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6.01 POPLITEAL FOSSA  Politeal artery

DR. LAYGO/APRIL 7, 2016 - Deepest structure in the fossa, difficult to palpate
FINALS: QUIZ 1 (lying at femoral bone)
Bold,red letters=Emphasized during lecture; Italic,blue letters=Audio; Green= OT/BOOK - Anterior to artery are the capsule of the knee joint,
POPLITEAL FOSSA the back of femur and popliteus
 Diamond-shaped; lozenge-shaped  FLOOR (anterior wall)
 Located at the posterior aspect of the knee (intermuscular  Popliteal surface of femur
space at the back of the knee)  Oblique popliteal ligament – strong ligament, located
 Named popliteal because it is related to the popliteus muscle deep in popliteal fossa
 Area where you have the dorsal popliteal vessels  Tendinous expansion of the semimembranosus muscle
 Well-defined, fat-filled hollow transmitting neurovascular  Capsule of knee joint
structures at the posterior part of the knee  Popliteal muscle and fascia
*Popliteus Muscle
 Upper (femoral) and lower (tibial) triangles
 Important landmark (always give in practical
BOUNDARIES
exam)
 ROOF (posterior wall)  Arises within capsule of knee joint
 Skin  Origin: lateral condyle of femur
 Popliteal fascia  Then goes to the posterior aspect of tibia above
o Expansion of the semimembranosus tendon that popliteal or soleal line, Tendon passes
passes downward and outward downward and backward, Emerges through
o Covers the popliteus muscle and inserts to the inferolateral aspect of posterior part of capsular
popliteal line ligament
o Has (2 parts)  Insertion: popliteal or soleal line
 Superficial popliteal fascia  Separates lateral semilunar cartilage from
 Deep popliteal fascia lateral ligament of knee joint
o Small/Short saphenous vein  Action: flexor of leg, medial rotator of tibia when
 Pierces this fascia; pass between 2 knee is flexed
heads of gastrocnemius muscle  Nerve supply: Medial Popliteal (Tibial) nerve
 Develops from lateral part of the  Superomedial – upper medial
dorsal venous arch of the foot  Semimembranosus (more medial)
 Ascends accompanying the sural  Part of semitendinosus
nerve, follows the lateral border of the
 Superolateral – upper lateral
tendo calcaneus
 Biceps femoris
 Goes upward and terminates at
 Inferomedial – lower medial
popliteal vein
 Superficial to the enveloping fascia of  Gastrocnemius (medial head)
the calf of the leg  Inferolateral – lower lateral
 Deep to it is the branch of the medial  Plantaris
popliteal nerve  Gastrocnemius (lateral head)
*All veins of the lower extremities drain to CONTENTS OF POPLITEAL FOSSA
great saphenous vein except for small  From Medial To Lateral: A-V-N-N
saphenous vein  Popliteal artery and its branches
 Lateral sural cutaneous nerve  Popliteal vein and its tributaries
 Sural communicating nerve  Tibial nerve
 End of posterior femoral cutaneous nerve  Common fibular (peroneal) nerve
 Fascia Lata 1. Fat
 Popliteal vein 2. Popliteal artery
 Continuation of the femoral artery
 8 inches long
 Starts as the femoral artery passes
the adductor hiatus, medial to Tibial
nerve
 Ends lateral to the tibial nerve
 Passes downwards between the
condyles of femur
 Ends at distal border of Popliteus
muscle
 Divides into: Anterior and Posterior
Tibial Arteries

