knee anatomy medical education images osteology ligaments muscles neurovascular free use

mkdir -p /home/daytona/workspace/knee-anatomy-ppt && ls /home/daytona/workspace/…

~/knee-anatomy-ppt/create_ppt.js

const pptxgen = require("pptxgenjs");
const { execSync } = require("child_process");

const pres = new pptxgen();
pres.layout = 'LAYOUT_16x9';
pres.title = 'Functional Anatomy of the Knee';
pres.author = 'Postgraduate Orthopaedics';

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// ─── HELPERS ──────────────────────────────────────────────────

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// ═══════════════════════════════════════════════════════════════
// SLIDES
// ═══════════════════════════════════════════════════════════════

// 1. Title Slide
addTitleSlide(
  "FUNCTIONAL ANATOMY OF THE KNEE",
  "Osteology · Muscles · Neurovascular Structures · Applied Aspects"
);

// 2. Outline
addContentSlide("Contents", [
  "1. Introduction & Classification",
  "2. Osteology – Distal Femur, Proximal Tibia, Patella",
  "3. Articular Surfaces & Joint Type",
  "4. Intra-articular Structures – Cruciate Ligaments",
  "5. Menisci – Structure & Function",
  "6. Extra-articular Structures – Collateral Ligaments",
  "7. Muscles Acting on the Knee",
  "8. Posterolateral & Posteromedial Corner",
  "9. Neurovascular Structures",
  "10. Bursae of the Knee",
  "11. Applied Anatomy & Clinical Correlates",
  "12. Biomechanics – Screw-Home Mechanism",
], null, null);

// 3. Section: Introduction
addSectionDivider("INTRODUCTION");

// 4. Intro slide
addContentSlide("The Knee Joint – Overview", [
  "Most frequently injured joint due to anatomic structure, exposure to forces, and functional demands",
  "Largest and most complex joint in the body",
  "Type: Synovial, modified hinge (ginglymo-arthrodial) joint",
  "Articulations:",
  { sub: "Tibiofemoral joint (weight-bearing)" },
  { sub: "Patellofemoral joint (extensor mechanism)" },
  "Three broad structural categories:",
  { sub: "Osseous structures" },
  { sub: "Extra-articular structures (capsule, ligaments, tendons)" },
  { sub: "Intra-articular structures (menisci, cruciate ligaments)" },
], null, null);

// 5. Section: Osteology
addSectionDivider("OSTEOLOGY");

// 6. Distal Femur
addContentSlide("Distal Femur", [
  "Two rounded condyles with eccentric curvature – flattened anteriorly, prominent posteriorly",
  "Medial condyle – longer articular surface, angled ~22° off sagittal plane",
  "Lateral condyle – wider, oriented along sagittal plane",
  "Trochlear groove (patellofemoral groove) anteriorly between condyles",
  "Intercondylar notch separates condyles posteriorly",
  "Medial & lateral epicondyles – attachment sites for collateral ligaments",
  "Adductor tubercle – proximal medial, attachment for adductor magnus",
  "Lateral condyle houses the popliteal groove for the popliteus tendon",
],
"https://upload.wikimedia.org/wikipedia/commons/thumb/6/62/Knee_diagram.svg/800px-Knee_diagram.svg.png",
"Bony anatomy of the knee (Wikipedia Commons)", "right");

// 7. Proximal Tibia
addContentSlide("Proximal Tibia", [
  "Medial tibial plateau: subtly concave – stable, non-meniscal dependent",
  "Lateral tibial plateau: subtly convex – less stable, requires lateral meniscus",
  "Intercondylar eminence with medial & lateral tubercles (tibial spines) between plateaus",
  "Attachment areas for cruciate ligaments and menisci anterior and posterior to eminence",
  "Tibial tubercle: anterior eminence for insertion of patellar tendon (ligamentum patellae)",
  "Gerdy's tubercle: lateral tibial tubercle – distal insertion of iliotibial band",
  "Posterior tibial slope: ~7–10°, important for ACL/PCL tension",
  "Fibular head: articulates with tibia via superior tibiofibular joint lateral to knee",
], null, null);

