The innervation of vastus medialis obliquus

Günal, İzge; Araç, Şükrü; Sahinoglu, Kay han; Birvar, K

doi:10.1302/0301-620x.74b4.1624528

Cited by 25 publications

(24 citation statements)

References 3 publications

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“…1 d) also showed distal innervation from a branch that accompanied the saphenous nerve. Gunal et al 18) report secondary innervation from the saphenous nerve in their entire sample of 60 specimens.…”

Section: Discussionmentioning

confidence: 99%

Vastus Medialis: a Reappraisal of VMO and VML

Skinner

Adds

2012

J Phys Ther Sci

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Abstract.[Purpose] The morphology and innervation pattern of the vastus medialis (VM) were investigated to determine if there was an anatomical distinction between the oblique (VMO) and longus (VML) parts. [Subjects and Methods] Forty lower limbs were dissected. The innervation pattern was observed in 39 specimens. Muscle length and fibre angles of 14 specimens were recorded.[Results] In 22 specimens there was a distinct separation between the VML and VMO (change in fibre angle, fibrofascial plane, vasculature or nerve branch). The mean fibre angle of VMO was 52°, and the mean VML fibre angle was 5° (relative to the shaft of the femur). Ten limbs (25.6%) had separate innervation to the VML. The separation between VMO and VML was found to be more proximal than expected, with the VMO on average accounting for 70% of the VM, in contrast to the much more distal point of separation reported elsewhere, leading us to raise the possibility that VML and vastus intermedius may have been misidentified in some previous studies. [Conclusions] In conclusion the VML/VMO division (when present) is much more proximal than has been previously reported, and there is no consistent pattern of innervation to the two parts of the muscle.

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Section: Discussionmentioning

confidence: 99%

Vastus Medialis: a Reappraisal of VMO and VML

Skinner

Adds

2012

J Phys Ther Sci

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“…Nevertheless, the fiber orientation in the distal part of the muscle is noticeably more horizontal than in the proximal part, and there is considerable evidence the distal part has a role in maintaining patellar alignment [24]. The distal part, which can be considered the functional equivalent of the VMO, has its own motor point, is a relatively weak extensor, inserts into the medial border of the patella [23], is more active at 90°fl exion than the rest of quadriceps [22], and pulls the patella medially [15,17,25]. Although Peeler et al [31] said there was no sign of a separate nerve entering the VMO, numerous authors disagree [16,17,20,41,44].…”

Section: Discussionmentioning

confidence: 99%

“…The distal part, which can be considered the functional equivalent of the VMO, has its own motor point, is a relatively weak extensor, inserts into the medial border of the patella [23], is more active at 90°fl exion than the rest of quadriceps [22], and pulls the patella medially [15,17,25]. Although Peeler et al [31] said there was no sign of a separate nerve entering the VMO, numerous authors disagree [16,17,20,41,44]. Also, a large number of anatomic atlases and texts have included illustrations that show numerous twigs from the nerve to the VM entering the muscle along its length [7, 29, 33-36, 39, 43].…”

Section: Discussionmentioning

confidence: 99%

Clinical Anatomy of the Quadriceps Femoris and Extensor Apparatus of the Knee

Waligora

Johanson

Hirsch

2009

Clin Orthop Relat Res

122

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Most descriptions of the extensor mechanism of the knee do not take into account its complexity and variability. The quadriceps femoris insertion into the patella is said to be through a common tendon with a threelayered arrangement: rectus femoris (RF) most superficially, vastus medialis (VM) and lateralis (VL) in the intermediate layer, and vastus intermedius (VI) most deeply. We dissected 20 limbs from 17 cadavers to provide a more detailed description of the anterior components of the knee: the tendon, the patellar retinacula, and the patellofemoral ligaments. Only three of the 20 specimens exhibited the typically described quadriceps pattern. The remainder had bilaminar and even more complex trilaminar and tetralaminar fiber arrangements. We found an oblique head of the vastus lateralis (VLO), separated from the longitudinal head by a layer of fat or fascia, in 60% of the specimens. However, we found no distinct oblique head of the vastus medialis (VMO) in any specimen. The medial patellofemoral ligament (MPFL) was more common than the lateral (LPFL), supporting its suggested role as the principal passive medial stabilizer of the patella. Because the quadriceps muscle group plays a direct role in patellofemoral joint function, investigation into the clinical applications of its highly variable anatomy may be worthwhile with respect to joint dysfunction and failures of TKAs.

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“…Most investigations deal primarily with the distal part of the VM, which is also termed vastus medialis obliquus (VMO) (Fig. 6) [3,14,26,40,46,48,50,53]. We were not able to find a separate innervation to the different sections of VM, nor a clearly distinct fascial plane between the two heads.…”

Section: Discussionmentioning

confidence: 81%

The interaction between the vastus medialis and vastus intermedius and its influence on the extensor apparatus of the knee joint

Grob

Manestar

Filgueira

et al. 2017

Knee Surg Sports Traumatol Arthrosc

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spanned over a long distance between: (1) patella, (2) rectus femoris tendon and (3) aponeurosis of the VI, with the insertion into the VI being the largest. VM units were inserted twice-once on the anterior and once on the posterior side of the VI. The VI consists of a complex multilayered structure. The layers of the medial VI aponeurosis fused with the aponeuroses of the tensor vastus intermedius and vastus lateralis. Together, they form the two-layered intermediate layer of the quadriceps tendon. The VM and medial parts of the VI were innervated by the same medial division of the femoral nerve. Conclusion The VM consists of multiple muscle units inserting into the entire VI. Together, they build a potential functional muscular complex. Therefore, the VM acts as an indirect extensor of the knee joint regulating and adjusting the length of the extensor apparatus throughout the entire range of motion. It is of clinical importance that, besides the VM, substantial parts of the VI directly contribute to the medial pull on the patella and help to maintain medial tracking of the patella during knee extension. The interaction between the VM and VI, with responsibility for the Abstract Purpose Although the vastus medialis (VM) is closely associated with the vastus intermedius (VI), there is a lack of data regarding their functional relationship. The purpose of this study was to investigate the anatomical interaction between the VM and VI with regard to their origins, insertions, innervation and function within the extensor apparatus of the knee joint. Methods Eighteen human cadaveric lower limbs were investigated using macro-dissection techniques. Six limbs were cut transversely in the middle third of the thigh. The mode of origin, insertion and nerve supply of the extensor apparatus of the knee joint were studied. The architecture of the VM and VI was examined in detail, as was their anatomical interaction and connective tissue linkage to the adjacent anatomical structures. Results The VM originated medially from a broad hammock-like structure. The attachment site of the VM always Electronic supplementary material The online version of this article

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The innervation of vastus medialis obliquus

Cited by 25 publications

References 3 publications

Vastus Medialis: a Reappraisal of VMO and VML

Vastus Medialis: a Reappraisal of VMO and VML

Clinical Anatomy of the Quadriceps Femoris and Extensor Apparatus of the Knee

The interaction between the vastus medialis and vastus intermedius and its influence on the extensor apparatus of the knee joint

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