Knee

“ On the contrary, if the leg is placed only slightly forward with but little flexion of the knee, as explained in the detailed description, the upper body has to be bent further downward in order that the hands reach the lower leg at the ankle. ”

“ Experiment 29. To show the ligamentous action of the muscles. Standing with the back fixed against a wall to steady the pelvis, the knee can be flexed so as to almost touch the abdomen. Take the same position and keep the knee rigid. When the heel has been but slightly raised a sharp pain in the back of the thigh follows any effort to carry it higher. Flexion of the leg to a right angle, increases the distance from the lines of insertion on the pelvic bones to the tuberosities of the tibia by two or three inches—an amount of stretching these muscle cannot undergo. ”

“ Not dwelling on the transition from descent on both knees to descent on one knee, which, less abject, comes a stage nearer the erect attitude, it will suffice to note the transition from kneeling on one knee to bending the knee. That this form of obeisance is an abridgment is well shown us by the Japanese:
"On meeting, they show respect by bending the knee; and when they wish to do unusual honor to an individual they place themselves on the knee and bow down to the ground. ”

“ Although an ungainly deformity, it is much less frequently the source of complaint than knock-knee, because it scarcely interferes with locomotion—as a matter of fact, the subjects of bow-knee, although short in stature, are unusually sturdy on their legs. ”

“ Its lower end forms the outer projection of the ankle. In front of the knee joint, embedded in a thick, strong tendon, is an irregularly disk-shaped bone, the patella, or knee-cap. It increases the leverage of important muscles, and protects the front of the knee joint, which is, from its position, much exposed to injury.
Fig. 23.—Patella, or Knee-Cap.
49. The Foot. The bones of the foot, 26 in number, consist of the tarsal bones, the metatarsal, and the phalanges. The tarsal bones are the seven small, irregular bones which make up the ankle. ”

“ A Loose Cartilage, or a Displaced Cartilage in the Knee Joint is apt to become caught in the hinge between the thigh bone and the leg bone, and by causing a sudden stretching of the ligaments of the joint to give rise to intense pain. ”

“ The knee also is formed from it as a center. But as the inside of the leg is a straight line and the outside of the leg is hollow at the knee, it follows that, for a close-fitting pants leg at the knee, the outside first requires a reduction of say three-eighths to one-half an inch, on double cloth, which again is allowed at the inside, after which the width may be reduced equally on each side, if such reduction is necessary. ”

“ When they salute a person of rank, they bend the knee in such a manner as to touch the ground with their fingers." We are shown the same thing equally well, or better, in China, where, among the specified gradations of obeisance, the third is defined as bending the knee, and the fourth as actually kneeling. ”

“ The change in the knee is most significant. The armour plating of thicknesses has tended to disappear. The knee is usually innocent of patches and often left, in Tyrolese fashion, uncovered. The change is due to our change in style. While the foot still demanded broad holds, necessarily found at longer intervals, for its balance, the knee was constantly in requisition for an intermediate push up. While grip climbing obtained, the knee was more useful than the foot to jam with or to scrape downward against the rocks. ”

“ Whether the pain of a wound in the knee is not greater than the pain of a wound in the groin—are points which to this day remain unsettled.
Chapter 4.XLIV.
The anguish of my knee, continued the corporal, was excessive in itself; and the uneasiness of the cart, with the roughness of the roads, which were terribly cut up—making bad still worse—every step was death to me: so that with the loss of blood, and the want of care-taking of me, and a fever I felt coming on besides— (Poor soul! said my uncle Toby) —all together, an' please your honour, was more than I could sustain. ”

“ Most of the painful knee conditions of which patients complain are not directly due to true pathological conditions either of the knee joint itself or of its neighboring structures, but rather to affections of other portions of the leg that set a special strain upon the knee and, above all, to various kinds of foot disturbances. ”

“ As a bodily act of reverence, kneeling, either on one knee or on both knees, includes every kind of bowing, just as a profound bow includes a moderate bow, and therefore in such kneeling the head is not to be bowed. ”

