480 SURGICAL APPLIED ANATOMY. [Chap. xxi. 



The si/novial membrane of the knee-joint extends 

 upwards as a large cul-de-sac above the patella and 

 beneath the extensor tendon. This cul-de-sac reaches 

 a point an inch or more alx>ve the upper margin of the 

 trochlear surface on the femur, and is rendered very 



, 4|fi // 



Fig. 45. Vertical Section of Normal Knee-joint (Braune). 



a, Quadriceps ; 1. semimembranosiis ; c, trastrocnemius ; a, posterior crucial 

 ligament ; e, ligamentuiu patelht ; /, bursa between quadriceps and femur. 



distinct when the joint is distended with fluid (Fig. 

 46). When the knee is bent, the cul-de-sac is drawn 

 down, and therefore this position of the limb is 

 advised when operations ai-e about to be performed 

 upon the lower end of the femur. Above the sy no vial 

 pouch is a bursa that separates the quadriceps tendon 

 from the femur, and is usually over an inch in its 

 vertical measurement (Fig. 45). From the exami- 

 nation of two hundred and sixty knee-joints in .both 

 infants and adults Schwartz found that this bursa 