// 8. Patella
addContentSlide("Patella", [
  "Largest sesamoid bone in the body; triangular – wider at proximal pole",
  "Articular surface divided by a vertical ridge → smaller medial & larger lateral facet",
  "Functions:",
  { sub: "Increases lever arm of quadriceps (enhances extensor force ~50%)" },
  { sub: "Protects anterior femoral condyles" },
  { sub: "Reduces friction of quadriceps tendon on femur" },
  "Patellofemoral contact varies with flexion:",
  { sub: "Extension: distal patella contacts lateral condyle only" },
  { sub: "45° flexion: contact moves to mid-patella" },
  { sub: "Full flexion: proximal facets contact femur" },
  "Patella travels 7–8 cm relative to femoral condyles during flexion/extension",
], null, null);

// 9. Section: Intra-articular Structures
addSectionDivider("INTRA-ARTICULAR STRUCTURES");

// 10. ACL
addContentSlide("Anterior Cruciate Ligament (ACL)", [
  "Originates from posterior medial surface of lateral femoral condyle",
  "Inserts on anterior intercondylar area of tibia",
  "Average length: 32 mm; diameter: 10 mm",
  "Two functional bundles:",
  { sub: "Anteromedial (AM) bundle – tight in flexion" },
  { sub: "Posterolateral (PL) bundle – tight in extension" },
  "Primary restraint to anterior tibial translation (~85–90%)",
  "Secondary restraint to internal tibial rotation",
  "Vascular supply: middle geniculate artery (branch of popliteal artery)",
  "Richly innervated with mechanoreceptors – proprioception",
  "Extra-synovial but intra-articular",
],
"https://cdn.orris.care/cdss_images/985f4e4f9c054aefa6816271ab2b141cd87f86b4b7136e0d039a9d783a99fa89.png",
"ACL & PCL bundles – cadaveric dissection (Campbell's Operative Orthopaedics)", "right");

// 11. PCL
addContentSlide("Posterior Cruciate Ligament (PCL)", [
  "Largest intra-articular ligament – length ~38 mm, diameter ~13 mm",
  "Cross-sectional area 120–150% greater than ACL",
  "Origin: lateral surface of medial femoral condyle",
  "Insertion: midline depression on posterior tibia, 10–15 mm below plateau level",
  "Two bundles:",
  { sub: "Anterolateral (AL) bundle – 85% of cross-section, tight in flexion" },
  { sub: "Posteromedial (PM) bundle – tight in extension" },
  "Primary restraint to posterior tibial translation (~95%)",
  "Meniscofemoral ligaments (Humphrey & Wrisberg) accompany PCL",
  { sub: "Present in ≥93% of knees; connect posterior horn of lateral meniscus to intercondylar notch" },
  "'Cornerstone' of the knee – reconstructed first in multi-ligament injuries",
], null, null);

// 12. Menisci
addContentSlide("Menisci – Structure & Function", [
  "Semilunar fibrocartilage structures; C-shaped in cross-section",
  "Medial meniscus: C-shaped, larger, firmly attached to capsule & MCL – less mobile",
  "Lateral meniscus: O-shaped, smaller, loosely attached – more mobile (~10 mm vs. 5 mm posterior excursion)",
  "Composition: 70% type I collagen; circumferential (majority) + radial fibres",
  "Vascular zones:",
  { sub: "Red-red zone (outer 1/3) – vascular, heals well" },
  { sub: "Red-white zone (middle 1/3) – watershed" },
  { sub: "White-white zone (inner 1/3) – avascular" },
  "Functions:",
  { sub: "Load transmission – distribute 60–70% of compressive load" },
  { sub: "Shock absorption, joint lubrication, proprioception" },
  { sub: "Deepens articular surface – secondary stabiliser" },
],
"https://upload.wikimedia.org/wikipedia/commons/thumb/0/09/Meniscus.svg/640px-Meniscus.svg.png",
"Superior view of tibial plateau showing medial & lateral menisci", "right");

// 13. Section: Extra-articular
addSectionDivider("EXTRA-ARTICULAR STRUCTURES");

