Knee joint

• Skeleton

• Muscle

• ligament

skeleton

• Femur

• Tibia

• Fibula

( 未參與 knee joint)

• patella

femur

Tibia and Fibula

Patella

muscle

Posterior thigh muscle / hamstrings

1 Biceps fermoris

2 Semitendinosus

3 Semimembranosus

Biceps Fermoris

• Proximal attachment : long head:

ischial tuberosity Short head : linea aspera and lateral

supracondylar line of femur

• Distal attachment : lateral side of head of

fibula,tendon is spilt at this site by fibular collateral ligament of knee

Biceps Fermoris • hamstrings 的外側

• 2-joint muscle

• main action :flexes leg and rotates it laterally when knee is flexed ； extends thigh(e.g. when starting to walk)

Semitendinosus

• Proximal Attachment: ishchial tuberosity

• Distal Attachment: medial surface of superior part of tibia

Semimembranosus

• Proximal attachment: ishchial tuberosity

• Distal attachment: posteromedial aspect of the tibia

Semitendinosus & Semimembranosus

• 2-joint muscle

• Extend thigh

• Flex leg and rotate it medially when knee flexion

• When thigh and knee are flexed, these muscle can extend trunk

Gracilis

• Proximal attachment :

body and inferior ramus of pubis

• Distal attachment :

superior part of medial surface of tibia

Gracilis

• Medial thigh muscle

• 2-joint muscle

• Main action : adducts thigh ； flexes leg ；helps rotate it medially

Muscle of gluteal region

• Gluteus Maximus Muscle

• Tensor Fasciae Latae

• Iliotibial Tract

Iliotibial Tract

• upper end: the iliac crest lower end: the lateral condyle of tibia

• The tensor fasciae latae and superficial 3/4 of gluteus maximus insert into the iliotibial tract,which acts as a long aponeurosis of the muscles.

• Steadys the pelvis and assists in knee extension

Gluteus Maximus Muscle

• Proximal attachment : ilium posterior to posterior

gluteal line ； dorsal surface of sacrum and coccyx ； sacrotuberous ligament

• Distal attachment : superficial 3/4 of gluteus

maximus attaching to iliotibial tract ； deep distal 1/4 of gluteus maximus attaching to gluteal tuberosity of femur

Gluteus Maximus Muscle

• Main action :

extends thigh(especially from flexed position)and assists in its lateral rotation ； steadies thigh and assits in rising from sitting position

Tensor Fasciae Latae

• Proximal attachment :

anterior superior iliac spine ； anterior part of iliac crest

• Distal attachment :

iliotibial tract

Tensor Fasciae Latae

• 2-joint muscle

• Main action :

adduct and medially rotate thigh ； keep pelvis level when ipsilateral limb is weight bearing and advance opposite(unsupported)side during its swing phase

muscles of posterior compartment of the leg

• Popliteus • Gastronemius

Popliteus

• Proximal attachment :

lateral surface of lateral condyle of femur and lateral meniscus

• Distal attachment :

posterior surface of tibia, superior to soleal line

Popliteus

• Deep muscle of posterior compartment of the leg

• Main action :plantarflexes ankle when knee is extended ；raises heel during walking ； flexes leg at knee joint

Gastronemius

僅標出 proximal attachment • Proximal attachment : lateral head ： lateral

aspect of lateral condyle of femur

Medial head ： popliteal surface of femur,superior to medial condyle

• Distal attachment : posterior surface of

calcaneus via calcaneal tendon

Gastronemius

• Superficial muscle of posterior compartment of the leg

• 2-joint muscle

• Main action :

plantarflexes ankle when knee is extended ；raises heel during walking ； flexes leg at knee joint

Anterior compartment of thigh

Quadriceps femoris

由深到淺Vastus intermediusVastus lateralisVastus medialisRectus femoris

*intermedius 在最深層 , 此圖看不到

Quadriceps Femoris

• Vastus intermediusorigin: Upper two thirds of anterior femoral shaft

• Vastus lateralis and medialisorigin: Either side of linea aspera on the posterior femoral shaft

Quadriceps Femoris

• Rectus femorisorigin: Anterior inferior iliac spine(aiis)

• Insertion: Four converge into a single quadriceps tendon which inserts on and surrounds patella, then continues as the patellar ligament to inserts on the tibial tuberosity

Quadriceps Femoris

• Strongest muscle in the body

• Knee extension by all four act together

• Rectus femoris is 2-joint muscle→knee extensor and hip flexor

Ligaments of knee

Ligaments of knee

• Anterior cruciate ligament (ACL)• Posterior cruciate ligament (PAL)• Medial collateral ligament (MCL)• Lateral collateral ligament (LCL)

Cruciate ligaments• Anterior cruciate ligam

entAnterior intercondylar of tibia → medial aspect of lateral femoral condyle

• Posterior cruciate ligamentposterior intercondylar of tibia → lateral surface of medial femoral condyle

Cruciate ligaments

• The cruciates bind the tibia and femur together, prevent excessive anteroposterior movement, and may contribute to the mechanical check necessary for medial rotation of the knee.

Medial collateral ligaments

• Also called tibial collateral ligament

• Medial epicondyle of femur →medial conyle of tibia

• Stabilize knee joint, prevent from opening on medial side

Lateral collateral ligament

• Also called fibular collateral ligament

• Lateral epiconyle of femur → head of fibula

• Stabilize knee joint, prevent from opening on lateral side

Transverse ligament of knee

• Intra-articular ligament

• A transverse band that passes between the lateral and medial menisci in the front part of the knee joint

• Tethers the anterior edges of the menisci to each other during knee movements

Posterior meniscofemoral ligament

• Intra-articular ligament

• the medial condyle of the femur ←→ the posterior crus of the lateral meniscus.

Oblique popliteal ligament

• Extracapsular ligament• tendinous expansion of s

emimembranosus muscle• the medial condyle of the

tibia ←→

the lateral condyle of the femur.

• Reinforces the joint capsule posteriorly

Patellar ligament

• Extracapsular ligament

• A strong flattened fibrous band adjoining the margins of the patella to the tuberosity of the tibia

參考來源• http://www.ithaca.edu/faculty/lahr/LE2000/LE_hip.html#a• http://www.gla.ac.uk/ibls/fab/glossary/hipbone.html• http://www.gla.ac.uk/ibls/fab/tutorial/anatomy/kneet.html• http://www.gla.ac.uk/ibls/fab/glossary/iliotibialtract.html• http://www.gla.ac.uk/ibls/fab/glossary/popliteus.html• http://www.arthroscopy.com/sp05001.htm• http://ect.downstate.edu/courseware/haonline/figs/l13/130207.htm• http://ronnie.cz/_img/Clanky/1449_7.jpg• http://ronnie.cz/_img/Clanky/1449_3.jpg• http://www.activebodychiro.com/injuries/cruciate_ligament_tear.htm• http://www.coachroblowe.com/injuries-lower-knee-acl-overview.htm• 老師的 ppt