Pes anserinus (leg)

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Pes anserinus
Pes anserinus.png
Muscles of the gluteal and posterior femoral regions. Area of pes anserinus is encircled at bottom. Sartorius, gracilis, semitendinosus and semimembranosus are labeled at bottom left.
Details
Identifiers
Latin pes anserinus
TA2 2612
FMA 311256
Anatomical terminology

Pes anserinus ("goose foot") refers to the conjoined tendons of three muscles of the thigh. It inserts onto the anteromedial (front and inside) surface of the proximal tibia. The muscles are the sartorius, gracilis and semitendinosus sometimes referred to as the guy ropes. The name "goose foot" arises from the three-pronged manner in which the conjoined tendon inserts onto the tibia.

Contents

Structure

The three tendons, from front to back, that conjoin to form the pes anserinus come from the sartorius muscle, the gracilis muscle, and the semitendinosus muscle. [1] [2] It inserts onto the proximal anteromedial surface of the tibia. [2]

The pes anserinus is around 5 cm below the medial tibial joint line. [2] It lies superficial to the tibial insertion of the medial collateral ligament of the knee. [1]

Clinical significance

Pes anserinus tendinitis/bursitis syndrome, or pes anserine bursitis, is a cause of chronic knee pain and weakness. [3] [4] It occurs when the medial portion of the knee is inflamed. If the bursa underlying the tendons of the sartorius, gracilis, and semitendinosus gets irritated from overuse or injury, a person can develop this ailment. This condition usually occurs in athletes from overuse. This pathology is characterized by pain, swelling, and / or tenderness. [3]

The semitendinosus tendon can be used in certain techniques for reconstruction of the anterior cruciate ligament. [5]

History

The name "goose foot" arises from the three-pronged manner in which the conjoined tendon inserts onto the tibia. [6]

Additional Images

Related Research Articles

<span class="mw-page-title-main">Human leg</span> Lower extremity or limb of the human body (foot, lower leg, thigh and hip)

The leg is the entire lower limb of the human body, including the foot, thigh or sometimes even the hip or buttock region. The major bones of the leg are the femur, tibia, and adjacent fibula. The thigh is between the hip and knee, while the calf (rear) and shin (front) are between the knee and foot.

<span class="mw-page-title-main">Knee</span> Leg joint in primates

In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia, and one between the femur and patella. It is the largest joint in the human body. The knee is a modified hinge joint, which permits flexion and extension as well as slight internal and external rotation. The knee is vulnerable to injury and to the development of osteoarthritis.

<span class="mw-page-title-main">Hamstring</span> Any of the three tendons in the thigh

In human anatomy, a hamstring is any one of the three posterior thigh muscles between the hip and the knee.

<span class="mw-page-title-main">Sartorius muscle</span> Longest muscle in the human body

The sartorius muscle is the longest muscle in the human body. It is a long, thin, superficial muscle that runs down the length of the thigh in the anterior compartment.

<span class="mw-page-title-main">Tibia</span> Leg bone in vertebrates

The tibia, also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two bones in the leg below the knee in vertebrates ; it connects the knee with the ankle. The tibia is found on the medial side of the leg next to the fibula and closer to the median plane. The tibia is connected to the fibula by the interosseous membrane of leg, forming a type of fibrous joint called a syndesmosis with very little movement. The tibia is named for the flute tibia. It is the second largest bone in the human body, after the femur. The leg bones are the strongest long bones as they support the rest of the body.

<span class="mw-page-title-main">Anterior cruciate ligament</span> Type of cruciate ligament in the human knee

The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments in the human knee. The two ligaments are also called "cruciform" ligaments, as they are arranged in a crossed formation. In the quadruped stifle joint, based on its anatomical position, it is also referred to as the cranial cruciate ligament. The term cruciate translates to cross. This name is fitting because the ACL crosses the posterior cruciate ligament to form an "X". It is composed of strong, fibrous material and assists in controlling excessive motion. This is done by limiting mobility of the joint. The anterior cruciate ligament is one of the four main ligaments of the knee, providing 85% of the restraining force to anterior tibial displacement at 30 and 90° of knee flexion. The ACL is the most injured ligament of the four located in the knee.

<span class="mw-page-title-main">Bursitis</span> Human disease

Bursitis is the inflammation of one or more bursae of synovial fluid in the body. They are lined with a synovial membrane that secretes a lubricating synovial fluid. There are more than 150 bursae in the human body. The bursae rest at the points where internal functionaries, such as muscles and tendons, slide across bone. Healthy bursae create a smooth, almost frictionless functional gliding surface making normal movement painless. When bursitis occurs, however, movement relying on the inflamed bursa becomes difficult and painful. Moreover, movement of tendons and muscles over the inflamed bursa aggravates its inflammation, perpetuating the problem. Muscle can also be stiffened.

<span class="mw-page-title-main">Medial collateral ligament</span> Ligament on the inner side of the knee joint

The medial collateral ligament (MCL), also called the superficial medial collateral ligament (sMCL) or tibial collateral ligament (TCL), is one of the major ligaments of the knee. It is on the medial (inner) side of the knee joint and occurs in humans and other primates. Its primary function is to resist valgus forces on the knee.