// 14. MCL Complex
addContentSlide("Medial Collateral Ligament (MCL) Complex", [
  "Three components: superficial MCL (sMCL), deep MCL, posterior oblique ligament (POL)",
  "sMCL: origin – proximal & posterior to medial femoral epicondyle; inserts – proximal medial tibia",
  { sub: "Primary restraint to valgus stress (67%) and external rotation" },
  "Deep MCL: vertical capsular thickening with meniscofemoral & meniscotibial portions",
  { sub: "Attaches just below medial tibial plateau cartilage" },
  "POL: from semimembranosus insertion, reinforces posteromedial capsule",
  "Posteromedial Corner (PMC):",
  { sub: "POL + SM tendon expansions + oblique popliteal ligament + posterior medial capsule" },
  "Dynamic reinforcement: pes anserinus, vastus medialis obliquus, SM expansions",
],
"https://cdn.orris.care/cdss_images/bfddd510eae00abb4dd986e9ac91a2cdb69de543c1af456675c04061222f596f.png",
"Medial-side structures: SMCL, POL, SM, medial meniscus (Rockwood & Green)", "right");

// 15. Lateral & Posterolateral Corner
addContentSlide("Lateral Collateral Ligament & Posterolateral Corner (PLC)", [
  "Fibular Collateral Ligament (FCL / LCL): femur → fibular head (~70 mm, extracapsular)",
  { sub: "Origin: 1.4 mm proximal & 3.1 mm posterior to lateral epicondyle" },
  { sub: "Primary restraint to varus stress; resists external tibial rotation" },
  "PLC key structures: FCL, Popliteus tendon, Popliteofibular ligament (PFL)",
  "Popliteus complex: dynamic internal tibial rotator",
  { sub: "Popliteus muscle → tendon → arises from femur in popliteal groove" },
  { sub: "PFL connects popliteus tendon to fibular head" },
  "Iliotibial Band (ITB): inserts at Gerdy's tubercle; three layers (superficial, deep, capsulo-osseous)",
  { sub: "Kaplan fibers restrain internal tibial rotation, especially in ACL-deficient knee" },
  "Biceps femoris: direct (styloid) & anterior (tibial plateau) arms; important lateral dynamic stabiliser",
  "Common peroneal nerve lies 1.5–2 cm distal to fibular styloid deep to biceps",
], null, null);

// 16. Section: Muscles
addSectionDivider("MUSCLES OF THE KNEE");

// 17. Extensor Mechanism
addContentSlide("Extensor Mechanism – Quadriceps", [
  "Four components forming 3-layered tendon inserting on patella:",
  { sub: "Anterior layer: Rectus femoris (antero-superior patella)" },
  { sub: "Middle layer: Vastus medialis & vastus lateralis (oblique fibres)" },
  { sub: "Deep layer: Vastus intermedius (posterior edge of proximal pole)" },
  "Quadriceps tendon: mean length 86.9 mm, thickness 8.5 mm proximal to patella",
  "Medial retinaculum (VMO): medial patellar tracking; prevents lateral subluxation",
  "Lateral retinaculum: from vastus lateralis to ITB; when tight causes patellar tilt",
  "Patellar tendon (ligamentum patellae): patella apex → tibial tubercle, 4–5 cm long",
  "Nerve supply: Femoral nerve (L2–L4)",
  "Action: Extension of knee; RF also flexes hip",
], null, null);

// 18. Flexors
addTwoColSlide(
  "Flexors of the Knee",
  [
    "HAMSTRINGS (posterior thigh)",
    "Biceps femoris (long + short head)",
    "  → Knee flexion, external rotation",
    "Semitendinosus → Pes anserinus",
    "  → Knee flexion, internal rotation",
    "Semimembranosus → PM tibia",
    "  → Knee flexion; tenses posterior capsule via OPL",
    "Nerve: Sciatic (L5-S2)",
  ],
  [
    "OTHER FLEXORS",
    "Gastrocnemius (medial + lateral head)",
    "  → Spans posterior knee; also plantarflexes",
    "  → Nerve: Tibial nerve (S1-S2)",
    "Popliteus – 'Unlocks' the knee",
    "  → Internal tibial rotation (last 5° extension)",
    "  → Nerve: Tibial nerve (L4-S1)",
    "Gracilis – via pes anserinus",
    "Sartorius – via pes anserinus",
    "  (both: obturator/femoral, L2-L3)",
  ],
  "Medial Compartment",
  "Posterior / Other"
);

