Anatomy Tables - Joints of the Lower Limb Anatomy Tables - Joints of the Lower Limb Osteology os coxae (pelvic or innominate bone) three fused bones: ischium, ilium & pubis acetabulum socket for head of femur (Latin, acetabulum = a shallow wide-mouthed vessel or cup) acetabular notch notch in the inferior margin of the acetabulum lunate surface of acetabulum smooth articular surface within the acetabulum obturator foramen large foramen surrounded by the superior and inferior pubic rami, the ischial ramus and the acetabulum; obturator means to occlude or stop up, a reference to the fact that the obturator membrane closes the obturator foramen almost completely; a site of attachment for the obturator externus m. and the obturator internus m.

femur long cylindrical central part of femur; also known as: shaft head smooth, rounded proximal end; articulates with acetabulum fovea capitis femoris pit in the femoral head; attachment site of ligamentum capitis femoris (Latin, fovea = a pit + capitis = head) neck constricted area distal to head intertrochanteric line on anterior surface; ridge coursing between greater and lesser trochanters intertrochanteric crest on posterior surface; heavy ridge coursing between greater and lesser trochanters medial condyle located at distal end; articulates with medial condyle of tibia (Greek, kondyle = the knob formed by the knuckle of any joint) lateral condyle located at distal end; articulates with lateral condyle of tibia (Greek, kondyle = the knob formed by the knuckle of any joint) intercondylar fossa between the condyles at distal end; accommodates cruciate ligaments patellar surface the smooth anterior surface at the inferior end of the femur; it articulates with the posterior surface the patella patella a sesamoid bone in the quadriceps femoris tendon; articulates with anterior surface of

 inferior femur tibia medial condyle at proximal end; articulates with medial condyle of femur; larger than lateral condyle (Greek, kondyle = the knob formed by the knuckle of any joint) lateral condyle at proximal end; articulates with lateral condyle of femur; smaller than medial condyle (Greek, kondyle = the knob formed by the knuckle of any joint) intercondylar eminence projection between condyles; attachment site of cruciate ligaments & medial & lateral meninsci (Greek, kondyle = the knob formed by the knuckle of any joint) Joints - Hip acetabular labrum fibrocartilage fibrocartilage forming rim of acetabulum; deepens the acetabulum (Latin, acetabulum = a shallow wide-mouthed vessel or cup + labrum = lip) transverse acetabular ligament bridges the acetabular notch; forms a bridge over the artery in the ligament of the femoral head (ligamentum capitis femoris) (Latin, acetabulum = a shallow vessel or cup) ligamentum capitis femoris intracapsular ligament connecting transverse acetabular ligament with fovea cap

itis femoris; also known as: ligament of the femoral head (Latin, capitis = head) zona orbicularis fibrous capsular fibers fromthe hip bone to the intertrochanteric line, forming a collar to help hold the femoral head in place pubofemoral ligament capsular ligament of hip joint connecting superior pubic ramus to medial surface of femoral neck iliofemoral ligament capsular ligament of the hip joint connecting anterior inferior iliac spine to intertrochanteric line ischiofemoral ligament capsular ligament of the hip joint connecting body of ischium to posterior femoral neck (Latin, ischion = hip joint) hip joint synovial acetabulum of os coxae articulates with femoral head; reinforced by capsular ligaments (iliofemoral, pubofemoral, ischiofemoral, zona orbicularis) and containing acetabular labrum & ligamentum capitis femoris iliopectineal bursa bursa lies deep to the iliopsoas tendon as it crosses the neck of the femur and the capsule of the hip joint Joints - Knee masses of loose fatty tissue on both

 sides of the patellar ligament knee joint synovial femoral condyles articulate with tibial condyles; reinforced by intracapsular ligaments (anterior cruciate & posterior cruciate), a capsular ligament (tibial collateral ligament), and an extracapsular ligament (fibular collateral ligament); contains medial & lateral menisci patellar ligament tendon connects quadriceps femoris muscle group to the tibial tuberosity; patella is a sesamoid bone within the quadriceps tendon tibial collateral ligament capsular ligament of the knee joint connecting medial epicondyle of femur with medial surface of medial tibial condyle; its attachment to the medial meniscus is clinically relevant fibular collateral ligament extracapsular ligament, not part of the fibrous capsule of the knee; connects lateral epicondyle of femur with fibular head anterior cruciate ligament intracapsular ligament connecting anterior aspect of intercondylar eminence of tibia with medial surface of lateral femoral condyle posterior cruciate ligament intracapsular ligament connecting posterior aspect of intercondylar eminence of tibia with lateral surface of medial fem

oral condyle medial meniscus fibrocartilage C-shaped intra-articular disc within knee joint between medial femoral condyle & medial tibial condyle; attached to tibial collateral ligament, coronary ligament, & intercondylar eminence (Greek, meniskos = crescent) lateral meniscus fibrocartilage C-shaped intra-articular disc within knee joint between lateral femoral condyle & lateral tibial condyle; attached to coronary ligament & intercondylar eminence (Greek, meniskos = crescent) posterior meniscofemoral ligament intracapsular ligament connects posterior part of lateral meniscus with lateral surface of medial femoral condyle suprapatellar bursa bursa superior extension of the synovial membrane of the knee joint; passes deep to the quadriceps tendon prepatellar bursa connects calcaneus with cuboid & bases of lateral 3 metatarsals interosseous talocalcaneal ligament suppots fibrous capsule of subtalar joint (Latin, inter = between + os = bone) tarsometatarsal joints reinforced by dorsal & plantar ligaments metatarsophalangeal joints (5

) chondyloid joint connecting head of metatarsal with proximal phalanx; reinforced by collateral ligaments longitudinal arch of the foot combination of synovial joints & syndesmoses passes from calcaneus to talus to navicular to cuneiforms to metatarsals; supported by plantar calcaneonavicular ligament & many other ligaments; supported by tendons of tibialis anterior & tibialis posterior mm.

transverse arch of the foot combination of synovial joints & syndesmoses passes through distal row of tarsal bones; supported by shape of bones and many ligaments; supported by tendons of fibularis longus & tibialis anterior & tibialis posterior mm. Muscles internal iliac a., anterior division pubic br., acetabular br., anterior br., posterior br. medial thigh and hip anterior and posterior brs. pass on the anterior and posterior sides of the adductor brevis m.; aberrant obturator a. arises from the inferior epigastric a. in 30% of cases Clinical Terms Definition popliteal/Baker's cyst a synovial cyst or pouch that occurs in the synovial lining of the knee. Presents in the popliteal fossa (area behind the knee). Synovial fluid escapes from the knee joint and into the cyst in individuals who suffer from degenerative and other joint disease. Typically these cysts are not painful unless swelling is extensive. Aspiration of the cyst is therapeutic only temporarily since recurrence is common. Most disappear spontaneously after several years. Larger cysts can be removed surgically.

