関: quadriceps femoris、quadriceps muscle、rectus femoris、vastus intermedius、vastus lateralis

WordNet

dividing an animal into right and left halves (同)median

PrepTutorEJDIC

中間の,中間に位置する / 平均の,並なみの
『広大な』,広範囲な / (数・量・程度などにおいて)ものすごい,ばく大な

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/04 17:00:53」(JST)

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The vastus medialis (/ˈvæstəs ˌmɛdiˈeɪlɨs/ or /ˈvæstəs ˌmɛdiˈælɨs/) (vastus internus or teardrop muscle) is an extensor muscle located medially in the thigh that extends the knee. The vastus medialis is part of the quadriceps muscle group.

Structure

The vastus medialis is a muscle present in the anterior compartment of thigh, and is one of the four muscles that make up the quadriceps muscle. ^[a] It is the most medial of the "vastus" group of muscles, the others being vastus intermedius and vastus lateralis. The vastus medialis arises medially along the entire length of the femur, and attaches with the other muscles of the quadriceps in the quadriceps tendon.^[1]

The vastus medialis muscle originates from a continuous line of attachment on the femur, which begins on the front and middle side (anteromedially) on the intertrochanteric line of the femur. It continues down and back (posteroinferiorly) along the pectineal line and then descends along the inner (medial) lip of the linea aspera and onto the medial supracondylar line of the femur. The fibers converge onto the inner (medial) part of the quadriceps femoris tendon and the inner (medial) border of the patella.^[1]

The obliquus genus muscle is the most distal segment of the vastus medialis muscle. Its specific training plays an important role in maintaining patella position and limiting injuries to the knee. With no clear delineation, it is simply the most distal fibers of the vastus medialis.

Function

The vastus medialis is one of five muscles in the anterior compartment of the thigh.^[1] It is involved in knee extension, along with the other muscles which make up the quadriceps muscle.^[1] The vastus medialis also contributes to correct tracking of the patella^[2]

A division of the vastus medialis muscle into two groups of fibers has been hypothesized, a long and relatively inline group of fibres with the quadriceps ligament, the vastus medialis longus; and a shorter and more obliquely oriented with group of fibbres, the vastus medialis obliquus. There is as yet insufficient evidence to conclusively confirm or deny this hypothesis.^[3]

Clinical significance

Knee pain

Knee pain is thought to be primarily associated with specific quadriceps muscle weakness or fatigue, especially in the vastus mediallis obliquus (VMO). It is known that fatigue can be caused by many different mechanisms, ranging from the accumulation of metabolites within muscle fibers to the generation of an inadequate motor command in the motor cortex.^[4] Characteristics of the vastus medialis, including its angle of insertion, correlate with presence of knee joint pain (patellofemoral pain syndrome).^[5] However, this syndrome is complex and definitive evidence of causality has not yet been published.

Misfiring and fatiguing of the VMO causes mal-tracking of the patella and subsequent damage to surrounding structures creating increased force on the knees, often resulting in injuries such as patellofemoral pain syndrome, anterior cruciate ligament rupture, chondromalacia, and tendinitis.^[6] Through the use of electromyography, researchers can evaluate and record the electrical activity produced by the skeletal muscle of the VMO to analyze the biomechanics and detect any possible abnormalities, weakness, or fatigue. With an analysis of muscle activity of the VMO through the use of electromyography, proper rehabilitative plans and goals can be established to not only correct the already established abnormality, but even prevent such injuries if tested sooner. Preventing injuries is crucial as well as teaching proper training techniques to ensure there are no valgus collapse forces causing unplanned stress on other structures of the knee, causing asymmetry, and predisposing that individual for injury!

Additional images

Right femur. Posterior surface.
Muscles of the iliac and anterior femoral regions.
The femoral artery.
Vastus medialis
Vastus medialis muscle
Vastus medialis muscle
Vastus medialis muscle
Vastus medialis muscle
Vastus medialis muscle
Muscles of thigh. Cross section.

