DEPARTMENT I - ANATOMY AND EMBRYOLOGY

MEDICINE

Myology, and Arthrology- Lower

Limb

LECTURE no. 5
Assoc. Prof. Şişu Alina, MD, PhD
 Anterior compartment of the thigh
• After removing the skin from the anterior thigh, it can
be identified the cutaneous nerves and veins of the
thigh and the fascia lata.
• The fascia lata is a dense layer of deep fascia
surrounding the large muscles of the thigh.
• The greater saphenous vein reaches the femoral vein
by passing through a weakened part of this fascia
called the fossa ovalis which has a sharp border called
the falciform margin.
 Muscles in the anterior compartment of
the thigh

• The musculature of the thigh can be split into

three sections; anterior, medial and posterior.
The muscles in the anterior thigh compartment
are innervated by the femoral nerve, and as a
general rule,  act to extend the leg at the knee.
• The muscles of the anterior thigh are the
sartorius, quadriceps femoris, articularis
genu muscle.
• In addition to these, the end of the iliopsoas
muscle passes into the anterior compartment.
• Iliopsoas (belongs to the anterior compartment of
the pelvic muscles!!!)
• The iliopsoas is actually two muscles, the psoas major
and the illiacus.
• They originate in different areas, but come together to
form a tendon, hence why they are commonly referred to
as one muscle.
• Attachments: The psoas major originates from the
lumbar vertebrae, and the iliacus originates from the iliac
fossa of the pelvis.
• They insert together onto the lesser trochanter of the
femur.
• Actions: The iliopsoas flexes the lower limb at the hip
joint, assists in lateral rotation at the hip joint.
• Innervation: The psoas major is innervated by anterior
rami of L1-L3, while the iliacus is innervated by the
femoral nerve.
The iliopsoas muscle, comprised of the iliacus
and psoas major
 Anterior compartment of thigh
• Muscles:
Iliopsoas.
Sartorius.
Quadriceps:
Rectus femoris.
Vastus lateralis.
Vastus intermedius.
Vastus medialis.

Articularis genu muscle

• The anterior compartment of the thigh contains a
large muscle, consisting of four heads, the
quadriceps femoris muscle.
• This is a strong extensor of the knee.
• The four heads of the quadriceps femoris
muscle are the:
• rectus femoris
• vastus lateralis
• vastus medialis
• vastus intermedius
• One other muscle of the anterior compartment is
the sartorius.
• Articularis genu muscle
• Sartorius
• The sartorius muscle in the longest muscle in the body.
• It is long and thin, running across the thigh in a inferomedial
direction.
• It is found more superficially to the other muscles in the leg.
• Attachments: Originates from the anterior superior iliac spine, and
attaches to the superior, medial surface of the tibia.
• The sartorius muscle originates from the anterior superior iliac spine
and part of the notch between the anterior superior iliac spine and
anterior inferior iliac spine.
• It runs obliquely across the upper and anterior part of the thigh in
an inferomedial direction.
• It passes behind the medial condyle of the femur to end in a tendon.
This tendon curves anteriorly to join the tendons of the gracilis and
semitendinosus muscles in the pes anserinus, where it inserts into
the superomedial surface of the tibia.
• Actions: At the hip joint, it is a flexor, abductor and lateral rotator.
• At the knee joint, it is also a flexor,
• Innervation: Femoral nerve
The sartorius and pectineus muscles of the
anterior thigh.
• Quadriceps Femoris
• The quadriceps femoris consists of four individual muscles; three vasti
muscles and the rectus femoris.
• They form the main bulk of the thigh, and collectively are one of the most
powerful muscles in the body.
• The quadriceps femoris attaches to the patella via a tendon.
• The patella attaches to the tibia by the patellar tendon. The quadriceps
femoris is the main extensor of the knee.
• Rectus Femoris
• Attachments: Originates from the ilium, just superior to the acetabulum. 
• It runs straight down the leg (the latin for straight is rectus), and attaches to
the patella by the quadriceps femoris tendon.
• Actions: This is the only muscle of the quadriceps to cross both the hip and
knee joints.
• It flexes the leg at the hip joint, and extends at the knee joint.
• Innervation: Femoral nerve
• The Vasti Muscles
• These are the vastus medialis, intermedius and lateralis.
• They are found exaclty where their names suggest; the medialis lies on the
medial side of the anterior thigh, and the lateralis lies on the lateral side.
• The intermedius is found deep to the medialis, lateralis and the rectus
femoris. These muscles extend at the knee joint, and are innervated by the
femoral nerve.
The vasti muscles of the thigh
Nerve of the Anterior Compartment of the
Thigh

