CLINICAL ANATOMY OF KNEE JOINT

DESCRIPTION:

Knee Joint, also termed as tibiofibular joint is one of the most important joint in human body which helps in movement and weight bearing. Knee Joint is encased by a capsule filled with fluid called synovial fluid. It is a complex joint contains great clinical significance.

TYPE:

Synovial Hinge Joint

LIGAMENTS AND THEIR FUNCTIONS:

The Ligaments Of Knee Joint are divided under two categories:

      1) Extracapsular Ligaments

      2) Intracapsular Ligaments

EXTRACAPSULAR LIGAMENTS:

LIGAMENTS	FUNCTIONS
Patellar Ligament	Connects Patella with Tibia
Medial Collateral Ligament	Prevents lateral displacement of knee joint
Lateral Collateral Ligament	Prevents medial displacement of knee joint

INTRACAPSULAR LIGAMENTS:

LIGAMENTS	FUNCTIONS
Medial & Lateral Menisci	Act as a shock absorber
Anterior Cruciate Ligament	Prevents the knee from Hyperextension
Posterior Cruciate Ligament	Supports the posterior side of the knee

CLINICAL CASES:

    ·      During sports or any strenous activities, If a blow (any       hard objects) hits the medial side of the knee joint,             Lateral Collateral Ligament will most likely to be           injured.

    ·      During sports or any strenous activities, If a blow              (any hard objects) hits the lateral side of the knee joint,      Medial Collateral Ligament will most likely to be          injured.

    ·      In an accident, in which knee becomes hyperextended      above its normal range of motion, Anterior Cruciate          Ligament will most likely to be teared. (Anterior                Cruciate Ligament injury is common as compared to        Posterior Cruciate Ligament)

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ANTERIOR COMPARTMENT OF THIGH 

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OBJECTIVES:

Identify the muscles of the anterior compartment of thigh in terms of their origin, insertion, nerve supply and actions.

CONTENTS

• Muscles Of The Anterior Compartment Of Thigh
• Their Nerve Supply
• Actions
• Origin Insertion
• Summary

INTRODUCTION:

In order to make study easier, The Anatomy of thigh is studied in three compartments, namely Anterior, Posterior and Medial Compartmant Of Thigh. The discussion topic of this article is the Anterior Compartment Of Thigh.

MUSCLES:

• QUADRICEPS: The major muscle group present in the Anterior compartment of the thigh. Rectus Femoris, Vastus Lateralis, Vastus Medialis and Vastus Intermedius are the muscles forming this group.
• ILIOPSOAS: A small group muscle in the Anterior compartment of the thigh formed by muscles Iliacus, Psoas Major and Psoas Minor. They are termed as one because they share common tendon.
• PECTINEUS
• SARTORIUS

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NERVE SUPPLY

All the muscles of the Anterior compartment of thigh is innervated by Femoral Nerve (L2,L3 and L4) except Psoas Major & Minor, which are innervated by L1, l2 & L3 anterior rami. Femoral nerve the main nerve of lumbar plexuses formed by anterior rami of lumbar 2nd,3rd and 4th nerves.

MUSCLE ACTIONS:

• QUADRICEPS: Extension of leg at knee joint
• ILIOPSOAS: Flexes thigh at hip joint
• PECTINEUS: Flexion, Adduction & assist in medial rotation
• SARTORIUS: At Hip Joint – Flexion, Abduction & Lateral Rotation At Knee Joint – Flexion

ORIGIN AND INSERTION:

• QUADRICEPS: Rectus Femoris Originate from Anterior Inferior Iliac Spine, Vastus Lateralis Originate from greater trochanter & Lateral lip of Linea Aspera, Vastus Medialis Originate from intertrochanteric line & Medial lip of Linea Aspera, Vastus Intermedius Originate from Anterolateral surface of Femur shaft. All the four muscles insert in patella bone by sharing common tendon “Quadriceps Tendon”.
• ILIOPSOAS: Iliacus Muscle Originate from Iliac Crest & Iliac Fossa of Ilium Bone & Insert in Lesser Trochanter of femur. Psoas Major & Minor Orginate from Each side of Thoracic 12th till Lumbar 5 vertebrae & Insert in Lesser Trochanter Of Femur
• PECTINEUS: Originate from Pubis ( Superior Ramus) & Insert in Pectineal Line of Femur bone
• SARTORIUS: Originate from Anterior Superior Iliac Spine & Insert in Superior medial surface of Tibia bone

SUMMARY:

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FEMORAL TRIANGLE:

Femoral Triangle is a hollow space triangle shape anatomical structure present anteriorly on both thighs in the upper medial region.

Location: 
Upper Medial region of both thigh anteriorly.

BOUNDARIES:

SUPERIOR BORDER: Inguinal Ligament

LATERAL BORDER: Sartorius Muscle

MEDIAL BORDER: Adductor Longus Muscle

ROOF: Fascia Lata

FLOOR: Pectineus & Iliopsoas

CONTENTS:

• Femoral Nerve
• Femoral Artery 
• Femoral Vein
• Femoral Lymph nodes

CLINICAL SIGNIFICANCE:

Just below the Inguinal Ligament, femoral artery can be easily palpated in the femoral triangle in order to measure femoral pulse rate. Femoral Triangle contains great clinical significance for performing procedures like coronary angiography because femoral artery lies superficially in it.

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