// 19. Pes Anserinus
addContentSlide("Pes Anserinus", [
  "Conjoined tendon of Sartorius, Gracilis, Semitendinosus on proximal medial tibia",
  "Mnemonic: 'Say Grace before Tea'",
  "Located ~2 cm below medial joint line, anterior to sMCL",
  "Functions:",
  { sub: "Primary flexors of knee with secondary internal rotation" },
  { sub: "Protect against rotary and valgus stress at knee" },
  { sub: "Recent data: sectioning semitendinosus alone increases valgus laxity at 0° and 30°" },
  "Pes anserinus bursa: located between tendons and MCL",
  { sub: "Bursitis common in obese, osteoarthritic, diabetic patients" },
  { sub: "Presents as medial knee pain 2–3 cm distal to joint line" },
  "Clinically important when harvesting semitendinosus/gracilis for ACL reconstruction",
], null, null);

// 20. Semimembranosus Expansions
addContentSlide("Semimembranosus – Five Distal Expansions", [
  "1. Oblique popliteal ligament (OPL): PM tibia → laterally to lateral gastrocnemius head",
  { sub: "Key posterior capsule stabiliser; can be tightened surgically" },
  "2. Expansion to posterior capsule",
  "3. Direct tibial insertion (primary) – posteromedial tibia",
  "4. Expansion to deep MCL",
  "5. Expansion to posterior horn of medial meniscus",
  "Dynamic tightening of posterior capsule with SM contraction",
  "Clinical relevance: SM is the cornerstone of posteromedial corner reconstruction",
  "OPL disruption leads to posterior instability and knee hyperextension",
],
"https://cdn.orris.care/cdss_images/751ab266bee1daa0b15f387d10c6a835fe2bd342c9d89eb0b55c7fdbeaa338ab.png",
"Medial supporting structures of the knee (Campbell's Operative Orthopaedics)", "right");

// 21. Section: Neurovascular
addSectionDivider("NEUROVASCULAR STRUCTURES");

// 22. Popliteal Artery
addContentSlide("Arterial Supply – Popliteal Artery", [
  "Continuation of femoral artery through the adductor hiatus",
  "Deepest structure in popliteal fossa – difficult to palpate (requires deep pressure)",
  "Descends obliquely; divides at lower border of popliteus into:",
  { sub: "Anterior tibial artery (through interosseous membrane)" },
  { sub: "Posterior tibial artery (continues in posterior compartment)" },
  "Branches in popliteal fossa:",
  { sub: "Superior medial & lateral geniculate arteries" },
  { sub: "Middle geniculate artery – supplies cruciate ligaments" },
  { sub: "Inferior medial & lateral geniculate arteries" },
  { sub: "Anterior & posterior tibial recurrent arteries" },
  "Geniculate anastomosis around knee joint",
  "Clinical: popliteal artery is at risk in posterior knee dislocations (~20–30%)",
], null, null);

// 23. Venous & Lymphatic
addContentSlide("Venous Drainage & Lymphatics", [
  "Popliteal vein: superficial to popliteal artery in popliteal fossa",
  { sub: "Exits superiorly through adductor hiatus → femoral vein" },
  { sub: "Receives small saphenous vein (pierces roof of popliteal fossa)" },
  "Posterior cutaneous nerve of thigh descends through popliteal fossa roof",
  "Deep lymphatics: follow popliteal vessels → popliteal nodes → deep inguinal nodes",
  "Superficial lymphatics: medial side → superficial inguinal nodes",
  "Baker's cyst (popliteal cyst):",
  { sub: "Herniation of joint synovium through posterior capsule between medial gastrocnemius and semimembranosus" },
  { sub: "Common in adults with intra-articular pathology (meniscal tear, OA)" },
  { sub: "May compress popliteal vein → DVT-like presentation" },
], null, null);

