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Vastus medialis

Contents

Anatomy

Anterior view
Anteromedial view
Posterior view

General information

  • This section is strictly limited to anatomy, you might be looking for clinical relevant information which is found under the clinical chapters -- muscles section, click here to go to that page

Position

  • Partly deep

Origin

  • Medial aspect of linea aspera
  • Linea intertrochanteric
    • Distal 1/2
  • Linea mediale supracondylaris
    • Proximal part
  • Tendon and adjacent fascia of adductor longus and adductor magnus
  • Medial septum intermusculare

Insertion

  • Tuberositas tibiae / proximal and medial limitation of patella
    • Via patella and patellar ligament

Main function

  • Knee
    • Extension

Nerve innervation

  • Segmental
    • L2-L4
  • Peripheral
    • Femoral nerve

Arterial supply

  • Femoral artery

Palpation

  • Patient position
    • Supine
  • Place your hand just proximal and medial to the patella
  • Ask the patient to press the posterior part of the knee down towards the bench so that the quadriceps is contracted
  • Feel for the contraction of the vastus medialis and palpate it further proximal

STRENGTH TEST

  • Patient position
    • Seated with knees over the edge of the treatment table
  • Stabilize the patient's knee by holding your one hand just proximal to the patella ventrally on femur
  • Place your other hand just distal and ventral on the tibia just proximal to the ankle joint
  • Ask the patient to press the foot out towards extension for the knee while your give resistance and press towards flexion
  • Regarding tensor fascia latae
    • If the patient is twisting the knee into medial rotation, this may indicate that the patient is trying to compensate by using tensor fascia latae to a larger degree. TFL will also be more active by having the patient lean the upper body backwards during the testing
  • Regarding hamstrings
    • If the patient is leaning the upper body backwards, then this may also indicate too much pressure on an over-activated hamstring and that the patient is trying to relieve it by having less stretch on the muscle
  • Regarding rectus femoris
    • A third option as to why the patient compensates by leaning backwards,is that if rectus femoris is stronger than the other quadriceps muscles. In these cases the patient prefers having the hip as extended as possible to have maximum efficiency of the muscle due to leverage