The femoral nerve (L2,L3,L4) supplies the muscles of the anterior

compartment of the thigh, including the pectineus muscle.
The psoas muscles receives its nerve supply from the lumbar plexus.
 Muscles in the medial compartment of the
thigh
• There are 5 muscles in the medial compartment
of the thigh, these are, the gracilis, obturator
externus, adductor brevis, adductor longus and
adductor magnus.
• These muscles all adduct the thigh at the hip,
hence they are known as the adductor muscles.
As well as their common function, they also have
a common innervation and blood supply; they
are innervated by the obturator nerve, and
supplied with blood by the obturator artery.
 Medial compartment of thigh
• Muscles:
Gracilis.
Adductor longus.
Adductor brevis.
Adductor magnus.
Obturator externus.
• Adductor Longus
• This is a flat, large muscle.
• The lateral border of the adductor longus makes
up the medial border of the femoral triangle.
• It also contributes to the floor of the femoral
triangle
• Attachments: Originates from the body of pubis,
and expands into a fan shape, attaching broadly
to the linea aspera.
• Actions: Adduction and medial rotation of the
thigh
• Innervation: Obturator nerve (L2-L4)
 Adductor Brevis

• It is a shorter muscle than the adductor

longus, it lies slightly posterior to the
adductor longus and the pectineus.
• Attachments: Originates from the body of
pubis and inferior pubic rami.
• It attaches to the linea aspera on the
posterior surface of the femur, proximal to
the adductor longus.
• Actions: Adduction of the thigh
• Innervation: Obturator nerve (L2-L4)
 Adductor Magnus
• The adductor magnus is the largest muscle in the medial
compartment.
• It lies posteriorly to the other muscles.
• Because of its size, a portion of the adductor magnus can be found
in the posterior compartment of the leg, with different functions.
• Attachments: The adductor part originates from the inferior rami of
pubis and the rami of ischium, attaching to the linea aspera of the
femur.
• The hamstring portion originates from the ischial tuberosity and
attaches to the adductor tubercle on the distal, medial side of the
femur.
• Actions: They both adduct the thigh.
• The adductor component also flexes the thigh, while the hamstring
portion extends the thigh.
• Innervation: Adductor part is innervated by the obturator nerve (L2-
L4), the hamstring part is innervated by the tibial nerve (L4-S3)
 Adductor hiatus

• The adductor hiatus is

a hiatus (gap) between
the adductor magnus
muscle and the femur
that allows the passage
of the femoral vessels
from the anterior thigh to
the posterior thigh and
then the popliteal fossa.
• It is the termination of
the adductor canal and
lies about 5 cm superior
to the knee.
• Obturator Externus
• This is one of the smaller muscles of the medial
thigh, and it is located most superiorly.
• Attachments: It originates from the membrane
of the obturator foramen, and adjacent bone.
• It passes under the neck of femur, attaching to
posterior aspect of the greater trochanter
• Actions: Laterally rotates the thigh
• Innervation: Obturator nerve (L2-L4)
• Gracilis
• This is the most superficial and medial of the
medial thigh muscles.
• It is the only muscle of this group to cross at
both the hip and knee joints.
• Attachments: It originates from the inferior rami
of the pubis, and the body of the pubis.
Descending almost vertically down the leg, it
attaches to the medial surface of the tibia,
inbetween the tendons of the sartorius
(anteriorly) and the semitendinosus (posteriorly)
• Actions: Adduction of the thigh at the hip, and
flexion of the leg at the knee
• Innervation: Obturator nerve (L2-L4)
• Pectineus
• This muscle can be classified into either the anterior or
medial compartments or the thigh.
• It is innervated by the femoral nerve, a characteristic of
the anterior compartment, but its actions are typical of a
muscle from the medial compartment.
• It forms part of the base of the femoral triangle
• Attachments:  It originates from the pectineal line on the
anterior surface of the pelvis, and attaches to the
pectineal line on the posterior side of the femur, just
inferior to the lesser trochanter
• Actions: Adduction and flexion at the hip joint
• Innervation: Femoral nerve
 Posterior compartment of thigh

• Muscles:
Biceps femoris:
Long head.
Short head.
Semimembranosus.
Semitendinosus.
• Adductor Hiatus
 Posterior compartment of thigh