“ The knee of the horse corresponds with the human wrist. Like the joints generally, it should be large, by which the surface of muscular and ligamentous contact becomes increased, and the stability of the limb in proportion augmented; by this form also the tendinous insertions are further removed from the centre of motion, and thereby their power is increased. The knee should be carefully examined, to see whether the skin has been broken by falls; and great caution is necessary in this, for the hair sometimes grows so well over the scar as to leave it hardly discernible. ”

“ By elongating the thigh-piece by means of the screw, extension is kept up. Great complaint is commonly made by the patient of pain and stiffness in the knee for a long time after the treatment of broken thigh in the bent position.
There is no possibility of treating fracture of the thigh, with any satisfaction or credit, on the outside of the limb with the knee bent; however attentively the splints are placed, shortening, eversion of the foot, and deformity of the whole limb, are sure to follow. ”

“ BOW-LEG (Genu Varum) , a deformity characterized by separation of the knees when the ankles are in contact. Usually there is an outward curvature of both femur and tibia, with at times an interior bend of the latter bone. At birth all children are more or less bandy-legged. The child lies on its nurse’s knee with the soles of the feet facing one another; the tibiae and femora are curved outwards; and, if the limbs are extended, although the ankles are in contact, there is a distinct space between the knee-joints. During the first year of life a gradual change takes place. ”

“ Moderate extension for the most part sufficeth, extension being made at the leg, and counter-extension at the thigh.
38. Dislocations at the elbow are more troublesome than those at the knee, and, owing to the inflammation which comes on, and the configuration of the joint, are more difficult to reduce if the bones are not immediately replaced. For the bones at the elbow are less subject to dislocation than those of the knee, but are more difficult to reduce and keep in their position, and are more apt to become inflamed and ankylosed. ”

“ If the leg stump is ten centimetres long, if the knee joint is freely mobile and capable of complete, or almost complete, active extension, and if there are no adherent scars around the tuberosities of the tibia, the American apparatus with free knee joint should be adopted. ”

“ The word is also used of articulation resembling the knee-joint in shape or position in other animals; it thus is applied to the carpal articulation of the fore leg of a horse, answering to the ankle in man, or to the tarsal articulation or heel of a bird’s foot. ”

“ The knee, when fully developed, is generally hollow, comparatively soft, gnarled, and hard to rupture, so that it has the quality of a spring that becomes more rigid as it is extended or compressed out of its normal shape. ”

“ Otherwise she is better, steadily and slowly moving up through all her relapses. My knee never gets the least better; it hurts to-night, which it has not done for long. I do not suppose my doctor knows any least thing about it. ”

“ The phenomena which announce the presence of foreign bodies in the joint of the knee, are sometimes clothed in a character of such evidence, that they cannot be mistaken; at other times, the nature of the disease eludes the most accurate researches: the cause of this variety may be easily perceived. ”

“ In adolescent knock-knee the patient seeks advice because of the deformity or of pain after exertion, especially at the medial side of the epiphysial junctions, of being easily tired, and of incapacity for any occupation involving standing. The bones are coarse and badly formed, and there is frequently a spinous process projecting downwards from the medial side of the tibia about three finger-breadths below the joint. ”

“ Where the leg, for instance, has been lost, they feel as if the foot was present, but as though the leg were shortened. If the thigh has been taken off, there seems to them to be a foot at the knee; if the arm, a hand seems to be at the elbow, or attached to the stump itself. ”

“ Some men, and nearly all women, when they use the knee incline it inward across the front of the body, so as to place it on a hold with its point or outside surface in the direct line of ascent. This leads to a very constricted attitude. ”

“ When thigh of a leg is exposed, take hold of leg outside of skin and push knee forward so it is uncovered inside of skin. Sever knee joint with scalpel or scissors, using care not to cut through skin on outside of joint. ”

“ The man softly, yet awkwardly, lifted the robe, folded it back, and slowly uncovered the knee. The leg was worn away almost to skin and bone, but the knee itself was swollen with inflammation. He bathed it with some water, mixed with vinegar and herbs, then drew down the deer-skin shirt, and did the same with the child's shoulder. Both shoulder and knee bore the marks of teeth,—where a huge wildcat had made havoc—and the body had long red scratches. ”