// 24. Nerve Supply
addContentSlide("Nerve Supply of the Knee", [
  "Femoral nerve (L2–L4):",
  { sub: "Via branches to vastus medialis, intermedius, lateralis, RF" },
  { sub: "Saphenous nerve (terminal sensory branch) – medial knee & leg" },
  "Sciatic nerve – divides above popliteal fossa into:",
  { sub: "Tibial nerve (L4–S3): motor to posterior compartment, sensory to sole" },
  { sub: "Common peroneal nerve (L4–S2): passes lateral to fibular neck" },
  "Common peroneal (fibular) nerve:",
  { sub: "Divides into superficial peroneal (eversion + dorsum sensation) & deep peroneal (dorsiflexion, web space)" },
  { sub: "At risk in fibular neck fractures, lateral knee surgery, peroneal nerve palsy" },
  "Obturator nerve: posterior division provides articular branch to knee",
  "Hilton's Law: nerves supplying muscles crossing a joint also supply that joint",
], null, null);

// 25. Popliteal Fossa
addTwoColSlide(
  "Popliteal Fossa – Boundaries & Contents",
  [
    "BOUNDARIES",
    "Superomedial: Semimembranosus",
    "Superolateral: Biceps femoris",
    "Inferomedial: Medial head of gastrocnemius",
    "Inferolateral: Lateral head of gastrocnemius & plantaris",
    "Roof: Superficial fascia + skin (small saphenous vein + posterior cutaneous nerve of thigh)",
    "Floor: Popliteal surface of femur, capsule, popliteus",
  ],
  [
    "CONTENTS (Superficial → Deep)",
    "1. Popliteal lymph nodes",
    "2. Posterior cutaneous nerve of thigh",
    "3. Tibial nerve",
    "4. Common peroneal nerve",
    "5. Popliteal vein",
    "6. Popliteal artery (deepest)",
    "Fat",
    "Mnemonic: 'N (nerve) before V (vein) before A (artery) – Never Very Awkward'",
  ],
  "Boundaries",
  "Contents"
);

// 26. Section: Bursae
addSectionDivider("BURSAE OF THE KNEE");

// 27. Bursae
addTwoColSlide(
  "Bursae Around the Knee Joint",
  [
    "ANTERIOR BURSAE",
    "Suprapatellar bursa – between quadriceps & femur; communicates with joint",
    "Prepatellar bursa – between patella & skin ('housemaid's knee')",
    "Superficial infrapatellar bursa – between patellar tendon & skin",
    "Deep infrapatellar bursa – between patellar tendon & tibial tubercle",
  ],
  [
    "POSTERIOR & MEDIAL",
    "Popliteal (Baker's) cyst – between medial gastrocnemius & semimembranosus",
    "Semimembranosus bursa – overlying SM insertion",
    "Pes anserinus bursa – below conjoined insertion, over MCL",
    "Iliotibial band bursa – between ITB & lateral femoral condyle",
    "Biceps femoris bursa – beneath biceps tendon",
  ],
  "Anterior",
  "Posterior & Medial/Lateral"
);

// 28. Section: Applied
addSectionDivider("APPLIED ANATOMY & CLINICAL CORRELATES");

// 29. ACL Injury
addClinicalSlide("ACL Injury – Applied Anatomy", [
  "Most commonly injured ligament; non-contact pivot deceleration mechanism",
  "Unhappy Triad (O'Donoghue): ACL + MCL + medial meniscus (now: ACL + MCL + lateral meniscus more common)",
  "Lachman Test (best): 20–30° flexion, anterior tibial draw – sensitivity ~85%",
  "Pivot Shift Test: internal rotation + valgus – anterior subluxation of lateral plateau reduced with flexion",
  "Anterolateral ligament (ALL) tear accompanies ACL in ~85% of rotational injuries → Segond fracture",
  "MRI: T2 signal loss, wavy course; bone bruise at lateral femoral condyle + lateral tibial plateau",
  "Reconstruction: graft options – patellar tendon (BTB), hamstring (ST/G), quadriceps tendon",
  "Graft placed through tibial tunnel (anterior to PCL) and femoral tunnel (posterior to anterior wall of notch)",
]);

