Anatomy- Popliteal fossa and posterior leg Flashcards
what is the popliteal fossa
space posterior to the knee joint, the main structure by which things enter and leave the leg
what is the superiormedial border of the popliteal fossa
semitendinosus/ semimembranosus
what is the superolateral border of the popliteal fossa
biceps femoris
what is the inferior border of the popliteal fossa
medial and lateral heads of the gastrocnemius
what happens to the small saphenous vein at the popliteal fossa
ends- passes through the deep fascia (popliteal fascia) in the median plane of the limb to drain into the popliteal vein
what is the roof of the popliteal fossa
popliteal fascia
what is contained in the PF in the median plane from superficial to deep (4) and where do these come from
(neurovascular bundle)
- tibial nerve (from sciatic)
- popliteal vein (continuation of posterior tibial vein)
- popliteal lymph nodes (located along the popliteal vein)
- popliteal artery (continuation of femoral artery)
where does the sciatic nerve divide and into what
sueprior apex of the fossa
into the tibial nerve and common fibular nerve
(this can happen in the gluteal or posterior thigh region)
what is the path of the tibial nerve
descends vertically through the fossa, straight down leg
what is the path of the common fibular nerve
skirts the lateral border of the fossa, deep to the beceps femoris tendon leaving the fossa between that tendon and the lateral head of the gastrocnemius to reach the fibular neck
what happens to the common fibular as it reaches the fibular head
winds around fibular head then divides into deep and superficial fibular nerves
where are the sural nerves found
within the region of the popliteal fossa (mainly in superficial fascia)
what do the sural nerves supply
skin and fascia on the posterolateral aspect of the leg and foot
what nerves give rise to the sural cutaneous nerves (which produces which nerve)
tibal nerve- medial sural cutaneous nerve
common fibular- lateral sural cutaneous nerve
what is the sural communicating branch
nerve that connects the medial and lateral sural cutaneous nerves and allows them to communicate
what forms the sural nerve
medial sural sutaneous nerve and fibres in the communicating branch combine to form sural nerve
what is the path of the sural nerve
leave the fossa to descend alongside the small saphenous vein in the superficial aspect of the medial plane of the posterior aspect of the leg
what does the tibial nerve give branches to supply
both heads of the gastrocnemius
the 2 deeper muscles of the fossa
what lies deep to the lateral head of the gastrocnemius in 90% of people
plantaris muscle
what is the calcaneal tendon
achilles tendon
what muscles combines inferiorly with the achilles tendon
plantatis
what muscle is deep to the plantaris
popliteus muscle
what tendons form the calcaneal
gastrocnemius and soleus
where does the calcaneal tendon attach
calcaneal tuberosity of the calcaneus
what is the normal result of the ankle jerk reflex
contraction of the gastrocnemius and soleus with the ankle slight platar flexing
what nerve roots does the ankle jerk reflex test
S1,2 (tibial nerve)
what is the common fibular nerve vulnerable to
compression injury against the neck of the fibula- causes dysfunction of the nerve and muscle it supplies and abnormal sensation in the area of skin supplied by the nerve
can also be damage in fractures of the fibular neck
what can make it difficult to palpate the popliteal pulse
popliteal artery’s deep location
the presence of popliteal fat
what aids examination of the popliteal pulse
flexion of the knee to 30 degrees and relaxation of the hamstring muscles
what muscles are in the superficial posterior compartment of the leg
gastrocnemius
soleus
plantaris
popliteus
what nerve supplies the superficial group
tibial nerve
what does the superficial group do
platarflexors
what do the deep group of muscles do
flexors of toes and platarflexors of ankle
what nerve supplies the deep group muscles
tibial
what muscles are in the deep posterior compartment of the leg
flexor hallucis longus (toes)
flexor digitorum longus (digits)
tibialis posterior
what divides the posterior compartment of the leg
intermuscular septa and the interoseous membrane between the tibia and the fibula
what is the extra role of the tibialis posterior
assists the tibialis anterior (ant compartment) in inversion of the food
what is the path of the tibial nerve in the posterior compartment
goes through the compartment deep to soleus in the company of the posterior tibial artery (and accompanying veins)
from anterior to posterior, what leaves the posterior compartment to reach to sole of the foot
Tom Dick ANd Harry
tendons of Tibialis posterior and flexor Digitorum longus
posterior tibial Atery
tibial Nerve
the tendon of flexor Hallucis longus
how do ‘Tom Dick And Harry’ reach the sole of the foot
pass posterior to the medial malleolus and deep to the flexor retinaculum
where does the plantaris orginiate and insert
supracondylar ridge
calcaneal tendon
where does the popliteus originate and insert
posterior surface of proximal tibia
lateral femoral condyle
what doe s gastrocnemius have two of
heads
muscle bellies
where do the heads of the gastrocnemius attach distally
to calcaneus via the achilles tendon
where do the heads of the gastrocnemius attach to proximally
to their respective (medial and lateral) femoral condyle
what are the roles of the gastrocnemius
as passes both knee and ankle joints:
- weak knee flexor
- powerful ankle plantar-flexor
what is the proximal attachment of the soleus
neck of the fibula and the soleal line of the tibia (appears to slope inferiorly from lateral to medial)
what is the distal attachment of the soleus
calcaneus via the achilles tendon
is the ankle jerk reflex a deep tendon reflex
yes
what position must the patient be in for the ankle jerk reflex
supine, lower limb external rotated, knee flexed, ankle dorsiflexed with gastrocnemius and soleus relaxed
what tendon is struck in the ankle jerk test and where
calcaneal- proximal to its insertion into the calcaneus
what is the fibular artery a branch of
the posterior tibial artery
where does the popliteal artery branch and into what
immediately distal to the popliteal fossa
anterior and posterior tibial arteries
what does the anterior tibial artery do
pierces the interosseous membrane to supply the anterior compartment of the leg
what does the posterior tibial artery do
supplies the posterior compartment of the leg
what is the path of the posterior tibial artery
runs with the tibial nerve, mainly between the superficial and deep muscles
how does the posterior tibial artery leave the compartment
passes posterior to the medial malleolus (posterior tibial pulse) and deep to the flexor retinaculum
where does the posterior tibial artery terminate and how
in the foot by dividing into the medial and lateral plantar arteries
what does the fibular artery branch from
posterior tibial artery in the proximal half of the compartment
what is the path and role o the fibular artery
descends in the compartment on the posterior intermuscular septum and sends perforating branches through the septum to supply to lateral compartment of the leg
where does the flexor digitorum longus attach to proximally and distally
medial surface of tibia (inferior to soleal line)
distal phalanges of lateral four toes
where does the flexor hallucis longus attach to proximally and distally
posterior surface of the tibula and the interosseous membrane
distal phalanx of the great toe
where does the tibilalis posterior attach to proximally and distally
interosseous membrane
medial tarsal bones
what in the lower limb does the sciatic nerve supply
posterior compartment of thigh
all compartments of the leg
intrinsic muscles of the foot
