The Knee
(Tibiofemoral)
Joint
BY: JACKIE, STACEY, GABE, AND SCHARLIE
Bones and
Surface Anatomy
By: Jackie
KNEE (TIBIOFEMORAL)
JOINT
FEMUR:
• Lateral Epicondyle
• Lateral Condyle
• Medial Epicondyle
• Medial Condyle
• Intercondylar Fossa
TIBIA:
• Lateral Condyle
• Medial Condyle
• Tibial Tuberosity
• Intercondylar Eminence
FIBULA:
• Head
PATELLA
SURFACE ANATOMY
• Vastus Medialis
• Vastus Lateralis
• Patella
SURFACE ANATOMY
• Biceps Femoris Tendon
• Semitendinous Tendon
• Semimembranous
Tendon
SURFACE ANATOMY
• Medial Head of
Gastronemius
• Lateral Head of
Gastronemius
• Soleus
• Popliteal Fossa
Ligaments,
Bursae, and
Cartilage
BY: STACEY
Ligament Review

lig·a·ment

a short band of tough, flexible, fibrous connective
tissue that connects two bones or cartilages or
holds together a joint.

a membranous fold that supports an organ and
keeps it in position.
Knee Ligaments
 Patellar Ligament
 Transverse Ligament
 Anterior Cruciate Ligament
 Oblique Popliteal Ligament
 Tibial Collateral Ligament
 Arcuate Popliteal Ligament
 Fibular Collateral Ligament
 Posterior Cruciate Ligament
 PTA
OTA Fine People
Patellar Ligament
Tibial Collateral Ligament
Anterior Cruciate Ligament
Posterior Cruciate Ligament
Oblique Popliteal
Arcuate Popliteal
Fibular Collateral
Tendon Review
ten·don
a flexible but inelastic cord of strong fibrous collagen tissue
attaching a muscle to a bone.
Quadriceps Femoris Tendon
Cartilage Review
firm, whitish, flexible connective tissue found in various
forms in the larynx and respiratory tract, in structures such
as the external ear, and in the articulating surfaces of
joints.
Lateral and Medial
Menisci
Bursa Review
bur·sa
plural noun: bursae
a fluid-filled sac or saclike cavity, especially one
countering friction at a joint.
Prepatellar Bursa
Deep Infrapatellar
Bursa
Subcutaneous
Infrapatellar Bursa
Suprapatellar Bursa
Muscles and Nerves
TIBIOFEMORAL JOINT
BY: GABE
Rectus Femoris
Rectus Femoris
 Origin:
ASIS
 Insertion:
Patella via quadriceps tendon and then the
tibial tuberosity via patellar tendon (ligament)
 Action:
 Nerve:
Hip Flexion and knee extension
Femoral Nerve
Vastus Intermedialis
Vastus Intermedialis
 Origin:
Anterior 2/3 and the lateral shaft of the femur
 Insertion:
Patella via quadriceps tendon and then
tibial tuberosity via patellar ligament
 Action:
 Nerve:
Knee Extension
Femoral Nerve
Vastus Lateralis
Vastus Lateralis
 Origin:
femur
Intertrochanteric line and linea aspera of the
 Insertion:
Patella via quadriceps tendon then tibial
tuberosity via patellar tendon (ligament)
 Action:
 Nerve:
Knee Extension
Femoral Nerve
Vastus Medialis
Vastus Medialis
 Origin:
Linea aspera of the femur
 Insertion:
Patella via the quadriceps tendon and the
tibial tuberosity via the patellar tendon (ligament)
 Action:
 Nerve:
Knee extension
Femoral Nerve
Biceps Femoris
Biceps Femoris
 Origin:
 Long
Head- Ischial tuberosity
 Short Head- Linea aspera of the femur
 Insertion:
Head of the fibula and lateral condyle of the tibia
 Action:
 Long
Head- Extends hip and flexes knee
 Short Head- Flexes knee and laterally rotates hip
 Nerve:
Tibial Nerve
Semimembranosus
Semimembranosus
 Origin:
Ischial tuberosity
 Insertion:
 Action:
 Nerve:
Posterior medial condyle of the tibia
Extends and medial rotates the hip; Knee flexion
Tibial Nerve
Semitendinosus
Semitendinosus
 Origin:
Ischial tuberosity
 Insertion:
 Action:
 Nerve:
Proximal part of medial shaft of tibia
Extends and medially rotates hip; Flexes knee
Tibial nerve
Popliteus
Popliteus
 Origin:
Lateral condyle of femur and lateral meniscus
 Insertion:
 Action:
 Nerve:
Posterior surface of tibia
Unlocks knee and weakly flexes the knee
Tibial
Gastrocnemius
Gastrocnemius
 Origin:
Lateral
head- Lateral condyle of femur
Medial
Head- Superior to medial condyle of
femur
 Insertion:
Posterior calcaneus via calcaneal
(Achilles) tendon
 Action:
 Nerve:
Plantar flexes ankle
Tibial
Tibiofemoral Nerves
 Sciatic
Nerve
 Femoral Nerve
 Tibial Nerve
 Superficial Fibular (Peroneal) Nerve
 Deep Fibular (Peroneal) Nerve
Tibiofemoral
Nerves
Vascular Supply
ARTERIES AND VEINS THAT
PASS THROUGH THE KNEE
(TIBIOFEMORAL) JOINT
By: Scharlie
Arteries:

