dots-menu
×

Home  »  Anatomy of the Human Body  »  pages 346

Henry Gray (1825–1861). Anatomy of the Human Body. 1918.

pages 346

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 are derived from the obturator, femoral, tibial, and common peroneal.

Movements.—The movements which take place at the knee-joint are flexion and extension, and, in certain positions of the joint, internal and external rotation. The movements of flexion and extension at this joint differ from those in a typical hinge-joint, such as the elbow, in that (a) the axis around which motion takes place is not a fixed one, but shifts forward during extension and backward during flexion; (b) the commencement of flexion and the end of extension are accompanied by rotatory movements associated with the fixation of the limb in a position of great stability. The movement from full flexion to full extension may therefore be described in three phases:
  1. In the fully flexed condition the posterior parts of the femoral condyles rest on the corresponding portions of the meniscotibial surfaces, and in this position a slight amount of simple rolling movement is allowed.


FIG. 352– Capsule of right knee-joint (distended). Posterior aspect. (See enlarged image)
  2. During the passage of the limb from the flexed to the extended position a gliding movement is superposed on the rolling, so that the axis, which at the commencement is represented by a line through the inner and outer condyles of the femur, gradually shifts forward. In this part of the movement, the posterior two-thirds of the tibial articular surfaces of the two femoral condyles are involved, and as these have similar curvatures and are parallel to one another, they move forward equally.
  3. The lateral condyle of the femur is brought almost to rest by the tightening of the anterior cruciate ligament; it moves, however, slightly forward and medialward, pushing before it the anterior part of the lateral meniscus. The tibial surface on the medial condyle is prolonged farther forward than that on the lateral, and this prolongation is directed lateralward. When, therefore, the movement forward of the condyles is checked by the anterior cruciate ligament, continued muscular action causes the medial condyle, dragging with it the meniscus, to travel backward and medialward, thus producing an internal rotation of the thigh on the leg. When the position of full extension is reached the lateral part of the groove on the lateral condyle is pressed against the anterior part of the corresponding meniscus, while the medial part of the