Rupture of a Baker's cyst can present with pain and swelling to the calf. terrible triad injury to the knee joint including: a torn anterior cruciate ligament, a torn tibial collateral ligament, and a torn medial meniscus. drawer sign rupture of the anterior cruciate ligament (common in skiing injuries) allows the tibia to slide anteriorly from the femur-called the anterior drawer sign. Rupture of the posterior cruciate ligament (harder, but happens in head-on collisions with no seatbelt and the tibia strikes the dashboard) allows the tibia to slide posteriorly from the femur-the posterior drawer sign. Pott's fracture dislocation of the ankle that occurs when the foot is forcibly everted. This pulls hard on the medial ligament (very strong) and often tears off the medial malleolus. The talus then moves laterally, shearing off the lateral malleolus or more commonly breaking the fibula superior to the inferior tibiofibular joint. If the tibia is carried anteriorly the posterior margin of the distal end of the tibia is also sheared off by the talus, producing a trimalleolar fracture.

knee prosthesis replacement for a knee joint genu valgus/varus lateral angulation of the leg in relation to the thigh (exaggeration of the knee angle) is called genu valgum (knock-knee). Medial angulation of the leg in relation to thigh is a deformity called genu varum (bowleg). A valgus stress at the knee pushes it to create a knock-knee, testing the medial collateral ligament. A varus stress pushes the knee into bow-leg position, to test lateral collateral ligament. The material presented in these tables is contained in the book: MedCharts Anatomy by Thomas R. Gest & Jaye Schlesinger Published by ILOC, Inc., New York Copyright © 1995, unauthorized use prohibited. The excellent editorial assistance of Knee Joint - Anatomy Pictures and Information Home > Skeletal System > Bones of the Leg and Foot > Knee Joint Knee Joint The knee joint is one of the strongest and most important joints in the human body. It allows the lower leg to move relative to the thigh while supporting the body’s weight. Movements at the knee joint are essential to many everyday activities, including walking, running, sitting and standing.

The knee, also known as the tibiofemoral joint, is a synovial hinge joint formed between three bones: the femur, tibia, and patella. Two rounded, convex processes (known as condyles) on the distal end of the femur meet two rounded, concave condyles at the proximal end of the tibia.... Move up/down/left/right: Click compass arrows Rotate image: Click and drag in any direction, anywhere in the frame Identify objects: Click on them in the image 2D Interactive 3D Rotate & Zoom Change Anatomical System Knee Joint, Cross-section Full Knee Joint Description [Continued from above] . . . The patella lies in front of the femur on the anterior surface of the knee with its smooth joint-forming processes on its posterior surface facing the femur. The joint-forming surfaces of each bone are covered in a thin layer of hyaline cartilage that gives them an extremely smooth surface and protects the underlying bone from damage. Between the femur and tibia is a figure-eight-shaped layer of tough, rubbery fibrocartilage known as the meniscus.

The meniscus acts as a shock absorber inside the knee to prevent the collision of the leg bones during strenuous activities such as running and jumping. As with all synovial joints, a joint capsule surrounds the bones of the knee to provide strength and lubrication. The outer layer of the capsule is made of fibrous connective tissue continuous with the ligaments of the knee to hold the joint in place. Oily synovial fluid is produced by the synovial membrane that lines the joint capsule and fills the hollow space between the bones, lubricating the knee to reduce friction and wear. Many strong ligaments surround the joint capsule of the knee to reinforce its structure and hold its bones in the proper alignment. On the anterior surface of the knee, the patella is held in place by the patellar ligament, which extends from the inferior border of the patella to the tibial tuberosity of the tibia. Posteriorly, the oblique popliteal ligament and arcuate popliteal ligament join the femur to the tibia and fibula of the lower leg.

Along the medial side of the knee, the medial collateral ligament (MCL) connects the medial side of the femur to the tibia and prevents forces applied to the lateral side of the knee from moving the knee medially. Likewise, the lateral collateral ligament (LCL) binds the lateral side of the femur to the fibula and prevents forces applied to the medial side of the knee from moving the knee laterally. Two internal ligaments – the anterior and posterior cruciate ligaments – also help to maintain the proper alignment of the knee. The anterior cruciate ligament (ACL) is the most anterior of these internal ligaments and extends obliquely from the inner surface of the lateral condyle of the femur to the anterior intercondylar space of the tibia. The ACL plays an important role in preventing hyperextension of the knee by limiting the anterior movement of the tibia. Directly behind the ACL is the posterior cruciate ligament (PCL), which extends obliquely from the inner surface of the medial condyle of the femur to the posterior intercondylar space of the tibia. The PCL prevents the posterior movement of the tibia relative to the femur.

In addition to the joint capsule and ligaments that support the knee, there are also several important structures surrounding the knee that help cushion and protect the joint from friction and outside forces. Small pockets of synovial fluid, known as bursae, surround the knee to reduce the friction from movement of tendons across the surface of the joint. Several of these bursae, including the suprapatellar bursa, are instrumental in the reduction of friction between the patella and femur. Pockets of adipose tissue around the knee, known as articular fat pads, help to cushion the knee from external stress. The largest of these pads, the infrapatellar fat pad, absorbs shock to the anterior surface of the knee and cushions the patellar ligament as it moves with the patella during flexion and extension of the knee. As the knee is a synovial hinge joint, its function is to permit the flexion and extension of the lower leg relative to the thigh. The range of motion of the knee is limited by the anatomy of the bones and ligaments, but allows around 120 degrees of flexion.

A special characteristic of the knee that differentiates it from other hinge joints is that it allows a small degree of medial and lateral rotation when it is moderately flexed. Prepared by Tim Taylor, Anatomy and Physiology Instructor Knee (Distal Femur and Proximal Tibia) | eFossils Resources Knee (Distal Femur and Proximal Tibia) Who is Lucy? Knee (Distal Femur and Proximal Tibia) A critical adaptation for efficient bipedalsim relates to the need to keep the body’s center of gravity balanced over the stance leg during the stride cycle. Birds solved this issue by having the entire leg (from the hips all the way to the feet) as close as possible to the body’s center line. In humans, whose hips are wide apart, the shaft of the femur is angled so that the knee is closer to the body’s midline than the hips. This angle is called the bicondylar angle, and the resulting knee joint is referred to as a valgus knee. The effect is to bring the knees closer together, placing the feet directly below the center of gravity. Compared to modern humans, an ape femur is almost vertical within a horizontal plane.