// 30. PCL & Posterior Instability
addClinicalSlide("PCL & Knee Dislocation – Applied Anatomy", [
  "PCL injury: dashboard injury mechanism; posterior drawer test, sag sign (Godfrey's test)",
  "Isolated PCL injuries: often managed conservatively with good outcomes",
  "Multi-ligament injury (knee dislocation): ligaments torn in 2 or more planes",
  "Popliteal artery injury occurs in 20–30% of knee dislocations – ABI <0.9 mandates CT angiogram",
  "Peroneal nerve injury: 15–25% of knee dislocations; at risk in posterolateral corner injuries",
  "Spontaneous reduction common – high index of suspicion needed",
  "Arcuate sign (fibular head avulsion): indicates posterolateral corner injury",
  "Reverse pivot shift test: posterolateral instability",
  "Surgical management: reconstruction within 3 weeks recommended; PCL reconstructed first",
]);

// 31. Patellofemoral
addClinicalSlide("Patellofemoral Disorders – Applied Anatomy", [
  "Q-angle: line from ASIS to patella center vs. line from tibial tubercle to patella center; normal <20° (F), <15° (M)",
  "High Q-angle → increased lateral patellar force → subluxation risk",
  "Medial Patellofemoral Ligament (MPFL): primary restraint to lateral patellar displacement (50–60%)",
  "MPFL ruptures at femoral attachment in acute patellar dislocation (90%)",
  "Patellar height: Insall-Salvati ratio = patellar tendon length / patella length (normal ~1.0)",
  "Patella alta (>1.2): predisposes to recurrent dislocation",
  "Patella baja (<0.8): after tibial tubercle osteotomy or quadricepsplasty",
  "Sinding-Larsen-Johansson disease: traction apophysitis at inferior patella pole (adolescents)",
  "Osgood-Schlatter disease: traction apophysitis at tibial tubercle (adolescent males)",
]);

// 32. Meniscal Applied
addClinicalSlide("Meniscal Injuries – Applied Anatomy", [
  "Medial meniscus tears more common (less mobile, firmly attached)",
  "Lateral meniscus tears more common in ACL-deficient knee",
  "Bucket-handle tear: vertical longitudinal – can displace centrally, blocks extension",
  "McMurray's test: rotation + valgus/varus with flexion – click/pain at joint line",
  "Thessaly test: single-leg knee bend at 20° + rotation – sensitivity 90% for medial tears",
  "MRI criterion: Grade 3 signal reaching articular surface = tear",
  "Posterior horn medial meniscus – most common tear site",
  "Repair vs. resection: repair in vascular zone (outer 1/3), young patients",
  "Total meniscectomy → 50% reduction in tibiofemoral contact area → accelerated OA",
  "Discoid lateral meniscus: Wrisberg variant – posterior instability, snapping knee",
]);

// 33. Popliteal Fossa Clinical
addClinicalSlide("Popliteal Fossa & Neurovascular – Applied Anatomy", [
  "Baker's cyst: transilluminates, fluctuant posterior knee swelling; MRI confirms – treat underlying intra-articular pathology",
  "Popliteal artery aneurysm: most common peripheral artery aneurysm; associated with aortic/femoral aneurysms",
  "Complications: thrombosis, distal embolization, leg ischaemia; diagnose with duplex Doppler",
  "Peroneal nerve palsy: foot drop + loss of eversion + sensory loss in dorsum – at fibular neck",
  "Common peroneal nerve injured by: tight plaster cast, prolonged squatting, fibula fracture, lateral knee surgery",
  "Tibial nerve entrapment (tarsal tunnel) distal, but common peroneal is the classic knee-level nerve injury",
  "Saphenous nerve: injured in medial knee approach; causes medial leg paraesthesia",
  "Obturator nerve referred pain: hip pathology may present as medial knee pain (Hilton's Law)",
]);

