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CASfi



Stereoscopic Studies

ANATOMY

Prepared under authority of the
University of Edinburgh

by
Professor D. J. Cunningham

F.R.S., M.D. (Edin. et DubL), D.S.C. (Glasg. et St. And.), D.C.L. (Oxon.)

Edited by

David Waterston

M. A., M.D., F.R.C.S.E., F.R.S.E., Lecturer and Senior Demonstrator of Anatomy.

University of Edinburgh

Professor M. H. Cryer

M.D., D.D.S., Professor of Oral Surgery, University of Penn.; Visiting Surgeon,

Phila. General Hospital, etc.

Frederick E. Neres

M.D., formerly Instructor in Otology and Operative Otology, New York Post

Graduate Medical School and Hospital; Chief of Clinic, Manhattan

Eye, Ear, Noae and Throat Hospital, New York City




NEW YORK



Imperial Publishing Company



BIOLOGY

THE (,:N;.k.\L LIBRARY
UNIVERSITY OF CALIFORNIA
, UUUIF08NIA 94720



MAR 22 197]

Stereoscopic Studies of Anatomy

Section VIII
Table of Contents

LOWER LIMB
Continued

Gluteal Region

No. 1. Superficial Structures.

No. 2. ^Structures under Gluteus Maximus.

No. 3. Deep dissection.

Back of Thigh

No. 4. .Hamstring Muscles.

No. 5. Adductor Magnus and great Sciatic Nerve.

Hip-Joint

No. 6. Pelvic and Hip-Joint Ligaments from behind.
No. 7. Ligaments of Hip-Joint from the front.

Knee-joint

No. 8. .Ligaments, Synovial Membrane, etc., from the front.

No. 9. Ligaments, Tendons, and Synovial Membrane from the inner side.

No. 10. Tendons and Ligaments from behind.

No. 11. Crucial Ligaments and Semilunar Cartilages from behind.

No. 12. Structures on head of Tibia.

Popliteal Space

No. 13. Superficial Structures.
No. 14. Boundaries of the Space.
No. 15. Popliteal Vessels and Nerves.
No. 16. Floor of the Space, etc.

Front of Leg
No. 17. Muscles, etc.
No. 18. Vessels and Nerves.

Dorsum of Foot

No. 19. Superficial Structures exposed.

No. 20. Anterior Annular Ligament in position.

No. 21. The deeper structures.

Inner Side of Ankle
No. 22. Internal Annular Ligament and Structures related to it.

Back of Leg

No. 23. Showing the Muscles.

fsio. 24. Deeper Lying Group of Muscles.

No. 25. The Peroneal Vessels, etc.

Sole of Foot

No. 26. Superficial Dissection.

;\ T o. 27. The first layer of Muscles exposed.

v o. 28. Second layer.

No. 29. Plantar Arch and fourth layer. I

Articulations, Ankle and Foot
No. 30. Ligaments on outer side of foot.
f- T o. 32. Ligaments seen from behind.
No. 31. Ligaments on inferior and inner aspect.

Biology
GIFT



Section VIII.



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-KNIA

94720



THE EDINBURGH STEREOSCOPIC ATLAS OF ANATOMY.

LOWER LIMB.

GLUTEAL BEOHON-No. la. BIOLOGY LIBRARY

THE SUPERFICIAL STRUCTURES HAVE BEEN REMOVED TO SHOW THE GLUTEUS MAXIMUS AND THE

CUTANEOUS NERVES.

The gluteal region extends from the crest of the ilium above to the gluteal fold below, and from the
middle line outwards as far as to the great trochanter of the femur.
The cutaneous nerves in this region are as follows :

(1) Crossing the crest of the ilium near the outer margin of the erector spinas muscle are three

branches from the posterior primary divisions of three lumbar nerves.

The iliac branches of th* ilio-hypogastric and last dorsal nerves cross the iliac crest further
forwards and are not shown.

(2) Piercing the gluteus maximus are some small branches from the posterior primary divisions of

the upper sacral nerves, usually three in number.

(3) Winding round the lower margin of the gluteus maximus are a perforating cutaneous nerve from

the anterior primary divisions from the second and third sacral nerves, and some branches from
the small sciatic nerve. The latter are external to the ischial tuberosity, the former internal.