In quadrupeds the positioning of the center of gravity during locomotion is less critical since the quadruped is usually supported by 2 or more legs during the stride cycle rather than just 1 as with humans. Australopiths have a human-like bicondylar angle9,18. A result of the femur’s bicondylar angle pulling the knees inward is that the tibia stands almost parallel with the body’s center of gravity. Unlike the femur, the tibial shaft lies at a right angle to its proximal surface. Also of note, the human medial and lateral proximal articular condyles (i.e., the flattened surfaces on the top of the tibia that articulate with the femur) are relatively larger and elongated anteroposteriorly (i.e., longer front to back) compared to quadrupeds. The comparatively larger lateral proximal condyle (also seen on the femur and helps to create the bicondylar angle) is an adaptation to increased weight transfer through the femur and into the foot. In addition, modern human condyles are more concave and elliptical in shape to accommodate the elliptical femoral distal condyles.

Quadrupeds tibial condyles appear relatively spherical and are more convex. The elliptical shape in humans helps to lock the knee in place and create straight-forward forward leg movement9. A chimpanzee's tibia retains smaller lateral proximal condyles, and may exhibit an obtuse angle between the tibial proximal surface and the shaft. The autralopith tibia has a nearly right angle between the shaft and the proximal surface.

Anatomy Tables - Joints of the Upper & Lower Limbs Anatomy Tables - Joints of the Upper & Lower Limbs Osteology three fused bones: ischium, ilium & pubis acetabulum socket for head of femur (Latin, acetabulum = a shallow wide-mouthed vessel or cup) acetabular notch notch in the inferior margin of the acetabulum lunate surface of acetabulum smooth articular surface within the acetabulum obturator foramen large foramen surrounded by the superior and inferior pubic rami, the ischial ramus and the acetabulum; obturator means to occlude or stop up, a reference to the fact that the obturator membrane closes the obturator foramen almost completely; a site of attachment for the obturator externus m. and the obturator internus m.

femur long cylindrical central part of femur; also known as: shaft head smooth, rounded proximal end; articulates with acetabulum fovea capitis femoris pit in the femoral head; attachment site of ligamentum capitis femoris (Latin, fovea = a pit + capitis = head) neck constricted area distal to head intertrochanteric line on anterior surface; ridge coursing between greater and lesser trochanters intertrochanteric crest on posterior surface; heavy ridge coursing between greater and lesser trochanters medial condyle located at distal end; articulates with medial condyle of tibia (Greek, kondyle = the knob formed by the knuckle of any joint) lateral condyle located at distal end; articulates with lateral condyle of tibia (Greek, kondyle = the knob formed by the knuckle of any joint) intercondylar fossa between the condyles at distal end; accommodates cruciate ligaments patellar surface the smooth anterior surface at the inferior end of the femur; it articulates with the posterior surface the patella patella a sesamoid bone in the quadriceps femoris tendon; articulates with anterior surface of

 inferior femur tibia ( N513 , TG3-08 , TG3-09 ) medial condyle at proximal end; articulates with medial condyle of femur; larger than lateral condyle (Greek, kondyle = the knob formed by the knuckle of any joint) lateral condyle at proximal end; articulates with lateral condyle of femur; smaller than medial condyle (Greek, kondyle = the knob formed by the knuckle of any joint) intercondylar eminence projection between condyles; attachment site of cruciate ligaments & medial & lateral meninsci (Greek, kondyle = the knob formed by the knuckle of any joint) Joints - Pectoral Girdle & Shoulder ( N419 , TG2-42A , TG2-42BC ) the joint what connects the clavicle with the sternum a synovial joint; its joint capsule is subdivided by a fibrous articular disc; it is strengthened by the sternoclavicular, interclavicular and costoclavicular ligaments; the sternoclavicular joint has the range of movement, but not the form, of a ball and socket joint acrom

ioclavicular joint ( N423 , TG2-42 ) the joint between the distal end of the clavicle and the acromion of the scapula a plane synovial joint; the shape of the articulation encourages the acromion to slide inferior to the clavicle during dislocation (shoulder separation) a condition that occurs when the coracoclavicular ligament is torn; a small articular disk occurs within this joint capsule articular disc of sternoclavicular joint ( TG2-42BC ) fibrocartilage serves as a shock absorber of forces transmitted along the clavicle from the upper limb and divides the SC joint into two compartments coracoclavicular ligament ( N423 , TG2-42 ) syndesmosis connects upper surface of coracoid process to under surface of clavicle; often subdivided into conoid (posteromedial) & trapezoid ligaments coracoacromial ligament a part of the glenohumeral joint (Greek, glene = a shallow socket + eidos = appearence) shoulder joint ( N423 , TG2-42A , TG2-42

BC ) synovial, ball & socket, diarthrosis connects humerus & scapula; glenoid labrum deepens the socket, glenohumeral ligaments/bands add strength anteriorly; tendon of long head of biceps passes through shoulder joint subscapular bursa extension of glenohumeral cavity protects the subscapular tendon where it passes inferior to the coracoid process and over the scapular neck tendon of the long head of the biceps tendon enlosed by a synovial sheath moves back and forth in the intertubercular groove of the humerus transverse humeral ligament ( N423 , TG2-42A , TG2-42BC ) syndesmosis passes from the lesser to greater tubercle and holds the tendon of the long head of the biceps in the intertubercular groove Joints - Elbow & Wrist posterior - fanlike, weak oblique - slender, deepens the socket for the trochlea of the humerus extends from the medial epicondyle of the humerus to the coronoid process and olecranon of the ulna (Latin, ulna = elbow) radiouln

ar joint, proximal ( N438 , TG2-43BC ) synovial, pivot connects radial head with ulna; annular ligament holds radial head against radial notch of ulna (Latin, ulna = elbow) annular ligament ( N438 , TG2-43BC ) the ligament that encircles the head of the radius it forms 4/5 of a circle - the radial notch of the ulna forms the other 1/5; it attaches to the margins of the radial notch; it holds the head of the radius against the ulna and cups in distal to the head to provide restraint against distal dislocation of the radius (Latin, anulus = ring) radioulnar joint, intermediate characterized by an intracapsular articular disk; radius articulates with the proximal row of carpals radial collateral ligament, wrist it connects the styloid process of the radius with the scaphoid and trapezium it reinforces the articular capsule on the lateral side of the wrist ulnar collateral ligament, wrist it connects the styloid process of the ulna to the pisiform and triquetrum it reinforces the articular capsule on the medial side of the

 wrist (Latin, ulna = elbow) distal radioulnar articulation ( TG2-44C ) synovial, pivot the rounded head of the ulna articulates with the ulnar notch on the medial distal end of the radius dorsal radiocarpal ligament connects distal carpal bones with metacarpals of fingers; tightly bound by ligaments to limit motion metacarpophalangeal joints ( N458 , TG2-45 ) synovial, condyloid or ellipsoid connects metacarpal head to base of proximal phalanx; strengthened by collateral ligaments; heads of metacarpals are firmly joined by transverse metcarpal ligaments to provide a stable platform for finger movements transverse metacarpal ligament, deep ( N458 , TG2-45 ) a ligament that connects the metacarpophalangeal joints 2-5 on their palmar surface limited motion is permitted between the distal ends of adjacent metacarpal bones due to the presence of the deep transverse metacarpal ligaments; the metacarpal bones are bound together to form a solid foundation for finger movements interphalange

