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Arteries of Femoral Head and Neck

See also Plates 499, 530

 

Anterior view

 

 

Posterior view

 

Retinacular

Superior

 

Acetabular

Superior

Retinacular

 

branch of

arteries

Anterior

 

obturator artery

Posterior

arteries

(subsynovial)

Inferior

 

(often minute)

Inferior

(subsynovial)

 

 

 

 

 

Anastomosis

 

 

 

 

Anastomosis

between medial

 

 

 

 

 

 

 

 

 

and lateral

 

 

 

 

 

circumflex

 

 

 

 

Ischiofemoral

femoral

 

 

 

 

 

 

 

 

ligament and

arteries

 

 

 

 

 

 

 

 

joint capsule

 

 

 

 

 

lliofemoral (Y)

 

lliopsoas

Medial

 

 

 

circumflex

 

 

 

tendon

 

 

ligament and

 

 

 

 

femoral artery

 

 

 

 

joint capsule

 

 

 

 

Medial circumflex

 

 

 

 

 

 

 

 

femoral artery

Lateral

 

 

Ascending,

 

 

circumflex

 

 

 

 

femoral artery

 

Transverse,

 

Profunda femoris

 

 

 

 

 

Descending

 

 

 

 

 

(deep femoral)

 

 

 

branches of

 

 

Nutrient artery

 

artery

 

Lateral circumflex

 

 

of femur

 

 

 

femoral artery

 

 

 

 

 

 

 

Nutrient artery

 

 

 

 

 

of femur

 

 

 

 

 

 

 

Anterior view in situ

 

 

Coronal section

 

 

 

Iliacus

 

 

Medial circumflex

 

muscle

 

 

 

 

 

 

 

femoral artery

 

Psoas

Acetabular labrum

 

 

 

 

Anastomosis

 

muscle

 

 

 

 

 

 

 

 

 

Ligaments and

Lateral circumflex

 

Femoral

joint capsule

 

artery

femoral artery

 

 

 

 

 

Synovial

 

Ascending,

 

Pectineus

 

Transverse,

 

muscle

membrane

 

 

 

Descending

 

 

 

 

 

 

Retinacular

 

branches

 

 

 

 

 

 

 

arteries

 

 

 

 

 

 

 

Acetabular

 

 

 

 

 

branch

 

 

 

 

 

Obturator

 

 

 

 

 

artery

 

 

 

 

 

 

 

 

Medial

 

 

 

 

 

circumflex

 

 

 

 

 

femoral

 

 

 

 

 

artery

 

 

 

 

 

Profunda femoris

 

 

 

 

 

(deep femoral)

 

Epiphyseal

 

 

artery

 

 

 

 

 

plate

 

 

Medial circumflex femoral artery

 

 

 

 

Medial circumflex

 

lliopsoas tendon

 

 

 

 

 

femoral artery

 

Lateral circumflex femoral artery

 

Femur of child: anterior view

Plate 491Hip and Thigh

in adductor canal

Sartorius muscle Profunda femoris (deep femoral) artery and vein

Pectineus muscle lliopsoas muscle

Rectus femoris muscle

Vastus medialis muscle

Lateral femoral cutaneous nerve

Vastus intermedius muscle

Femur

Vastus lateralis muscle

Tensor fasciae latae muscle

lliotibial tract Gluteus maximus muscle Sciatic nerve

Vastus medialis muscle

Rectus femoris muscle

Vastus intermedius muscle

Vastus lateralis muscle

Iliotibial tract

Lateral intermuscular septum of thigh

Biceps

Short head

femoris

 

muscle

Long head

Semitendinosus muscle

Semimembranosus muscle

Rectus femoris tendon Vastus intermedius muscle lliotibial tract Vastus lateralis muscle

Articularis genus muscle

Lateral intermuscular septum of thigh

Femur

Biceps femoris muscle

Common fibular (peroneal) nerve

Tibial nerve

Thigh: Serial Cross Sections

7

Fascia lata

Branches of femoral nerve

Femoral artery and vein

Adductor longus muscle

Great saphenous vein

Obturator nerve (anterior branch)

Adductor brevis muscle

Obturator nerve (posterior branch)

Gracilis muscle

Adductor magnus muscle

Posterior femoral cutaneous nerve

Semimembranosus muscle

Semitendinosus muscle

Biceps femoris muscle (long head)