• There are three muscles in the posterior compartment of the thigh, and
collectively they are known as the hamstrings.
• They are: biceps femoris, semitendinosus, and semimembranosus.
• All three are innervated by the sciatic nerve.
• Biceps femoris
• Like the biceps brachii in the arm, this muscle has two heads.
• It is found laterally in the posterior thigh.
• Attachments:  The long head originates with the semitendinosus muscle
from the ischial tuberosity of the pelvis.
• The short head originates from the lateral edge of the linea aspera on
posterior surface of the femur. 
• Together, the heads form a tendon, which inserts onto the fibula.
• Actions: Main action is flexion at the knee.
• It also extends the leg at the hip, and laterally rotates at the hip and knee.
• Innervation: Sciatic nerve
• Semitendinosus
• This is medial to the biceps femoris, and lies on top (posterioly) of the
semimembranosus muscles
• Attachments: The semitedinosus originates from the ischial tuberosity,
and attaches to the medial surface of the tibia.
• Actions: Flexion of the leg at the knee joint.
• Extension of thigh at the hip.
• Medially rotates the thigh at the hip joint and the leg at the knee joint.
• Innervation: Sciatic nerve
• PES ANSERINUS!!!!!!!!
• Semimembranosus
• This lies deep to the semiteninosus muscle in the posterior compartment
of the thigh.
• Attachments: It also originates from the ischial tuberosity, but does so
more superiorly than the other two muscles.
• It attaches to the medial tibial condyle.
• Actions: Flexion of the leg at the knee joint.
• Extension of thigh at the hip.
• Medially rotates the thigh at the hip joint and the leg at the knee joint.
• Innervation: Sciatic nerve
 Muscles in the anterior compartment of
the leg

• There are four muscles in the anterior compartment of the leg:

• Tibialis anterior
• Extensor digitorum longus
• Extensor hallucis longus
• Fibularis tertius

• They exert their force on the foot, collectively causing

dorsiflexion and inversion of the foot, and extension of the
digits.
• The muscles in this compartment are innervated by the deep
fibular nerve, and blood is supplied via the anterior tibial
artery.
 Extensor hallucis longus muscle

This muscle lies in between the extensor digitorum

longus and the tibialis anterior.
Most of its surface is covered by the previously
mentioned muscles.
Attachments: Originates from the middle half of the
shaft of the fibula, the tendon crosses anterior to the
ankle joint and attaches to the base of the distal phalanx
 of the hallucis.
Action: Extends the great toe, and because of its path
anterior to the ankle joint, it also dorsiflexes the foot.
Innervation: Deep fibular nerve
 Tibialis anterior muscle

This is the most medial muscle in the

anterior compartment, it lies against the
lateral surface of the tibia.
Attachments: Originates from the lateral
surface of the tibia, attaches to the
medial cuneiform and the base of
metatarsal I.
Actions: Dorsiflexion and inversion of
the foot
Innervation: Deep fibular nerve
Diagram of the foot, showing the tendons and attachments
of all the muscles in the anterior compartment of the leg
 Extensor digitorum muscle

Much like the extensor digitorum in the arm, this

muscle extends the digits of the foot.
It is the most lateral of the muscles in the anterior
compartment, but a medial portion of the muscle
lies underneath the tibialis anterior.
Attachments: Originates from the lateral condyle
of the tibia and the medial surface of the superior
half of the fibula.
The fibres converge into a tendon, which travels
on the dorsal surface of the foot, splitting into four
tendons inserting into the lateral four phalanges.
Actions: Extends the lateral four toes, and
dorsiflexes the foot
Innervation: Deep fibular nerve
Muscles in the lateral compartment of the
leg

• There are two muscles in the lateral compartment of the

leg; the fibularis longus and brevis. In older texts, they are
referred to as the peronei longus and brevis.
• As the fibularis longus and brevis are in the same muscular
compartment, they have the same function and innervation.
• The common anatomical function of the muscles is
eversion – turning the sole of the foot outwards.
• In reality, the job of these muscles is to fix the medial
margin of the foot during running, and preventing
excessive inversion.

