| Pes anserinus (leg) | |
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| Muscles of the gluteal and posterior femoral regions. Area of pes anserinus is encircled at bottom. sartorius, gracilis and semitendinosus are labeled at bottom left. |
The pes anserinus ("goose's foot") is the insertion of the conjoined tendons of three muscles[1] onto the anteromedial (front and inside) surface of the proximal extremity of the tibia.
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Anatomy
The three muscles are (from anterior to posterior):[2]
The conjoined tendon lies superficial to the tibial insertion of the medial collateral ligament (MCL) of the knee.
Mnemonic
A good mnemonic to remember the muscles which contribute tendons to this conjoined tendon and the innervations of these muscles is SGT FOT (sergeant FOT)
S- Sartorius G- Gracilis T- semiTendinosus (from medial to lateral)
F- femoral nerve O- obturator nerve T- tibial nerve (one of the two component nerves of the sciatic nerve [the other being the common fibular (or common peroneal) nerve]. It should be noted that the sciatic nerve itself cannot technically innervate anything because it is merely the designation for the common sheath that encases the tibial and common fibular nerves.)
Notice the order of the muscles (S, G, T) follows the order of the innervating nerves which correspond to those muscles (F, O, T)
Another useful mnemonic is
Say Grace before Tea
Elucidating the insertion of the three muscles from anterior to posterior
Sartorius - Gracilis - semiTendinosus
Clinical significance
It is a major cause of chronic knee pain and weakness ("pes anserinus bursitis").[3][4] Pes bursitis is a condition in which the medial portion of the knee is inflammed. If the bursa underlying the tendons of the sartorius, gracilis, and semitendinosis gets irritated from overuse or injury a person can develop this ailment. This condition usually occurs in athelete from overuse. This pathology is characterized by pain, swelling, and tenderness. (eMedicine, MD. M. Glencross).
It can also be used to surgically repair the anterior cruciate ligament.[5]
References
- ^ 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:. PMID 14695588. http://dx.doi.org/10.1002/ca.10142.
- ^ Mnemonic at medicalmnemonics.com 3447
- ^ pmr/104 at eMedicine - "Pes anserinus bursitis"
- ^ 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:. PMID 17414530. http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=1076-1608&volume=13&issue=2&spage=63.
- ^ 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:. PMID 12486734. http://dx.doi.org/10.1002/ca.10073.
External links
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