Vastus intermedius muscle
The vastus intermedius arises from the front and lateral surfaces of the body of the femur in its upper two-thirds, sitting under the rectus femoris muscle and from the lower part of the lateral intermuscular septum. Its fibers end in a superficial aponeurosis, which forms the deep part of the quadriceps femoris tendon; the vastus medialis and vastus intermedius appear to be inseparably united, but when the rectus femoris has been reflected during dissection a narrow interval will be observed extending upward from the medial border of the patella between the two muscles, the separation may be continued as far as the lower part of the intertrochanteric line, however, the two muscles are continuous. Due to being the deeper middle-most of the quadriceps muscle group, the intermedius is the most difficult to stretch once maximum knee flexion is attained, it cannot be further stretched by hip extension as the rectus femoris can, nor is it accessible to manipulate with massage therapy to stretch the fibres sideways as the vastus lateralis and vastus medialis are.
This article incorporates text in the public domain from page 471 of the 20th edition of Gray's Anatomy PTCentral
The gracilis muscle is the most superficial muscle on the medial side of the thigh. It is thin and flattened, broad above and tapering below, it arises by a thin aponeurosis from the anterior margins of the lower half of the symphysis pubis and the upper half of the pubic arch. The muscle's fibers run vertically downward; this tendon passes behind the medial condyle of the femur, curves around the medial condyle of the tibia where it becomes flattened, inserts into the upper part of the medial surface of the body of the tibia, below the condyle. For this reason, the muscle is a lower limb adductor. At its insertion the tendon is situated above that of the semitendinosus muscle, its upper edge is overlapped by the tendon of the sartorius muscle, which it joins to form the pes anserinus; the pes anserinus is separated from the medial collateral ligament of the knee-joint by a bursa. A few of the fibers of the lower part of the tendon are prolonged into the deep fascia of the leg. By its inner or superficial surface gracilis is in relation with the fascia lata, below with the sartorius and internal saphenous nerve.
By its outer or deep surface with the adductor longus and magnus, the internal lateral ligament of the knee-joint, from which it is separated by a synovial bursa common to the tendons of the gracilis and semitendinosus. The obturator nerve innervates the gracilis muscle via the lumbar spinal vertebrae; the muscle adducts, medially rotates, laterally rotates, flexes the hip as above, aids in flexion of the knee. The gracilis muscle is used as a flap in microsurgery. According to the classification of Mathes and Nahai, it presents a type II blood supply, allowing it to be transferred on its artery derived from the medial circumflex femoral artery; this artery enters the muscle about 10 cm from the pubic symphysis. At this point the nerve enters. Gracilis muscle is used in reconstructive surgery, either as a pedicled flap or as a free microsurgical flap. Both pedicled and free flaps can be musculocutaneos; as a pedicled flap, gracilis muscle can be used in perineal and vaginal reconstruction, after oncological surgery, in the treatment of recurrent anovaginal and rectovaginal fistulas as well in the coverage of the neurovascular bundle after vascular surgery.
As a functioning pedicled flap, the gracilis muscle can be transferred for the treatment of anal incontinence. This technique called graciloplasty was described in the 1950s by Pickrell and was revolutionized in the late 1980s by the introduction of chronic muscle electro-stimulation; the gracilis microsurgical free flap is used in the reconstruction of upper and lower limbs, in breast reconstruction and – as a free functioning flap – to restore forearm function or in dynamic reconstruction of facial paralysis. Gracilis Muscles Clinical Role The muscle may be split to reduce bulk for facial reanimation, as well as to repair hand muscles, it can be used to fashion an external anal sphincter. This article incorporates text in the public domain from page 471 of the 20th edition of Gray's Anatomy Anatomy figure: 12:02-07 at Human Anatomy Online, SUNY Downstate Medical Center - "Muscles of the anterior compartment of the thigh." Anatomy figure: 14:02-02 at Human Anatomy Online, SUNY Downstate Medical Center - "Muscles that form the superficial boundaries of the popliteal fossa."