Medial intermuscular septum of thigh

Sartorius muscle

Nerve to vastus medialis muscle

Saphenous nerve

Femoral artery and vein

Great saphenous vein

Adductor longus muscle

Gracilis muscle

Adductor brevis muscle

Profunda femoris (deep femoral) artery and vein

Adductor magnus muscle

Posterior intermuscular septum of thigh

Sciatic nerve

Vastus medialis muscle

Sartorius muscle

Saphenous nerve and descending genicular artery

Great saphenous vein

Gracilis muscle

Adductor magnus tendon

Popliteal vein and artery

Semimembranosus muscle

Semitendinosus muscle

 

 

 

Hip and Thigh

Plate 492

Knee: Medial and Lateral Views

Medial view

Vastus medialis muscle

Quadriceps femoris tendon

Medial epicondyle of femur

Patella

Medial patellar retinaculum

Joint capsule

Patellar ligament

Tibial tuberosity

Lateral view

lliotibial tract (cut)

Biceps femoris

Long head

muscle (cut)

Short head

Bursa deep to iliotibial tract

Fibular collateral ligament and bursa deep to it

Plantaris muscle

Biceps femoris tendon and its inferior subtendinous bursa

Common fibular (peroneal) nerve

Head of fibula

Gastrocnemius muscle

Soleus muscle

Fibularis (peroneus) longus muscle

Sartorius muscle (cut)

Gracilis muscle (cut)

Tendon of semitendinosus muscle (cut)

Semimembranosus muscle and tendon

Adductor magnus tendon

Parallel fibers

Tibial

collateral

Oblique fibers

ligament

 

Semimembranosus

 

bursa

 

 

Anserine bursa

 

 

deep to

 

 

Semitendinosus,

 

Pes

Gracilis, and

 

 

anserinus

Sartorius tendons

 

Gastrocnemius muscle

Soleus muscle

 

 

Vastus lateralis muscle

Quadriceps femoris tendon

Patella

Lateral patellar retinaculum

Joint capsule of knee

Patellar ligament

Tibial tuberosity

Tibialis anterior muscle

Plate 493

Knee

Right knee in extension

Vastus intermedius muscle

Vastus lateralis muscle

lliotibial tract

Lateral patellar retinaculum

Lateral epicondyle of femur

Fibular collateral ligament and bursa

Biceps femoris tendon and its inferior subtendinous bursa

Dashed oval indicates bursa deep to iliotibial tract

Insertion of iliotibial tract to Gerdy’s tubercle and oblique line of tibia

Common fibular (peroneal) nerve

Head of fibula

Fibularis (peroneus) longus muscle

Extensor digitorum longus muscle

Tibialis anterior muscle

Joint opened,

knee slightly in flexion

Femur

Articularis genus muscle

Synovial membrane (cut edge)

Lateral condyle of femur

Origin of popliteus tendon (covered by synovial membrane)

Subpopliteal recess

Lateral meniscus

Fibular collateral ligament

Head of fibula

Patella (articular surface on posterior aspect)

Vastus lateralis muscle (reflected inferiorly)

Knee: Anterior Views 7

See also Plate 497

Femur

Articularis genus muscle

Vastus medialis muscle

Rectus femoris tendon

becoming

 

Quadriceps femoris tendon

Patella

 

Medial epicondyle of femur

Medial patellar retinaculum

Tibial collateral ligament

Semitendinosus,

Pes

Gracilis, and

anserinus

Sartorius tendons

 

Anserine bursa

 

Medial condyle of tibia

Patellar ligament

 

Tibial tuberosity

 

Gastrocnemius muscle

Suprapatellar (synovial) bursa

Cruciate ligaments (covered by synovial membrane)

Medial condyle of femur

Infrapatellar synovial fold

Medial meniscus

Alar folds (cut)

Infrapatellar fat pads (lined by synovial membrane)

Suprapatellar (synovial) bursa (roof reflected)

Vastus medialis muscle (reflected inferiorly)

 

 

 

Knee

Plate 494

Knee: Interior

See also Plate 501

Inferior view

lliotibial tract blended into lateral patellar retinaculum and capsule

Bursa

Subpopliteal recess

Popliteus tendon

Fibular collateral ligament

Bursa

Lateral condyle of femur

Anterior cruciate ligament

Arcuate popliteal ligament

Patellar ligament

Medial patellar retinaculum blended into joint capsule

Suprapatellar synovial bursa

Synovial membrane (cut edge)

Infrapatellar synovial fold

Posterior cruciate ligament

Tibial collateral ligament (superficial and deep fibers)

