Файл: Atlas of musculoskeletal ultrasound anatomy. By M Bradley and P O\'Donnell, 2002.pdf

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ultrasound musculoskeletal anatomy

194

Pes anserinus

(Figures 240 and 241)

Insertion of sartorius, gracilis and semitendinosus. Semitendinosus inserts onto antero-medial tibia shaft, posterior to gracilis and sartorius. A bursa (anserine bursa) separates gracilis and semitendinosus from the tibia, with another bursa between them and sartorius.

Notes

limb Lower

Knee

FIG. 240 TS, leg extended

Pes anserinus

Fat

Lateral

Medial

Tibia

FIG. 241 TS, pes anserinus

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196

Medial knee

Medial meniscus

(Figures 242–244)

Notes

limb Lower

Knee

FIG. 242 LS, leg straight. Valgus strain may be applied to assess stability

Deep medial collateral ligament

Meniscus

Proximal

Distal

Medial femoral condyle

Medial tibial plateau

FIG. 243 LS, medial meniscus

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Medial collateral ligament

Femoral condyle

 

Tibia

Proximal

Distal

 

Medial meniscus

FIG. 244 LS, medial knee

 

Medial collateral ligament

(Figures 245–249)

Approximately 10 cm in length, arises from the medial femoral epicondyle and extends to the proximal medial tibial shaft. Deeper layer is attached to the medial tibial condyle and blends with the medial meniscus.

Notes

limb Lower

Knee

FIG. 245 LS, leg straight, apply valgus strrain for stability

Sartorius tendon

Medial collateral-superficial and deep layers

Tibia

Femoral condyle

Proximal

Medial meniscus

Distal

FIG. 246 LS, medial collateral ligament

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ultrasound musculoskeletal anatomy

FIG. 247 LS panorama, medial knee

Proximal

Medial collateral

Distal

Femoral condyle

Meniscus Tibia

FIG. 248 LS, medial collateral ligament

200


Femoral attachment

Tibial attachment

Proximal

Femur

Medial meniscus

Tibia

Distal

FIG. 249 LS, medial collateral ligament

limb Lower

Knee

201

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202

Lateral knee

Lateral collateral ligament

(Figures 250–252)

The lateral collateral ligament arises from the lateral femoral epicondyle and extends to the apex of the fibula.

Notes

limb Lower

Knee

FIG. 250 LS, leg extended, probe over lateral knee

Lateral collateral

Proximal

Distal

Femoral condyle

Fibula

FIG. 251 LS, lateral collateral ligament

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Ligament

Fibula head

Proximal

Distal

Femoral condyle

Popliteus tendon

FIG. 252 LS, lateral collateral ligament, composite image

Common peroneal nerve

(Figures 253 and 254)

This is a terminal branch of the sciatic nerve formed just proximal to the popliteal fossa. It lies on the lateral head of gastrocnemius and then on the neck of the fibula and is deep to biceps femoris. It pierces peroneus longus to divide into superficial and deep branches.

Notes


limb Lower

Knee

FIG. 253 TS, knee flexed, probe over fibula neck

Fibula head

Fibula neck

Peroneus longus

Proximal

Common peroneal nerve

Peroneus brevis

Distal

FIG. 254 TS, common peroneal nerve

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Posterior knee

Popliteal fossa

(Figures 255 and 256)

Contents:

Popliteal artery and vein, and branches, tibial and common peroneal nerves, lymph nodes and fat.

Boundaries

Lateral: biceps.

Medial: semitendinosus, semimembranosus.

Inferior: medial and lateral heads of gastrocnemius.

Posterior cruciate ligament

The posterior cruciate ligament (PCL) extends from lateral surface of medial femoral condyle to posterior intercondylar area of tibia.

Notes

limb Lower

Knee

FIG. 255 LS, posterior knee, medial popliteal fossa

Medial head gastrocnemius

Proximal

Posterior tibial

plateau

 

 

Distal

PCL

FIG. 256 LS, posterior cruciate ligament

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Lateral popliteal fossa

(Figures 257–260)

Biceps femoris attaches to apex of fibula.

Popliteus tendon arises from the lateral femoral epicondyle, and is attached to the lateral meniscus. The muscle attaches to the posterior tibia proximal to the soleal line. Popliteus bursa lies between the muscle and tibia.

Notes

limb Lower

Knee

FIG. 257 LS, probe over lateral popliteal fossa. Biceps femoris insertion normally appears slightly hypo-echoic and expanded

Biceps tendon

Fibular head

Proximal

Distal

FIG. 258 LS, biceps

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Popliteus tendon

Femur

Proximal

Tibia

Distal

FIG. 259 LS, popliteus tendon

Popliteus

Lateral collateral ligament

Tibia

Proximal

Lateral femoral condyle

Lateral meniscus

Distal

FIG. 260 LS, posterolateral knee

Popliteal fossa “cyst space”

(Figures 261 and 262)

Cyst neck lies between medial head of gastrocnemius and semimembranosus tendon.