Cross section image: pembody/body18b—Plastination Laboratory at the Medical University of Vienna
Quadriceps femoris muscle
The quadriceps femoris is a large muscle group that includes the four prevailing muscles on the front of the thigh. It is the great extensor muscle of the knee, forming a large fleshy mass which covers the front and sides of the femur; the name derives from Latin four-headed muscle of the femur. It is subdivided into four separate portions or'heads', which have received distinctive names: Rectus femoris occupies the middle of the thigh, covering most of the other three quadriceps muscles, it originates on the ilium. It is named from its straight course; the other three lie deep to rectus femoris and originate from the body of the femur, which they cover from the trochanters to the condyles: Vastus lateralis is on the lateral side of the femur. Vastus medialis is on the medial side of the femur. Vastus intermedius lies between vastus lateralis and vastus medialis on the front of the femur, but deep to the rectus femoris, it cannot be seen without dissection of the rectus femoris. All four parts of the quadriceps muscle insert into the tuberosity of the tibia via the patella, where the quadriceps tendon becomes the patellar ligament.
There is a fifth muscle of the quadriceps complex, forgotten and taught called articularis genus. In addition, recent cadaver studies have confirmed the presence of a sixth muscle, the tensor vastus intermedius. While the muscle has variable presentations, it originates at the proximal femur, runs between the vastus lateralis and vastus intermedius muscles, inserts distally at the medial aspect of the patellar base. Considered a part of the vastus lateralis, the tensor vastus intermedius muscle is innervated by an independent branch of the femoral nerve and its tendinous belly can be separated from the vasti lateralis and intermedius muscles in most cases. Femoral nerve. All four quadriceps are powerful extensors of the knee joint, they are crucial in walking, running and squatting. Because the rectus femoris attaches to the ilium, it is a flexor of the hip; this action is crucial to walking or running as it swings the leg forward into the ensuing step. The quadriceps the vastus medialis, play the important role of stabilizing the patella and the knee joint during gait.
In strength training, the quadriceps are trained by several leg exercises. Effective exercises include the leg press; the isolation movement is the leg extension exercise. In body building communities, this muscle is colloquially referred to as the "leg triceps"; the proper Latin plural form of the adjective quadriceps would be quadricipites. In modern English usage, quadriceps is used in both plural; the singular form quadricep, produced by back-formation, is used. Hamstring Quadriceps_muscle at the Duke University Health System's Orthopedics program Muscles/Quadriceps at exrx.net "Anatomy diagram: 39960.000-1". Roche Lexicon - illustrated navigator. Elsevier. Archived from the original on 2014-01-01
The sartorius muscle is the longest muscle in the human body. It is a long, superficial muscle that runs down the length of the thigh in the anterior compartment; the sartorius muscle originates from the anterior superior iliac spine and part of the notch between the anterior superior iliac spine and anterior inferior iliac spine. It runs obliquely across the anterior part of the thigh in an inferomedial direction, it passes behind the medial condyle of the femur to end in a tendon. This tendon curves anteriorly to join the tendons of the gracilis and semitendinosus muscles in the pes anserinus, where it inserts into the superomedial surface of the tibia, its upper portion forms the lateral border of the femoral triangle, the point where it crosses adductor longus marks the apex of the triangle. Deep to sartorius and its fascia is the adductor canal, through which the saphenous nerve, femoral artery and vein, nerve to vastus medialis pass. Like the other muscles in the anterior compartment of the thigh, sartorius is innervated by the femoral nerve.
It may originate from the outer end of the inguinal ligament, the notch of the ilium, the ilio-pectineal line or the pubis. The muscle may be split into two parts, one part may be inserted into the fascia lata, the femur, the ligament of the patella or the tendon of the semitendinosus; the tendon of insertion may end in the fascia lata, the capsule of the knee-joint, or the fascia of the leg. The muscle may be absent in some people; the sartorius muscle can move the hip joint and the knee joint, but all of its actions are weak, making it a synergist muscle. At the hip, it can flex, weakly abduct, laterally rotate the thigh. At the knee, it can flex the leg. Turning the foot to look at the sole or sitting cross-legged demonstrates all four actions of the sartorius. One of the many conditions that can disrupt the use of the sartorius is pes anserine bursitis, an inflammatory condition of the medial portion of the knee; this condition occurs in athletes from overuse and is characterized by pain and tenderness.