• Peroneus=fibula
Muscles of the lateral leg; fibularis
longus and brevis
 Fibularis longus muscle
• This is the longer and more superficial muscle of the two.
• Attachments: The tendon of the fibularis longus has a
slightly odd anatomical course:
• The fibularis longus originates from the superior and
lateral surface of the fibula and the lateral tibial condyle. 
• The fibres converge into a tendon, which the descends
into the foot, posterior to the lateral malleolus.
• The tendon then crosses under the foot, and attaches to
the bones on the medial side, namely the medial
cuneiform and base of metatarsal I.
• Actions: Eversion and plantarflexion of the foot.
• Also supports the lateral and tranverse arches of the
foot.
• Innervation: Superficial fibular (peroneal) nerve.
Fibularis brevis muscle
•is deeper and shorter than the fibularis longus.
•Attachments: It originates from the inferior and
lateral surface of the fibular shaft.
•The muscle belly forms a tendon, which descends
with the fibularis longus tendon.
•It travels into the foot, posterior to the lateral
malleolus, passing over the calcaneus and the
cuboidal bones.
•The tendon of the fibularis brevis attaches to a
tubercle on metatarsal V.
•Actions: Eversion of the foot.
•Innveration: Superficial fibular (peroneal) nerve.
Muscles in the posterior compartment of the
leg

• The posterior compartment of the leg is the

largest out of the three.
• There are seven muscles, organised into two
groups; superficial and deep.
• These groups are separated by a fascia.
• Generally, the muscles in this area of the leg
perform plantarflexion, invert the foot, and flex
the toes.
• All the muscles are innervated by the tibial nerve
(a branch of the sciatic).
Fibularis tertius muscle
•This muscle isn’t always present, and is
sometimes considered part of the extensor
digitorum longus.
•Attachments: Originates with the extensor
digitorum longus from the medial surface of the
fibula.
•The tendon descends with the extensor digitorum
longus tendon, where, at the foot, it diverges away
and attaches to the dorsal surface of metatarsal V.
•Actions: Its most important role is to evert the
foot, but it also is a weak dorsiflexor.
Superficial Muscles
•These are the muscles that form the characteristic shape of the
posterior leg (the ‘calf’).
•They all insert into the heel bone of the foot, via the calcaneal tendon,
and perform plantar flexion.

Gastrocnemius muscle
•The gastrocnemius is the most superficial of the superficial muscles. It
has a medial and a lateral head.
•It is made of of mainly fast muscle fibres, and so produces forceful,
quick movements such as running and jumping.
•Attachments: The lateral head originates from the lateral femoral
condyle, and medial from the medial condyle.
•The fibres converge, and form a single muscle belly.
•In the lower part of the leg, the gastrocnemius muscle belly combines
with the soleus to from a tendon that inserts into the calcaneus, the
calcaneal tendon (Achille`s tendon).
•Actions: It plantarflexes at the ankle joint, and because it crosses the
knee, it is a flexor there.
•Innervation: Tibial nerve
• Plantaris
• This is a small muscle with a long tendon, absent in 10% of people.
The long tendon can easily be mistaken for a nerve as it descends
down the leg
• Attachments: Originates from the lateral supracondylar line of the
femur. The muscle decends medially, deep to the gastrocnemius,
condensing into the tendon that runs down the leg, between the
gastrocnemius and soleus. The tendon attaches to the calcaneal
tendon.
• Actions: It plantarflexes at the ankle joint, and because it crosses
the knee, it is a flexor there. It is not a vital muscle for these
movements.
• Innervation: Tibial nerve

• Soleus
• The soleus muscle is found deep to the gastrocnemius.
• It is large and flat, named soleus because it looks like a sole – a flat
fish.
• Attachments: Originates from the soleal line of the tibia and
proximal fibular area. The muscle narrows in the lower part of the
leg, and joins the calcaneal tendon.
• Actions: Plantarflexes the foot at the ankle joint
• Innervation: Tibial nerve
 Deep muscles
• There are four muscles in the deep compartment of the posterior leg. 
• One, the popliteus, acts on the knee.
• The others act on the ankle and toes.

Popliteus muscle
• The popliteus is the most superior of all the muscles in the deep compartment of the
leg, forming part of the base of the popliteal fossa.
• Attachments: Originates from the posterior surface of the tibia, attaches to the
lateral condyle of the femur.
• Actions: Laterally rotates the femur on the tibia – ‘unlocking’ the joint  so that flexion
at the knee joint can occur.
• Innervation: Tibial nerve.

