Vastus medialis

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Vastus medialis
Illu lower extremity muscles.jpg
Muscles of lower extremity
Details
Origin Medial side of femur
Insertion Quadriceps tendon
Artery Femoral artery
Nerve Femoral nerve
Actions Extends knee
Identifiers
Latin musculus vastus medialis or musculus vastus internus
TA98 A04.7.02.023
TA2 2620
FMA 22432
Anatomical terms of muscle

The vastus medialis (vastus internus or teardrop muscle) is an extensor muscle located medially in the thigh that extends the knee. The vastus medialis is part of the quadriceps muscle group.

Contents

Structure

The vastus medialis is a muscle present in the anterior compartment of thigh, and is one of the four muscles that make up the quadriceps muscle. The others are the vastus lateralis, vastus intermedius and rectus femoris. [1] It is the most medial of the "vastus" group of muscles. The vastus medialis arises medially along the entire length of the femur, and attaches with the other muscles of the quadriceps in the quadriceps tendon. [1]

The vastus medialis muscle originates from a continuous line of attachment on the femur, which begins on the front and middle side (anteromedially) on the intertrochanteric line of the femur. It continues down and back (posteroinferiorly) along the pectineal line and then descends along the inner (medial) lip of the linea aspera and onto the medial supracondylar line of the femur. The fibers converge onto the inner (medial) part of the quadriceps tendon and the inner (medial) border of the patella. [1]

The obliquus genus muscle is the most distal segment of the vastus medialis muscle. Its specific training plays an important role in maintaining patella position and limiting injuries to the knee. With no clear delineation, it is simply the most distal group of fibers of the vastus medialis.

Function

The vastus medialis is one of four muscles in the anterior compartment of the thigh. [1] It is involved in knee extension, along with the other muscles which make up the quadriceps muscle. [1] The vastus medialis also contributes to correct tracking of the patella. [2]

A division of the vastus medialis muscle into two groups of fibers has been hypothesized, a long and relatively inline group of fibres with the quadriceps ligament, the vastus medialis longus; and a shorter and more obliquely oriented with group of fibres, the vastus medialis obliquus. There is as yet insufficient evidence to conclusively confirm or deny this hypothesis. [3]

Clinical significance

Knee pain

Knee pain is thought to be primarily associated with specific quadriceps muscle weakness or fatigue, especially in the vastus medialis obliquus (VMO). It is known that fatigue can be caused by many different mechanisms, ranging from the accumulation of metabolites within muscle fibers to the generation of an inadequate motor command in the motor cortex. [4] Characteristics of the vastus medialis, including its angle of insertion, correlate with presence of knee joint pain (patellofemoral pain syndrome). [5] However, this syndrome is complex and definitive evidence of causality has not yet been published.

Misfiring and fatiguing of the VMO causes mal-tracking of the patella and subsequent damage to surrounding structures creating increased force on the knees, often resulting in injuries such as patellofemoral pain syndrome, anterior cruciate ligament rupture, chondromalacia, and tendinitis. [6] Through the use of electromyography, researchers can evaluate and record the electrical activity produced by the skeletal muscle of the VMO to analyze the biomechanics and detect any possible abnormalities, weakness, or fatigue. With an analysis of muscle activity of the VMO through the use of electromyography, proper rehabilitative plans and goals can be established to not only correct the already established abnormality, but even prevent such injuries if tested sooner. Preventing injuries is crucial as well as teaching proper training techniques to ensure there are no valgus collapse forces causing unplanned stress on other structures of the knee, causing asymmetry, and predisposing that individual for injury.

Additional images

See also

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">Thigh</span> The part of the body between the pelvis and the knee; upper leg

In anatomy, the thigh is the area between the hip (pelvis) and the knee. Anatomically, it is part of the lower limb.

<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">Patella</span> Kneecap, bone covering knee joint

The patella, also known as the kneecap, is a flat, rounded triangular bone which articulates with the femur and covers and protects the anterior articular surface of the knee joint. The patella is found in many tetrapods, such as mice, cats, birds and dogs, but not in whales, or most reptiles.

<span class="mw-page-title-main">Quadriceps</span> Group of human leg muscle

The quadriceps femoris muscle is a large muscle group that includes the four prevailing muscles on the front of the thigh. It is the sole extensor muscle of the knee, forming a large fleshy mass which covers the front and sides of the femur. The name derives from Latin four-headed muscle of the femur.

<span class="mw-page-title-main">Vastus intermedius muscle</span> Body of the femur muscle

The vastus intermedius (Cruraeus) arises from the front and lateral surfaces of the body of the femur in its upper two-thirds, sitting under the rectus femoris muscle and from the lower part of the lateral intermuscular septum. Its fibers end in a superficial aponeurosis, which forms the deep part of the quadriceps femoris tendon.

<span class="mw-page-title-main">Vastus lateralis muscle</span> Human muscle in the thigh

The vastus lateralis, also called the vastus externus, is the largest and most powerful part of the quadriceps femoris, a muscle in the thigh. Together with other muscles of the quadriceps group, it serves to extend the knee joint, moving the lower leg forward. It arises from a series of flat, broad tendons attached to the femur, and attaches to the outer border of the patella. It ultimately joins with the other muscles that make up the quadriceps in the quadriceps tendon, which travels over the knee to connect to the tibia. The vastus lateralis is the recommended site for intramuscular injection in infants less than 7 months old and those unable to walk, with loss of muscular tone.

