Popliteal fossa & back of thigh

1. POPLITEAL FOSSA & BACK OF THIGH
Dr. Prabhakar Yadav
Associate Professor
Department of Human Anatomy
B.P. Koirala Institute of Health Sciences

2. Back of Thigh:
Extent:
CUTANEOUS INNERVATION:
1. Posterior cutaneous nerve of the thigh
2. Cutaneous branches of the obturator nerve
3. Medial branches of anterior cutaneous nerve of thigh
4. Branches of Lateral cutaneous nerve of the thigh

3. CONTENTS OF POSTERIOR COMPARTMENT OF THE THIGH
Muscles: Hamstring muscles & short head of biceps femoris.
Nerve: Sciatic nerve.
Arteries: Arterial anastomoses on the back of thigh.
MUSCLES ON THE BACK OF THE THIGH
The hamstring muscles are:
1. Semitendinosus.
2. Semimembranosus.
3. Biceps femoris (long head).
4. Ischial head of adductor magnus.
characteristic features of hamstring muscles
1. Arise from the ischial tuberosity.
2. Are inserted into one of the bones of the leg.
3. Are flexors of the knee and extensors of the hip joint
4. Are supplied by tibial part of the sciatic nerve.

4. Tibial collateral ligament morphologically represents :
degenerated tendon of adductor magnus.

5. Muscle Origin Insertion Nerve supply
Biceps femoris
(a) Long head
Inferomedial part
of upper area of
ischial tuberosity
Into the head
of fibula
in front of its
styloid process
Tibial part of sciatic nerve
Biceps femoris
(a) Long head
Lateral lip of
linea aspera &
from upper 2/3rd
of lateral
supracondylar
line
Into the head
of fibula
in front of its
styloid process
Common peroneal part of
sciatic nerve

6. Muscle Origin Insertion Nerve supply
Semitendinosus Inferomedial part
of upper area of
ischial tuberosity
Upper part of
medial surface of
the tibia
Tibial part of sciatic
nerve
Semimembranosus Superolateral part
of upper area of
ischial tuberosity
Horizontal groove
on posterior aspect
of medial condyle
of the tibia
Tibial part of sciatic
nerve
Ischial part of
adductor magnus
lateral part of
lower area of
ischial tuberosity
Into the adductor
tubercle
Tibial part of sciatic
nerve

7. Actions of
semitendinosus, semimembranosus & biceps femoris:
1. Chief flexors of knee.
2. Weak extensors of the hip,
3. When the knee is semiflexed:
• biceps femoris - lateral rotator of leg
• semimembranosus & semitendinosus - medial
rotators of leg.
4. When hip is extended:
• biceps femoris- lateral rotator of leg
• semitendinosus & semimembranosus- medial
rotators of leg.

8. SCIATIC NERVE
• Thickest nerve
• Extent:
Course:
In Pelvis:
• Arises in the pelvis from ventral rami of L4–S3 spinal
nerves.
In gluteal region:
• leaves pelvis through greater sciatic foramen below
piriformis to enter the gluteal region.
• descends between the greater trochanter and ischial
tuberosity
In thigh.
Enter thigh at lower border of glutes maximus & run
vertically downward
• Above the popliteal fossa (junction of middle and
lower thirds of thigh), it divides into terminal tibial
and common peroneal nerves

10. Branches
1. Articular branchesto the hip joint: arise in gluteal
region.
2. Muscular branches:
• Tibial part of supplies hamstring muscle.
• Common peroneal part supplies short head of
biceps femoris

11. ARTERIAL ANASTOMOSES ON THE BACK OF THE
THIGH:
1. Longitudinal arterial anastomosis:
Main arterial supply: perforating branches of
profunda femoris .

12. 2. Trochanteric anastomosis: situated in
Trochanteric fossa.
Formed by:
1. Ascending branch of medial circumflex femoral
artery.
2. Ascending branch of lateral circumflex femoral
artery.
3. Descending branch of the inferior gluteal artery.
4. Descending branch of the superior gluteal artery.
3. Cruciate anastomosis: situated at back of femur at
level of the lesser trochanter.
Formed by:
1. Transverse branch of medial circumflex femoral
artery.
2. Transverse branch of lateral circumflex femoral
artery.
3. Ascending branch of first perforating artery.
4. Descending branch of inferior gluteal artery.

13. POPLITEAL FOSSA
Diamond-shaped depression on back of knee joint.
BOUNDARIES
Superomedially: Semitendinosus & semimembranosus
Superolaterally: Biceps femoris.
Inferomedially: Medial head of gastrocnemius.
Inferolaterally: Lateral head of gastrocnemius
supplemented by the plantaris.

