Book - An Atlas of Topographical Anatomy 22

From Embryology

XXII. Transverse section of the lower third of the left thigh and knee

Fig. 1. Transverse section of the lower third of the left thigh (male, middle age). Fig. 2. Transverse section through the left knee of the same body.


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Braune W. An atlas of topographical anatomy after plane sections of frozen bodies. (1877) Trans. by Edward Bellamy. Philadelphia: Lindsay and Blakiston.

Plates: 1. Male - Sagittal body | 2. Female - Sagittal body | 3. Obliquely transverse head | 4. Transverse internal ear | 5. Transverse head | 6. Transverse neck | 7. Transverse neck and shoulders | 8. Transverse level first dorsal vertebra | 9. Transverse thorax level of third dorsal vertebra | 10. Transverse level aortic arch and fourth dorsal vertebra | 11. Transverse level of the bulbus aortae and sixth dorsal vertebra | 12. Transverse level of mitral valve and eighth dorsal vertebra | 13. Transverse level of heart apex and ninth dorsal vertebra | 14. Transverse liver stomach spleen at level of eleventh dorsal vertebra | 15. Transverse pancreas and kidneys at level of L1 vertebra | 16. Transverse through transverse colon at level of intervertebral space between L3 L4 vertebra | 17. Transverse pelvis at level of head of thigh bone | 18. Transverse male pelvis | 19. knee and right foot | 20. Transverse thigh | 21. Transverse left thigh | 22. Transverse lower left thigh and knee | 23. Transverse upper and middle left leg | 24. Transverse lower left leg | 25. Male - Frontal thorax | 26. Elbow-joint hand and third finger | 27. Transverse left arm | 28. Transverse left fore-arm | 29. Sagittal female pregnancy | 30. Sagittal female pregnancy | 31. Sagittal female at term
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Pages where the terms "Historic Textbook" and "Historic Embryology" appear on this site, and sections within pages where this disclaimer appears, indicate that the content and scientific understanding are specific to the time of publication. This means that while some scientific descriptions are still accurate, the terminology and interpretation of the developmental mechanisms reflect the understanding at the time of original publication and those of the preceding periods, these terms and interpretations may not reflect our current scientific understanding.     (More? Embryology History | Historic Embryology Papers)



THIS and the following plates are taken from sections from another body, but can be used equally well in the series. The arteries were injected, the body frozen lying on the back, and the lower extremities left in their normal position, i. e. somewhat rotated outwards.


Fig. 1. The section here passed through the lower third of the thigh nearly a hand's breadth above the upper border of the knee, at the position of the passage of the artery through the adductor opening. The plate represents the left thigh, and the upper surface of the lower portion ; the external aspect of the extremity being to the left, and the internal to the right.


The adductor longus is not seen, as it terminated just above the line of section. Of the adductors the magnus only is present ; its section is associated with the great vessels. It is no longer attached to the linea aspera, but all the muscular tissue to be seen here passes directly into its tendon, which terminates at the internal condyle of the femur.


This is exactly the spot where the artery passes through the adductor opening, in order to reach the back of the bone. The artery itself lies surrounded by a system of veins, which render ligature a matter of difficulty, on account of their free anastomosis. Between the artery and the bone lies the vein, with two small ones opening into it; on the opposite side are two venae comites, which are lodged between the artery and the long saphena nerve. If the artery be tied at this level, the incision must be made between the sartorius and the internal vastus, but upon the outer side of the former; the strong dense fascia under the sartorius must be divided; and the saphena nerve and vense comites pulled on one side ; there is thus more difficulty in reaching and isolating the artery in this place than higher up (vide Plates XX and XXI).


It is not correct to describe the course of the artery as spiral with regard to the bone. It lies certainly in front of the bone above, in the middle of it farther down, and at the knee-joint completely behind it. One can convince oneself on any preparation, whether the artery be injected or not, that the artery passes downwards in a tolerably straight direction ; it is the bone on the contrary that describes a twist round the artery. The relation of the artery to the sartorius is constant throughout the entire length of the thigh.


The great sciatic nerve, like the artery, has changed its position from the upper section. As higher up it lay behind the adductor magnus, so here it will be seen behind the short head of the biceps. There is nothing further to say about the muscles. The prominence of the central tendinous intersections indicates the termination of the muscles, as well as forming the separation between the individual portions of the quadriceps, which higher up were separated by fascia.


