoted at the elbow joint (the fulcrum of the lever) the force of the biceps is applied through its tendon close to the fulcrum the hand is 7 times as far away from the elbow joint. Thus, the hand will move 7 times as far (and fast) as the biceps shortens (lever ratio, 7 1), but the biceps will have to exert 7 times as much force as the hand is supporting. skeletal lever system multiplies the distance over which an extremity can be moved (Fig. 9.13). However, this means the muscle must exert a much greater force than the actual weight of the load being lifted (the muscle force is increased by the same ratio that the length change at the end of the extremity is increased). In the case of the human...

Location of Injury and Imaging Prognosis

Hamstring Tendon Partial Tear

A more recent study of 30 MRI-proven hamstring injuries in Australian Rules football players showed high correlation with volume of involvement (range 0.04 cm3 to 175.6 cm3, median 16.8 cm3) and maximum cross-sectional percentage (8 to 100, median 46 ) with time lost from competition (13 to 48 days, median 27) 14 . Linear fluid signal representing the length inter- and intramuscular fluid and edema showed strong correlation but was not statistically significant in this study. More injuries occurred distally (19 versus 11 defined as above or below origin of biceps femoris short head) but there was no correlation with location of injury and missed competition (Fig. 6). Fig. 6. Grade 1 strain of the distal semitendinosus muscle (A). Coronal T1 showing partial tear of distal biceps femoris tendon in this professional football defensive back (B).

Distribution of Injuries and Ultrasound versus MR

Images Mri Hamstring

A review of 179 cases of injury to the hamstring muscle complex (HMC) using ultrasound (102 cases) and MR (97 cases) showed there were 21 injuries involving the proximal insertion on the ischial tuberosity with 16 tendon avulsions 154 injuries of the muscle belly, and only 4 injuries of the distal tendon or bone insertion site 33 . Approximately 80 (124 cases) of injuries involved the biceps femoris (54 proximal, 48 mid, and 22 distal) 61 involved the myotendinous junction and 35 were considered epimyseal or involving the periphery of the muscle. Multiple muscle involvement was only seen in 5 cases for these authors, others have shown using MR primarily that multiple muscle injury occurs nearly 30 to 40 of the time 13,14,21 . was the best predictor for time to return to competition. Tears showed decreased cross-sectional involvement over time with both modalities. Ultrasonography was found to be more useful for evaluating epimyseal injuries and MR better for intramuscular tendon...

Figure 1131

The muscles, bones, and joints in the body are arranged in lever systems. The basic principle of a lever is illustrated by the flexion of the arm by the biceps muscle (Figure 11-33), which exerts an upward pulling force on the forearm about 5 cm away from the elbow joint. In this example, a 10-kg weight held in the hand exerts a downward force of 10 kg about 35 cm from the elbow. A law of physics tells us that the forearm is

Muscle Action

Muscles work in pairs to produce movement at the joints (see Display 20-1 for a description of various types of movement). As one muscle, the prime mover, contracts, an opposing muscle, the antagonist, must relax. For example, when the biceps brachii on the anterior surface of the upper arm contracts to flex the arm, the triceps brachii on the posterior surface must relax (Fig. 20-2). When the arm is extended, these actions are reversed. In a given movement, the point where the muscle is attached to a stable part of the skeleton is the origin the point where a muscle is attached to a moving part of the skeleton is the insertion.

Anatomy

Semitendinosus Strain

The hamstring complex is composed of three major muscles biceps femoris and semimembranosus and semitendinosus muscles. The biceps femoris is composed of a long and short head. The long head arises on the medial aspect of the posterior ischial tuberosity with a common tendon insertion with the semitendinosus called the conjoined tendon 25 (Fig. 5A-D). Distally it inserts on the fibular head. Depending on leg positioning and relationship to the ground it can serve as a hip extensor, knee flexor, and external rotator of the hip and knee (Fig. 5E,F). The short head of the biceps tendon is not biarticular but has a proximal attachment on the lateral aspect of the linea aspera below the gluteal tuberosity and inserts distally on the fibular head 26 . The short head of the biceps can be absent, and unlike the long head that receives innervation via a tibial portion of The semitendinosus is another biarticular muscle with a common origin of the long head of the biceps femoris via the...

Imaging Modalities

Posterior Calf Muscles

Coronal fluid sensitive images of posterior thighs demonstrating (A) Type 1 muscle strain injury with mild feathery edema along the intramuscular myotendinous junction of biceps femoris in a professional football wide receiver (B) Type 2 injury of the proximal myotendinous junction of biceps femoris with intramuscular hematoma formation and (C) Type 3 injury proximal biceps femoris with retraction of the tendon (arrow) in a professional football cornerback. Fig. 2. Coronal fluid sensitive images of posterior thighs demonstrating (A) Type 1 muscle strain injury with mild feathery edema along the intramuscular myotendinous junction of biceps femoris in a professional football wide receiver (B) Type 2 injury of the proximal myotendinous junction of biceps femoris with intramuscular hematoma formation and (C) Type 3 injury proximal biceps femoris with retraction of the tendon (arrow) in a professional football cornerback.

Results

LCL, posterolateral capsule, popliteus tendon, biceps femoris tendon, and lateral head of gastrocnemius muscle. Type II was treated with medial ligament reconstruction. Results were 72 excellent, 18 good, 7 fair, and 2 poor. Laurencin and associates (1992) reviewed 25 TKAs in 25 patients with average preoperative valgus deformities of 32 degrees.6 To correct valgus deformity, they found it necessary to release the ITB at the level of the joint line in 76 , the popliteus and LCL in 56 , and biceps tendon just proximal to its fibular attachment in one case (3 ). They made an attempt at cruciate retention in all patients, but 16 required sacrifice of the PCL for ligamentous balancing. All 25 patients required a lateral retinacu-lar release for patellar tracking. The average postoperative alignment of the knees was 6 degrees valgus (range 0 to 10 degrees), and with an average follow-up of 5 years, there was no evidence of loosening and no revisions. Complications included 202 three...

31 Days To Bigger Arms

31 Days To Bigger Arms

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