1. The Knee (Tibiofemoral Joint)By
Todd Piraino
Tammi Wells
Holly Cox

2. Quadriceps femoris tendon
Connects the quadriceps femoris muscles to the superior aspects of the patella. Controls knee flexion and extension

3. Patellar ligament
Connects Patella to the tuberosity of the Tibia.

4. Oblique popliteal ligament
A strong broad flat fibrous ligament that pass obliquely across and strengthens the posterior part of the knee.

5. Arcuate Popliteal Ligament
A triangular band in the posterior part of the knee that passes medially downward from the lateral condyle of the femur to the area between the condyles of the tibia and to the head of the fibula

6. Tibial collateral ligament and Fibular collateral ligament
Tibial Collateral ligament also known as Medial Collateral ligament or MCL.
Fibular Collateral ligament is located on the lateral side of the knee.

7. Anterior Cruciate Ligament and Posterior Cruciate Ligament
The function of the ACL is to provide stability to the knee. It limits rotational movements of the knee and restrains excessive extension of the lower leg.
PCL prevents the Tibia from sliding to far backwards in relation to the Femur. Stronger of the two cruciate ligaments.

8. Transverse Ligament
Connects the Anterior margin of the lateral meniscus to the anterior end of the medial meniscus.

9. Prepatellar Bursa, Deep Infrapatellar Bursa, Supra Patellar Bursa, Subcutaneous Infrapatellar Bursa
Bursa are fluid filled capsules that prevent friction between tissues in joints.

10. Lateral Meniscus and Medial Meniscus
The Meniscus are fibrocartilage that separate the Tibia and Femur to decrease contact area between the bone. Acts as a shock absorber and reduces friction between the two bones.

11. Femur: Lateral Condyle, Medial Condyle, Intercondylar Fossa.
Condyles of the Femur articulate with the Tibia
Lateral
Condyle
Medial
Condyle
Intercondylar Fossa

12. Femur: Lateral Epicondyle, Medial Epicondyle
Epicondyles are not part of the articulating surface. Main purpose is attachment points for ligaments and tendons.
Lateral
Epicondyle
Medial
Epicondyle

13. Tibia: Lateral Condyle, Medial Condyle, Intercondylar Eminence.
Articulate with the Femur.
Intercondylar Eminence

14. Tibial Tuberosity and Head of Fibula

15. Buckwheat says, “Otay, that’s gonna leave a mark.”

16. This guy is probably hearing the sound of popcorn coming from his knee.

17. More sound of popcorn.
Most likely a torn ACL

18. ACL Injury
Most common type of Knee injury. Hyperextension is the main cause. Torn ACL’s are most often related to high impact sports or when the knee is forced to make sharp changes in movement during sudden stops from high speed. Very prevalent in Alpine skiing, Soccer, Rugby, Hockey, and martial arts.

19. Repair of ACL
It has become an outpatient operation with many people returning home the day of the surgery and bearing weight within a week.

21. Surface Anatomy
Popliteal fossa- a mostly fat-filled diamond shaped space posterior to the knee. All the important nerves and vessels from the thigh to the leg pass through this fossa.
Patella- (knee cap) is a small, triangular bone located anterior to the knee joint. It articulates with the patellar surface of the femur.

22. Surface Anatomy
*The soleus is a long flat muscle that runs down the posterior of the lower leg, underneath the gastrocnemius.
*The gastrocnemius creates the distinctive shape of the calf and is an important muscle for overall leg development and symmetry. Gastrocnemius is Greek means ‘The belly of the calf’.
The medial head is the inner head of the two gastrocnemius heads that are located at the rear of the lower leg.
The lateral head is the outer head of the two gastrocnemius heads.
Medial head of
Lateral head of

23. Surface Anatomy
The hamstrings are located on the posterior aspect of the thigh.
It is made up of the
Semitendinosus
Semimembranosus
Biceps femoris
*******
Point of attachments for the
Semimembranosus tendon
Semitendinosus tendon
Biceps femoris tendon

24. Surface Anatomy
Vastus lateralis is the largest component of the quadriceps, located on the lateral aspect of the thigh.
Vastus medialis covers the medial aspect of the thigh
The Quadriceps femoris consists of four muscles:
Rectus femoris
Vastus lateralis
Vastus intermedius
Vastus medialis

25. Surface Anatomy Popliteal fossa Lateral head of Gastrocnemius
Medial head of Gastronemius
Soleus

26. Popliteal Fossa
The popliteal fossa is a fat-filled diamond shaped shallow depression which is posterior to the knee.
All the important nerves and vessels from the thigh to the leg pass through the popliteal fossa.