Inferior Gluteal Artery

Branches from the Internal Iliac
Artery.

Leaves pelvis through the greater
sciatic foramen and passes
inferior to the piriformis.
Inferior Gluteal
Artery (CUT)
Posterior
View
Medial
Circumflex
Femoral Artery
Femoral Artery

Medial Circumflex Femoral
Artery


Branches Posteriorly behind
Femur
Lateral Circumflex Femoral
Artery

Branches Anteriorly in front
of Femur

Both may branch from
profundus femoris or femoral
arteries

Both encircle thigh,
anastomose, and supply
thigh muscles and proximal
end of Femur.
Anterior
View
Inferior
Gluteal
Artery

Femoral



Femoral
Artery
Continuation of External Iliac
Artery distal to inguinal
ligament.
Passes through adductor
hiatus and becomes
Popliteal Artery
Popliteal

Continuation of Femoral
Artery

Passes behind Posterior Knee

Divides into anterior and
posterior tibial arteries

Gives Rise to Genicular
Arteries
Popliteal
Artery
Anterior
View
Anterior
Tibial Artery
Posterior
Tibial Artery
Popliteal


Anterior Tibial Artery

Branches from Popliteal Artery

Passes anteriorly between
Tibia and Fibula

Runs down anterior/lateral
aspect of Tibia
Posterior Tibial Artery

Branches from Popliteal Artery

Continues down posterior
aspect of lower leg
Anterior
Tibial
Anterior
View
Posterior
Tibial
Anterior
Tibial
Posterior
View
Fibular
(Peroneal)


Fibular (Peroneal) Artery

Braches from Popliteal Artery

Runs down lateral aspect of lower
leg

Perforating braches supply distal
muscles
Dorsalis Pedis Artery

Continuation of Anterior Tibial Artery

Begins at ankle joint between
malleoli to top of foot
Anterior
View of
foot
Anterior
Tibial
Artery
Perforating
Fibular
Artery
Dorsalis
Pedis
Artery
Veins:

Anterior Tibial Vein

Superior continuation of dorsalis
Pedis Vein

Runs up anterior tibia until
moving posterior to join posterior
tibial vein


Drains into Popliteal Vein
Anterior
Tibial Vein
Posterior
Tibial Vein
Posterior Tibial Vein


Drains into Popliteal Vein after
joining the Anterior Tibial Vein
Both supply calf and foot
Anterior
View