// 34. Biomechanics
addContentSlide("Biomechanics – Screw-Home Mechanism & Stability", [
  "Knee range of motion: 0° (full extension) to ~135–140° (full flexion); ~10° hyperextension in some",
  "Screw-Home mechanism:",
  { sub: "Terminal ~5° of extension: automatic external tibial rotation (or internal femoral rotation)" },
  { sub: "Locks the knee in full extension for energy-efficient standing" },
  { sub: "Unlocked by popliteus – 'key that unlocks the knee'" },
  "Medial condyle is longer → tibia externally rotates as it reaches full contact",
  "Biomechanical axis: line from hip centre → knee centre → ankle centre",
  { sub: "Normal valgus alignment ~6° at knee" },
  "Joint reaction force in knee during walking: 2–3× body weight; stair climbing: 4–5×",
  "PCL force is maximal at 90° knee flexion",
  "MCL acts as primary restraint to valgus and external rotation",
], null, null);

// 35. Summary / Closing
const sSummary = pres.addSlide();
sSummary.background = { color: WHITE };
sSummary.addShape(pres.ShapeType.rect, {
  x: 0, y: 0, w: 10, h: 0.72, fill: { color: ACCENT }, line: { type: "none" }
});
sSummary.addText("Key Takeaways", {
  x: 0.3, y: 0, w: 9.4, h: 0.72,
  fontSize: 22, fontFace: "Calibri", bold: true, color: WHITE, valign: "middle"
});
const keyPoints = [
  { text: "Osseous:", options: { bold: true, fontSize: 15, fontFace: "Calibri", color: ACCENT, breakLine: false } },
  { text: " Eccentric femoral condyles, concave/convex tibial plateaus, sesamoid patella – all contribute to stability & motion", options: { fontSize: 14, fontFace: "Calibri", color: BLACK, breakLine: true, paraSpaceAfter: 6 } },
  { text: "Ligaments:", options: { bold: true, fontSize: 15, fontFace: "Calibri", color: ACCENT, breakLine: false } },
  { text: " ACL (anterior translation), PCL (posterior translation), MCL (valgus), LCL (varus)", options: { fontSize: 14, fontFace: "Calibri", color: BLACK, breakLine: true, paraSpaceAfter: 6 } },
  { text: "Menisci:", options: { bold: true, fontSize: 15, fontFace: "Calibri", color: ACCENT, breakLine: false } },
  { text: " Load distribution, stability, shock absorption; inner 1/3 avascular", options: { fontSize: 14, fontFace: "Calibri", color: BLACK, breakLine: true, paraSpaceAfter: 6 } },
  { text: "Muscles:", options: { bold: true, fontSize: 15, fontFace: "Calibri", color: ACCENT, breakLine: false } },
  { text: " Quadriceps (extension), Hamstrings + gastrocnemius (flexion), Popliteus (unlocking)", options: { fontSize: 14, fontFace: "Calibri", color: BLACK, breakLine: true, paraSpaceAfter: 6 } },
  { text: "Neurovascular:", options: { bold: true, fontSize: 15, fontFace: "Calibri", color: ACCENT, breakLine: false } },
  { text: " Popliteal artery (deepest), Tibial & common peroneal nerves (sciatic bifurcation)", options: { fontSize: 14, fontFace: "Calibri", color: BLACK, breakLine: true, paraSpaceAfter: 6 } },
  { text: "Clinical pearls:", options: { bold: true, fontSize: 15, fontFace: "Calibri", color: RED, breakLine: false } },
  { text: " Popliteal artery in knee dislocations, peroneal nerve at fibular neck, MPFL in patellar instability", options: { fontSize: 14, fontFace: "Calibri", color: BLACK, breakLine: false } },
];
sSummary.addText(keyPoints, { x: 0.35, y: 0.85, w: 9.3, h: 4.7, valign: "top", wrap: true });

// ─── WRITE FILE ────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/knee-anatomy-ppt/Functional_Anatomy_of_the_Knee.pptx" })
  .then(() => console.log("SUCCESS: PPT created"))
  .catch(e => { console.error("ERROR:", e); process.exit(1); });

cd /home/daytona/workspace/knee-anatomy-ppt && node create_ppt.js 2>&1

ls -lh /home/daytona/workspace/knee-anatomy-ppt/