27. Arteries of knee
The major blood vessels around the knee travel with the popliteal nerve down the back of the leg.
The popliteal artery and popliteal vein are the largest blood supply to the leg and foot.
If the popliteal artery is damaged beyond repair, it is very likely the leg will not be able to survive

28. Arteries ( and muscles they innervate)
Femoral artery
Popliteal artery
(Popliteus, Gastrocnemius)
Posterior tibial artery
Dorsalis pedis
Fibular (peroneal)
Anterior tibial artery
Lateral circumflex femoral artery
(Rectus femoris, Vastus intermedialis,
Vastus lateralis, Vastus medialis)
Medial circumflex femoral artery
Inferior gluteal artery
(Biceps femoris, Semimembranosus)
Deep femoral artery (profunda)
(Semitendinosus)

29. Veins Anterior tibial vein Posterior tibial vein
Fibular (peroneal vein)
Popliteal vein
Femoral vein
Small saphenous vein
Great saphenous vein

30. Wire man Femoral artery Popliteal artery Fibular (peroneal) artery
Femoral vein
Femoral artery
Popliteal vein
Popliteal artery
Small saphenous vein
Fibular (peroneal) artery
Fibular (peroneal) vein
Anterior tibial artery
Great Saphenous vein
Posterior tibial artery
Anterior tibial vein
Posterior tibial vein
Dorsalis pedis

31. Flat Man …………NERVES *Femoral nerve *Sciatic nerve Common fibular nerve
Semitendinosus, Semimembranous
Biceps femoris (long head)
Rectus Femoris
Vastus intermedialis
Vastus lateralis
Vastus medialis
Common fibular nerve
*Deep fibular nerve (peroneal)
Biceps femoris (long head)
*Superficicial fibular nerve (peroneal)
*Tibial nerve
Gastrocnemius, Popliteus

32. Classroom Models Inguinal ligament External iliac artery Femoral nerve
Femoral artery

33. Classroom models External iliac artery Femoral nerve Inguinal ligament
Femoral artery
Femoral vein
Anterior tibial artery
Deep fibular nerve (peroneal)
Dorsalis pedis artery

34. Classroom Models Tibial nerve Sciatic nerve Common fibular
(peroneal) nerve
Popliteal vein
Popliteal artery
Tibial nerve
Posterior tibial artery
Tibial nerve

35. Classroom Models
Sciatic nerve
Tibial nerve

36. KNEE
MUSCLES

37. ANTERIOR KNEE MUSCLES
Function as extensors

38. Quadriceps Femoris: *largest muscle in the body, consists of 4 muscles

39. Rectus Femoris: Most anterior of quadriceps
Origin: Anterior Inferior Iliac Spine
Insertion: Tibial Tuberosity
Innervation: Femoral Nerve
Vascular Supply: Lateral Circumflex Femoral Artery

40. Action:
Hip flexion
Knee extension

41. Vastus Medialis Origin: Linea Aspera Insertion:
Tibial Tuberosity via Patellar Tendon
Innervation:
Femoral Nerve
Vascular Supply:
Lateral Circumflex Femoral Artery

42. Action:
Knee extension

43. Vastus Intermedialis Origin: Anterior Femur
Insertion: Tibial Tuberosity via Patellar Tendon
Innervation: Femoral Nerve
Vascular Supply: Lateral Circumflex Femoral Artery

44. Action:
Knee extension

45. Vastus lateralis: Origin: Linea Aspera Insertion:
Tibial tuberosity via Patellar Tendon
Innervation:
Femoral Nerve
Vascular Supply:
Lateral Circumflex Femoral Artery
Vastus
Lateralis

46. Action:
Knee Extension

47. POSTERIOR KNEE MUSCLES

48. (named due to tendons being long and stringlike in popliteal area)
HAMSTRINGS: composed of Biceps Femoris, Semimembranous and Semitendinosus Function as flexors
(named due to tendons being long and stringlike in popliteal area)

49. Ah, those hamstrings… Or not?? See how they work?
**This is the torn version that we don’t need to know.

50. Biceps Femoris-long head:
Origin:
Ischial Tuberosity
Insertion:
Fibular Head
Innervation:
Sciatic Nerve
Vascular Supply:
Inferior Gluteal Artery

51. Action:
Hip extension
Knee flexion

52. Biceps Femoris – Short Head:
Origin:
Lateral Lip of Linea Aspera
Insertion:
Fibular Head
Innervation:
Common Peroneal Nerve
Vascular Supply:
Inferior Gluteal Artery

53. Action:
Knee flexion

54. Semimembranosus: Origin: Ischial Tuberosity Insertion:
Posterior surface of Medial Condyle of Tibia
Innervation:
Sciatic Nerve
Vascular Supply:
Inferior Gluteal Artery

55. Action:
Extend hip
Flex knee

56. Semitendinosus: Origin: Ischial Tuberosity Insertion:
Anteromedial surface of proximal Tibia
Innervation:
Sciatic Nerve
Vascular Supply:
Deep Femoral Artery

57. Action:
Extend hip
Flex knee

58. Posterior Distal Knee Muscles:
- Flexors

59. Popliteus: Origin: Lateral Condyle of Femur Insertion:
Posteriorly on Medial Condyle of Tibia
Innervation:
Tibial Nerve
Vascular Supply:
Popliteal Artery

60. Action:
Initiates knee flexion by unlocking the knee when fully extended

61. Gastrocnemius: Innervation: Origin: Tibial Nerve
Vascular Supply:
Popliteal Artery
Origin:
Medial and Lateral Condyles of Femur
Insertion:
Posterior Calcaneus
The reason for high heels?

62. Action: Ankle plantar flexion when knee extended
Raises heel while walking with knee extended
Action:
OR…
(Sorry, couldn’t resist!)

63. Action:
Knee flexion
(Basketball players learning Charleston)

64. BFB:
Bye
From
Bob

65. References www. getfittogolf. com. au physiomed. patientsite. com www
References physiomed.patientsite.com