(4) On the outer side, some terminal twigs from the external cutaneous nerve of the thigh may be

found near the great trochanter.

The glutens maximus is a large muscle with a wide origin (see No. 1). It is quadrilateral in outline.
Above and to its outer side lie the gluteai fascia covering the gluteus medius muscle. This fascia encloses the
gluteus maximus. Below the lower margin lie the fat, etc. of the ischio-rectal fossa, and, further out, the
small sciatic nerve and the upper part of the hamstring muscles.

It will be noticed that the lower border of the muscle is oblique in direction, and therefore does not
.correspond to the gluteal fold, which is transversely directed, and crosses the lower border of the muscle.



Bony joints. 1. Posterior superior iliac
spine.

2. Sacral cornua.

3. Great trochanter.
etci 4. Semitendinosus and

biceps.



The figures indicate

Muscles, etc. 5. Semimembranosus.



6. Adductor maguus.

7. Ischio-rcctal fossa.
Nerves. 8. Lumbar branches.

9. Sacral branches.



Nerves. 10. Perforating cutaneous.

11. Branches of small

sciatic.

12. Long pudenda).

13. Small sciatic.



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THE EDINBURGH STEREOSCOPIC ATLAS OF ANATOMY. Section VIII. No. 2

BIOLOGY LIBRARY

LOWER LIMB,

GLUTEAL REGION No. 1.

THE SUPERFICIAL STRUCTURES HAVE BEEN REMOVED, AND THE GLUTEUS MAXIMUS TAKEN AWAY IN NEARLY
ITS WHOLE EXTENT. THE GLUTEUS MEDIUS HAS ALSO BEEN REMOVED, AND THE ISCHIO-RECTAt FOSSA
HAS BEEN OPENED UP FROM BEHIND.

The gluteus maxiraus has an extensive origin from the rough surface on the ilium between the superior
curved line and the crest, and from the sides and back of the lower two pieces of the sacrum and upper three
pieces of the coccyx, as well as from the great sacro-sciatic ligament and the lumbar aponeurosis. It is
inserted partly into the gluteal ridge of the femur, but chiefly into the fascia lata.

The gluteus medius, arising from the dorsum of the ilium, is inserted into the outer aspect of the great
.trochanter.

Under cover of these two muscles are the greater* and lesser sciatic foramina, with the structures trans-
mitted by them.

Through the greater notch emerges the pyriformis muscle, which is a useful landmark, since the gluteal
vessels and superior gluteal nerve lie above it, and several other structures below it. The great sciatic nerve,
however, not infrequently (as here) emerges in two divisions, of which the upper, representing the peroneal or
external popliteal nerve, comes through the pyriformis muscle, splittingit into two parts, while the lower,
representing the tibial or internal popliteal nerve, emerges below it. The trunk of the nerve lies almost
midway between the ischial tuberosity and the great trochanter, rather to the inner side.

The great sciatic nerve rests upon the innominate bone, with the nerve to the quadratus fernoris intf rven-
'ing, on the obturator internus and gemelli, the cjuadratus femoris and adductor magnus muscles.

and a
deepdi

The other deeply-seated structures are shown in another view.




1. Ischial tuberosity,

2. Glutens medius (divided).

3. Gluteus masimus (divided).

4. Glutens minimus.

5. Pyrifo/mia.



The figures indicate



6. Obturator internus and gemelli.

7. Quadratus femorie.

8. Tendon of biceps and semitendinosus.

9. Tendon of semimembranosus.
10. Gluteal vessels.



11. Great sciatic nerve.

12. Internal pudic vessels and uerve, and nerve

to obturator interims.

13. Inferioi hsemorrhoida) vesscia and nerve.

14. Superioi gluteal nerve.



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Section VIII. No. 3

BIOLOGY LIBRARY

THE GENERAL LITTRARY
UNIVE . :.IFORNIA

94/20



THE EDINBURGH STEREOSCOPIC ATLAS OF ANATOMY.

LOWER LIMB.

QLUTEAL REGION. No 2.

PORTIONS OP THE PYRIFORMIS, OBTURATOR INTERNUS AND GEMELLI, AND QUADRATUS FEMORIS
MUSCLES, HAVE BEEN REMOVED, AND THE TENDON OF THE BICEPS AND SEMITENDINOS^
DIVIDED AND TURNED ASIDE.