The pes anserinus is made up from the tendons of the gracilis and sartorius muscles. When inflammation of the bursa underlying the tendons occurs they separate from the head of the tibia. Sartorius comes from the Latin word sartor, meaning tailor, it is sometimes called the tailor's muscle; this name was chosen in reference to the cross-legged position. In French, the muscle name itself "couturier" comes from this specific position, referred to as "sitting as a tailor". There are other hypotheses as to the genesis of the name. One is that it refers to the location of the inferior portion of the muscle being the "inseam" or area of the inner thigh that tailors measure when fitting trousers. Another is that the muscle resembles a tailor's ribbon. Additionally, antique sewing machines required continuous cross body pedaling; this combination of lateral rotation and flexion of the hip and flexion of the knee gave tailors enlarged sartorius muscles. The sartorius is called the honeymoon muscle; this article incorporates text in the public domain from page 470 of the 20th edition of Gray's Anatomy Anatomy photo:14:st-0407 at the SUNY Downstate Medical Center Cross section image: pembody/body15a—Plastination Laboratory at the Medical University of Vienna Cross section image: pelvis/pelvis-e12-15—Plastination Laboratory at the Medical University of Vienna
Anterior compartment of thigh
The anterior compartment of thigh contains muscles which extend the knee and flex the hip. The anterior compartment is one of the fascial compartments of the thigh that contains groups of muscles together with their nerves and blood supply; the anterior compartment contains the sartorius muscle and the quadriceps femoris group, which consists of the rectus femoris muscle and the three vasti muscles – the vastus lateralis, vastus intermedius, the vastus medialis. The iliopsoas is sometimes considered a member of the anterior compartment muscles, as is the articularis genus muscle; the anterior compartment is separated from the posterior compartment by the lateral intermuscular septum and from the medial compartment by the medial intermuscular septum. The nerve of the anterior compartment of thigh is the femoral nerve. Innervation for the quadriceps muscles come from the posterior division of the femoral nerve, while the anterior division gives a lateral and a medial branch, the second being responsible for the innervation of the sartorius muscle.
The iliacus and the psoas major and psoas minor muscles, sometimes considered part of the anterior compartment, do not share the same innervation. Whereas the iliacus is innervated by the femoral nerve, the psoas is innervated by ventral rami of L1-L3; when the external iliac artery crosses the inguinal ligament, it becomes the femoral artery, which supplies blood to the anterior compartment and is the largest blood vessel of the inferior member. The anterior compartment of thigh contains muscles which are extensors of the knee and flexors of the hip joints; the anterior compartment may be affected as part of a compartment syndrome. Antthigh at The Anatomy Lesson by Wesley Norman knee/muscles/thigh1 at the Dartmouth Medical School's Department of Anatomy Overview at stanford.edu
Anatomical terminology is a form of scientific terminology used by anatomists and health professionals such as doctors. Anatomical terminology uses many unique terms and prefixes deriving from Ancient Greek and Latin; these terms can be confusing to those unfamiliar with them, but can be more precise, reducing ambiguity and errors. Since these anatomical terms are not used in everyday conversation, their meanings are less to change, less to be misinterpreted. To illustrate how inexact day-to-day language can be: a scar "above the wrist" could be located on the forearm two or three inches away from the hand or at the base of the hand. By using precise anatomical terminology such ambiguity is eliminated. An international standard for anatomical terminology, Terminologia Anatomica has been created. Anatomical terminology has quite regular morphology, the same prefixes and suffixes are used to add meanings to different roots; the root of a term refers to an organ or tissue. For example, the Latin names of structures such as musculus biceps brachii can be split up and refer to, musculus for muscle, biceps for "two-headed", brachii as in the brachial region of the arm.
The first word describes what is being spoken about, the second describes it, the third points to location. When describing the position of anatomical structures, structures may be described according to the anatomical landmark they are near; these landmarks may include structures, such as the umbilicus or sternum, or anatomical lines, such as the midclavicular line from the centre of the clavicle. The cephalon or cephalic region refers to the head; this area is further differentiated into the cranium, frons, auris, nasus and mentum. The neck area is called cervical region. Examples of structures named according to this include the frontalis muscle, submental lymph nodes, buccal membrane and orbicularis oculi muscle. Sometimes, unique terminology is used to reduce confusion in different parts of the body. For example, different terms are used when it comes to the skull in compliance with its embryonic origin and its tilted position compared to in other animals. Here, Rostral refers to proximity to the front of the nose, is used when describing the skull.
