KNEE JOINT 405 



The knee joint is supplied on its posterior aspect by twigs derived from 

 all the genicular branches of the popliteal. These twigs are variable in 

 their origin, and the anastomoses which are formed between them are 

 unimportant and inconstant. They are supplemented by another artery, 

 the posterior recurrent tibiaL This small vessel ramifies over the distal 

 part of the oblique popliteal ligament, and inosculates with the two inferior 

 genicular branches of the popliteal. 



The middle genicular artery is destined chiefly for the supply of the 

 interior of the joint. It pierces the oblique popliteal ligament, passes 

 forwards between the cruciate ligaments, and ramifies in the fatty tissue 

 in that situation. Its terminal twigs usually anastomose with the middle 

 arch in front of the knee joint. It will be dissected, at a later stage, in the 

 interior of the joint. 



Articular Nerves of the Knee Joint. The knee joint is 

 richly supplied with nerves. No less than ten distinct 

 branches may be traced to it. The femoral nerve, the 

 common peroneal, and the tibial nerve trunks contribute 

 three twigs apiece to this articulation, and the obturator 

 nerve furnishes a filament to its posterior aspect. The femoral 

 nerve supplies the joint through branches which proceed from 

 the nerves to the vastus lateralis, vastus medialis, and to the 

 musculus articularis genu portion of the vastus intermedius. 

 These nerves pierce the fibres of the quadriceps muscle, and 

 are distributed to the proximal and anterior part of the 

 articulation. The articular branch from the nerve to the 

 vastus medialis is of larger size than the other two, and 

 it accompanies an articular branch of the arteria genu 

 suprema. The common peroneal nerve gives off (i) the 

 superior and inferior lateral articular nerves, which accompany 

 the corresponding genicular arteries, and end in fine filaments 

 which pierce the capsule of the joint; and (2) the recurrent 

 articular nerve, which accompanies the anterior recurrent 

 tibial artery. This nerve ends chiefly in the tibialis anterior 

 muscle ; but a fine twig may reach the distal part of the 

 anterior aspect of the knee joint. The tibial nerve furnishes the 

 knee joint with superior and inferior medial articular branches 

 and a middle articular nerve, which accompany the corre- 

 sponding genicular arteries. The branch from the obturator 

 nerve descends on the postero-medial aspect of the popliteal 

 artery as far as the back of the knee joint. At that point 

 it leaves the artery and, inclining forwards, breaks up into 

 several filaments which pierce the oblique popliteal ligament 

 separately. 



Dissection. Remove the popliteal vessels, tibial and common 

 peroneal nerves, and the muscles surrounding the knee joint, 

 i 26 & 