The biceps femoris is a muscle of the thigh located to the posterior, or back. As its name implies, it consists of two heads; the long head is considered part of the hamstring muscle group, while the short head is sometimes excluded from this characterization, as it only causes knee flexion and is activated by a separate nerve.

<span class="mw-page-title-main">Gracilis muscle</span> Most superficial muscle on the medial side of the thigh

The gracilis muscle is the most superficial muscle on the medial side of the thigh. It is thin and flattened, broad above, narrow and tapering below.

The semimembranosus muscle is the most medial of the three hamstring muscles in the thigh. It is so named because it has a flat tendon of origin. It lies posteromedially in the thigh, deep to the semitendinosus muscle. It extends the hip joint and flexes the knee joint.

<span class="mw-page-title-main">Semitendinosus muscle</span> One of the hamstring muscles; posterior part of the thigh

The semitendinosus is a long superficial muscle in the back of the thigh. It is so named because it has a very long tendon of insertion. It lies posteromedially in the thigh, superficial to the semimembranosus.

The knee examination, in medicine and physiotherapy, is performed as part of a physical examination, or when a patient presents with knee pain or a history that suggests a pathology of the knee joint.

<span class="mw-page-title-main">Patellar tendon</span> Tendon in the human knee

The patellar tendon is the distal portion of the common tendon of the quadriceps femoris, which is continued from the patella to the tibial tuberosity. It is also sometimes called the patellar ligament as it forms a bone to bone connection when the patella is fully ossified.

The saphenous nerve is the largest cutaneous branch of the femoral nerve. It is derived from the lumbar plexus (L3-L4). It is a strictly sensory nerve, and has no motor function. It commences in the proximal (upper) thigh and travels along the adductor canal. Upon exiting the adductor canal, the saphenous nerve terminates by splitting into two terminal branches: the sartorial nerve, and the infrapatellar nerve. The saphenous nerve is responsible for providing sensory innervation to the skin of the anteromedial leg.

<span class="mw-page-title-main">Knee bursae</span>

The knee bursae are the fluid-filled sacs and synovial pockets that surround and sometimes communicate with the knee joint cavity. The bursae are thin-walled, and filled with synovial fluid. They represent the weak point of the joint, but also provide enlargements to the joint space. They can be grouped into either communicating and non-communicating bursae or, after their location – frontal, lateral, or medial.

<span class="mw-page-title-main">Pes anserine bursitis</span> Medical condition

Pes anserine bursitis is an inflammatory condition of the medial (inner) knee at the anserine bursa, a sub muscular bursa, just below the pes anserinus.

<span class="mw-page-title-main">Medial knee injuries</span> Medical condition

Medial knee injuries are the most common type of knee injury. The medial ligament complex of the knee consists of:

The anserine bursa is a sub muscular bursa located deep to the pes anserinus on the anteromedial proximal tibia. Pes anserine bursitis is a common inflammatory condition of the anserine bursa.

In the skeleton of humans and other animals, a tubercle, tuberosity or apophysis is a protrusion or eminence that serves as an attachment for skeletal muscles. The muscles attach by tendons, where the enthesis is the connective tissue between the tendon and bone. A tuberosity is generally a larger tubercle.

References

  1. 1 2 Cai, Shaoren; Jin, Yong; Zhang, Wanyu; Liao, Zhongtang (2019-09-01). "Bloodletting-cupping for 169 cases of pes anserinus myotenositis". World Journal of Acupuncture - Moxibustion. 29 (3): 231–234. doi:10.1016/j.wjam.2019.08.001. ISSN   1003-5257. S2CID   201960589.
  2. 1 2 3 Finnoff, Jonathan T.; Nutz, David J.; Henning, Philip T.; Hollman, John H.; Smith, Jay (2010). "Accuracy of Ultrasound-Guided versus Unguided Pes Anserinus Bursa Injections". PM&R. 2 (8): 732–739. doi:10.1016/j.pmrj.2010.03.014. ISSN   1934-1563. PMID   20598959. S2CID   26845656.
  3. 1 2 pmr/104 at eMedicine - "Pes anserinus bursitis"
  4. Alvarez-Nemegyei J (April 2007). "Risk factors for pes anserinus tendinitis/bursitis syndrome: a case control study". J Clin Rheumatol. 13 (2): 63–5. doi:10.1097/01.rhu.0000262082.84624.37. PMID   17414530. S2CID   34207995.
  5. Zaffagnini S, Golanò P, Farinas O, et al. (January 2003). "Vascularity and neuroreceptors of the pes anserinus: anatomic study". Clin Anat. 16 (1): 19–24. doi:10.1002/ca.10073. PMID   12486734. S2CID   27142035.
  6. Mochizuki T, Akita K, Muneta T, Sato T (January 2004). "Pes anserinus: layered supportive structure on the medial side of the knee". Clin Anat. 17 (1): 50–4. doi:10.1002/ca.10142. PMID   14695588. S2CID   20678095.