The rectus femoris muscle is one of the four quadriceps muscles of the human body. The others are the vastus medialis, the vastus intermedius, and the vastus lateralis. All four parts of the quadriceps muscle attach to the patella by the quadriceps tendon.

<span class="mw-page-title-main">Iliopsoas</span> Joined psoas and the iliacus muscles

The iliopsoas muscle refers to the joined psoas major and the iliacus muscles. The two muscles are separate in the abdomen, but usually merge in the thigh. They are usually given the common name iliopsoas. The iliopsoas muscle joins to the femur at the lesser trochanter. It acts as the strongest flexor of the hip.

<span class="mw-page-title-main">Femoral nerve</span> Long nerve down the thigh and inner leg

The femoral nerve is a nerve in the thigh that supplies skin on the upper thigh and inner leg, and the muscles that extend the knee. It is the largest branch of the lumbar plexus.

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">Adductor canal</span> Aponeurotic tunnel in the middle third of the thigh

The adductor canal is an aponeurotic tunnel in the middle third of the thigh giving passage to parts of the femoral artery, vein, and nerve. It extends from the apex of the femoral triangle to the adductor hiatus.

<span class="mw-page-title-main">Tuberosity of the tibia</span> Slight protrusion at the top front end

The tuberosity of the tibia or tibial tuberosity or tibial tubercle is an elevation on the proximal, anterior aspect of the tibia, just below where the anterior surfaces of the lateral and medial tibial condyles end.

<span class="mw-page-title-main">Anterior compartment of thigh</span> Muscles which extend the knee and flex the hip

The anterior compartment of thigh contains muscles which extend the knee and flex the hip.

<span class="mw-page-title-main">Patellofemoral pain syndrome</span> Medical condition

Patellofemoral pain syndrome is knee pain as a result of problems between the kneecap and the femur. The pain is generally in the front of the knee and comes on gradually. Pain may worsen with sitting, excessive use, or climbing and descending stairs.

Patellar subluxation syndrome, is an injury that is concerned with the kneecap. Patellar subluxation is more common than patellar dislocation and is just as disabling.

<span class="mw-page-title-main">Patellar dislocation</span> Medical condition

A patellar dislocation is a knee injury in which the patella (kneecap) slips out of its normal position. Often the knee is partly bent, painful and swollen. The patella is also often felt and seen out of place. Complications may include a patella fracture or arthritis.

<span class="mw-page-title-main">Vastus muscles</span> Human thigh muscles

The vastus muscles are three of the four muscles that make up the quadriceps femoris muscle of the thigh. The three muscles are the vastus intermedius, the vastus lateralis, and the vastus medialis located in the middle, on the outside, and inside of the thigh, respectively. The fourth muscle is the rectus femoris muscle a large fleshy muscle which covers the front and sides of the femur.

<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:

References

PD-icon.svgThis article incorporates text in the public domain from page 471 of the 20th edition of Gray's Anatomy (1918)

  1. 1 2 3 4 5 Drake, Richard L.; Vogl, Wayne; Tibbitts, Adam W.M. Mitchell; illustrations by Richard; Richardson, Paul (2005). Gray's anatomy for students. Philadelphia: Elsevier/Churchill Livingstone. pp. 518–519. ISBN   978-0-8089-2306-0.
  2. ↑ Sheehan, FT; Borotikar, BS; Behnam, AJ; Alter, KE (2012). "Alterations in in vivo knee joint kinematics following a femoral nerve branch block of the vastus medialis: Implications for patellofemoral pain syndrome". Clinical Biomechanics. 27 (6): 525–31. doi:10.1016/j.clinbiomech.2011.12.012. PMC   3328589 . PMID   22244738.
  3. ↑ Smith, TO; Nichols, R; Harle, D; Donell, ST (2009). "Do the vastus medialis obliquus and vastus medialis longus really exist? A systematic review". Clinical Anatomy. 22 (2): 183–99. doi:10.1002/ca.20737. PMID   19090000. S2CID   5192483.
  4. ↑ Enoka, RM; Duchateau, J (2008). "Muscle fatigue: what, why, and how it influences muscle function". The Journal of Physiology. 586 (1): 11–23. doi:10.1113/jphysiol.2007.139477. PMC   2375565 . PMID   17702815.
  5. ↑ Jan, MH; Lin, DH; Lin, JJ; Lin, CH; Cheng, CK; Lin, YF (2009). "Differences in sonographic characteristics of the vastus medialis obliquus between patients with patellofemoral pain syndrome and healthy adults". The American Journal of Sports Medicine. 37 (9): 1743–9. doi:10.1177/0363546509333483. PMID   19521000. S2CID   25690317.
  6. ↑ Lefebvre, R; Leroux, A; Poumarat, G; Galtier, B; Guillot, M; Vanneuville, G; Boucher, JP (2006). "Vastus medialis: anatomical and functional considerations and implications based upon human and cadaveric studies". Journal of Manipulative and Physiological Therapeutics. 29 (2): 139–144. doi:10.1016/j.jmpt.2005.12.006. PMID   16461173.
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