Below the level of the pyriforrais muscle, the sciatic and internal pudic arteries emerge close
to one another through the great sacro-sciatic foramen.

The internal pudic artery, with two venae comites, passes almost at once into the lesser
sacro-sciatic foramen, lying above the obturator internus muscle, and it is accompanied by the internal
pudic nerve and the nerve to the obturator internus. The latter nerve lies close to the muscle to
which it is distributed, i.e. on the outer side of the artery, and it gives a branch to the superior
gemellus muscle. The internal pudic vessels and nerve then pass into the lateral wall of the
ischio-rectal fossa, and there give off their inferior haemorrhoidal branches.

The nerve to the quadratus femoris is a small muscular branch from the sacral plexus which
passes down, covered by the great sciatic nerve and by the obturator internus and gemelli muscles.
It supplies also the inferior gemellus musclo and the hip-joint.

With these dissections, the view of the Hip-joint should be referred to. (Hip-joint, No. 1.)



The figures indicate

1. Ischial tuberosity.

2. Great troclmntcr of femur.

3. Gluteus minimus.

4. Pyriforniis (divided).

5. Obturatur internus and gemelli (divided).

6. Quadratus femoris (divided).



7. Gluteus medius (insertion).

8. Internal pudic vessels and nerve, arid nerve

to obturator internus.

9. Great sciatic nerve.

10. Nerve to quadratus femoris.



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THE EDINBURGH STEREOSCOPIC ATLAS OF ANATOMY.



Section VHI.-No. 4



LOWER LIMB.

BACK OP THIGH, No. 1.

THE SKIN, LAYERS OF FASCIA. AND SUPERFICIAL STRUCTURES HAVE BEEN REMOVED

TO SHOW THE MUSCLES.

The hamstring group of muscles forms a large muscular mass on the back of the thigh.

The biceps and semitendinosus, arising by a common tendon from the posterior, inferior, and
internal facet on the back part of the ischial tuberosity, lie at first side by side.

The semimembranosus arising from the anterior, superior, and external portion of this area of
the ischial tuberosity is concealed in the upper part, but, lower down, appears between the other
muscles, and lies more in the centre of the limb.

The biceps covers the great sciatic nerve, crossing it very obliquely from above downwards
and outwards, and under cover of that muscla the nerve usually divides into the two terminal
branches which, in this specimen, lie very superficially in the popliteal space.

A septum of connective tissue separates the biceps from the adjacent vastus externus muscle,
but there is only a very thin septum between the semimembranosus and the adductor muscles on
the inner side of the thigh.

The hamstrings are all supplied by the great sciatic nerve.



1. Biceps muscle.

2. Seraitendinosus muscle.

3. Semimembranosus muscle.

4. Gluteus maximus insertion.
6. Vastus externus muscle.



The figures indicate :

6. Adductor magnus muscle.

7. Adductor gracilis and sartorius muscles.

8. Quadratus femoris muscle.

9. Great sciatic nerve in two bands.

10. External and internal popliteal nerves.



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THE EDINBURGH STEREOSCOPIC ATLAS OF ANATOMY. Section VIII. No. 5

LOWER LIMB,

BACK OF THIGH-NO. 2.

THE BICEPS, SEMIMEMBRANOSUS AND SEMITENDINOSUS HAVE BEEN REMOVED, TO EXPOSE THE ADDUCTOR

MAGNUS AND THE GREAT SCIATIC NERVE LYING ON IT.

The great sciatic nerve, arising from L 4, 5, S 1, 2, 3, runs downwards in the thigh on the posterior surface
of the adductor magnus, under cover of the long head of the biceps muscle, as far as to the upper angle of the
popliteal space, where it divides into the internal and external popliteal nerves. This division often occurs higher
up, and in all cases the two parts, tibial and peroneal, of which the nerve consists, can be made out, and the
branches which are given oft' by the single trunk can be referred to one or other of the two divisions.

Thus, from the tibial division arise branches to the semimembranosus, semitendinosus, long head of
biceps and to the dorsal, or hamstring portion, of the adductor magnus muscles, while the outer, or peroneal
division gives a branch to the short head of the biceps, and often an articular branch to the knee-joint.