“ On the back of the thigh, runs another great group of muscles, which bend or flex the limb when they shorten. When the knee is bent, you can feel their tendons, or sinews, stand out as hard cords beneath the knee ”

“ The knee-cap in women looks straight forward, while in men it is turned a little outward; and in women the knees touch, or even overlap each other, while in men they are quite free. In running, a woman has to move the knees round each other, and to throw the feet out in a succession of small semicircles, which accounts for the peculiarity in her gait. ”

“ The greater part of the body, from the waist down to the knee is covered with it, variegated here and there with neat regular stripes of the untattooed skin, which when they are well oiled, make them appear in the distance as if they had on black silk knee-breeches. ”

“ The thighs are wasted very much—little remains upon them beyond the skin. The cap of the knee, which is large, and protrudes considerably, is of a reddish colour, unlike the aspect of the flesh or skin in general. ”

“ Many patients with thigh amputation feel, more or less distinctly, their knee, or their calf. But even where they do not, the foot may seem separate from the stump, though possibly located nearer it than natural. ”

“ I plodded conscientiously through the twenty-six letters, and the only malady I could conclude I had not got was housemaid’s knee.
I felt rather hurt about this at first; it seemed somehow to be a sort of slight. Why hadn’t I got housemaid’s knee? Why this invidious reservation? After a while, however, less grasping feelings prevailed. I reflected that I had every other known malady in the pharmacology, and I grew less selfish, and determined to do without housemaid’s knee. Gout, in its most malignant stage, it would appear, had seized me without my being aware of it; ”

“ When an amputation is deferred to the secondary period, a joint is often lost. A leg which might have been cut off below the knee in the first instance is frequently obliged to be removed above the knee when done in the second. ”

“ The same may be said for the markings on the bone, which indicate the presence of powerful muscles whose action is to keep the thigh straight with the back—or in other words, to keep the body erect. Below the knee are the two bones of the leg: the inner one, or shin-bone (the tibia) , is very short for the height of the animal, and the joint on its lower part, on which moves the ankle-bone, is not so deep and perfect as in man, whose weight is constantly to be borne on it whilst it is being moved in walking. ”

“ The thigh-bone is very much longer in proportion to that of the metatarsus—the one below it—than is the case with other animals, and thus the knee is very much lower down. He has also no hock, and can thus bend his knee as completely as a human being. ”

“ The reason the knees are used is to be accounted for by the fact that, owing to the great length of the human leg and thigh in proportion to the length of the arm, the knee would naturally be brought to the ground, and the instep and top of the toes would be used instead of the sole and heel of the almost inflexible foot. Why the elbow should be employed instead of the hand is less easy to understand, but probably it is better suited to give support to the head and fore-part of the body. ”

“ The knee-cap, for instance, which really belongs to the thigh, is attached to it by muscle, but to the shin-bone by a stout ligament. And so with the bones of the arm; they are connected to one another by ligaments; but to the trunk only by muscle, excepting at one end of the collar-bone.
"But this was a very significant fact. Ligament decays much more slowly than muscle, so that in a body of which the muscles had largely decayed the bones might still be held together by ligament. ”

“ The knee, the wrist, the carpal, the tarsal, and the clavicular joints depend for their stability almost entirely on the strength of their ligaments. These joints are rarely dislocated, but as the main incidence of the violence falls on the ligaments they are frequently sprained. ”

“ The left leg, hand, and arm, and the right shoulder, should be in the same vertical plane when firing in the open kneeling on the right knee. When kneeling on both knees, the body may rest on both heels, or be kept upright to suit the height of the cover, the elbows in both instances being unsupported by the body. ”

“ Sometimes the pain is confined to the knee, and if the examination is restricted to that joint the disease at the hip may be overlooked. At this stage the attitude of the limb is not constant; at one time it may be natural, and at another slightly flexed and abducted. Tenderness of the joint may be elicited by pressing either in front or behind the head of the bone, but is of little diagnostic importance. ”