Notes

^ The others being the vastus lateralis, vastus intermedius and rectus femoris.^[1]

References

This article incorporates text in the public domain from the 20th edition of Gray's Anatomy (1918)

^ ^a ^b ^c ^d ^e Drake, Richard L.; Vogl, Wayne; Tibbitts, Adam W.M. Mitchell; illustrations by Richard; Richardson, Paul (2005). Gray's anatomy for students. Philadelphia: Elsevier/Churchill Livingstone. p. 518-519. ISBN 978-0-8089-2306-0.
^ Sheehan, FT; Borotikar, BS; Behnam, AJ; Alter, KE (2012). "Alterations in in vivo knee joint kinematics following a femoral nerve branch block of the vastus medialis: Implications for patellofemoral pain syndrome". Clinical biomechanics 27 (6): 525–31. doi:10.1016/j.clinbiomech.2011.12.012. PMC 3328589. PMID 22244738.
^ Smith, TO; Nichols, R; Harle, D; Donell, ST (2009). "Do the vastus medialis obliquus and vastus medialis longus really exist? A systematic review". Clinical Anatomy 22 (2): 183–99. doi:10.1002/ca.20737. PMID 19090000.
^ Enoka, RM; Duchateau, J (2008). "Muscle fatigue: what, why, and how it influences muscle function". The Journal of Physiology 586 (1): 11–23. doi:10.1113/jphysiol.2007.139477. PMC 2375565. PMID 17702815.
^ Jan, MH; Lin, DH; Lin, JJ; Lin, CH; Cheng, CK; Lin, YF (2009). "Differences in sonographic characteristics of the vastus medialis obliquus between patients with patellofemoral pain syndrome and healthy adults". The American journal of sports medicine 37 (9): 1743–9. doi:10.1177/0363546509333483. PMID 19521000.
^ Lefebvre, R; Leroux, A; Poumarat, G; Galtier, B; Guillot, M; Vanneuville, G; Boucher, JP (2006). "Vastus medialis: anatomical and functional considerations and implications based upon human and cadaveric studies". Journal of Manipulative and Physiological Therapeutics 29 (2): 139–144. doi:10.1016/j.jmpt.2005.12.006. PMID 16461173.

External links

The KNEEguru - educational site packed with knee content with sections on the quadriceps muscle
Cross section image: pembody/body18b - Plastination Laboratory at the Medical University of Vienna
PTCentral

UpToDate Contents

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1. 大腿四頭筋腱の損傷 quadriceps muscle and tendon injuries
2. Patellofemoral pain
3. Approach to the adult with knee pain likely of musculoskeletal origin
4. 膝の身体診察 physical examination of the knee
5. 膝蓋骨外側脱臼の認識および初期マネージメント recognition and initial management of lateral patellar dislocations

English Journal

A comparison of electromyography and stroke kinematics during ergometer and on-water rowing.

Fleming N1, Donne B, Mahony N.Author information 1a Department of Kinesiology, Recreation and Sport , Indiana State University , Terre Haute , USA.AbstractAbstract This study assessed muscle recruitment patterns and stroke kinematics during ergometer and on-water rowing to validate the accuracy of rowing ergometry. Male rowers (n = 10; age 21 ± 2 years, height 1.90 ± 0.05 m and body mass 83.3 ± 4.8 kg) performed 3 × 3 min exercise bouts, at heart and stroke rates equivalent to 75, 85 and 95% V̇O2peak, on both dynamic and stationary rowing ergometers, and on water. During exercise, synchronised data for surface electromyography (EMG) and 2D kinematics were recorded. Overall muscle activity was quantified by the integration of rmsEMG and averaged for each 10% interval of the stroke cycle. Muscle activity significantly increased in rectus femoris (RF) and vastus medialis (VM) (P <0.01), as exercise intensity increased. Comparing EMG data across conditions revealed significantly (P <0.05) greater RF and VM activity during on-water rowing at discrete 10% intervals of stroke cycle. In addition, the drive/recovery ratio was significantly lower during dynamic ergometry compared to on-water (40 ± 1 vs. 44 ± 1% at 95%, P <0.01). Results suggest that significant differences exist while comparing recruitment and kinematic patterns between on-water and ergometer rowing. These differences may be due to altered acceleration and deceleration of moving masses on-ergometer not perfectly simulating the on-water scenario.
Journal of sports sciences.J Sports Sci.2014 Jun;32(12):1127-38. doi: 10.1080/02640414.2014.886128. Epub 2014 Feb 28.
Abstract This study assessed muscle recruitment patterns and stroke kinematics during ergometer and on-water rowing to validate the accuracy of rowing ergometry. Male rowers (n = 10; age 21 ± 2 years, height 1.90 ± 0.05 m and body mass 83.3 ± 4.8 kg) performed 3 × 3 min exercise bou
PMID 24576175

Torque-related changes in mechanomyographic intensity patterns for the superficial quadriceps femoris muscles.

