introduction to anatomy of the kneeuelplus0
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Introduction to AnatomyIntroduction to Anatomy
of the Kneeof the KneeIMSIMS
PT1012PT1012
2009-20102009-2010D.ReidD.Reid
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Learning Outcomes:Learning Outcomes:
By the end of this session you should be ableBy the end of this session you should be able
to:to:
1. Identify the articular surfaces of the knee joint.1. Identify the articular surfaces of the knee joint.
2. Identify the major ligaments of the knee joint.2. Identify the major ligaments of the knee joint.
3. Describe the movements at the knee joint.3. Describe the movements at the knee joint.
4. Identify the major muscle groups around the knee4. Identify the major muscle groups around the knee
joint. joint.
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The KneeThe Knee
Articulation between the thigh and the leg. Articulation between the thigh and the leg.
Femur, tibia and patella are involved in theFemur, tibia and patella are involved in the
joint. The fibula is NOT part of the knee!! joint. The fibula is NOT part of the knee!!
Primarily a modified hinge joint with thePrimarily a modified hinge joint with the
main motion occurring in the sagittal plane.main motion occurring in the sagittal plane.
Stability is dependent upon the ligamentsStability is dependent upon the ligaments
connecting the femur to the tibia and theconnecting the femur to the tibia and the
musclesmuscles which cross the joint.which cross the joint.
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Bony Articulations of Femur Bony Articulations of Femur
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Bony Articulations of TibiaBony Articulations of Tibia
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Anterior Aspect of the Knee Anterior Aspect of the Knee
1. Femur
2. Adductor Tubercle
3. Medial Epicondyle
4. Medial Condyle
5. Base of Patella
6.Apex of Patella
7. Lateral Condyle
8. Lateral Epicondyle
9. Medial Condyle Tibia
10. Tibial Tuberosity
12. Lateral Condyle Tibia
13. Superior Tibiofibular Joint
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The MenisciThe Menisci
Two separate, fibrocartilage discs lieTwo separate, fibrocartilage discs lie
between the tibial and femoral condylesbetween the tibial and femoral condyles
Attached to the tibia via their anterior Attached to the tibia via their anterior and posterior hornsand posterior horns
Lateral meniscus is almost a full circleLateral meniscus is almost a full circle
Medial meniscus is C-shapedMedial meniscus is C-shaped Attached anteriorly via a transverse Attached anteriorly via a transverse
ligamentligament
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Functions of MenisciFunctions of Menisci
Enhance stability by deepening contactEnhance stability by deepening contact
surface on the tibia.surface on the tibia.
Participate in shock absorption.Participate in shock absorption. Protect underlying articular cartilage andProtect underlying articular cartilage and
subchondral bone.subchondral bone.
Enhance lubrication of the joint.Enhance lubrication of the joint. Limit motion between tibia and femur.Limit motion between tibia and femur.
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Transverse section of Tibial PlateauTransverse section of Tibial Plateau
showing Meniscishowing Menisci8. Medial Condyle
tibia
11. Lateral Condyle
18. Medial Collateral
Ligament
19. Medial Meniscus
20. Posterior
Cruciate Ligament
21. Anterior Cruciate
Ligament
23. Lateral meniscus
24. Lateral CollateralLigament
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Major Ligaments of the Knee jointMajor Ligaments of the Knee jointIntracapsular:Intracapsular:
Ligamentum PatellaeLigamentum Patellae
Anterior Cruciate Ligament (ACL)- Prevents tibia moving Anterior Cruciate Ligament (ACL)- Prevents tibia moving
forward on femur. Anterior Drawer test to assess.forward on femur. Anterior Drawer test to assess.
Posterior Cruciate Ligament (PCL)- Prevents tibia movingPosterior Cruciate Ligament (PCL)- Prevents tibia moving
backwards on femur. Posterior Drawer test to assess.backwards on femur. Posterior Drawer test to assess.
Extracapsular:Extracapsular:
Lateral (Fibular) Collateral- Round, cord-like, strong. Lateral femoralLateral (Fibular) Collateral- Round, cord-like, strong. Lateral femoralepicondyle to head of fibula. Varus stress test to assess.epicondyle to head of fibula. Varus stress test to assess.
Medial (Tibial) Collateral-Flat band. Medial femoral epicondyle to medialMedial (Tibial) Collateral-Flat band. Medial femoral epicondyle to medial
condyle of tibia. Attaches to medial meniscus. Valgus stress test tocondyle of tibia. Attaches to medial meniscus. Valgus stress test to
assess.assess.
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Anterior Anterior
Aspect of Aspect of KneeKnee
3. Medial Femoral
Epicondyle
8. Lateral Femoral
Epicondyle
17. Medial Ligament
18. Medial Meniscus
19. Anterior Cruciate
21. Posterior Cruciate
22. Lateral Meniscus
24. Lateral Ligament
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Posterior Posterior
Aspect of the Aspect of theKneeKnee
3. Medial Femoral
Epicondyle
7. Lateral FemoralEpicondyle
18. Medial Ligament
19. Medial Meniscus
20. Posterior Cruciate
21. Anterior Cruciate
23. Lateral Meniscus24. Lateral Ligament
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Bursae of the KneeBursae of the Knee
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Bursa and Fat PadBursa and Fat Pad
Bursa
Blue
Fat Pad
Greenish
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Muscle Action at the KneeMuscle Action at the Knee
ExtensionExtension
QuadricepsQuadriceps – Rectus femorisRectus femoris
– Vastus lateralisVastus lateralis – Vastus intermediusVastus intermedius
– Vastus medialisVastus medialis
Tensor fasciae lataeTensor fasciae latae
and Gluteus maximusand Gluteus maximusvia Iliotibial tractvia Iliotibial tract
FlexionFlexion
HamstringsHamstrings – Biceps femorisBiceps femoris
– SemimembranosusSemimembranosus – SemitendinosusSemitendinosus
GracilisGracilis
SartoriusSartorius
GastrocnemiusGastrocnemius
PopliteusPopliteus
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RotationRotation
MedialMedial
PopliteusPopliteus
SemitendinosusSemitendinosus
SemimembranosusSemimembranosus
SartoriusSartorius
GracilisGracilis
LateralLateral
Biceps femorisBiceps femoris
TFL and Glut.TFL and Glut.
MaximusMaximus
Rotation is only possible when the knee is flexed
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Musculature around the KneeMusculature around the Knee
Anterior Aspect Anterior Aspect
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Muscle Insertions around the KneeMuscle Insertions around the Knee
Posterior AspectPosterior Aspect
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Musculature around the KneeMusculature around the Knee
Posterior aspectPosterior aspect
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Musculature around the KneeMusculature around the Knee
Posterior aspectPosterior aspect
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Blood Supply around the KneeBlood Supply around the Knee
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Common BiomechanicalCommon Biomechanical
Deformities of the KneeDeformities of the Knee
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SummarySummary
Modified Hinge type of synovial jointModified Hinge type of synovial joint
Articulation between femur, tibia and patella Articulation between femur, tibia and patella
Patella articulates with the femur Patella articulates with the femur
Menisci on tibial condyles aid shockMenisci on tibial condyles aid shockabsorption, deepen articular surfaceabsorption, deepen articular surface
Stability is dependent on ligaments (mainlyStability is dependent on ligaments (mainly
ACL,PCL, LCL, MCL) and surrounding ACL,PCL, LCL, MCL) and surrounding
musclesmuscles
Functions mainly in sagittal plane in gait witFunctions mainly in sagittal plane in gait wit
some rotation possiblesome rotation possible