al joints ( N458 , TG2-45 ) synovial, hinge connect proximal & middle phalanges (proximal interphalangeal joint) and middle & distal phalanges (distal interphalangeal joint); strengthened by collateral ligaments Joints - Hip ( N487 , TG3-55 ) fibrocartilage fibrocartilage forming rim of acetabulum; deepens the acetabulum (Latin, acetabulum = a shallow wide-mouthed vessel or cup + labrum = lip) transverse acetabular ligament bridges the acetabular notch; forms a bridge over the artery in the ligament of the femoral head (ligamentum capitis femoris) (Latin, acetabulum = a shallow vessel or cup) ligamentum capitis femoris intracapsular ligament connecting transverse acetabular ligament with fovea capitis femoris; also known as: ligament of the femoral head (Latin, capitis = head) zona orbicularis ( TG3-55A , TG3-55B ) fibrous capsular fibers fromthe hip bone to the intertrochanteric line, forming

 a collar to help hold the femoral head in place pubofemoral ligament capsular ligament of hip joint connecting superior pubic ramus to medial surface of femoral neck iliofemoral ligament capsular ligament of the hip joint connecting anterior inferior iliac spine to intertrochanteric line ischiofemoral ligament capsular ligament of the hip joint connecting body of ischium to posterior femoral neck (Latin, ischion = hip joint) hip joint ( N487 , TG3-54 ) synovial acetabulum of os coxae articulates with femoral head; reinforced by capsular ligaments (iliofemoral, pubofemoral, ischiofemoral, zona orbicularis) and containing acetabular labrum & ligamentum capitis femoris iliopectineal bursa ( N487 , N496 , TG3-54 ) bursa lies deep to the iliopsoas tendon as it crosses the neck of the femur and the capsule of the hip joint Joints - Knee masses of loose fatty tissue on both sides of the patellar ligament knee joint ( N507 , N5

09 , TG3-57 , TG3-58 , TG3-59 ) synovial femoral condyles articulate with tibial condyles; reinforced by intracapsular ligaments (anterior cruciate & posterior cruciate), a capsular ligament (tibial collateral ligament), and an extracapsular ligament (fibular collateral ligament); contains medial & lateral menisci patellar ligament ( N511 , TG3-57 ) tendon connects quadriceps femoris muscle group to the tibial tuberosity; patella is a sesamoid bone within the quadriceps tendon tibial collateral ligament capsular ligament of the knee joint connecting medial epicondyle of femur with medial surface of medial tibial condyle; its attachment to the medial meniscus is clinically relevant fibular collateral ligament extracapsular ligament, not part of the fibrous capsule of the knee; connects lateral epicondyle of femur with fibular head anterior cruciate ligament intracapsular ligament connecting anterior aspect of intercondylar eminence of tibia with medial surface of lateral femoral condyle posterior cruciate ligament intrac

apsular ligament connecting posterior aspect of intercondylar eminence of tibia with lateral surface of medial femoral condyle medial meniscus ( N507 , N509 , TG3-58 , TG3-59 ) fibrocartilage C-shaped intra-articular disc within knee joint between medial femoral condyle & medial tibial condyle; attached to tibial collateral ligament, coronary ligament, & intercondylar eminence (Greek, meniskos = crescent) lateral meniscus ( N507 , N509 , TG3-58 , TG3-59 ) fibrocartilage C-shaped intra-articular disc within knee joint between lateral femoral condyle & lateral tibial condyle; attached to coronary ligament & intercondylar eminence (Greek, meniskos = crescent) posterior meniscofemoral ligament intracapsular ligament connects posterior part of lateral meniscus with lateral surface of medial femoral condyle suprapatellar bursa internal iliac a., anterior division pubic br., acetabular br., anterior br., posterior br.

medial thigh and hip anterior and posterior brs. pass on the anterior and posterior sides of the adductor brevis m.; aberrant obturator a. arises from the inferior epigastric a. in 30% of cases Clinical Terms Definition separated shoulder the acromioclavicular joint is weak even though it's external (coracoclavicular) ligament is strong. The injury often occurs from a hard fall on the shoulder with the impact taken by the acromion or from a fall on the outstretched upper limb. The injury is severe if the AC and the coracoclavicular ligaments are torn. When the coracoclavicular ligament tears, the shoulder separates from the clavicle because of the weight of the upper limb. Rupture of this ligament also allows the fibrous capsule of the joint to also be torn so that the acromion can pass inferior to the acromial end of the clavicle. Disolocation of the AC joint makes the acromion more prominent, and the clavicle may move superior to this process.

pulled elbow transient subluxation (incomplete dislocation) of the head of the radius is called a "pulled elbow." Children are prone to this injury, as a parent may pull on a child's upper limb while the forearm is pronated causing tearing of the distal attachment of the anular ligament, where it is loosely attached to the neck of the radius. The radial head then moves distally, and the anular ligament may become pinched between the head of the radius and the capitulum of the humerus. The treatment is simple and involves supination of the forearm while the elbow is flexed, and the tear of the anular ligament will heal in a cast in 2 weeks. A.K.A. "nursemaid's elbow" pitcher's elbow disease of the elbow in which a piece of cartilage or bone is torn from the head of the radius due to the repetitive stress of throwing a baseball. popliteal/Baker's cyst a synovial cyst or pouch that occurs in the synovial lining of the knee. Presents in the popliteal fossa (area behind the knee).

Synovial fluid escapes from the knee joint and into the cyst in individuals who suffer from degenerative and other joint disease. Typically these cysts are not painful unless swelling is extensive. Aspiration of the cyst is therapeutic only temporarily since recurrence is common. Most disappear spontaneously after several years. Larger cysts can be removed surgically. Rupture of a Baker's cyst can present with pain and swelling to the calf. terrible triad injury to the knee joint including: a torn anterior cruciate ligament, a torn tibial collateral ligament, and a torn medial meniscus. drawer sign rupture of the anterior cruciate ligament (common in skiing injuries) allows the tibia to slide anteriorly from the femur-called the anterior drawer sign. Rupture of the posterior cruciate ligament (harder, but happens in head-on collisions with no seatbelt and the tibia strikes the dashboard) allows the tibia to slide posteriorly from the femur-the posterior drawer sign. Pott's fracture dislocation of the ankle that occurs when the foot is forcibly everted. This pulls hard on the medial ligament (very strong) and often tears off the medial malleolus.