The adductor magnus muscle consists of two portions. The one, truly adductor in character, arises from
the anterior surface of the arch of the pubis. Its fibres are horizontal in direction above, and oblique lower
down, and are inserted into the back of the femur internal to the gluteal ridge, into the linea aspera, and into
a small portion of the internal supracondylar ridge.

The other portion, hamstring in character, arises from the lower part of the ischial tuberosity, and passes
in a vertical direction, forming the inner thick part of the muscle, to be inserted into the adductor tubercle,,
and the internal intermuscular septum.

The opening for the popliteal artery is seen between the two portions, and the vertical portion is supplied
by the great sciatic nerve, and the horizontal and oblique by the obturator nerve.

The short head of the biceps arises from the outer lip of the linea aspera of the femur, from the upper
half of the external supracondylar ridge, and from the external intermuscular septum.

Vessels. Piercing the insertion of the adductor magnus are seen several vessels, the perforating branches
of the profunda femoris artery, usually four in number, forming an ana-stomotic chain in the back of the thigh, ~
which communicates with the circumflex vessels above and with the articular branches of the popliteal artery belov- '(_



\ . Vastus cxternus muscle.

2. Short head of biceps Hexor cruris
. muscle, and its insertion.

3. Adductor magnus muscle, vertical

fibres.

4. Adductor magnus muscle, upper

horizontal fibres (sometimes called
adductor minimus).



The figures indicate

5, Insertion of gluteus maximus

muscle.
H. Tendons of semimembrauosus and

eemitendiiiosu? muscles.
7. Aperture iii adductor magnus for

femoral vessels.



S

J<

8. Adductor gracilis muscle. p

9. Sartorius muscle.

10. Tendon of adductor magnus,

1 1 . Vastus internus muscle.

12. External intermuscular septum. ~

13. Trunk of great sciatic nerve.

14. Popliteal vessels.



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THE EDINBURGH STEREOSCOPIC ATLAS OF ANATOMY.



Section YllL~No. 6

BIOLOui

TH2 GENERAL

UNIVERSITY 01 , NM

94720



LOWER LIMB. ARTICULATIONS.

HIP JOINT No. I.
PELVIC AND HIP JOINTS, SEEN FROM BEHIND.

I. The ligaments connecting the sacrum and the innominate bone on this aspect are seen to 1)0
ftS. follows:

The oblique ligament is attached above to the posterior superior spine of the ilium and below to
the lateral tubercle of the third piece of the sacrum.

The great or posterior sacro-sciatic ligament is attached above to the posterior spines of the
ilium, and to the outer borders and posterior surfaces of the lower three pieces of the sacrum an$
upper two pieces of the coccyx. Thence the fibres pass to be attached below to the inner border of the
ischial tuberosity, and also pass forwards to the ramus of the ischium, where they form the falciform
process. Some of the fibres are continued into the tendon of origin of the biceps muscle.

The small or anterior sacro-sciatic ligament springs by a wide attachment from the side of tho
lower part of the sacrum and from the coccyx. The ligament rapidly narrows, and is inserted into
the spme of the ischium, its pelvic surface is intimately connected with the coccygeus muscle, and
muscle fibres are often present in it.

These two ligaments limit the greater and lesser sacro-sciatic foramina.

II. In the hip-joint, the ischio femoral band is seen, the fibres of which, in the position o
extension of this limb, wind round the back of the femur in a zonular manner.

The partial extent to which the posterior aspect of the neck of the femur is covered by the
capsular ligament should be noticed. In front, the reflected tendon of the rectus femoris is. seen
joining the capsule.



The figures indicate:



1. Posterior superior spine of the ilium.

2. Tubercle on crest of ilium.

3. Back part of the ischial tuberosity.

4. Great trochanter.

5. Oblique ligament.



6. Great sacro-sciatic ligament.

7. Small sacro-sciatic ligament.

8. Ischio-femoral band of capsule of the hip-joint.

9. Lower limit of capsule on the back of the neck

of the femur.



10. Reflected tendon of the rectus femoris muscle.





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THE EDINBURGH STEREOSCOPIC ATLAS OF ANATOMY.