Medial condyle of femur

Oblique popliteal ligament

Semimembranosus tendon

Posterior aspect

Superior view

Posterior meniscofemoral ligament

Arcuate popliteal ligament

Fibular collateral ligament

Bursa

Popliteus tendon

Subpopliteal recess

Lateral meniscus

Superior articular surface of tibia (lateral facet)

lliotibial tract blended into capsule

Infrapatellar fat pad

Semimembranosus tendon

Oblique popliteal ligament

Posterior cruciate ligament

Tibial collateral ligament (deep fibers bound to medial meniscus)

Medial meniscus

Synovial membrane

Superior articular surface of tibia (medial facet)

Joint capsule

Anterior cruciate ligament

Patellar ligament

Anterior aspect

Superior view: ligaments and cartilage removed

Attachment of posterior cruciate ligament

Intercondylar eminence

 

Attachment of synovial membrane

Attachment of synovial membrane

 

Superior articular surface Superior articular surface of tibia (medial facet)

of tibia (lateral facet)

Attachment of anterior Attachments of horns cruciate ligament

of lateral meniscus

Attachments of horns of medial meniscus

 

 

 

Tibial tuberosity

 

Anterior

 

aspect

 

 

 

 

 

 

Plate 495

 

 

Knee

Knee: Cruciate and Collateral Ligaments 7

Right knee in flexion: anterior view

Anterior cruciate ligament

Lateral condyle of femur (articular surface)

Popliteus tendon

Fibular collateral ligament

Lateral meniscus

Transverse

ligament of knee

Head of fibula

Gerdy’s tubercle

Adductor tubercle on medial epicondyle of femur

Medial condyle of femur (articular surface)

Tibial collateral ligament (superficial and deep fibers)

Medial meniscus

Medial condyle of tibia

Posterior cruciate ligament

Medial condyle of femur (articular surface)

Medial meniscus

Tibial collateral ligament (superficial and deep fibers)

Medial condyle of tibia

Tibial tuberosity

Right knee in extension: posterior view

Posterior cruciate ligament

Anterior cruciate ligament

Posterior meniscofemoral ligament

Lateral condyle of femur (articular surface)

Popliteus tendon

Fibular collateral ligament

Lateral meniscus

Head of fibula

 

 

 

Knee

Plate 496

Knee: Anteroposterior Radiograph and Posterior View

See also Plate 494

Femur

Patella

Lateral epicondyle

Lateral condyle of femur Intercondylar eminence Lateral condyle of tibia

Head of fibula

Neck of fibula

Fibula

Semitendinosus muscle

Sartorius muscle

Semimembranosus muscle

Gracilis muscle

Medial head of gastrocnemius muscle (cut)

Medial subtendinous bursa of gastrocnemius muscle (open)

Oblique popliteal ligament

Medial epicondyle

Medial condyle of femur

Medial condyle of tibia

 

Tibia

Plantaris muscle (cut)

Iliotibial tract (band)

 

Biceps femoris muscle

 

Lateral head of gastrocnemius

 

muscle (cut and reflected superiorly

 

and laterally)

 

Lateral subtendinous

 

bursa of gastrocnemius muscle

 

Lateral collateral ligament

Arcuate popliteal ligament

Tibial collateral ligament

Biceps femoris tendon

Bursa of semimembranosus muscle

Common fibular (peroneal) nerve

Popliteus muscle

Semimembranosus tendon

Fibula

Interosseous membrane

 

Tibia

Plate 497

Knee

Knee: Posterior and Sagittal Views 7

Right knee: posterior view

 

Femur (popliteal surface)

Adductor magnus tendon

Attachment of joint capsule

Medial head of gastrocnemius

 

muscle and

Plantaris muscle

Subtendinous bursa

 

Tibial collateral ligament

Lateral head of gastrocnemius muscle and

Subtendinous bursa

 

Semimembranosus tendon

Fibular collateral ligament

and its inferior Oblique popliteal ligament Subtendinous bursa (tendinous expansion of

semimembranosus muscle)

Biceps femoris tendon and

Semimembranosus bursa Bursa beneath it deep to tendon (broken line)

Arcuate popliteal ligament

Popliteus muscle (edge of capsule that arches over popliteus muscle)

 

Head of fibula

 

Posterior ligament of

 

fibular head

Femur

Attachment of joint capsule

 

Articularis

Interosseous membrane

genus muscle

 

 

Tibia

 

 

Quadriceps

 

 

femoris tendon

 