The talus then moves laterally, shearing off the lateral malleolus or more commonly breaking the fibula superior to the inferior tibiofibular joint. If the tibia is carried anteriorly the posterior margin of the distal end of the tibia is also sheared off by the talus, producing a trimalleolar fracture. knee prosthesis replacement for a knee joint genu valgus/varus lateral angulation of the leg in relation to the thigh (exaggeration of the knee angle) is called genu valgum (knock-knee). Medial angulation of the leg in relation to thigh is a deformity called genu varum (bowleg). A valgus stress at the knee pushes it to create a knock-knee, testing the medial collateral ligament. A varus stress pushes the knee into bow-leg position, to test lateral collateral ligament. The material presented in these tables is contained in the book: MedCharts Anatomy by Thomas R. Gest & Jaye Schlesinger Published by ILOC, Inc., New York Copyright © 1995, unauthorized use prohibited.

The excellent editorial assistance of The Knee Joint - Articulations - Movements - Injuries - TeachMeAnatomy The Knee Joint Last Updated: January 3, 2017 Revisions: 30 7.4 Unhappy triad The knee joint is a bicondylar type synovial joint, which mainly allows for flexion and extension (and a small degree of medial and lateral rotation). It is formed by articulations between the patella, femur and tibia. In this article, we shall examine the anatomy of the knee joint – its articulating surfaces, ligaments and neurovascular supply. Fig 1.0 – A broad overview of the bony structures of the knee joint. Articulating Surfaces © 2015-2017 TeachMeAnatomy.com [CC-BY-NC-ND 4.0] Fig 1.1 – More detailed view of the bony surfaces. The inferior surface of the femur and superior surface of the tibia is shown. The knee joint consists of two articulations (see fig. 1.1): Tibiofemoral – The medial and lateral condyles of the femur articulating with the tibia.

Patellofemoral – The anterior and distal part of the femur articulating with the patella. The tibiofemoral joint is the weight-bearing joint of the knee. The patellofemoral joint allows the tendon of the quadriceps femoris (the main extensor of the knee) to be inserted directly over the knee, increasing the efficiency of the muscle. Both joint surfaces are lined with hyaline cartilage, and enclosed within a single joint cavity. The patella is formed inside the tendon of the quadriceps femoris; its presence minimises wear and tear on the tendon. Neurovasculature The blood supply to the knee joint is through the genicular anastomoses around the knee, which are supplied by the genicular branches of the femoral and popliteal arteries. The nerve supply, according to Hilton’s law, is by the nerves which supply the muscles which cross the joint. These are the femoral, tibial and common fibular nerves. Menisci The medial and lateral menisci are fibrocartilage structures in the knee that serve two functions: To deepen the articular surface of the tibia, thus increasing stability of the joint. To act as shock absorbers.

They are C shaped, and attached at both ends to the intercondylar area of the tibia. In addition to the intercondylar attachment, the medial meniscus is fixed to the tibial collateral ligament and the joint capsule. Any damage to the tibial collateral ligament results in tearing of the medial meniscus. The lateral meniscus is smaller and does not have any extra attachments, rendering it fairly mobile. © 2015-2017 TeachMeAnatomy.com [CC-BY-NC-ND 4.0] Fig 1.2 – Posterior view of the knee joint, with the joint capsule removed. Note the close relationship of the tibial collateral ligament, and the medial meniscus Fig 1.3 – The menisci of the knee joint. Superior surface of the tibia Bursae A bursa is synovial fluid filled sac, found between moving structures in a joint – with the aim of reducing wear and tear on those structures. There are four bursae found in the knee joint.

Suprapatella bursa – This is an extension of the synovial cavity of the knee, located between the quadriceps femoris and the femur. Prepatella bursa – Found between the apex of the patella and the skin. Infrapatella bursa – Split into deep and superficial. The deep bursa lies between the tibia and the patella ligament. The superficial lies between the patella ligament and the skin. Semimembranosus bursa – Located posteriorly in the knee joint, between the semimembranosus muscle and the medial head of the gastrocnemius. Fig 1.4 – Sagittal view of the knee joint, showing the major bursae. Ligaments The major ligaments in the knee joint are: 1. Patellar ligament – A continuation of the quadriceps femoris tendon distal to the patella. It attaches to the tibial tuberosity. 2. Collateral ligaments – These are two strap-like ligaments.

They act to stabilise the hinge motion of the knee, preventing any medial or lateral movement Tibial (medial) collateral ligament – A wide and flat ligament, found on the medial side of the joint. Proximally, it attaches to the medial epicondyle of the femur, distally it attaches to the medial surface of the tibia. Fibular (lateral) collateral ligament – Thinner and rounder than the tibial collateral, this attaches proximally to the lateral epicondyle of the femur, distally it attaches to a depression on the lateral surface of the fibular head. 3. Cruciate Ligaments – These two ligament connect the femur and the tibia. In doing so, they cross each other, hence the term ‘cruciate’ (Latin for like a cross) Anterior cruciate ligament – attaches at the anterior intercondylar region of the tibia and ascends posteriorly to attach to the femur, in the intercondylar fossa. It prevents anterior dislocation of the tibia onto the femur.

Posterior cruciate ligament – attaches at the posterior intercondylar region of the tibia, and ascends anteriorly to attach to the femur in the intercondylar fossa. It prevents posterior dislocation of the tibia onto the femur. © 2015-2017 TeachMeAnatomy.com [CC-BY-NC-ND 4.0] Fig 1.5 – The major ligaments of the knee joint:Green – patella ligamentRed – collateral ligamentsDark blue – anterior cruciate ligamentLight blue – posterior cruciate ligament Movements There are four main movements that the knee joint permits: Extension: Produced by the quadriceps femoris, which inserts into the tibial tuberosity. Flexion: Produced by the hamstrings, gracilis, sartorius and popliteus. Lateral rotation: Produced by the biceps femoris. Medial rotation: Produced by five muscles; semimembranosus, semitendinosus, gracilis, sartorius and popliteus.

NB: Lateral and medial rotation can only occur when the knee is flexed (if the knee is not flexed, the medial/lateral rotation occurs at the hip joint). Clinical Relevance: Injury to the Knee Joint Collateral ligaments Injury to the collateral ligaments is the most common pathology affecting the knee joint. It is caused by a force being applied to the side of the knee when the foot is placed on the ground. Damage to the collateral ligaments can be assessed by asking the patient to medially rotate and laterally rotate the leg. Pain on medial rotation indicates damage to the medial ligament, pain on lateral indicates damage to the lateral ligament. If the tibial collateral ligament is damaged, it is more than likely that the medial meniscus is torn, due to their attachment. Cruciate ligaments The anterior cruciate ligament (ACL) can be torn by hyperextension of the knee joint, or by the application of a large force to the back of the knee with the joint partly flexed. To test for this, you can perform an anterior drawer test, where you attempt the pull the tibia forwards, if it moves, the ligament has been torn.