THE GENERAL LIBRARY
UNIVERSITY OF (. \LIFORNTA
94720



LOWER LIMB.

ARTICULATIONS, HIP-JOINT No. 2.

The capsular ligament of the hip-joint is an extremely strong fibrous structure, strengthened in
several parts by bands of fibres which are distinctively named.

It is attached to the innominate bone around the margin of the acetabulum, and to the trans-
verse ligament which bridges over the notch in the margin, and, below, it is attached to the femur
along the anterior intertrochanteric line and to the root of the great trochanter, while, behind, its
attachment crosses the neck of the femur.

The principal bands on the anterior portion of the capsule are the ilio-femoral, the pubo-femoral,
and the ischio-femoral. The first is attached above to the anterior inferior iliac spine, and divides
into^two limbs which pass to the upper and to the lower ends of the anterior intertrochanteric line,
leaving between them a triangular interval, which is here very small in amount.

A band of fibres passing horizontally from the anterior inferior spine to the root of the great
trochanter is often termed the ilio-trochanteric band.

To the inner side of the ilio-femoral band is a weak spot, where there is often an aperture com-
municating with the bursa under the ilio-psoas.

The pubo-femorai band is more horizontal in direction, passing from the pubic -bone near the
pectin eal eminence, to join the capsule.

The ischio-femoral band consists of some fibres which pass from the ischium, below the aceta-
bulum, and join the lower and back part of the capsule.

A small portion of the cotyloid ligament is seen. It is a rim of fibro-cartilage around the margin
of the acetabulum.



1. Anterior inferior spine of ilium.

2. Ilio-trochanteric band.

3. Ilio-femoral band.

4. Lower part of ilio-femoral band.



The figures indicate

5. Upper part of ilio-femoral band

6. Cotyloid ligament.
". Pubo-femoral band.
8. Ischio-femoral band.



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THE EDINBURGH STEREOSCOPIC ATLAS OF ANATOMY.



LOWER LIMB.



Section VIII. No. 8

BIOLOGY LIBRARY

THE GENERAL LTTOSABY

ARTICULATIONS, KNEE-JOINT No. 1. UNIVERSITY oe

OilV'^O

RIGHT KNEE-JOINT, VIEWED FROM IN FRONT.

The fibrous expansion from the quadriceps extensor which fills up the interval on each side of
the ligamentum patellae has been removed to show the synovial membrane and the edges of the
semilunar cartilages.

The ligamentum patellae is about two inches in length, and passes from the apex and lower
border of the patella to the lower part of the anterior tubercle of the tibia. Some of its fibres are
continuous with the tendon of the quadriceps. The ligament is separated from the joint by the infra-
patellar pad of fat (which has been removed), and a bursa intervenes between it and the upper part
of the tuberosity of the tibia.

The synovial membrane of the knee-joint is seen on each side passing upwards in the form of a
pouch, in front of the lower end of the femur, and the extent to which it covers the front of the bone
should be noticed.

The semilunar cartilages are attached to the head of the tibia along their margins by the
coronary ligament. This has been removed from the outer Cartilage, and the margins of the two
cartilages are seen in the position in which they can be felt in the living subject. In relation to the
joint on each side are seen the tendon of the sartorius muscle on the inner aspect, and that of the
biceps on the outer.

The figures indicate



1. Tendon of insertion of the quadriceps

extensor muscle.

2. Patella.

3. Ligamentum patellae.

4. Synovial membrane on the outer side.

5. Synovial membrane on the inner side.



6. Margin of the external semilunar cartilage.

7. Internal semilunar cartilage and coronary

ligament.

8. Anterior tubercle of the tibia.
9.. Tendon of the sartorius muscle.

10. Tendon of the biceps flexor cruris.



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THE EDINBURGH STEREOSCOPIC ATLAS OF ANATOMY.



Section VIII. No. 9

BIOLOGY LIBRARY

THE CK \KKAL LIF.RARY
U N 1 V K K SIT V O F C A 1 ,1 FOR NT^
94720



LOWER LIMB.

ARTICULATIONS, KNEE-JOINT No. 2.
TWO SPECIMENS OF THE RIGHT KNEE-JOINT, VIEWED FROM THE INNER SIDE.