Fibular (Peroneal) Vein

More posterior/lateral in lower
leg

Drains into the Popliteal Vein
Popliteal Vein



Femoral
Vein
Anterior and Posterior Tibial
Veins join to form the Popliteal
Vein
Crosses back of knee and
becomes Femoral Vein at
thigh
Femoral Vein

Superior continuation of
Popliteal Vein

Becomes the External Iliac
Vein in the inguinal region
Popliteal
Vein
Fibular
(Peroneal)
Vein
Anterior
View

Small Saphenous Vein



Runs along lateral aspect of
foot and through the calf
muscle
Great
Saphenous
Vein
Drains into Popliteal Vein at
the knee
Great Saphenous Vein

Superficial and longest vein
in the body

Begins in common with Small
Saphenous Vein in ankle

Extends up medial side of
calf, knee, and thigh

Drains into the Femoral Vein
Small
Saphenous
Vein
Anterior
View
Overview:
Arteries
and Veins
Quiz
1.
3.
2.
4.
5.
Clinical Concerns for
the Knee
(Tibiofemoral) Joint
TORN ACL, PLANTAR
FASCIITIS, AND TKR
By Scharlie
TKR By Gabe
Torn ACL
• The injury may occur with or without contact.
Women have an increased risk of ACL injury
because of differences in anatomy, muscle mass,
and training. Symptoms of ACL tear include
hearing a loud pop as the ligament tears, pain,
knee swelling, and difficulty walking
Torn ACL Treatment
Treatment options include:
•Acute treatment: R.I.C.E
•Nonsurgical treatment only: a physical rehab program.
•ACL surgery to reconstruct the ACL (will still need physical therapy)
Recovery from an ACL injury varies for each person. Your treatment
should continue until your knee is stable and strong rather than for a
certain length of time.
Plantar Fasciitis
Signs and Symptoms:
When plantar fasciitis occurs, the pain is typically sharp and unilateral. Heel pain
worsens by bearing weight on the heel after long periods of rest. Improvement of
symptoms is usually seen with continued walking
Risk Factors:
Identified risk factors for plantar fasciitis include excessive running, standing on hard
surfaces for prolonged periods of time, high arches of the feet, and flat feet. Obesity is
seen in 70% of individuals with plantar fasciitis. Achilles tendon tightness and inappropriate
footwear have also been identified as significant risk factors.
Treatment:
Non-surgical: (90% of cases)Include rest, heat, ice, calf-strengthening exercises,
techniques to stretch the calf muscles, Achilles tendon, and plantar fascia, and
weight reduction.
Surgical: Plantar fasciotomy (release of fascia) is often considered after
conservative treatment has failed to resolve the issue after six months and is
viewed as a last resort.
Videos:
Torn ACL Surgical Repair
https://www.youtube.com/watch?v=9EgRHfoleLc
Dr. E. Edward Khalfayan, M.D.
Total Knee Replacement Surgery
http://www.youtube.com/watch?v=H9NrKylKMIY
Questions
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Resources:

Google Images:
https://www.google.com/search?q=anatomy+and+physiology&biw=1366&bih=650&source=lnms&tbm=isch&sa=
X&ei=WIttVOG2DKWQigLJr4CYDQ&ved=0CAYQ_AUoAQ

Moore KL, Agur AM, Dalley AF, Essential Clinical Anatomy. 4th ed. Baltimore,MD: Lippincott Williams &
Wilkins;2011.

Pearson Learning Solutions Lab Manual, Integrate Anatomy & Physiology: Pearson Learning Solutions;2011.

Youtube:


http://www.youtube.com/watch?v=H9NrKylKMIY

https://www.youtube.com/watch?v=9EgRHfoleLc
Google Web

http://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/basics/definition/con-20025664#

http://www.webmd.com/a-to-z-guides/anterior-cruciate-ligament-acl-injuries-treatment-overview