© 2015-2017 TeachMeAnatomy.com [CC-BY-NC-ND 4.0] Fig 1.5 – A positive posterior drawer test, signifying damage to the posterior cruciate ligament The most common mechanism of posterior cruciate ligament (PCL) damage is the ‘dashboard injury’. This occurs when the knee is flexed, and a large force is applied to the shins, pushing the tibia posteriorly. This is often seen in car accidents, where the knee hits the dashboard. The posterior cruciate ligament can also be torn by hyperextension of the knee joint, or by damage to the upper part of the tibial tuberosity. To test for PCL damage, perform the posterior draw test. This is where the clinician holds the knee in flexed position, and pushes the shin posteriorly. If there is movement, the ligament has been torn. Inflammation of the Bursae Friction between the skin and the patella cause the prepatella bursa to become inflamed, producing a swelling on the anterior side of the knee. This is known as housemaid’s knee.

Similarly, friction between the skin and tibia can cause the infrapatella bursa to become inflamed, resulting in what is known as clergyman’s knee (typically caused by clergymen kneeling on hard surfaces during prayer). Unhappy triad Due to the attachment of the medial collateral ligament to the medial meniscus, damage to the medial collateral can affect this important cartilaginous structure. A lateral force to an extended knee, such as a rugby tackle, can rupture the medial collateral ligament, damaging the medial meniscus in the process. The ACL is also affected, which completes the ‘unhappy triad’. Ligaments of the Knee | Knee Anatomy | Knee Joints Advertisement # The knee is the joint where the bones of the lower and upper legs meet. The largest joint in the body, the knee moves like a hinge, allowing you to sit, squat, walk or jump. The knee consists of three bones: • femur – the upper leg bone, or thigh bone • tibia – the bone at the front of the lower leg, or shin bone • patella – the thick, triangular bone that sits over the other bones at the front of the knee, or kneecap.

The ends of the bones are covered with a layer of cartilage, a slick, elastic material that absorbs shock and allows the bones to glide easily against one another as they move. Between the tibia and femur bone are two crescent-shaped pads of connective tissue that reduce friction and disperse the weight of the body across the joint. They are: • The lateral meniscus, situated at the outside of the knee. • The medial meniscus, situated on the inside of the knee. The bones are held together by a joint capsule, which consists of two distinct layers – an outer layer of dense connective tissue and an inner membrane, called the synovium, which secretes a fluid to lubricate the joint.

The outer layer of the capsule is attached to the ends of the bones and is supported by these ligaments and tendons: • quadriceps tendon, which attaches the quadriceps to the patella • medial collateral ligament (MCL), which gives stability to the inner part of the knee • lateral collateral ligament (LCL), which stabilizes the outer part of the knee • anterior cruciate ligament (ACL), which is located in the center of the knee and prevents excessive forward movement of the tibia • posterior cruciate ligament (PCL), which is located in the center of the knee and prevents excessive backward shifting of the knee. Two groups of muscles support the knee. They are: • Hamstrings – muscles on the back of the thigh, which run from the hip to just below the knee and work to bend the knee. • Quadriceps – four muscles on front of the thigh that run from the hip to the knee and straighten the knee from a bent position. Want to read more? Subscribe Now to Arthritis Today! Advertisement Knee Joint Anatomy: Overview, Gross Anatomy, Natural Variants Knee Joint Anatomy Author: Stephen Kishner, MD, MHA; Chief Editor: Thomas R Gest, PhD more...

Share Overview Overview The anatomy of the knee is reflective of its function in ambulation. Knee stability and pain-free range of motion are important in maintaining daily function. Most commonly, overuse, age, and traumatic injuries cause structural damage to the knee that may limit its function. Therefore, a thorough understanding of the anatomy of the knee is essential to properly diagnosing and treating knee pathology. [ 1 , 2 ] An image depicting the knee joint can be seen below. Knee joint, anterior view. Gross Anatomy Femur, tibia, fibula, and patella The knee is composed of 4 bones: the femur, tibia, fibula and patella. All these bones are functional in the knee joint, except for the fibula. The femur is the longest and strongest bone in the human body. The proximal end forms the head of the femur, which projects anterosuperomedially to articulate with the acetabulum. The distal end is wider and forms a double condyle that articulates with the tibia and patella. The tibia articulates with the distal lateral and medial femoral condyles.

The patella articulates anteriorly to the femoral condyles in the region of the intercondylar fossa (trochlear groove). The tibia lies distal to the femur and medial to the fibula. The proximal end consists of medial and lateral condyles, an intercondylar area, and the tibial tuberosity that articulates with the medial and lateral condyles of the femur. Distally, the tibia articulates with the ankle. The distal and proximal ends of the tibia articulate with the fibula. In addition, the shaft of the tibia and fibula are connected with an interosseous membrane to form a syndesmosis joint. The fibula does not articulate with the femur or patella. Furthermore, the fibula is not directly involved in weight transmission. The patella is the largest sesamoid bone in the human body. This bone is flat, proximally curved, and distally tapered; however, the shape can vary. The posterior patella articulates with the femur, but the apex sits proximal to the line of the knee joint. The tendon of the quadriceps femoris completely encompasses the patella.

Cartilaginous menisci The paired menisci are crescentic, fibrocartilaginous pads that attach to the intercondylar area and periphery of the tibial plateau. This cartilage serves to widen and deepen the articulating surface between the femoral condyles and the tibia. To deepen the surface, the peripheral borders are thick and convex, and the inner borders are thin and concave. The outer region is well-vascularized from capillaries branching off the fibrous capsule and synovial membrane. The inner regions, however, are avascular. Therefore, tears of the peripheral meniscus typically heal well, whereas tears of the inner meniscus do not. A discoid lateral meniscus occurs in up to 5% of the population. The lateral meniscus is generally wider and gets caught between the femur and tibia, which can cause "clunking" in some patients. Ligaments The ligaments of the knee joint can be divided into the extracapsular ligaments and intra-articular ligaments.

The extracapsular ligaments or external ligaments are the patellar ligament, medial collateral ligament (MCL), lateral collateral ligament (LCLs), oblique popliteal ligament, and arcuate popliteal ligament. The intra-articular ligaments are the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and the posterior meniscofemoral ligament. (See the image below.) Knee joint, anterior view. View Media Gallery The patellar ligament is the anterior ligament of the knee joint. It is the distal part of the quadriceps tendon and attaches to the tibial tuberosity. The vastus medialis and lateralis contribute to the patellar ligament medially and laterally through the medial and lateral retinacula, which make up the joint capsule of the knee on either side of the patella. The retinacula also maintain alignment of the patella relative to the patellar surface of the femur. The LCL extends from the lateral epicondyle of the femur to the lateral surface of the fibular head. The LCL is separated from the lateral meniscus by the popliteus tendon.