Different terminology is used in the arms, in part to reduce ambiguity as to what the "front", "back", "inner" and "outer" surfaces are. For this reason, the terms below are used: Radial referring to the radius bone, seen laterally in the standard anatomical position. Ulnar referring to the ulna bone, medially positioned when in the standard anatomical position. Other terms are used to describe the movement and actions of the hands and feet, other structures such as the eye. International morphological terminology is used by the colleges of medicine and dentistry and other areas of the health sciences, it facilitates communication and exchanges between scientists from different countries of the world and it is used daily in the fields of research and medical care. The international morphological terminology refers to morphological sciences as a biological sciences' branch. In this field, the form and structure are examined as well as the changes or developments in the organism, it is functional.
It covers the gross anatomy and the microscopic of living beings. It involves the anatomy of the adult, it includes comparative anatomy between different species. The vocabulary is extensive and complex, requires a systematic presentation. Within the international field, a group of experts reviews and discusses the morphological terms of the structures of the human body, forming today's Terminology Committee from the International Federation of Associations of Anatomists, it deals with the anatomical and embryologic terminology. In the Latin American field, there are meetings called Iberian Latin American Symposium Terminology, where a group of experts of the Pan American Association of Anatomy that speak Spanish and Portuguese and studies the international morphological terminology; the current international standard for human anatomical terminology is based on the Terminologia Anatomica. It was developed by the Federative Committee on Anatomical Terminology and the International Federation of Associations of Anatomists and was released in 1998.
It supersedes Nomina Anatomica. Terminologia Anatomica contains terminology for about 7500 human gross anatomical structures. For microanatomy, known as histology, a similar standard exists in Terminologia Histologica, for embryology, the study of development, a standard exists in Terminologia Embryologica; these standards specify accepted names that can be used to refer to histological and embryological structures in journal articles and other areas. As of September 2016, two sections of the Terminologia Anatomica, including central nervous system and peripheral nervous system, were merged to form the Terminologia Neuroanatomica; the Terminologia Anatomica has been perceived with a considerable criticism regarding its content including coverage and spelling mistakes and errors. Anatomical terminology is chosen to highlight the relative location of body structures. For instance, an anatomist might describe one band of tissue as "inferior to" another or a physician might describe a tumor as "superficial to" a deeper body structure.
Anatomical terms used to describe location
The periosteum is a membrane that covers the outer surface of all bones, except at the joints of long bones. Endosteum lines the inner surface of the medullary cavity of all long bones; the periosteum consists of dense irregular connective tissue. It is divided into an outer "fibrous layer" and inner "cambium layer"; the fibrous layer contains fibroblasts, while the cambium layer contains progenitor cells that develop into osteoblasts. These osteoblasts are responsible for increasing the width of a long bone and the overall size of the other bone types. After a bone fracture the progenitor cells develop into osteoblasts and chondroblasts, which are essential to the healing process; as opposed to osseous tissue, the periosteum has nociceptive nerve endings, making it sensitive to manipulation. It provides nourishment by providing the blood supply to the body from the marrow; the periosteum is attached to the bone by strong collagenous fibers called Sharpey's fibres, which extend to the outer circumferential and interstitial lamellae.
It provides an attachment for muscles and tendons. The periosteum that covers the outer surface of the bones of the skull is known as the "pericranium", except when in reference to the layers of the scalp; the word periosteum is derived from the Greek Peri-, meaning "surrounding", -osteon, meaning "bone". The Peri refers to the fact that the Periosteum is the outermost layer of long bones, surrounding other inner layers. Periostitis Endochondral ossification Intramembranous ossification Brighton, Carl T.. "Early histologic and ultrastructural changes in microvessels of periosteal callus". Journal of Orthopaedic Trauma. 11: 244–253. PMID 9258821. Periosteum - InnerBody