Landmarks, medical and surgical / by Luther Holden.

  • Luther Holden
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Landmarks, medical and surgical / by Luther Holden. Source: Wellcome Collection.

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    tne insertion of the ligament into the tubercle of the tibia. This is quite independent of the deep bursa between the tendon and the bone. 132. Synovial membrane of knee.—The synovial mem- brane of the knee, when the joint is extended, rises like a cul-de-sac above the upper border of the patella about two inches. It ascends, too, a little higher under the vastus internus than the vastus externus—a fact very manifest when the joint is distended. When the knee is bent this cul-de- sac is drawn down—hence the rule of bending the knee in operations near the lower end of the femur. The lower level of the synovial membrane of the knee is just above the level of the upper part of the head of the fibula. The tibio-fibular synovial membrane is, with rare exceptions, independent of that of the knee. 133. Popliteal tendons,—The tendons forming the boundaries of the popliteal space can be distinctly felt when the muscles which bend the knee are acting. On the outer side, we have the biceps running down to the head of the fibula. On the inner side we feel three tendons, disposed as follows :—nearest to the middle of the popliteal space is the semitendinosus, very salient and traceable high up the thigh ; next comes the thick round tendon of the semimembranosus ; still more internally is the gracilis. The sartorius, which forms a graceful muscular prominence on the inner side of the knee, does not become tendinous until it gets below it. 134. Popliteal bursa.—The precise position of the bursa in the popliteal space, which sometimes enlarges to the size of a hen's egg, is between the tendon of the inner head of the gastrocnemius and the tendon of the semimembranosus, just where they rub one against the other. The bursa is from one and a half to two inches long. When enlarged, it makes a swelling on the inner side of the popliteal space, which bulges and becomes tense when the knee is extended, and vice versa. I examined 150 bodies with a view to ascertain how often this bursa communicates with the synovial mem- brane of the knee. There was a communication about once