Tibialis posterior muscle

• This is the deepest out of the four muscles – it lies between the flexor digitorum
longus and flexor hallucis
• Attachments: Originates from the interosseous membrane between the tibia and
fibula, and posterior surfaces of the two bones. 
• The tendon enters to foot under the medial malleolus, and attaches to the plantar
surfaces of the medial tarsal bones.
• Actions: Inverts and plantarflexes the foot, maintains the medial arch of the foot.
• Innervation: Tibial nerve
Flexor digitorum longus muscle
•Surprisingly, a smaller muscle than the flexor hallucis longus.
•It is found medially in the posterior leg.
•Attachments: Originates from the medial surface of the tibia,
attaches to the plantar surfaces of the lateral four digits
•Actions:  Flexes the lateral four toes.
•Innervation: Tibial nerve.

Flexor hallucis longus muscle

•It is found on the lateral side of leg.
•Attachments: Originates from the posterior surface of the
fibula, attaches to the plantar surface of the phalanges of the
great toe.
•Actions: Flexes the great toe.
•Innervation: Tibial nerve .
 The muscles of the foot
1. The dorsal muscle of the foot
2. The plantar muscles of the foot

1. The dorsal muscle of the foot

Extensor digitorum brevis
Extensor hallucis brevis
 2. The plantar muscles of the foot

The first layer

Abductor hallucis
muscle
Flexor digitorum brevis
muscle
Abductor digiti quinti
muscle
The second layer
Quadratus plantæ
muscle
Lumbricales muscles
The third layer
Flexor hallucis brevis
muscle
Flexor digiti quinti
brevis muscle
Adductor hallucis
muscle
The fourth
layer
Interossei
dorsal and
plantar
muscles
 HIP JOINT - LIGAMENTS
The ligaments of the hip joint are as
follows:
1. Articular capsule.
2. Iliofemoral ligament (strongest).
3. Pubocapsular (Pubofemoral)
ligament.
4. Ischiocapsular (Ischiofemoral)
ligament.
5. Transverse acetabular ligament.
6. Glenoidal (Acetabular) labrum.
7. Ligamentum teres femoris (round
ligament of the head of femur).
 1. The Articular Capsule (capsula
articularis; capsular ligament)
The capsular ligament is a strong and dense fibrous sac which encloses the
joint.
Its attachments are as under:
1. On the hip bone, it is attached 5–6 mm beyond the acetabular margin, outer
aspect of the acetabular labrum and transverse acetabular ligament.
2. On the femur, it is attached anteriorly to the intertrochanteric line and
posteriorly 1 cm in front of(medial to) the intertrochanteric crest .
• The capsule is much thicker at the upper and forepart of
the joint, where the greatest amount of resistance is
required;
• behind and below, it is thin and loose.
• It consists of two sets of fibers, circular and longitudinal.
Coxal Articulation or Hip-joint (Articulatio
Coxæ)
• This joint is an enarthrodial
or ball-and-socket joint,
formed by the reception of
the head of the femur into
the cup-shaped cavity of the
acetabulum.
• Its main functions are:
(a)to support the body weight
during standing and
(b)to transmit the forces
generated by movements of
trunk to femur during
walking.
 HIP JOINT – ARTICULAR SURFACES
• The head of the femur articulates
with the acetabulum of the hip bone
to form the hip joint:
1. The head of femur forms more than
half of a sphere. It is covered by the
articular hyaline cartilage except for a
small pit—the fovea capitis for
ligamentum teres.
2. The acetabulum (Latin acetabulum
vinegar cup) presents three features:
- a horseshoe-shaped lunate
surface,
- acetabular notch, and
- acetabular fossa.
• Out of these, only lunate surface is
articular and covered by an articular
cartilage.
• The depth of the acetabulum is
increased by the acetabular labrum.
• The longitudinal fibers are greatest in amount at the upper
and front part of the capsule, where they are reinforced by
distinct bands, or accessory ligaments, of which the most
important is the iliofemoral ligament.
• The other accessory bands are known as the pubocapsular
and the ischiocapsular ligaments.
• The external surface of the capsule is rough, covered by
numerous muscles, and separated in front from the Psoas
major and Iliacus by a bursa.
 The Synovial Membrane
• The synovial membrane
lines inner aspect of the
fibrous capsule, the
intracapsular portion of
the femoral neck, glenoid
labrum (both surfaces),
transverse acetabular
ligament, ligamentum
teres, and fat in the
acetabular fossa.
• It is thin on the deep
surface of the iliofemoral
ligament where it is
compressed against the
head.
 2. The Iliofemoral Ligament (ligamentum
iliofemorale; Y-ligament; ligament of Bigelow)
• The iliofemoral ligament is a band
of great strength which lies in front
of the joint;
• it is intimately connected with the
capsule, and serves to strengthen.
• It is attached, above, to the lower
part of the anterior inferior iliac
spine;
• below, it divides into two bands,
one of which passes downward
and is fixed to the lower part of the
intertrochanteric line;
• the other is directed downward and
lateralward and is attached to the
upper part of the same line.

