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

Abstract

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

Magnetic resonance imaging of the tensor vastus intermedius: A topographic study based on anatomical dissections

“…The present anatomical study describes the anatomy and the corresponding MR image findings of an independent TVI muscle (Grob et al, ) from origin to the insertion into the quadriceps tendon. The existence of this muscle has only recently been reported as a component of the lateral part of the extensor apparatus of the knee joint (Grob et al, , , , ; Rajasekaran and Hall, ). In a preliminary MRI study on three cadaveric lower limbs, we were not able to distinguish the TVI from the adjacent vastii despite the fact that the TVI could be displayed in the subsequent dissection.…”

“…1-7). Besides the VL and VI, a third muscle, the TVI, contributes to the layers of the lateral extensor apparatus of the knee joint (Grob et al, 2016a(Grob et al, , 2016c(Grob et al, , 2017Rajasekaran and Hall, 2016). From an anatomical point of view, the tensor fasciae latae and its tendon, as part of the iliotibial tract (together with the tendon of the gluteus maximus), also belong to this construct, thereby providing the outer envelope.…”

“…Recent studies identify the TVI as an additional member of the extensor apparatus of the knee joint (Grob et al, 2016a(Grob et al, , 2016b(Grob et al, , 2016c(Grob et al, , 2017. Hidden behind the rectus femoris and neurovascular structures, the TVI could be divided only by careful dissection and with the aid of the supplying neurovascular structures (Fig.…”

Triceps, quadriceps or pentaceps femoris? Need for proper muscle definition

“…Recent research has provided major advances in the definition and the role of fascia. There has been renewed interest in recent years on the importance of fascia and supporting tissues in biomechanics and pathology [24]- [25] but it is difficult to obtain precise definitions and distinctions of these tissues [26].…”

The Anatomy of the Articularis Genus Muscle and Its Relation to the Extensor Apparatus of the Knee

“…Finally, the vastus medialis was released from its medial attachments at the medial intermuscular septum, the medial lip of the linea aspera, the tendon of the adductor magnus, the adductor canal, the aponeurosis of the adductor longus, and the periarterial connective tissue of the groove for the femoral vessels 16 and then was lifted laterally to allow viewing of the medial surface of the femur, the deep distal aspect of the quadriceps muscle group, and the capsule and cavity of the knee joint. The articularis genus, vastus intermedius, and vastus medialis were dissected separately.…”