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TRANSCRIBERS: ARANAS, D. & IÑIGO, A. Page 1 of 3
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3. Popliteal vein
 Formed by junction of anterior and posterior tibial
veins at the lower border of popliteus muscle
 Becomes femoral vein as it passes through the adductor
hiatus
 Lies on the lateral side of popliteal artery
o Popliteal artery and vein - bound together by a
fascial tube similar to the arrangement in the
region of femoral artery and vein, hence
neither can be displaced without interfering
with the other
 Comes from lateral side of the foot → short saphenous
vein (and lesser saphenous vein) → pierce deep
popliteal fascia → popliteal vein → femoral vein →
External Iliac vein
4. Small saphenous vein
 Tributaries
o Numerous small veins from the back of the leg
o Communicating veins with the deep veins of the
foot
o Important anastomotic branches that run upward
and medially
5. Lesser Saphenous vein/Accessory saphenous vein (Thorek)
 Joins the great saphenous vein and the great saphenous
vein goes to the femoral vein
 Posterior aspect - parts of your lesser saphenous
becomes your short saphenous veins then it goes into
the popliteus
 Lateral aspect - goes towards the great saphenous vein
6. Sciatic nerve
 As it exits adductor hiatus, it branches into the
o Lateral- Common fibular or peroneal nerve
o Medial- Tibial nerve
 Combination of Tibial Nerve and Common Peroneal
Nerve = Sural Nerve
o Sural nerve – a cutaneous branch that goes along
the small saphenous vein and anatomoses with
sural communicating branch of lateral popliteal
nerve
7. Posterior cutaneous nerve of the thigh (Posterior femoral
cutaneous nerve)
8. Articular branch of Obturator nerve
 Supplies knee joint
9. Connective Tissue
10. Popliteal Lymph Nodes
 6-8 lymph nodes lying along popliteal vessels
(embedded in fatty connective tissue)
 Lie under the deep fascia
*Popliteal Lymphatic Vessels - Receive lymph from
o Superficial lymph vessels from lateral and
posterior side of the foot and leg which accompany
the small saphenous vein
o Knee joint
o Deep lymph vessels accompanying anterior and
posterior tibial artieries
*Some of the posterior lymphatics will go to popliteal lymph
nodes, some directly towards inguinal lymph nodes
(superficial, the vertical and longitudinal lymph nodes)
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TRANSCRIBERS: ARANAS, D. & IÑIGO, A. Page 2 of 3
ANATOMY
11. Popliteal Bursa
 CC: Popliteal Bursitis
- Inflammation of the bursa
- Accumulation of fluid, results into distension of the
fossa
GENICULAR ANASTOMOSIS
*One of the things very important in the popliteal area is around
the knee joint is the anastomosis
 Anastomosis around the knee joint, supply the knee
 Formed from the branches of the following
1. Popliteal artery
2. Femoral artery
3. Tibial arteries
1. Popliteal artery - Popliteal artery gives off several branches
participating in the anastomosis
 Lateral and medial Superior Genicular Artery
 Branches at level of femoral condyle and
anastomoses anteriorly
 Middle Genicular Artery
 Pierces posterior ligament to supply knee joint
 Has branches to gastrocnemius
 Lateral and medial Inferior Genicular Artery
 Winds around front of the knee under the cover
of tibial and fibular collateral ligaments
 Anastomoses deep in the patellar ligament
2. Femoral artery
 Descending branch of Lateral Femoral Circumflex artery
 Articular branch of Descending Genicular artery
3. Anterior Tibial artery
 Anterior Tibial Recurrent artery
 Posterior Tibial Recurrent artery
 Circumflex Fibular artery
POPLITEAL NERVES
1. Tibial/ Medial Popliteal Nerve
 Enters upper angle and lies straight on the popliteal
fossa
 Lies superficial to popliteal vessels
 Innervates
o Popliteus muscle
o Gastrocnemius - medial and lateral heads
 The branch to the medial head of
gastrocnemius is the only medial branch of
tibial nerve, hence it is safer to open the fossa
on the medial aspect
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o Plantaris 10. The following structures are contents of the popliteal fossa, except:
o Soleus a. Articular branch of the obturator nerve
2. Common Fibular (Peroneal) Nerve – laterally b. Peroneal nerve
c. Greater saphenous vein
 Lies laterally with biceps femoris
d. NOTA
 Leaves popliteal fossa between tendinous insertion of 11. Function or action of Popliteal muscle?
biceps femoris and lateral head of gastrocnemius a. Flexor of leg
 Courses downward behind the fibular head, winds b. Flexor of knee
c. Medial rotator of the tibia when knee is flexed
around the lateral aspect of its neck and pierces the d. A and B
origin of the peroneus longus muscle e. A and C
 Then divides into 12. The _____ vein passes on the medial side of the knee, goes to foramen
ovale/saphenous opening
o Superfcial (Musculocutaneous)
a. Short saphenous vein
o Deep (Anterioir Tibial) b. Popliteal Vein
 Has no muscular branches c. Great Saphenous Vein
d. Lesser Saphenous Vein
 Branches in the popliteal fossa
o Lateral Sural/Lateral cutaneous nerve of the calf
o Sural Communicating Nerve
o 3 Genicular Branches
3. Posterior Cutaneous Nerve of Thigh
4. Articular Branch of the Obturator Nerve
CLINICAL SIGNIFICANCE
 Popliteal Cyst
 Enlargement of articular cartilage
 Neurovascular structures may be damaged during
dissection of cyst
 Femoral Canal
 If not obliterated, femoral hernia can result
 Contain femoral vessels and nerve
 Femoral Ring
 Contains femoral vessels and canal
PRACTICE QUIZ
1. What are the superomedial boundaries of popliteal fossa?
2. What is the anastomosis around the knee joint?
3. What vein penetrates through popliteal fascia draining to popliteal
vein?
4. Medial popliteal nerve is also known as?
5. The sciatic nerve branches into lateral and medial as it passes what
structure?
6. Inferiorly, the peroneal and the tibial nerves fuse to form what
structure?
a. Popliteal nerve
b. Sural nerve
c. Both C 12.
d. Neither E 11.
7. All statements are true about the popliteal artery except: C 10.
a. 8 centimeters long D 9.
b. Direct continuation of the femoral artery B (roof) 8.
c. Starts lateral to the tibial nerve and ends medial to it C 7.
d. Divides into anterior and posterior tibial arteries B 6.
8. The following structures form the floor of the fossa, except: Adductor hiatus 5.
a. Capsule of knee joint
Tibial nerve 4.
b. Deep popliteal fascia
Short (small) saphenous vein 3.
c. Popliteal muscle and fascia
Genicular anastomosis 2.

d. Popliteal surface of femur

Semimembranosus and semitendinosus 1.

9. The following structures form the genicular anastomosis, except:

a. Popliteal artery
b. Femoral artery
c. Tibial artery
d. NOTA

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TRANSCRIBERS: ARANAS, D. & IÑIGO, A. Page 3 of 3