The LCL also splits the tendon of the biceps femoris into 2 parts. The MCL extends from the medial epicondyle of the femur to the medial condyle and superior part of the medial surface of the tibia. The MCL is firmly attached to the medial meniscus, which is why these are commonly torn at the same time in contact sports. The oblique popliteal ligament and arcuate popliteal ligament reinforce the joint capsule on the posterior aspect. The oblique popliteal ligament is a recurrent expansion of the tendon of the semimembranosus, and it arises from the medial tibial condyle and passes toward the lateral femoral condyle, where it blends in with the rest of the joint capsule. The arcuate popliteal ligament arises from the posterior fibular head and passes over the tendon of the popliteus and spreads over the posterior surface of the knee. The ACL attaches posterior to the attachment of the medical meniscus on the anterior intercondylar area of the tibia and passes superior, posterior, and lateral, where it attaches to the posterior part of the medial side of the lateral condyle of the femur.

The PCL arises from the posterior intercondylar area and passes on the medial side of the ACL to attach to the anterior part of the lateral surface of the medial condyle of the femur. The menisci are wedge shaped and attach at their ends to the intercondylar area of the tibia. The medial meniscus is C shaped and firmly adheres to the deep surface of the MCL medially, the ACL anteriorly, and the PCL posteriorly. Because of these attachments, the medial meniscus is less mobile than the lateral meniscus. Cutaneous nerves Branches of the obturator, femoral, tibial, and common fibular nerves contribute to innervation of the knee joint. The infrapatellar branch of the saphenous nerve provides cutaneous sensation to the medial anterior aspect of the knee. The peripatellar plexus is composed of branches from anterior cutaneous branches of the femoral nerve and the lateral femoral cutaneous nerve to provide cutaneous sensation to the rest of the knee. Muscles and tendons The main motion of the knee joint is flexion and extension, with limited medial and lateral rotation.

The main muscle for extension is the quadriceps femoris, which is the most important muscle in stabilizing the knee joint. The quadriceps is made up of the vastus medialis and lateralis, rectus femoris, and vastus intermedius. The tensor fasciae latae is a weak extensor. Flexion is produced by the hamstring muscles, which consist of the semitendinosus, semimembranosus, and long head of the biceps femoris along with the short head of the biceps and, weakly, the gracilis, sartorius, gastrocnemius, and popliteus. The medial rotators of the knee are the semitendinosus, semimembranosus, popliteus, gracilis, and sartorius. The lateral rotator of the knee is the biceps femoris. Vascular supply Many vessels are involved in forming the arterial anastomosis around the knee joint.

This anastomosis is formed by the superior, middle, and inferior genicular branches of the popliteal artery; the descending genicular branch of the femoral artery; and the descending branch of the lateral circumflex femoral artery, the circumflex fibular artery, and the anterior and posterior tibial recurrent arteries. The anastomosis supplies the patella, the femoral and tibial condyles, bone marrow, articular capsule, and synovial membrane. The popliteal artery, however, is the major artery that crosses the popliteal fossa in the posterior aspect of the knee. Because of its location, this artery is susceptible to damage in knee injuries. The venous system of the knee joint is primarily composed of the popliteal and femoral veins. These veins simply run with their corresponding arteries and drain deoxygenated blood from the arterial anastomosis. The popliteal veins contain 3-4 valves. Bursae Many bursae surround the knee and the arrangement is complex and variable. However, the medial group, including the anserine bursa and the semimembranosus bursa, are clinically important.

The anserine bursa is located 4-5 cm distal to the anteromedial joint line and deep to the pes anserinus, the conjoint tendon formed by the sartorius, gracilis, and semitendinosus tendons (see the following image). Deep to the anserine bursa is the insertion of the MCL. This bursa can become inflamed with excessive physical activity. The semimembranosus bursa is located in the popliteal fossa and commonly causes posterior swelling of the knee joint secondary to degeneration within the knee joint. Pes anserine bursae. MCL = medial collateral ligament; semitend. = semitendinosus tendon. View Media Gallery Joint capsule The joint capsule consists of the external fibrous layer and the internal synovial membrane. The fibrous layer is thin, except for the thickened parts that make up the intrinsic ligaments of the knee. On the posterior aspect, it encloses the condyles and the intercondylar fossa. Distally, it attaches to the margin of the superior articular surface of the tibia.

The synovial membrane lines all surfaces of the articular cavity not covered with articular cartilage. It attaches to the periphery of the articular cartilage, which covers the femoral and tibial condyles, posterior surface of the patella, and the popliteal surface of the femur. Synovial fluid All freely moveable joints have some synovial fluid in them. Synovial fluid originates from plasma that is filtered by the capillary net and diffuses into the knee along with hyaluronic acid, which is locally synthesized. Synovial fluid transports nutrients, assists in the joint's defense, and lubricates the joint. Previous Tibia Home > Skeletal System > Bones of the Leg and Foot > Tibia Tibia The tibia, sometimes known as the shin bone, is the larger and stronger of the two lower leg bones. It forms the knee joint with the femur and the ankle joint with the fibula and tarsus. Many powerful muscles that move the foot and lower leg are anchored to the tibia. The support and movement of the tibia is essential to many activities performed by the legs, including standing, walking, running, jumping and supporting the body’s weight.

The tibia is located in the lower leg medial to the fibula, distal to the femur and proximal to the talus of the foot. It is widest at its proximal end near the femur, where it forms the distal end of the knee joint before tapering along its length to a much narrower bone at the ankle joint.... Move up/down/left/right: Click compass arrows Rotate image: Click and drag in any direction, anywhere in the frame Identify objects: Click on them in the image 2D Interactive 3D Rotate & Zoom Change Anatomical System Change View Angle Full Tibia Description [Continued from above] . . . The proximal end is roughly flat with the smooth, concave medial and lateral condyles forming the knee joint with the femur. Between the condyles is the intercondylar region, which includes the tibial spine and provides attachment points for the meniscus and anterior and posterior cruciate ligaments (ACL and PCL) of the knee. At the inferior edge of the lateral condyle is a small facet where the tibia forms the proximal tibiofibular joint with the fibula.

This joint is a planar joint, allowing the tibia and fibula to slightly glide past each other and adjust the position of the lower leg. Just below the condyles on the anterior surface is the tibial tuberosity, a major bony ridge that provides an attachment point for the patella through the patellar ligament. Extension of the lower leg involves the contraction of the rectus femoris muscle to pull on the patella, which in turn pulls on the tibial tuberosity. A thin, bony ridge known as the anterior crest continues distally from the tibial tuberosity, giving the shaft of the tibia a triangular cross section. The tibial tuberosity and anterior crest are clearly identifiable landmarks of the shin as they can be easily palpated through the skin. Approaching the ankle joint, the tibia widens slightly in both the medial-lateral and anterior-posterior planes. On the medial side, the tibia forms a rounded bony prominence known as the medial malleolus. The medial malleolus forms the medial side of the ankle joint with the talus of the foot; it can be easily located by palpation of the skin in this region.

