Vous êtes sur la page 1sur 26

Structure & Function of the Knee

One of the most complex simple structures in the human body.


The middle child of the lower extremity.
Osteology of the Knee
Distal femur

(ADDuctor tubercle)

Right Femur
Osteology of the Knee

The proximal tibia & fibula


The medial and lateral Fibular Tibial
Head Tuberosity
condyles of the tibia form the
shallow articulations with the
distal femur

The intercondylar/intercondyloid
eminence
the attachment point for the
cruciate ligaments
Interosseous
Membrane
Anatomy of the Knee: Anterior Aspect
Femur
Medial Condyle
Articular Cartilage
Quadriceps Tendon
Tibia
Tibial Plateau
Tibial Tuberosity
Patellar Tendon
Fibula
Medial Meniscus
Lateral Meniscus
Medial Collateral Ligament
Lateral Collateral Ligament
Anatomy of the Knee: Posterior Aspect
Femur
Medial condyle
Lateral condyle
ADDuctor Tubercle
Tibia
Tibial plateau
Fibula
Fibular Head
Medial Meniscus
Lateral Meniscus
Posterior Cruciate Ligament
Lateral Collateral Ligament
Medial Collateral Ligament
Popliteal space
Anatomy of the Knee
Cruciate Ligaments
Anterior: (ACL)
-resists anterior motion of the
tibia on a fixed femur
-resists extremes of knee
extension

Posterior: (PCL)
-resists posterior motion of
the tibia on a fixed femur
-resists extremes of knee
flexion
Anatomy of the Knee: Genu what?
Genu valgum refers to a
frontal deviation of the
position of the knee.
Commonly referred to as
knock-knee due to the
medial displacement of
the knee

Genu varum refers to a


frontal deviation of the
position of the knee.
Commonly referred to as
bow-leg
Anatomy of the Knee: Genu what?
Genurecurvatum:
Hyperextension of the tibiofemoral joint placing
excessive stress on the structures in the popliteal
space

Tibial nerve
Popliteal Vein
Popliteal Artery
Common Peroneal Nerve
Common Pathologies of the Knee
Osgood-Schlatters Chondromalacia of
Disease the Patella
Common Pathologies of the Knee
The menisci:
absorb shock and disperse large compressive forces
through the knee joint
They may not heal well:
inner 1/3: avascular (a)
middle 1/3: poor blood supply (b)
outer 1/3: good blood supply (c)
Myology of the Knee
Your subtopic
Rectus goes here
Femoris
Origin Anterior-inferior iliac spine
Insertion Tibial tuberosity via the quadriceps
tendon
Innervation Femoral n.
Action Hip flexion, knee extension

tidbit One of the heads of the quads


Myology of the Knee
Vastus Medialis
Origin Medial lip of the linea aspera
and the intertrochanterid line
of the femur
Insertion Tibial tuberosity via the
patellar tendon
Innervation Femoral n.
Action Knee extension
tidbit One of the heads of the
quad
VMO one of the first
muscles of the knee to atrophy Vastus
post-operatively, Medialis
responsible for last 10-15o of Obliquus
knee extension
Myology of the Knee
Vastus Lateralis
Origin Lateral lip of the linea aspera,
intertrochanteric line, lateral
region of the gluteal tuberosity
Insertion Tibial tuberosity via the
patellar tendon
Innervation Femoral n.
Action Knee extension
tidbit Part of the quads
Myology of the Knee
Vastus Intermedius
Origin Upper 2/3 of the anterior
femoral shaft

Insertion Tibial tuberosity via the patellar


tendon

Innervation Femoral n.
Action Knee extension
Q Angle of the Knee
The line of force of the quadriceps can be described by
the Q-angle. It identifies patellofemoral tracking.
Females:
-greater angle
-greater incidence
of patellofemoral
joint pain

Q
Angle
Compression at the Patellofemoral Joint
The Patella: Activity Force % Body Pounds of
Weight Force
-also known as the knee cap, is a Walking 850 N 1/2 x BW 100 lbs
thick, circular-triangular bone
which articulates with the femur Bike 850 N 1/2 x BW 100 lbs
and covers and protects the Stair Ascend 1500 N 3.3 x BW 660 lbs
anterior articular surface of the
Stair Descend 4000 N 5 x BW 1000 lbs
knee
Jogging 5000 N 7 x BW 1400 lbs
Squatting 5000 N 7 x BW 1400 lbs
Deep Squatting 15000 N 20 x BW 4000 lbs
To Squat or not to Squat?
Alignment is the key
Balance among the heads
of the quads is critical to
the health of your knees
Myology of the Knee
Your subtopic goes here
Semitendinosus
Origin Ischial tuberosity
Insertion Proximal-medial surface of the tibia
(pes anserinus)
Innervation Tibial portion of the sciatic n.
Action Hip extension, knee flexion,

tidbit One of the hamstrings


Myology of the Knee
Your subtopic
Biceps goes here
Femoris
Origin Ischial tuberosity
Insertion Head of the fibula
Innervation Tibial portion of the sciatic n.
Action Hip extension, knee flexion
tidbit One of the hamstrings

A B C D
Bicep F Bicep F Semimem Semiten
A
Myology of the Knee
Your subtopic goes here
Semimembranosus
Origin Ischial tuberosity
Insertion Medial condyle of the tibia, posterior aspect

Innervation Tibial portion of the sciatic n.


Action Hip extension, knee flexion
tidbit One of the hamstrings
Myology of the Knee
Your subtopic goes here
Sartorius
Origin ASIS
Insertion Proximal-medial surface of the tibia (via
the pes anserinus)
Innervation Femoral n.
Action Hip flexion, hip ABD, Hip ER, knee
flexion
tidbit Longest muscle in the body
Myology of the Knee
Your subtopic goes here
Gracillis
Origin Body and inferior ramus of the
pubis
Insertion Proximal-medial aspect of the
tibia (pes anserinus)
Innervation Obturator n.

Action Hip ADD, hip flexion, knee


flexion
What is the Pes Anserinus?
The semitendinosus, sartorius and gracillis all attach to the proximal
medial tibia through a broad sheet of connective
tissue known as the pes anserinus.

The 3 muscles:
-originate from different
bones on the pelvis
-perform different actions
at the hip
-are innervated by different
nerves

The all perform the following at the knee:


-flexion
-medial stability
Myology of the Knee
Popliteus
Origin Posterior aspect of the
lateral femoral condyle
Insertion Posterior surface of the
proximal tibia
Innervation Tibial n.
Action Initiates knee flexion
Myology of the Knee
Gastrocnemius
Origin Medial head: posterior aspect of the
medial femoral condyle
Lateral head: posterior aspect of the
lateral femoral condyle
Insertion Calcaneal tuberosity via the Achilles
tendon
Innervation Tibial n.
Action Flexion of the knee, plantar flexion,
What can you identify? (in her knee)

Quadriceps
Vastus medialis
Vastus lateralis
Vastus intermedius?
Rectus femoris
Sartorius

Anything else?