Fig. 2 is a section of the left knee-joint through the centre of the patella. The man, whose lower extremity afforded the preparation, had been a mason, and had probably knelt a great deal. At all events the large development and width of the prsepatellar bursa would suggest it. The patella lies with the external portion of its posterior articular surface so close to the external condyle of the femur, that only a narrow chink separates them ; while on the other hand it is raised from off the external condyle. The synovial cavity is divided by means of the ligamentum mucosum into two portions ; of these, one follows the patellar surface and passes upwards and inwards, whilst the other is applied over the inner condyle. This position of the patella upon the condyles renders it clear why in dislocation it glides by preference over the external condyle. The position itself is conditional on the curving inwards of the femur, so that the action of the powerful extensor muscles alone would cause the patella to glide outwards from off the flat hollow between the condyles, if these lateral tendinous masses did not securely hold it in position. These structures are interwoven as fibrous bundles with the lateral flat tendinous expansions which pass from the great extensor downwards to the leg, and assist in transmitting the power of extension beyond the patella and ligamentum patellae. In fracture of the patella they keep the fragments in position ; and, if the fracture of the bone be transverse, they are torn simultaneously with it. If the patella be sawn through, on the body, maintaining, however, these lateral ligamentous structures, and the leg be flexed, the halves of the patella separate slightly from each other ; if, however, they be divided in addition, there immediately ensues a very wide separation of the fragments. "We can thus understand why stellate fractures of the patella unite by bone, as in this instance the patella alone is involved ; whereas in transverse fracture the ligaments are also torn, the extensor muscles dislocating the upper fragment.


The plate shows broad ligamentous bands passing from the patella to both sides of the femur, and surrounding the entire knee-joint anteriorly and laterally.


Behind the articular surfaces of the condyles is the expansion of the synovial cavity between the crucial ligaments. The nerve, artery, and vein, lie close behind each other, the former being more external ; the sciatic nerve dividing into the external popliteal inside and below the biceps, and the internal popliteal more towards the middle.


The muscles, which in fig. 1 showed such fleshy masses, are here confined and diminished in bulk. They are for the most part completely reduced to tendon ; and the defined form of contour, which is characteristic of the region of the knee-joint, is dependent on that of the bones.


In synovitis, the patella would be lifted off the articular surface of the thigh bone, the distension of the capsule being especially evident in front. The posterior parts are but slightly yielding, and are consequently only slightly separated from the posterior surfaces of the condyles.


Historic Disclaimer - information about historic embryology pages 
Mark Hill.jpg
Pages where the terms "Historic Textbook" and "Historic Embryology" appear on this site, and sections within pages where this disclaimer appears, indicate that the content and scientific understanding are specific to the time of publication. This means that while some scientific descriptions are still accurate, the terminology and interpretation of the developmental mechanisms reflect the understanding at the time of original publication and those of the preceding periods, these terms and interpretations may not reflect our current scientific understanding.     (More? Embryology History | Historic Embryology Papers)
Braune Plates (1877): 1. Male - Sagittal body | 2. Female - Sagittal body | 3. Obliquely transverse head | 4. Transverse internal ear | 5. Transverse head | 6. Transverse neck | 7. Transverse neck and shoulders | 8. Transverse level first dorsal vertebra | 9. Transverse thorax level of third dorsal vertebra | 10. Transverse level aortic arch and fourth dorsal vertebra | 11. Transverse level of the bulbus aortae and sixth dorsal vertebra | 12. Transverse level of mitral valve and eighth dorsal vertebra | 13. Transverse level of heart apex and ninth dorsal vertebra | 14. Transverse liver stomach spleen at level of eleventh dorsal vertebra | 15. Transverse pancreas and kidneys at level of L1 vertebra | 16. Transverse through transverse colon at level of intervertebral space between L3 L4 vertebra | 17. Transverse pelvis at level of head of thigh bone | 18. Transverse male pelvis | 19. knee and right foot | 20. Transverse thigh | 21. Transverse left thigh | 22. Transverse lower left thigh and knee | 23. Transverse upper and middle left leg | 24. Transverse lower left leg | 25. Male - Frontal thorax | 26. Elbow-joint hand and third finger | 27. Transverse left arm | 28. Transverse left fore-arm | 29. Sagittal female pregnancy | 30. Sagittal female pregnancy | 31. Sagittal female at term

Reference

Braune W. An atlas of topographical anatomy after plane sections of frozen bodies. (1877) Trans. by Edward Bellamy. Philadelphia: Lindsay and Blakiston.


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Cite this page: Hill, M.A. (2019, December 16) Embryology Book - An Atlas of Topographical Anatomy 22. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Book_-_An_Atlas_of_Topographical_Anatomy_22

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© Dr Mark Hill 2019, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G