The Knee
(Tibiofemoral Joint)
By
Todd Piraino
Tammi Wells
Holly Cox
Quadriceps
femoris tendon
Connects the quadriceps femoris muscles
to the superior aspects of the patella.
Controls knee flexion and extension
Patellar ligament
Connects Patella to the
tuberosity of the Tibia.
Oblique popliteal
ligament
A strong broad flat fibrous
ligament that pass obliquely
across and strengthens the
posterior part of the knee.
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
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.
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.
Transverse
Ligament
Connects the Anterior margin
of the lateral meniscus to the
anterior end of the medial
meniscus.
Prepatellar Bursa,
Deep
Infrapatellar
Bursa, Supra
Patellar Bursa,
Subcutaneous
Infrapatellar Bursa
Bursa are fluid filled capsules
that prevent friction between
tissues in joints.
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.
Femur: Lateral
Condyle, Medial
Condyle,
Intercondylar Fossa.
Medial
Condyle
Lateral
Condyle
Condyles of the Femur
articulate with the Tibia
Intercondylar Fossa
Femur: Lateral
Epicondyle,
Medial
Epicondyle
Lateral
Epicondyle
Medial
Epicondyle
Epicondyles are not part of the
articulating surface. Main
purpose is attachment points
for ligaments and tendons.
Tibia: Lateral
Condyle, Medial
Condyle,
Intercondylar
Eminence.
Articulate with the Femur.
Intercondylar Eminence
Tibial Tuberosity
and Head of
Fibula
Buckwheat says,
“Otay, that’s gonna
leave a mark.”
This guy is probably
hearing the sound
of popcorn coming
from his knee.
More sound of
popcorn.
Most likely a torn ACL
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.
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.
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.
Surface Anatomy
*The soleus is a long flat muscle that
runs down the posterior of the lower
leg, underneath the gastrocnemius.
Medial head of
Lateral head of
*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.
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
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
Surface Anatomy
Popliteal fossa
Lateral head of Gastrocnemius
Medial head of Gastronemius
Soleus
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.
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
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)
Veins
Anterior tibial vein
Posterior tibial vein
Fibular (peroneal vein)
Popliteal vein
Femoral vein
Small saphenous vein
Great saphenous vein
Wire man
Femoral vein
Femoral artery
Popliteal vein
Popliteal artery
Small saphenous vein
Fibular (peroneal) artery
Fibular (peroneal) vein
Great Saphenous vein
Anterior tibial artery
Posterior tibial artery
Anterior tibial vein
Posterior tibial vein
Dorsalis pedis
Flat Man …………NERVES
*Femoral nerve
Rectus Femoris
Vastus intermedialis
Vastus lateralis
Vastus medialis
Common fibular nerve
Biceps femoris (long head)
*Superficicial fibular
nerve (peroneal)
*Sciatic nerve
Semitendinosus,
Semimembranous
Biceps femoris (long head)
*Deep fibular nerve (peroneal)
*Tibial nerve
Gastrocnemius,
Popliteus
External iliac artery
Femoral nerve
Classroom Models
Inguinal ligament
Femoral nerve
Femoral artery
External iliac artery
Inguinal ligament
Femoral nerve
Femoral artery
Femoral vein
Anterior tibial artery
Dorsalis pedis artery
Deep fibular nerve (peroneal)
Classroom models
Sciatic nerve
Common fibular
(peroneal) nerve
Classroom Models
Popliteal vein
Popliteal artery
Tibial nerve
Posterior tibial artery
Tibial nerve
Classroom Models
Sciatic nerve
Tibial nerve
K
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ANTERIOR KNEE MUSCLES
Function as
extensors
Quadriceps Femoris:
*largest muscle in the body, consists of 4 muscles
Rectus Femoris:
• Most anterior of quadriceps
• Origin: Anterior Inferior Iliac
Spine
• Insertion: Tibial Tuberosity
• Innervation: Femoral Nerve
• Vascular Supply: Lateral
Circumflex Femoral Artery
Action:
• Hip flexion
• Knee extension
Vastus Medialis
Origin:
• Linea Aspera
Insertion:
• Tibial Tuberosity via Patellar Tendon
Innervation:
• Femoral Nerve
Vascular Supply:
• Lateral Circumflex Femoral Artery
Action:
• Knee extension
Vastus Intermedialis
Origin: Anterior Femur
Insertion: Tibial Tuberosity via Patellar
Tendon
Innervation: Femoral Nerve
Vascular Supply: Lateral Circumflex
Femoral Artery
Action:
• Knee extension
Vastus lateralis:
Origin:
• Linea Aspera
Insertion:
• Tibial tuberosity via
Patellar Tendon
Innervation:
• Femoral Nerve
Vascular Supply:
• Lateral Circumflex Femoral
Artery
Vastus
Lateralis
Action:
• Knee Extension
POSTERIOR KNEE MUSCLES
HAMSTRINGS: composed of Biceps Femoris,
Semimembranous and Semitendinosus
Function as flexors
(named due to tendons being long and stringlike in popliteal area)
Ah, those hamstrings…
See how they work?
Or not??
**This is the torn version that we
don’t need to know.
Biceps Femorislong head:
Origin:
• Ischial Tuberosity
Insertion:
• Fibular Head
Innervation:
• Sciatic Nerve
Vascular Supply:
• Inferior Gluteal Artery
Action:
• Hip extension
• Knee flexion
Biceps Femoris – Short
Head:
Origin:
• Lateral Lip of Linea Aspera
Insertion:
• Fibular Head
Innervation:
• Common Peroneal Nerve
Vascular Supply:
• Inferior Gluteal Artery
Action:
• Knee flexion
Semimembranosus:
Origin:
• Ischial Tuberosity
Insertion:
• Posterior surface of Medial
Condyle of Tibia
Innervation:
• Sciatic Nerve
Vascular Supply:
• Inferior Gluteal Artery
Action:
• Extend hip
• Flex knee
Semitendinosus:
Origin:
• Ischial Tuberosity
Insertion:
• Anteromedial surface
of proximal Tibia
Innervation:
• Sciatic Nerve
Vascular Supply:
• Deep Femoral Artery
Action:
• Extend hip
• Flex knee
Posterior Distal Knee Muscles:
- Flexors
Popliteus:
Origin:
• Lateral Condyle of
Femur
Insertion:
• Posteriorly on Medial
Condyle of Tibia
Innervation:
• Tibial Nerve
Vascular Supply:
• Popliteal Artery
Action:
• Initiates knee
flexion by
unlocking the
knee when fully
extended
Gastrocnemius:
Origin:
• Medial and
Lateral
Condyles of
Femur
Innervation:
• Tibial Nerve
Vascular Supply:
• Popliteal
Artery
Insertion:
• Posterior
Calcaneus
The reason for high heels?
Action:
•
•
Ankle plantar flexion when knee extended
Raises heel while walking with knee
extended
OR…
(Sorry, couldn’t resist!)
Action:
• Knee
flexion
(Basketball players learning Charleston)
BFB:
B F
y r
e o
m
B
o
b
References
www.getfittogolf.com.au
physiomed.patientsite.com
www.anatomy.tv
www.freebase.com
www.chiropractic-help.com
www.orthobullets.com
www.msdlatinamerica.com
www.netteranatomy.com