On the lateral side of the tibia is a small recess known as the fibular notch, which forms the distal tibiofibular joint with the fibula. The tibia is classified as a long bone due to its long, narrow shape. Long bones are hollow in the middle, with regions of spongy bone filling each end and solid compact bone covering their entire structure. Spongy bone is made of tiny columns known as trabeculae that reinforce the ends of the bone against external stresses. Red bone marrow, which produces blood cells, is found in the holes in the spongy bone between the trabeculae. The hollow middle of the bone, known as the medullary cavity, is filled with fat-rich yellow bone marrow that stores energy for the body. Surrounding the medullary cavity and spongy bone is a thick layer of compact bone that gives the bone most of its strength and mass. Compact bone is made of cells surrounded by a matrix of hard calcium mineral and collagen protein that is both extremely strong and flexible to resist stress. Surrounding the compact bone is a thin, fibrous layer known as the periosteum.

Periosteum is made of a dense, fibrous connective tissue, which is continuous with the ligaments that connect the tibia to the surrounding bones and the tendons that connect the muscles to the tibia. These connections prevent the separation of the muscles and bones from each other. Finally, a thin layer of hyaline cartilage covers the ends of the tibia where it forms the knee and ankle joints. Hyaline is extremely smooth and slightly flexible, providing a smooth surface for the joint to slide across and a shock absorber to resist impacts. At birth, the tibia consists of two bones: a central shaft known as the diaphysis, and a thin cap just below the knee known as the proximal epiphysis. A thin layer of hyaline cartilage separates these two bones and allows them to move slightly relative to each other. The distal end of the tibia at the ankle is made of hyaline cartilage at birth, but begins to ossify around age 2 to form the distal epiphysis. Throughout childhood the diaphysis and the two epiphyses remain separated by a thin layer of hyaline cartilage known as the epiphyseal plate or the growth plate.

Cartilage in the epiphyseal plate grows throughout childhood and adolescence and is slowly replaced by bone. The net result of this growth is the lengthening of the tibia. At the end of adolescence, the diaphysis and epiphyses grow into the last of the cartilage and fuse to form a single tibia. The region where the diaphysis and epiphyses fuse is known as the metaphysis. Prepared by Tim Taylor, Anatomy and Physiology Instructor Joints of Lower Limb Joints of the Lower Limb Hip Joint The hip joint is an articulation between the hemispherical head of the femur and the cup-shaped acetabulum of the hip bone. The acetabular notch at the lower part of the acetabulum is bridged by the transverse ligament of the acetabulum. To the rim of the acetabulum is firmly attached a fibrocartilaginous ring, the acetabular labrum which deepens the acetabulum and clasps the head of the femur to form a more stable joint.

The round ligament of the head of the femur is attached to the transverse acetabular ligament and extends to the fovea centralis on the head of the femur. Examine the articular capsule of the hip joint from the front. First, note its attachment to the intertrochanteric line and to the bases of the greater and lesser trochanters. Define the strongest of the ligaments of the capsule, the iliofemoral ligament. Note that its apex is attached to the ilium between the two heads of the rectus femoris muscle. Identify the two limbs of the ligament, one passing to the base of the grater trochanter and other to the base of the lesser trochanter. Observe, in the image above, just how thick this capsular ligament is. Next observe the pubofemoral ligament on the inferomedial aspect of the capsule. Follow this ligament to its attachment to the base of the lesser trochanter and examine its wide attachment to the superior ramus of the pubis, just above the obturator foramen.

You can see that this capsular ligament is somewhat thinner if you take a look at it cut in cross section in the image above. If you examine the posterior aspect of the hip joint, you can define the fibers of the ischiofemoral ligament as they sweep over the neck of the femur. The capsule of the hip joint is very loose as it covers the posterior aspect of the neck of the femur and does not cover the neck of the femur completely. The hip joint receives its blood supply from small vessels which reach it by running up the neck of the bone after passing under the attachment of the capsule. The arteries that supply branches to the hip joint are the: medial circumflex direct branches of sacral plexus Knee Joint The knee joint is an articulation between the condyles of the femur and of the tibia as well as the lower end of the femur and the patella. The articulation between the femur and tibia is essentially a hinge joint with a very small amount of rotation possible. The articulation between the femur and patella is a plane joint where the patella glides on the femur. The condyles of the tibia are separated by the intercondylar eminence.

There are anterior and posterior condylar areas that serve as attachments to the anterior and posterior cruciate ligaments, respectively. By now you have learned about many of the large and strong muscles that arise or insert into the bones that make up the knee joint. The quadriceps femoris attaches into the patella and from that into the tibia via the patella ligament. The vastus lateralis and medialis part of this muscle strengthens the capsule of the knee joint. If part of the capsule is removed, you can identify the tibial collateral capsular ligament. This capsular ligament is fixed to the medial meniscus and is therefore more prone to be involved in certain sports injuries. Note that there is a fairly large fat pad beneath the patella. Usually this will provide freedom of movement between the patellar ligament and the bony knee structures allowing for compression and decompression in this area. Looking at the lateral aspect of the knee joint you can appreciate the attachment of very strong iliotibial tract. Remember that this is tensed by the tensor fasciae latae muscle. From the lateral view, you can also identify the tendon of the very strong biceps femoris muscle which attaches into the head of the fibula.

Also note the fibular collateral ligament. Specifically notice that this ligament if free from the capsule of the knee joint and, therefore, is not as likely to be injured in knee injuries occurring during games such as football. By observing the posterior aspect of the knee joint, identify the arcuate popliteal ligament This ligament arches upwards and medially over the popliteus from the head of the fibula. Note that the tendon of the popliteus is attached to the lateral epicondyle of the femur just deep to the attachment of the fibular collateral ligament. By removing the two heads of the gastrocnemius muscle and the vessels and nerves in the area, you can identify the oblique popliteal ligament. When the patella is cut away from the quadriceps muscle and reflected downwards, you can see the internal makeup of the knee joint. Note first that there is a small muscle that arises from the lower anterior surface of the femur and attaches into the upper part of the joint capsule. This is the articularis genu muscle.

Also notice the small fold of tissue that lies deep to the patella when it is in its normal position, the synovial infrapatellar fold When the knee is flexed and the various synovial folds are removed, you can see the inner structures making up the knee joint. You should be able to identify the: anterior cruciate ligament medial meniscus - firmly attached to the tibial collateral ligament transverse ligament tibial (medial) collateral ligament (not names on image) From the posterior view of the knee joint you should be able to identify the: anterior cruciate ligament

Question: What joint is between the femur and the tibia?
Answer: Knee