14. Floor: from above downward by:
(a) Popliteal surface of the femur.
(b) Capsule of the knee joint & oblique popliteal
ligament.
(c) Popliteal fascia covering the popliteus muscle
Roof: formed by strong popliteal fascia.
Superficial fascia over the roof contains:
(a) Short saphenous vein.
(b) Three cutaneous nerves:
i) terminal part of posterior cutaneous nerve of thigh
ii) posterior division of medial cutaneous nerve of thigh
iii) sural(peroneal) communicating nerve.
Roof is pierced by all these structures except posterior
division of medial cutaneous nerve of the thigh.

15. CONTENTS
1. Popliteal artery and its branches.
2. Popliteal vein and its tributaries.
3. Tibial nerve and its branches.
4. Common peroneal nerve and its branches.
5. Popliteal lymph nodes.
6. Popliteal pad of fat.
7. Posterior cutaneous nerve of the thigh (terminal part).
8. Terminal part of short saphenous vein.
9. Genicular branch of the obturator nerve.

16. Relationship of tibial nerve, popliteal vein & popliteal artery:
(a) In upper part of the fossa from the lateral to medial: Nerve, Vein & Artery (NVA).
(b) In middle part of the fossa from superficial to deep: Nerve, Vein & Artery (NVA).
(c) In lower part of the fossa from the lateral to medial: Artery, Vein & Nerve (AVN).

17. Popliteal Artery
Bigning, course & termination

18. Relations
Anterior (deep): Floor of the popliteal fossa (popliteal surface of
femur, posterior aspect of the knee joint & fascia covering
popliteus muscle;
Posterior (superficial): Popliteal vein, tibial nerve, fascial roof,
superficial fascia, and skin (from deep to superficial)

19. Branches
1. Cutaneous branches: Pierce the roof & supply overlying skin.
2. Muscular branches:
• Upper branches (two or three in number) - adductor magnus & hamstring muscles.
Terminate by anastomosing with the fourth perforating artery.
• Lower muscular branches - triceps surae muscles (i.e.two heads of gastrocnemius & soleus) & plantaris

20. Genicular (articular) branches: are five in number and supply the knee joint.
(a) Superior medial and lateral genicular arteries: wind around the corresponding femoral condyles and
take part in the formation of genicular anastomosis.
(b) Inferior medial and lateral genicular arteries: wind around the corresponding tibial condyles and
pass deep to the corresponding collateral ligaments of the knee joint to take part in the formation of
genicular anastomosis.
(c) Middle genicular artery: It pierces the oblique popliteal ligament of the knee to supply the cruciate
ligaments and synovial membrane of the knee joints

21. Popliteal Vein
• Formed at lower border of the popliteus by union of venae
comitantes accompanying anterior & posterior tibial arteries.
• It ascends superficial to popliteal artery and crosses it from
the medial to lateral side.
• popliteal vein continues as femoral vein at adductor hiatus.
Tributaries:
1. Small saphenous vein.
2. Veins corresponding to the branches of popliteal artery.

22. Tibial Nerve (L4, L5; S1, S2, S3)
• Larger terminal branch of the sciatic nerve.
• Extends vertically downward from the superior angle to the inferior angle of the popliteal fossa.
Branches:
1. Muscular branches: Both gastrocnemius, soleus, plantaris& popliteus.

23. 2. Genicular branches:
• Superior medial genicular,
• Middle genicular
• Inferior medial genicular
3. Cutaneous branch: is called sural nerve.
• arises in middle of the popliteal fossa.
• leaves the fossa at inferior angle.

24. Common Peroneal Nerve (L4, L5; S1, S2)
Pierces peroneus longus muscle & terminates by dividing into deep and superficial peroneal nerves.

25. Branches
Cutaneous branches
1. Sural communicating nerve: runs on posterolateral aspect of calf & join sural nerve .
2. Lateral cutaneous nerve (lateral sural nerve): supply skin of upper 2/3rd of the lateral side of the leg

26. Genicular (articular) branches
superior lateral genicular
supply t knee joint
inferior lateral genicular
recurrent genicular nerves----- supply superior tibiofibular joint.

27. Popliteal Lymph Nodes:
five to six in number, embedded in popliteal pad of fat.
Drain:
(a) Back and lateral side of calf of the leg.
(b) Lateral side of heel and foot

28. Genicular Branch of the Obturator Nerve:
- Is continuation of posterior division of obturator nerve.
- Runs on posterior surface of popliteal artery and pierces oblique popliteal ligament to supply capsule
of knee joint

30. SCIATIC NERVE INJURY
Commonly injured in
• I.V.Disc Prolapse
• Dislocation of hip joint
• Piriformis syndrome
• Intramuscular injection
• Penetrating wound and
fracture of pelvis
Sleeping foot:

32. Thank you