• This ligament is frequently called

the Y-shaped ligament of
Bigelow; and its upper band is
sometimes named the
iliotrochanteric ligament.
3. The Pubocapsular Ligament (ligamentum
pubocapsulare; pubofemoral ligament
This ligament is attached, above, to the obturator
crest and the superior ramus of the pubis; below,
it blends with the capsule and with the deep
surface of the vertical band of the iliofemoral
ligament.
 4. The Ischiocapsular Ligament (ligamentum
ischiocapsulare; ischiocapsular band;
ligament of Bertin).
• The ischiocapsular ligament consists of a
triangular band of strong fibers, which spring from
the ischium below and behind the acetabulum, and
blend with the circular fibers of the capsule.
 5. The Transverse Acetabular Ligament
(ligamentum transversum acetabuli;
transverse ligament).
• This ligament is in
reality a portion of the
glenoidal labrum,
though differing from it
in having no cartilage
cells among its fibers.
• It consists of strong,
flattened fibers, which
cross the acetabular
notch, and convert it
into a foramen through
which the nutrient
vessels enter the joint. 
6. The Glenoidal Labrum (labrum glenoidale;
cotyloid ligament)
• The glenoidal labrum is a
fibrocartilaginous rim
attached to the border of
the acetabulum.

• It bridges over the notch

as the transverse
ligament, and thus forms
a complete circle.
• Its two surfaces are
invested by synovial
membrane, the external
one being in contact with
the capsule, the internal
one being inclined inward
so as to narrow the
acetabulum, and embrace
the cartilaginous surface
of the head of the femur.
 7. The Ligamentum Teres Femoris

• The ligamentum teres

femoris is a triangular,
somewhat flattened
band implanted by its
apex into the antero-
superior part of the
fovea capitis femoris;
• its base is attached by
two bands, one into
either side of the
acetabular notch, and
between these bony
attachments it blends
with the transverse
ligament.
The muscles in relation with
the hip joint are :
Anterior: the Psoas major and
Iliacus, separated from the
capsule by a bursa;
Superior: the reflected head of
the Rectus femoris and
Glutæus minimus, the latter
being closely adherent to the
capsule;
Medial, the Obturator externus
and Pectineus;
Posterior, the Piriformis,
Gemellus superior, Obturator
internus, Gemellus inferior,
Obturator externus, and
Quadratus femoris.
• The arteries supplying the joint
are derived from the obturator
artery, medial femoral circumflex
artery, and superior and inferior
gluteal arteries.