Beck TW1, Stock MS, Defreitas JM.Author information 1a Department of Health and Exercise Science , University of Oklahoma , Norman , OK , USA.AbstractThe purpose of this study was to investigate changes in mechanomyographic (MMG) intensity patterns for the vastus lateralis (VL), rectus femoris (RF) and vastus medialis (VM) during submaximal to maximal concentric isokinetic, eccentric isokinetic and isometric muscle actions of the leg extensors. Eleven men (mean ± SD age = 20.1 ± 1.1 years) performed concentric, eccentric and isometric muscle actions of the dominant leg extensors on 3 separate days. Surface MMG signals were detected from the VL, RF and VM, processed with a wavelet analysis and examined with a trend plot. The results indicated that the trend plot was capable of tracking systematic changes in MMG amplitude and frequency with an increase in torque. However, these changes were statistically significant in only 26% of the cases. There were also no consistent differences between muscles or contraction types for the significance of the trend plots.
Computer methods in biomechanics and biomedical engineering.Comput Methods Biomech Biomed Engin.2014 May;17(7):714-22. doi: 10.1080/10255842.2012.715155. Epub 2012 Aug 24.
The purpose of this study was to investigate changes in mechanomyographic (MMG) intensity patterns for the vastus lateralis (VL), rectus femoris (RF) and vastus medialis (VM) during submaximal to maximal concentric isokinetic, eccentric isokinetic and isometric muscle actions of the leg extensors. E
PMID 22920285

The A55T and K153R polymorphisms of MSTN gene are associated with the strength training-induced muscle hypertrophy among Han Chinese men.

Li X1, Wang SJ, Tan SC, Chew PL, Liu L, Wang L, Wen L, Ma L.Author information 1a Department of Physical Education , Jiaozuo Teachers' College , Jiaozuo , China.AbstractAbstract Myostatin, encoded by the MSTN gene, is a strong regulator of skeletal muscle growth. The present study aimed to investigate whether the A55T and K153R polymorphisms of MSTN were associated with the strength training-induced muscle hypertrophy among Han Chinese men. A total of 94 healthy, untrained men were recruited for an 8-week strength training programme. The thicknesses of biceps and quadriceps, along with anthropometric measurements of the participants, were assessed before and after the programme. The MSTN polymorphisms were subsequently genotyped employing polymerase chain reaction-restriction fragment length polymorphism technique and confirmed by DNA sequencing. One-way analysis of variance was used to compare the pre- and post-training measurements between carriers of different polymorphic genotypes. Our results indicated that individuals with AT + TT genotype of the A55T polymorphism showed a significant increase in the thickness of biceps (0.292 ± 0.210 cm, P = 0.03), but not quadriceps (0.254 ± 0.198 cm, P = 0.07), compared to carriers of AA genotype. For the K153R polymorphism, the increases in the thicknesses of both biceps (0.300 ± 0.131 cm) and quadriceps (0.421 ± 0.281 cm) were significantly higher among individuals with KR than those with KK genotypes (P < 0.01 for both muscles). The results obtained therefore suggested a possible association between the two polymorphisms and the strength training-induced muscle hypertrophy among men of Han Chinese ethnicity.
Journal of sports sciences.J Sports Sci.2014 May;32(9):883-91. doi: 10.1080/02640414.2013.865252. Epub 2014 Jan 30.
Abstract Myostatin, encoded by the MSTN gene, is a strong regulator of skeletal muscle growth. The present study aimed to investigate whether the A55T and K153R polymorphisms of MSTN were associated with the strength training-induced muscle hypertrophy among Han Chinese men. A total of 94 healthy, u
PMID 24479661

Japanese Journal

持久的な間欠的筋力発揮時の筋音（筋振動信号）の変化動態

体力科学 65(1), 177-188, 2016
NAID 130005120699

健常成人に対する内側広筋斜走線維のトレーニング肢位の検討

愛知県理学療法学会誌 27(2), 54-59, 2015-12
NAID 40020695036

太白への鍼刺激が膝関節伸展運動時における大腿四頭筋の筋機能に与える影響:—異なる鍼刺激および運動回数による検討—

関西理学療法 15(0), 85-91, 2015
NAID 130005119029

「内側広筋」

Vastus medialis
	Muscles of lower extremity
Details
Latin	Musculus vastus medialis or musculus vastus internus
Origin	Medial side of femur
Insertion	Quadriceps tendon
Artery	Femoral artery
Nerve	Femoral nerve
Actions	Extends leg
Identifiers
Gray's	p.471
Dorlands; /Elsevier	Vastus medialis muscle
TA	A04.7.02.023
FMA	22432
	Anatomical terms of muscle

