14: Popliteal Fossa Flashcards
Popliteal fossa is a diamond-shaped depression posterior to knee joint. What are the superficial boundaries?
✓ Superolateral = Biceps femoris
✓ Superomedial = semimembranosus, semitendinosus
✓ Inferolateral = Lateral head of gastrocnemius
✓ Inferomedial = Medial head of gastrocnemius
✓ Roof (Posteriorly) = by skin and popliteal fascia
✓ Floor(anterior wall) = Popliteal surface of femur, posterior aspect of joint capsule of knee joint, popliteal fascia covering the popliteus muscle.
What are the deep boundaries of popliteal fossa?
✓ Superolateral = Lateral supracondylar line.
✓ Superomedial = Medial supracondylar line.
✓ Inferior = Soleal line of tibia.
✓ floor/anterior wall = popliteal surface of femur, posterior aspect of joint capsule of knee joint, popliteal fascia covering the popliteus muscle
Contents of popliteal fossa?
Tibial nerve in popliteal fossa: Larger terminal branch of ……. nerve
sciatic
Tibial nerve gives branches to ..?
Gives branches to soleus, gastrocnemius, plantaris, & popliteus muscles
Tibial nerve gives rise to medial sural cutaneous nerve, joined by sural communicating branch from common fibular nerve form ….. and supply ….?
to form sural nerve (Supplies lateral side of leg and ankle)
…. nerve is the Lateral smaller terminal branch of sciatic nerve
Common fibular nerve
Common fibular nerve runs along ……. muscle and leaves the fossa by passing superficial to ……..?
Runs along the biceps femoris muscle and leaves the fossa by passing superficial to lateral head of gastronemius muscle & winds around the neck of fibula.
Popliteal artery is Continuation of femoral artery at ..?
adductor hiatus
Popliteal artery ends at the inferior border of popliteus by dividing into …?
anterior and posterior tibial arteries
What is the Deepest structure in the popliteal fossa?
Popliteal artery (applied to joint
capsule, runs through intercondylar space of femur)
Note the following: then answer what do they supply?
Supply ligaments & capsule of the knee joint
Genicular arteries form anastomoses with …?
descending genicular artery (femoral artery), descending branch of lateral circumflex artery, anterior tibial recurrent artery.
Popliteal vein is:
1- Continuation of … ?
2- lies where … ?
3- continues as … ?
1- posterior tibial vein
2- superficial to popliteal artery
3- Continues as femoral vein
In case of Popliteal abscess and tumors, pus tend to spread …? (What direction)?
superiorly and inferiorly
Popliteal pulse is Difficult to feel, as artery is deep however it is best felt in …? (What part?)
inferior part
Weakening of popliteal pulse is a sign of …?
femoral artery obstruction
Causes edema and pain in popliteal fossa, may stretch the nerves or compress its blood supply. What’s the condition?
Popliteal aneurysm and hemorrhages
Collateral circulation is formed through..?
genicular arteries
What type of joint is knee joint? What movements happen?
hinge type synovial joint, which mainly allows for flexion and extension combined with gliding and rolling and rotation along vertical axis (medial and lateral rotation).
Knee joint is formed by articulations between..?
patella, femur and tibia
Popliteal aneurysm and hemorrhages (slide)
Articular surfaces: Medial and lateral condyles of the femur (slide)
Intercondylar eminence is not articular part, however it serves for attachment for what structures?
ACL, PCL, anterior & posterior ends of mensci
……… are in the capsular layer but outside the synovial membrane
Cruciate ligaments
Capsular ligament is:
1- attached to …. & ….
2- not attached to …..
1- medial collateral ligament & medial meniscus
2- lateral collateral ligament
……… serves for attachment of capsular ligament.
Patella & patellar ligament
Which collateral ligament is more injured?
MCL
Which ligament is extracapsular?
LCL
What separates LCL from lateral meniscus?
Popliteal muscle
Fibrous capsule has an opening for exit of tendon of ….. muscle.
popliteus
Oblique popliteal ligament- reflection from tendon of
……. muscle supports the joint capsule
semimembranosus
……… supports the joint laterally
Ileotibial tract
Fibular/lateral collateral ligament (from what to what?)
From lateral femoral epicondyle to fibular head
Tibial/medial collateral ligament (from to?)
- from femoral medial epicondyle to medial tibial condyle.
- Attached to medial meniscus.
- Weaker than fibular collateral ligament. More often injured
Posterior cruciate ligament extends …. (Direction?)
Superiorly, anteriorly, medially
Posterior cruciate ligament:
1- from to? (Location)
2- prevents? (Action)
3- limits movement of? (bones)
1- from Posterior Intercondylar area to lateral surface of medial femoral condyle
2- hyperflexion
3- femur moving anteriorly, tibia moving posteriorly
Anterior cruciate ligament:
1- from to? (Location)
2- prevents? (Action)
3- limits movement of? (bones)
1- from Anterior Intercondylar area to medial surface of lateral femoral condyle
2- hyoerextension
3- femur posteriorly, tibia anteriorly
Joins the anterior edges of the menisci
Transverse ligament of knee
Part of capsular ligament between menisci and tibial attachment
Coronary ligament
Function of menisci
✓ To deepen the articular surface of the tibia, thus increasing stability of the joint.
✓ To act as shock absorbers by increasing surface area to further dissipate forces
Nerve supply:
1- Anterior part ?
2- posterior?
3- Lateral part ?
4- medial aspect of knee joint ?
1- Articular branches from femoral nerve (Branches to vasti muscles)
2- Genicular branches from tibial
3- common fibular nerve
4- Saphenous and obturator nerves
Movements at knee joint
- extension
- flexion
- medial rotation at the end of extension
- lateral rotation at the beginning of flexion
What is Locked knee?
When knee is fully extended, with foot on the ground, knee is passively locked by Medial rotation of femoral condyles at the end of extension
What is unlocking knee?
Lateral rotation of femoral condyles by popliteus at the beginning of flexion (Unlocked joint is unstable)
Muscles for knee extension?
Quadriceps femoris (main)
Tensor fascia latae (weak)
What muscle responsible for Knee flexion?
Hamstrings + short head of biceps femoris (main)
Medial rotation at knee what muscles?
- Semitendinosus & semimembranosus (when knee is flexed)
- popliteus (when knee is extended)
Lateral rotation at knee what muscles?
Biceps femoris when knee is flexed
Bursae around the knee (slide)
Causes & types of knee fracture?
- Causes:
1. Falling directly onto the knee 2. Receiving sharp blow to knee - types:
1- stable
2- displaced (pulled by quadriceps tendon)
3- comminuted (many parts)
Patella dislocation (causes)
Compounded knee injury what structures affected?
- ACL
- MCL
- Medial meniscus
= unhappy triad
Posterior Cruciate Ligament (PCL) Injuries?
Causes of Anterior Cruciate Ligament (ACL) Injuries?
+ Grades of spains?
Causes of Collateral Ligament Injuries?
An athlete presented with pain on lateral rotation. What do you expect his problem is?
Lateral meniscus injury
Causes of Meniscus Tears (slide)
Genu varus Vs valgus?
Varus: bend medially
Valgus: bend laterally
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