1. The Knee (Tibiofemoral) Joint
By: Jackie, Stacey, Gabe, and scharlie

2. Bones and Surface Anatomy
By: Jackie

3. KNEE (TIBIOFEMORAL) JOINT
FEMUR:
Lateral Epicondyle
Lateral Condyle
Medial Epicondyle
Medial Condyle
Intercondylar Fossa
TIBIA:
Tibial Tuberosity
Intercondylar Eminence
FIBULA:
Head
PATELLA

4. SURFACE ANATOMY
Vastus Medialis
Vastus Lateralis
Patella

5. SURFACE ANATOMY
Biceps Femoris Tendon
Semitendinous Tendon
Semimembranous Tendon

6. SURFACE ANATOMY
Medial Head of Gastronemius
Lateral Head of Gastronemius
Soleus
Popliteal Fossa

7. Ligaments, Bursae, and Cartilage
By: stacey

8. Ligament Review lig·a·ment
a short band of tough, flexible, fibrous connective tissue that connects two bones or cartilages or holds together a joint.
a membranous fold that supports an organ and keeps it in position.

9. Knee Ligaments Anterior Cruciate Ligament Oblique Popliteal Ligament
Patellar Ligament
Transverse Ligament
Anterior Cruciate Ligament
Oblique Popliteal Ligament
Tibial Collateral Ligament
Arcuate Popliteal Ligament
Fibular Collateral Ligament
Posterior Cruciate Ligament
PTA OTA Fine People

10. Patellar Ligament Tibial Collateral Ligament Anterior Cruciate Ligament Posterior Cruciate Ligament

11. Oblique Popliteal Arcuate Popliteal Fibular Collateral

12. Tendon Review
ten·don a flexible but inelastic cord of strong fibrous collagen tissue attaching a muscle to a bone.

13. Quadriceps Femoris Tendon

14. Cartilage Review
firm, whitish, flexible connective tissue found in various forms in the larynx and respiratory tract, in structures such as the external ear, and in the articulating surfaces of joints.

15. Lateral and Medial Menisci

16. Bursa Review
bur·sa plural noun: bursae a fluid-filled sac or saclike cavity, especially one countering friction at a joint.

17. Prepatellar Bursa Deep Infrapatellar Bursa Subcutaneous Infrapatellar Bursa

18. Suprapatellar Bursa

22. Tibiofemoral Joint By: gabe
Muscles and Nerves
Tibiofemoral Joint
By: gabe

23. Rectus Femoris

24. Rectus Femoris Origin: ASIS
Insertion: Patella via quadriceps tendon and then the tibial tuberosity via patellar tendon (ligament)
Action: Hip Flexion and knee extension
Nerve: Femoral Nerve

25. Vastus Intermedialis

26. Vastus Intermedialis
Origin: Anterior 2/3 and the lateral shaft of the femur
Insertion: Patella via quadriceps tendon and then tibial tuberosity via patellar ligament
Action: Knee Extension
Nerve: Femoral Nerve

27. Vastus Lateralis

28. Vastus Lateralis
Origin: Intertrochanteric line and linea aspera of the femur
Insertion: Patella via quadriceps tendon then tibial tuberosity via patellar tendon (ligament)
Action: Knee Extension
Nerve: Femoral Nerve

29. Vastus Medialis

30. Vastus Medialis Origin: Linea aspera of the femur
Insertion: Patella via the quadriceps tendon and the tibial tuberosity via the patellar tendon (ligament)
Action: Knee extension
Nerve: Femoral Nerve

31. Biceps Femoris

32. Biceps Femoris Origin: Long Head- Ischial tuberosity
Short Head- Linea aspera of the femur
Insertion: Head of the fibula and lateral condyle of the tibia
Action:
Long Head- Extends hip and flexes knee
Short Head- Flexes knee and laterally rotates hip
Nerve: Tibial Nerve

33. Semimembranosus

34. Semimembranosus Origin: Ischial tuberosity
Insertion: Posterior medial condyle of the tibia
Action: Extends and medial rotates the hip; Knee flexion
Nerve: Tibial Nerve

35. Semitendinosus

36. Semitendinosus Origin: Ischial tuberosity
Insertion: Proximal part of medial shaft of tibia
Action: Extends and medially rotates hip; Flexes knee
Nerve: Tibial nerve

37. Popliteus

38. Popliteus Origin: Lateral condyle of femur and lateral meniscus
Insertion: Posterior surface of tibia
Action: Unlocks knee and weakly flexes the knee
Nerve: Tibial

39. Gastrocnemius

40. Gastrocnemius Origin: Lateral head- Lateral condyle of femur
Medial Head- Superior to medial condyle of femur
Insertion: Posterior calcaneus via calcaneal (Achilles) tendon
Action: Plantar flexes ankle
Nerve: Tibial

41. Tibiofemoral Nerves Sciatic Nerve Femoral Nerve Tibial Nerve
Superficial Fibular (Peroneal) Nerve
Deep Fibular (Peroneal) Nerve

42. Tibiofemoral Nerves

43. Arteries and veins that pass through the knee (tibiofemoral) joint
Vascular Supply
Arteries and veins that pass through the knee (tibiofemoral) joint
By: Scharlie

44. Arteries: Inferior Gluteal Artery
Inferior Gluteal Artery (CUT)
Inferior Gluteal Artery
Branches from the Internal Iliac Artery.
Leaves pelvis through the greater sciatic foramen and passes inferior to the piriformis.
Posterior View
Medial Circumflex Femoral Artery
Femoral Artery