The ligamentum patellae has been isolated in A, and in B the tendons have been turned aside to
show the internal lateral ligament.

On the inner side of the joint are found the tendons of the swtorvus, adductor graoilis and
semitendinosus muscles, passing down to be inserted into the upper part of the shaft of the tibia,
while the tendon of the sernvniembrortiosus lies more posteriorly, and is inserted mainly into the
inner tuberosity of the tibia.

The internal lateral ligament is continuous above with the tendon of the adductor magnus, and
probably represents a degenerated portion of that muscle. It is attached above to the internal
condyle below the adductor tubercle, and passes as a wide, flat band down to the inner part of the
shaft of the tibia, to which it is attached, below the internal tuberosity. A bursa intervenes between
it and the tendons which lie upon its superficial surface.

The pouch of synovial membrane which passes up on the. inner side in front of the lower end of
the femur is well seen in A.



1. Vastus interims muscle.

2. Sartorius muscle.

3. Adductor gracilis muscle,

4. Semitendinosus muscle.

5. Seraimembranosus muscle.



The figures indicate

6. Pouch of synovial membrane.

7. Internal lateral ligament.

8. Internal semilunar cartilage.

9. Tendon of adductor magnus.
10. Bursa.







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THE EDINBURGH STEREOSCOPIC ATLAS OF ANATOMY.



Section VIII. No. 10



LOWER LIMB.

ARTICULATIONS, KNEE-JOINT No 3.



BIOLOGY LIBRARY

THK GENERAL LIBRARY

UNIVERSITY OF CALIFORNIA"

Mir.tT,py, CAUFOJRNIA 94720"



RIGHT KNEE-JOINT, WITH TENDONS, ETC., FROM BEHIND.

The knee-joint is strengthened by the numerous tendons which pass over it on all sides. Thus
on the inner side at the back are the tendons of the semitendinosus, semimembranosus, adductor
gmcilis and sartor ins, with the inner head of the gastrocnemius, and 6n the outer side the bicep$ t
outer head of the gastrocnemius, \vith the plantaris, and the popliteus.

The posterior ligament of the joint is further strengthened by a strong oblique band derived
from the tendon of the se.mimembranosus.



The figures Indicate



IT Semimembranosus muscle and tendon.

'2. Semitendinosus tendon.

3. Short head of the biceps, and its tendon of

insertioa
V 4. Outer head of the gaswocnemius with the

plantaris.
5. Inner bead of the gastrocnemius.



6. and 7. Popliteus muscle.

8. Ligamentum posticum.

9. Tendon of the adductor magnus

10. Vastus extenma muscle.

11. Adductor gracilis tendon.

12. Sartorius muscle.

1 3. Origin of the extensor longus digitorura.




THE EDINBURGH STEREOSCOPIC ATLAS OF ANATOMY.



Section VIIL No. 11



LOWER LIMB.

ARTICULATIONS, KNEE-JOINT No. 4.



EIGHT KNEE-JOINT FROM BEHIND.

The tendons and the posterior ligament have been removed to show the semilunar cartilages
and the posterior crucial ligament.

The posterior crucial ligament is attached below to the back part of the head of the tibia,
between the articular surfaces, and to the posterior aspect of the head, receiving also a slip from the
external semilunar cartilage, and it passes upwards, forwards and inwards to be attached to the outer
surface of the internal condyle in its anterior oblique part. The upper part of the anterior crucial
ligament is seen ascending on the outer side of the former to be attached to the inner aspect of the
.external condyle near the back. On the outer side of the femur, the tendon of the popliteus muscle
iSprings from the front of a groove on -the outer aspect of the external condyle, under cover of the
external lateral ligament, which is attached to a tubercle on the external condyle at a higher level,
and passes down to the head of the fibula.

On the inner side the tendon of ihe'semimembranosus has been turned aside to show a bursa
which intervenes between it and the inner tuberosity of the tibia.



1. Posterior crucial ligament.

2. Internal semilunar cartilage.

3. External

4. External lateral ligament.

5. Tendon of the popliteus muscle.

6,. Upper end of the anterior crucial ligament.



The figures indicate

7. Tendon of the semimembranoeus muscle.

8. Posterior superior tibio-fibular ligament.

9. Tendon of adductor magnus muscle.


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