• The nerves are articular

branches from the sacral plexus,
sciatic nerve, obturator nerve.
 HIP JOINT - MOVEMENTS
The hip joint is a multiaxial joint
and permits the following
movements:
 Flexion and extension
movements occur around the
transverse axis;
 Abduction and adduction
movements occur around the
anteroposterior axis.
 Medial and lateral rotation-
occur around the vertical axis
 Circumduction (combination
of the above movements).
 The Knee-joint (Articulatio Genu)
• The knee joint is the largest and most complicated joint in the
body.
• It is the major weight-bearing joint in the body.
• The knee-joint was formerly described as a ginglymus or hinge-
joint, but is really of a much more complicated character.
• It must be regarded as consisting of three articulations in one:
 two condyloid joints, one between each condyle of the femur
and the corresponding meniscus and condyle of the tibia;
 and a third between the patella and the femur, partly arthrodial.
 ARTICULAR SURFACES
The articular surfaces of the knee joints are:
1. Articular surfaces of medial and lateral condyles of the femur.
2. Trochlear surface of the femur.
3. Articular surface of the patella.
4. Articular surfaces of medial and lateral condyles of the tibia.
 KNEE JOINT - LIGAMENTS
1. The Articular Capsule
2. The Medial and Lateral Menisci
3. The Ligamentum Patellæ
4. The Tibial Collateral
5. The Fibular Collateral
6. The Anterior Cruciate
7. The Posterior Cruciate
8. The Oblique Popliteal
9. The Transverse
10.The Coronary.
 1. The Articular Capsule
• It is a thin fibrous sac which surrounds the joint.
• It is deficient anteriorly, where it is replaced by the patella, quadriceps
femoris, medial and lateral patellar retinacula, and ligamentum patellae.
Femoral attachment
• It is attached about 1/2 to 1 cm beyond the articular margins with the
following three special features.
• Anteriorly it is deficient in the middle where it is pierced by the
suprapatellar bursa.
• Posteriorly it is attached to the intercondylar line.
• Laterally it encloses the origin of popliteus.
 1. The Articular Capsule
Tibial attachment
• It is attached about 1/2 to 1 cm beyond the articular margins
with the following three special features.
• Anteriorly it descends along the margins of the condyles to
tibial tuberosity, where it is deficient for the attachment of the
ligamentum patellae.
• Posteriorly it presents a gap behind the lateral condyle for the
passage of the tendon of popliteus muscle.
 Synovial Membrane
• The synovial membrane lines the
inner aspect of the fibrous
capsule and the portions of the
bones enclosed within it.
• On either side of the joint, the
synovial membrane passes
downward from the femur, lining
the capsule to its point of
attachment to the menisci; it may
then be traced over the upper
surfaces of these to their free
borders, and then along their
under surfaces to the tibia.
• In front above the patella, it is
prolonged as suprapatellar bursa,
and below the patella, it covers
the deep surface of the
infrapatellar pad of fat, which
separates it from the ligamentum
patellae
 Synovial Membrane
• From the posterior
aspect of the fibrous
capsule, the synovial
membrane projects
forward in the
intercondylar region
as cul-de-sac to
envelope the sides
of both cruciate
ligaments and in
front of the anterior
cruciate ligament.
 2. The Medial and Lateral Menisci
• The menisci are two crescentic lamellæ, which serve to deepen
the surfaces of the head of the tibia for articulation with the
condyles of the femur.
• The peripheral border of each meniscus is thick, convex, and
attached to the inside of the capsule of the joint; the opposite
border is thin, concave, and free.
• The upper surfaces of the menisci are concave, and in contact
with the condyles of the femur; their lower surfaces are flat, and
rest upon the head of the tibia; both surfaces are smooth, and
invested by synovial membrane.
• Each meniscus covers approximately the peripheral two-thirds of
the corresponding articular surface of the tibia.
 The medial meniscus
(meniscus medialis; internal
semilunar fibrocartilage)
• is nearly semicircular in
form,
• its anterior end, thin and
pointed, is attached to the
anterior intercondyloid fossa
of the tibia, in front of the
anterior cruciate ligament;
• its posterior end is fixed to
the posterior intercondyloid
fossa of the tibia, between
the attachments of the lateral
meniscus and the posterior
cruciate ligament.
The lateral meniscus
(meniscus lateralis;
external semilunar
fibrocartilage)
• is nearly circular and
covers a larger portion of
the articular surface than
the medial one.
• Its anterior end is
attached in front of the
intercondyloid eminence
of the tibia, lateral to, and
behind, the anterior
cruciate ligament, with
which it blends;
• the posterior end is
attached behind the
intercondyloid eminence
of the tibia and in front of
the posterior end of the
medial meniscus.
 3. The Ligamentum Patellæ (anterior
ligament)
• The ligamentum patellæ is the central
portion of the common tendon of the
Quadriceps femoris, which is continued from
the patella to the tuberosity of the tibia.
• It is attached:
 above, to the apex and adjoining margins of
the patella and the rough depression on its
posterior surface;
 below, to the tuberosity of the tibia;

• its superficial fibers are continuous over the

front of the patella with those of the tendon
of the Quadriceps femoris.

• The medial and lateral portions of the

tendon of the Quadriceps pass down on
either side of the patella, to be inserted into
the upper extremity of the tibia on either
side of the tuberosity.