45. Medial Circumflex Femoral Artery
Branches Posteriorly behind Femur
Lateral Circumflex Femoral Artery
Branches Anteriorly in front of Femur
Both may branch from profundus femoris or femoral arteries
Both encircle thigh, anastomose, and supply thigh muscles and proximal end of Femur.
Anterior View
Inferior Gluteal Artery

46. Femoral Artery
Femoral
Continuation of External Iliac Artery distal to inguinal ligament.
Passes through adductor hiatus and becomes Popliteal Artery
Popliteal
Continuation of Femoral Artery
Passes behind Posterior Knee
Divides into anterior and posterior tibial arteries
Gives Rise to Genicular Arteries
Popliteal Artery
Anterior View
Anterior Tibial Artery
Posterior Tibial Artery

47. Anterior Tibial Artery
Popliteal
Anterior Tibial Artery
Branches from Popliteal Artery
Passes anteriorly between Tibia and Fibula
Runs down anterior/lateral aspect of Tibia
Posterior Tibial Artery
Continues down posterior aspect of lower leg
Anterior Tibial
Posterior Tibial
Anterior View
Posterior View
Fibular (Peroneal)
Anterior Tibial

48. Anterior Tibial Artery Perforating Fibular Artery
Anterior View of foot
Anterior Tibial Artery
Fibular (Peroneal) Artery
Braches from Popliteal Artery
Runs down lateral aspect of lower leg
Perforating braches supply distal muscles
Dorsalis Pedis Artery
Continuation of Anterior Tibial Artery
Begins at ankle joint between malleoli to top of foot
Perforating Fibular Artery
Dorsalis Pedis Artery

49. Veins: Anterior Tibial Vein Posterior Tibial Vein
Superior continuation of dorsalis Pedis Vein
Runs up anterior tibia until moving posterior to join posterior tibial vein
Drains into Popliteal Vein
Posterior Tibial Vein
Drains into Popliteal Vein after joining the Anterior Tibial Vein
Both supply calf and foot
Anterior Tibial Vein
Posterior Tibial Vein
Anterior View

50. Fibular (Peroneal) Vein
More posterior/lateral in lower leg
Drains into the Popliteal Vein
Popliteal Vein
Anterior and Posterior Tibial Veins join to form the Popliteal Vein
Crosses back of knee and becomes Femoral Vein at thigh
Femoral Vein
Superior continuation of Popliteal Vein
Becomes the External Iliac Vein in the inguinal region
Femoral Vein
Popliteal Vein
Fibular (Peroneal)Vein
Anterior View

51. Small Saphenous Vein Great Saphenous Vein
Runs along lateral aspect of foot and through the calf muscle
Drains into Popliteal Vein at the knee
Great Saphenous Vein
Superficial and longest vein in the body
Begins in common with Small Saphenous Vein in ankle
Extends up medial side of calf, knee, and thigh
Drains into the Femoral Vein
Great Saphenous Vein
Small Saphenous Vein
Anterior View

52. Overview: Arteries and Veins Quiz1. 3. 2. 4. 5.

53. Clinical Concerns for the Knee (Tibiofemoral) Joint
Torn acl, plantar fasciitis, and tkr
By Scharlie
TKR By Gabe

54. Torn ACL
The injury may occur with or without contact. Women have an increased risk of ACL injury because of differences in anatomy, muscle mass, and training. Symptoms of ACL tear include hearing a loud pop as the ligament tears, pain, knee swelling, and difficulty walking

56. Torn ACL Treatment Treatment options include: Acute treatment: R.I.C.E
Nonsurgical treatment only: a physical rehab program.
ACL surgery to reconstruct the ACL (will still need physical therapy)
Recovery from an ACL injury varies for each person. Your treatment should continue until your knee is stable and strong rather than for a certain length of time.

57. Plantar Fasciitis

58. Signs and Symptoms:
When plantar fasciitis occurs, the pain is typically sharp and unilateral. Heel pain worsens by bearing weight on the heel after long periods of rest. Improvement of symptoms is usually seen with continued walking
Risk Factors:
Identified risk factors for plantar fasciitis include excessive running, standing on hard surfaces for prolonged periods of time, high arches of the feet, and flat feet. Obesity is seen in 70% of individuals with plantar fasciitis. Achilles tendon tightness and inappropriate footwear have also been identified as significant risk factors.
Treatment:
Non-surgical: (90% of cases)Include rest, heat, ice, calf-strengthening exercises, techniques to stretch the calf muscles, Achilles tendon, and plantar fascia, and weight reduction.
Surgical: Plantar fasciotomy (release of fascia) is often considered after conservative treatment has failed to resolve the issue after six months and is viewed as a last resort.

59. Torn ACL Surgical Repair https://www.youtube.com/watch?v=9EgRHfoleLc
Videos:
Torn ACL Surgical Repair
Dr. E. Edward Khalfayan, M.D.
Total Knee Replacement Surgery

60. Questions
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61. Resources: Google Images:
X&ei=WIttVOG2DKWQigLJr4CYDQ&ved=0CAYQ_AUoAQ
Moore KL, Agur AM, Dalley AF, Essential Clinical Anatomy. 4th ed. Baltimore,MD: Lippincott Williams & Wilkins;2011.
Pearson Learning Solutions Lab Manual, Integrate Anatomy & Physiology: Pearson Learning Solutions;2011.
Youtube:
Google Web