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Anatomy Atlases: Atlas of Human Anatomy in Cross Section: Section 7. Lower Limb

Atlas of Human Anatomy in Cross Section: Section 7. Lower Limb

Plate 7.9

Ronald A. Bergman, Ph.D., Adel K. Afifi, M.D., Jean J. Jew, M.D., and Paul C. Reimann, B.S.
Peer Review Status: Externally Peer Reviewed


Plate 7.9

Upper Left Quadrant

Lower Left Quadrant

Lower Right Quadrant

Upper Right Quadrant

1. Subcutaneous (subfascial) prepatellar bursa
2. Tendon m. quadriceps
3. Alar plica
4. Transverse medial patellar retinaculum
5. Vastus medialis m.

6. Medial femoral epicondyle
7. Sartorius m.
8. Great saphenous v.
9. Articular cavity
10. Tendon m. gracilis
11. Tendon and m. semimembranosus
12. Tendon m. semitendinosus
13. Gastrocnemius (medial head) m.

14. Intercondylar fossa
15. Posterior femoral cutaneous nerve and small saphenous v.
16. Popliteal v. and a.
17. Common peroneal nerve
18. Lateral sural cutaneous nerve
19. Tibial nerve
20. Plantaris m.
21. Articular cavity
22. Biceps femoris m.

23. Lateral femoral epicondyle
24. Iliotibial tract (Maissiat's band)
25. Tendon m. vastus lateralis
26. Articular cavity
27. Femur
28. Patella

This section passes through the patella (28) and the medial (6) and lateral (23) epicondyles of the femur (27). The intercondylar fossa (14) and the articular cavity (26, 9) are seen.

At this level, several tendons and a retinaculum are found. These include the tendon of the vastus lateralis muscle (25), iliotibial tract (24), tendon of semimembranosus muscle (11), tendon of semitendinosus muscle (12), tendon of gracilis muscle (10), the transverse medial patellar retinaculum (4), and the tendon of the quadriceps muscle (2).

The lateral sural cutaneous nerve (18) (seen for the first time) and the posterior femoral cutaneous nerve (15) are identified.

The lateral sural cutaneous nerve is extremely variable. It leaves the common peroneal in the popliteal space and supplies the skin of the lower lateral part of the calf. One branch (peroneal anastomotic branch) may join with a branch of the medial sural cutaneous nerve to form the sural nerve. This nerve is also variable but usually descends along the lateral edge of the calcaneal tendon and sends lateral calcaneal branches to the lateral side of the heel, as well as a lateral dorsal cutaneous nerve to the lateral side of the foot.

The posterior femoral cutaneous nerve arises from the first, second, and third sacral nerves. It leaves the pelvis at the posterior surface of the sciatic nerve. It continues distally in the thigh, breaking up into terminal branches. Perineal branches go to the skin of the medial part of the thigh and the adjacent part of the scrotum or labium majus. One of these branches, the long pudendal nerve, runs medially dorsad to the ischial tuberosity. Inferior cluneal branches go to the skin of the lower medial part of the buttock. Femoral branches supply the skin of the back of the thigh and calf.

The alar plica (3) or alar folds are prominent crescentic folds of synovial membrane, extending dorsalward on each side of the patella from the base of the infrapatellar synovial fold. Their free margins are concave and thin.

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