 

Suprapatellar fat body

Lateral

 

Suprapatellar (synovial) bursa

subtendinous

 

 

 

bursa of

 

Patella

gastrocnemius

 

 

 

muscle

 

Subcutaneous prepatellar bursa

 

 

 

 

Articular cavity

 

 

Synovial membrane

 

 

Patellar ligament

Synovial

 

Infrapatellar fat pad

membrane

 

 

 

 

 

Subcutaneous infrapatellar bursa

 

 

Deep (subtendinous) infrapatellar bursa

 

 

Lateral meniscus

Articular cartilages

 

Tibial tuberosity

 

 

 

Tibia

Sagittal section

 

 

 

 

(lateral to midline of knee)

 

 

 

Knee

Plate 498

Arteries of Thigh and Knee: Schema

See also Plates 491, 508, 509, 518

Deep circumflex iliac artery

Superficial circumflex iliac artery

Femoral artery

Ascending branch, Transverse branch, Descending branch of Lateral circumflex femoral artery

Profunda femoris (deep femoral) artery

Perforating branches

Femoral artery passing through adductor hiatus within adductor magnus muscle

Superior lateral genicular artery

Patellar anastomosis

Inferior lateral genicular artery (partially in phantom)

Posterior tibial recurrent artery (phantom)

Circumflex fibular branch

Anterior tibial artery

Interosseous membrane

External iliac artery

Inferior epigastric artery

Superficial epigastric artery

Superficial external pudendal artery

Obturator artery

Deep external pudendal artery Medial circumflex femoral artery

Femoral artery

Muscular branches

Descending genicular artery

Articular branch

Saphenous branch

Superior medial genicular artery

Popliteal artery (phantom)

Middle genicular artery (phantom)

Inferior medial genicular artery (partially in phantom)

Anterior tibial recurrent artery

Posterior tibial artery (phantom)

Fibular (peroneal) artery (phantom)

Plate 499

Knee

Bones of right leg

Anterior intercondylar area

Lateral condyle

Apex,

Head, Neck of fibula

Lateral surface

Anterior border

Interosseous border

Medial surface

Fibula

Lateral malleolus

Articular facet of lateral malleolus

Tibia and Fibula 7

Anterior view

 

 

Posterior view

 

Intercondylar eminence

 

 

Intercondylar eminence

 

Lateral

Medial

 

 

Medial

Lateral

 

intercondylar

intercondylar

 

intercondylar

intercondylar

 

tubercle

tubercle

Posterior

tubercle

tubercle

Superior

 

 

intercondylar

 

 

articular surfaces

 

 

area

 

 

 

(medial and

 

 

Medial

 

 

 

lateral facets)

 

 

 

 

 

 

 

 

condyle

 

 

 

Lateral condyle

 

 

 

 

 

 

 

 

Gerdy’s tubercle

 

 

 

 

 

 

(insertion of

 

 

 

Apex,

 

 

iliotibial tract)

 

 

 

Head,

 

 

 

 

 

 

Neck

 

 

 

 

 

 

of

 

Oblique line

 

 

 

fibula

 

 

 

 

 

 

 

 

 

 

 

Groove for

 

Tibial tuberosity

 

 

 

insertion of

 

 

 

 

semimembranosus

 

 

 

 

 

 

 

 

 

Soleal line

 

 

tendon

 

Lateral surface

 

 

 

 

 

 

 

 

 

 

Nutrient

 

 

 

 

 

 

foramen

 

Anterior border

 

 

 

 

 

 

Interosseous border

 

 

Posterior

 

 

 

 

 

 

 

 

 

 

 

 

surface

 

Medial surface

Posterior

 

 

 

 

surface

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medial crest

 

 

Medial border

 

 

 

 

 

 

 

 

 

Lateral surface

 

 

Tibia

 

 

 

Fibula

 

 

 

 

 

 

 

 

 

 

 

 

Posterior

 

 

 

 

 

 

border

 

 

Groove for

 

 

 

 

 

tibialis posterior

 

 

 

 

 

and flexor digitorum

 

 

 

 

longus tendons

 

 

 

 

 

 

 

 

 

Fibular notch

 

 

 

 

 

 

Lateral

 

 

Medial malleolus

 

 

malleolus

Inferior

 

 

 

Inferior

Malleolar fossa

 

 

 

of lateral

articular

Articular facet of medial malleolus

articular

malleolus

surface

 

 

 

surface

 

 

 

 

Leg

Plate 500

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