• The posterior surface of the ligamentum

patellæ is separated from the synovial
membrane of the joint by a large
infrapatellar pad of fat, and from the tibia by
a bursa.
 4. The Tibial Collateral Ligament
(ligamentum collaterale tibiale; internal
• lateral
The tibial collateral ligament is a ligament)
broad, flat, membranous band,
situated nearer to the back than to
the front of the joint.
• It is attached, above, to the medial
condyle of the femur immediately
below the adductor tubercle; below,
to the medial condyle and medial
surface of the body of the tibia.
• The fibers of the posterior part of the
ligament are short and incline
backward as they descend; they are
inserted into the tibia above the
groove for the Semimembranosus.
• It is crossed, at its lower part, by the
tendons of the Sartorius, Gracilis,
and Semitendinosus (pes
anserinus), a bursa being
interposed.
• Its deep surface covers the inferior
medial genicular vessels and nerve
and the anterior portion of the
tendon of the Semimembranosus,
with which it is connected by a few
fibers; it is intimately adherent to the
medial meniscus.
 5. The Fibular Collateral Ligament
(ligamentum collaterale fibulare; external
lateral or long external lateral ligament)
• The fibular collateral is a
strong, rounded, fibrous cord,
attached:
 superior: to the back part of
the lateral condyle of the
femur;
 inferior: , to the lateral side of
the head of the fibula, in front
of the styloid process.
• The greater part of its lateral
surface is covered by the
tendon of the Biceps femoris;
• The ligament has no
attachment to the lateral
meniscus.
 6,7. The Cruciate Ligaments (ligamenta
cruciata genu; crucial ligaments)
• These are two thick, strong
fibrous bands, which act as
direct bonds of union between
the femur and tibia.
• They are present inside the
knee joint.
• They maintain anteroposterior
stability of the knee joint. They
are named anterior and
posterior according to their site
of attachment to the tibia.
• The cruciate ligaments are
intracapsular but extrasynovial.
• The ligaments cross each
other like the letter “X” hence
• the name cruciate.
 6. The Anterior Cruciate Ligament
(ligamentum cruciatum anterius; external
crucial ligament)
• is attached to the depression
in front of the intercondyloid
eminence of the tibia, being
blended with the anterior
extremity of the lateral
meniscus;
• it passes upward, backward,
and lateralward, and is fixed
into the medial and back part
of the lateral condyle of the
femur.
 7. The Posterior Cruciate Ligament
(ligamentum cruciatum posterius; internal
crucial ligament)
• is stronger, but shorter and less oblique in its direction, than the
anterior.
• It is attached to the posterior intercondyloid fossa of the tibia,
and to the posterior extremity of the lateral meniscus; and
passes upward, forward, and medialward, to be fixed into the
lateral and front part of the medial condyle of the femur
 8. The Oblique Popliteal Ligament
(ligamentum popliteum obliquum; posterior
• ligament)
This ligament is a broad, flat,
fibrous band, formed of fasciculi
separated from one another by
apertures for the passage of
vessels and nerves.
• It is attached above to the upper
margin of the intercondyloid fossa
and posterior surface of the femur
close to the articular margins of
the condyles, and below to the
posterior margin of the head of
the tibia.
• Superficial to the main part of the
ligament is a strong fasciculus,
derived from the tendon of the
Semimembranosus and passing
from the back part of the medial
condyle of the tibia obliquely
upward and lateralward to the
back part of the lateral condyle of
the femur.
• The oblique popliteal ligament
forms part of the floor of the
popliteal fossa, and the popliteal
artery rests upon it.
9. The Transverse Ligament (ligamentum
transversum genu).
• It connects the
anterior convex
margin of the lateral
meniscus to the
anterior end of the
medial meniscus;
• its thickness varies
considerably in
different subjects,
and it is sometimes
absent.
 10. The Coronary ligaments

•  The coronary
ligaments are merely
portions of the
capsule, which
connect the periphery
of each meniscus with
the margin of the
head of the tibia.
 RELATIONS OF THE KNEE JOINT
Anteriorly:
 Quadriceps femoris;
Laterally:
 tendons of the Biceps
femoris;
 Popliteus;
 common peroneal nerve;
Medially:
 Sartorius,
 Gracilis,
 Semitendinosus,
 Semimembranosus;
Posteriorly:
 popliteal vessels
 tibial nerve,
 Popliteus,
 Plantaris,
 medial and lateral heads of
the Gastrocnemius,
 some lymph glands,
 fat.
The arteries
supplying the joint
are the highest
genicular, a branch
of the femoral, the
genicular branches
of the popliteal, the
recurrent branches
of the anterior
tibial, and the
descending branch
from the lateral
femoral circumflex
of the profunda
femoris.
• The nerves supplying the joint are derived
from the obturator, femoral, tibial, and
common peroneal.
The following movements occur at the knee
joints:
1. Flexion
2. Extension Main/active movements.
3. Medial rotation
4. Lateral rotation Conjunct movements.