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英文视频|膝关节解剖和重点词汇汇总
下方视频可放大观看:

视频中词汇汇总:

Anatomy of the Knee Joint膝关节解剖

Medial = closer to midline内侧=靠近中线

Medial Meniscus内侧半月板

Anterior前部

Posterior后部

Anterior Cruciate Ligament前交叉韧带

Patella髌骨

Femur 股骨

Knee Joint Capsule膝关节囊

Femoral Condyles股骨髁

Tibial Plateau胫骨平台

Patellofemoral Groove髌股沟

Articular Cartilage关节软骨

Medial Collateral Ligament内侧副韧带MCL

Lateral Collateral Ligament外侧副韧带LCL

Anterior Cruciate Ligament (ACL)前交叉韧带(ACL)

Posterior Cruciate Ligament (PCL)后交叉韧带(PCL)

Lateral Meniscus外侧半月板

Medial Meniscus内侧半月板

Imaginary Meniscus假想半月板

Flat Plate(Tibial Plateau)平板(胫骨平台)

Mensicus Wedge Shape弯月形楔子

Quadriceps Tendon股四头肌腱

Patellar Tendon髌腱

Hamstring Muscles腘绳肌

Hamstring Tendons腘绳肌腱

Tibial Nerve胫神经

Common Peroneal Nerve腓总神经

Sciatic Nerve坐骨神经

Popliteal Artery/Vein腘动脉/静脉


补充文章:

from:https://teachmeanatomy.info/lower-limb/joints/knee-joint/

The knee joint is a hinge type synovial joint, which mainly allows for flexion and extension (and a small degree of medial and lateral rotation). It is formed by articulations between the patella, femur and tibia.

In this article, we shall examine the anatomy of the knee joint – its articulating surfaces, ligaments and neurovascular supply.

Fig 1 – The femur, tibia and patella of the knee joint.

Articulating Surfaces

The knee joint consists of two articulations – tibiofemoral and patellofemoral. The joint surfaces are lined with hyaline cartilage and are enclosed within a single joint cavity.

Tibiofemoral – medial and lateral condyles of the femur articulate with the tibial condyles. It is the weight-bearing component of the knee joint.

Patellofemoral – anterior aspect of the distal femur articulates with the patella. It allows the tendon of the quadriceps femoris (knee extensor) to be inserted directly over the knee – increasing the efficiency of the muscle.

As the patella is both formed and resides within the quadriceps femoris tendon, it provides a fulcrum to increase power of the knee extensor and serves as a stabilising structure that reduces frictional forces placed on femoral condyles.

Fig 2 – More detailed view of the bony surfaces. The inferior surface of the femur and superior surface of the tibia is shown.

Neurovascular Supply

The blood supply to the knee joint is through the genicular anastomoses around the knee, which are supplied by the genicular branches of the femoral and popliteal arteries.

The nerve supply, according to Hilton’s law, is by the nerves which supply the muscles which cross the joint. These are the femoral, tibial and common fibular nerves.

Menisci

The medial and lateral menisci are fibrocartilage structures in the knee that serve two functions:

To deepen the articular surface of the tibia, thus increasing stability of the joint.

To act as shock absorbers by increasing surface area to further dissipate forces.

They are C shaped and attached at both ends to the intercondylar area of the tibia.

In addition to the intercondylar attachment, the medial meniscus is fixed to the tibial collateral ligament and the joint capsule. Damage to the tibial collateral ligament usually results in a medial meniscal tear.

The lateral meniscus is smaller and does not have any extra attachments, rendering it fairly mobile.

Fig 3 – Posterior view of the knee joint, with the joint capsule removed. Note the close relationship of the tibial collateral ligament, and the medial meniscus

Fig 4 – The menisci of the knee joint. Superior surface of the tibia

膝关节为铰链型滑膜关节,主要允许屈伸(以及小程度的内外侧旋转)。它由髌骨、股骨和胫骨之间的关节组成。

在这篇文章中,我们将检查膝关节的解剖-它的关节表面,韧带和神经血管供应。

图1 -膝关节的股骨、胫骨和髌骨。

阐明表面

膝关节由两个关节-胫股关节和髌股关节组成。关节表面衬有透明软骨,封闭在一个关节腔内。

胫股-股骨的内侧和外侧髁与胫骨髁关节。它是膝关节的承重部件。

髌股-股骨远端关节与髌骨的前侧面。它允许股四头肌肌腱(伸膝肌)直接插入膝盖上方,增加了肌肉的效率。

由于髌骨既在股四头肌肌腱内形成,也在股四头肌肌腱内,它提供了一个支点来增加膝关节伸肌的力量,并作为一个稳定结构来减少施加在股骨髁上的摩擦力。

图2 -骨表面的更详细视图。图示股骨的下表面和胫骨的上表面。

神经与血管的供应

膝关节的血液供应是通过膝关节周围的膝动脉吻合,由股动脉和腘动脉的膝动脉分支提供。

根据希尔顿定律,神经供应是由供应穿过关节的肌肉的神经构成的。这些是股神经,胫骨神经和腓骨神经。

半月板

内侧半月板和外侧半月板是膝关节的纤维软骨结构,有两个功能:

加深胫骨关节面,从而增加关节的稳定性。

减震器,减震器通过增加表面面积来进一步驱散力量。

它们呈C形,两端附着在胫骨的髁间区域。

除了髁间附着,内侧半月板固定在胫骨副韧带和关节囊上。胫骨副韧带的损伤通常导致内侧半月板撕裂。

外侧半月板较小,没有任何额外的附着,使其具有相当的可移动性。

图3 -关节囊被取出后膝关节后视图。注意胫骨副韧带和内侧半月板的密切关系

图4 -膝关节半月板。胫骨上表面

Bursae

A bursa is synovial fluid filled sac, found between moving structures in a joint – with the aim of reducing wear and tear on those structures. There are four bursae found in the knee joint:

Suprapatellar bursa – an extension of the synovial cavity of the knee, located between the quadriceps femoris and the femur.

Prepatellar bursa – found between the apex of the patella and the skin.

Infrapatellar bursa – split into deep and superficial. The deep bursa lies between the tibia and the patella ligament. The superficial lies between the patella ligament and the skin.

Semimembranosus bursa – located posteriorly in the knee joint, between the semimembranosus muscle and the medial head of the gastrocnemius.

Fig 5 – Sagittal view of the knee joint, showing the major bursae.

Ligaments

The major ligaments in the knee joint are:

Patellar ligament – a continuation of the quadriceps femoris tendon distal to the patella. It attaches to the tibial tuberosity.

Collateral ligaments – two strap-like ligaments. They act to stabilise the hinge motion of the knee, preventing excessive medial or lateral movement

Tibial (medial) collateral ligament – wide and flat ligament, found on the medial side of the joint. Proximally, it attaches to the medial epicondyle of the femur, distally it attaches to the medial condyle of the tibia.

Fibular (lateral) collateral ligament – thinner and rounder than the tibial collateral, this attaches proximally to the lateral epicondyle of the femur, distally it attaches to a depression on the lateral surface of the fibular head.

Cruciate Ligaments – these two ligaments connect the femur and the tibia. In doing so, they cross each other, hence the term 'cruciate’ (Latin for like a cross)

Anterior cruciate ligament – attaches at the anterior intercondylar region of the tibia where it blends with the medial meniscus. It ascends posteriorly to attach to the femur in the intercondylar fossa. It prevents anterior dislocation of the tibia onto the femur.

Posterior cruciate ligament – attaches at the posterior intercondylar region of the tibia and ascends anteriorly to attach to the anteromedial femoral condyle. It prevents posterior dislocation of the tibia onto the femur.

Fig 6 – Anterior view of the knee joint, showing some of the major ligaments. The patella ligament is situated on the anterior aspect of the knee joint, and is not visible is this diagram.

Movements

There are four main movements that the knee joint permits:

Extension:  Produced by the quadriceps femoris, which inserts into the tibial tuberosity.

Flexion: Produced by the hamstrings, gracilis, sartorius and popliteus.

Lateral rotation: Produced by the biceps femoris.

Medial rotation: Produced by five muscles; semimembranosus, semitendinosus, gracilis, sartorius and popliteus.

黏液囊

囊是充满滑液的囊,位于关节内运动结构之间,目的是减少关节结构的磨损。膝关节有四个滑囊:

髌上囊-膝关节滑膜腔的延伸,位于股四头肌和股骨之间。

髌前囊-位于髌骨顶点和皮肤之间。

髌下囊分为深囊和浅囊。深囊位于胫骨和髌骨韧带之间。浅层位于髌骨韧带和皮肤之间。

半膜囊-位于膝关节后部,半膜囊肌和腓肠肌内侧头之间。

图5 -膝关节矢状面,显示主要滑囊。

韧带

膝关节的主要韧带有:

髌韧带-髌远端股四头肌腱的延续。它附着在胫骨粗隆上。

副韧带-两个带状韧带。它们的作用是稳定膝关节的铰链运动,防止过度的内侧或外侧运动

胫骨(内侧)副韧带-宽而平的韧带,位于关节内侧。在近端,它附着于股骨的内上髁,在远端,它附着于胫骨的内髁。

腓骨(外侧)副韧带——比胫骨副韧带更薄、更圆,其近端附着于股骨外上髁,远端附着于腓骨头外侧表面的凹陷处。

交叉韧带——这两个韧带连接股骨和胫骨。在这样做的过程中,它们相互交叉,因此有了“十字”这个词(拉丁文的意思是像十字架)。

前交叉韧带-附着在胫骨的前髁间区域,在那里它与内侧半月板融合。它向后上升连接到股骨在髁间窝。它可以防止胫骨到股骨的前脱位。

后交叉韧带-附着在胫骨的后髁间区域,并向前上升附着在股骨前内侧髁上。它可以防止胫骨到股骨的后脱位。

图6 -膝关节前视图,显示一些主要韧带。髌骨韧带位于膝关节的前部,在这张图中是不可见的。

运动

膝关节允许的主要运动有四种:

伸展:由股四头肌产生,插入胫骨粗隆。

屈肌:由腘绳肌、股薄肌、缝匠肌和腘肌产生。

横向旋转:由股二头肌产生。

内侧旋转:由五块肌肉产生;半膜肌、半腱肌、股薄肌、缝匠肌和腘肌。


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