　　[★]

英: vastus medialis (K), vastus medialis muscle
ラ: musculus vastus medialis
関: 大腿四頭筋、大腿直筋、中間広筋、外側広筋

起始

大腿骨(粗線内側唇)

停止

脛骨(脛骨粗面)

神経

大腿神経

機能

膝関節の伸展

カテゴリ

大腿の伸筋＞:大腿の伸筋

「vastus lateralis」

　　[★]

外側広筋

関: lateral great muscle、musculus vastus lateralis、quadriceps femoris、quadriceps muscle、rectus femoris、vastus intermedius、vastus medialis

「quadriceps muscle」

　　[★] 四頭筋

関: musculus quadriceps、quadriceps、quadriceps femoris、rectus femoris、vastus intermedius、vastus lateralis、vastus medialis

「rectus femoris」

　　[★] 大腿直筋

関: quadriceps femoris、quadriceps muscle、vastus intermedius、vastus lateralis、vastus medialis

「vastus intermedius」

　　[★]

中間広筋

関: quadriceps femoris、quadriceps muscle、rectus femoris、vastus lateralis、vastus medialis

「medial」

　　[★]

adj.

内側の、中心の、中央の、内側性の

関: center、central、centre、centro、centrum、hub、inner、inside、interior、medialis、medially、middle

「vast」

　　[★]

adj.

莫大な、巨大な

関: colossal、enormous、enormously、giant、huge、hugely、immense、immensely、mega、prodigious

「medialis」

　　[★]

内側

関: inner、inside、interior、medial、medially

[2] The others being the vastus lateralis, vastus intermedius and rectus femoris.^[1]

[GRAYS2005-1] Drake, Richard L.; Vogl, Wayne; Tibbitts, Adam W.M. Mitchell; illustrations by Richard; Richardson, Paul (2005). Gray's anatomy for students. Philadelphia: Elsevier/Churchill Livingstone. p. 518-519. ISBN 978-0-8089-2306-0.

[3] Sheehan, FT; Borotikar, BS; Behnam, AJ; Alter, KE (2012). "Alterations in in vivo knee joint kinematics following a femoral nerve branch block of the vastus medialis: Implications for patellofemoral pain syndrome". Clinical biomechanics 27 (6): 525–31. doi:10.1016/j.clinbiomech.2011.12.012. PMC 3328589. PMID 22244738.

[4] Smith, TO; Nichols, R; Harle, D; Donell, ST (2009). "Do the vastus medialis obliquus and vastus medialis longus really exist? A systematic review". Clinical Anatomy 22 (2): 183–99. doi:10.1002/ca.20737. PMID 19090000.

[5] Enoka, RM; Duchateau, J (2008). "Muscle fatigue: what, why, and how it influences muscle function". The Journal of Physiology 586 (1): 11–23. doi:10.1113/jphysiol.2007.139477. PMC 2375565. PMID 17702815.

[6] Jan, MH; Lin, DH; Lin, JJ; Lin, CH; Cheng, CK; Lin, YF (2009). "Differences in sonographic characteristics of the vastus medialis obliquus between patients with patellofemoral pain syndrome and healthy adults". The American journal of sports medicine 37 (9): 1743–9. doi:10.1177/0363546509333483. PMID 19521000.

[7] Lefebvre, R; Leroux, A; Poumarat, G; Galtier, B; Guillot, M; Vanneuville, G; Boucher, JP (2006). "Vastus medialis: anatomical and functional considerations and implications based upon human and cadaveric studies". Journal of Manipulative and Physiological Therapeutics 29 (2): 139–144. doi:10.1016/j.jmpt.2005.12.006. PMID 16461173.

リンク元	「内側広筋」「vastus lateralis」「quadriceps muscle」「rectus femoris」「vastus intermedius」
関連記事	「medial」「vast」「medialis」

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vastus medialis