Popliteal fossa , vessels and neves of the leg and dorsum of the foot Flashcards
what is the spuerolateral border of the popliteal fossa?
tendon of the biceps femoris
what is the superomedial border of the popliteal fossa
semimebranosus (mostly) and semitendinosus tendon
what is the inferolateral and inferomedial borders of popliteal fossa
inferolateral- lateral head of the gastrocnemius
inferomedial - medial head of the gastrocnemius
that is the roof and floor of the popliteal fossa
popliteal fascia of fascia lata
what is the floor of the popliteal fossa
posterior surface of the capsule of the knee and popliteus muscle
what are the nerves of the popliteal fossa?
termination of the posterior femoral cutaneous nerve
division of the sciatic nerve into its tibial and common fibular components
muscular and cutaneous branches of the tibial nerve
cutaneous branches of the fibular nerve
what are the others structures in the popliteal fossa other than nerves
popliteal vein and its tributaries
popliteal artery and its branches
popliteal lymph nodes and lymphatic vessels and fat
how are the contents of the popliteal fossa encountered and what are they surrounded by?
in order from superficial to deep are NERVES, veins then arteries
surround by an ample amount of packing material (fat)
what is the popliteal artery a direct continuation of?
femoral after it emerges from the adductor hiatus
deepest of the vascular structures in the popliteal fossa
when does the popliteal artery terminate?
at the inferior border of the popliteus muscle by dividing into the anterior and posterior tibial arteries
where is the medial and lateral superior genicular aa located
DEEP to hamstring musculature
pass in their respective directions SUPERFICIAL to the heads of the gastrocnemius to participate in genicular anastomosis
lateral and medial inferior genicular aa.
located DEEP to the heads of the gastrocnemius muscle
what supplies the interior knee joint?
middle genicular
arises from the ANTERIOR surface of the popliteal artery
where do the sural branches off the popliteal artyer go?
pass directly into the lateral and medial heads of the gastrocnemius
what is the course of the anterior tibial artery in proximal portion of leg versus distal portion of leg
descends b/w tibial anterior and extensor hallicus longus above
then between the tibialis anterior and extensor digitorum longus bleow
passes deep to extensor retinaculum and terminates as the dorsal pedis artery
what is the course of the anterior tibial recurrent artery
given off as soon as the anterior tibial artery courses superior to the interosseous membrane
ascends through the substance of the tibialis anterior muscle to joint the genicular anastomosis
what are the branches off the anterior tibial artery
anterior tibial recurrent
medial and lateral malleolar branches
dorsalis pedis
when does the anterior tibial turn into the dorsalis pedis?
as it passes inferior to the superior extensor retinaculum
what are the branches of the dorsalis pedis artery
lateral and medial tarsal arteries
arcuate a
first dorsal metatarsal a
deep plantar a
what are the branches off the posterior tibial?
fibular a communicating branch posterior medial malleolar medial calcaneal medial and lateral plantar arteries
from what arteries do the genicular anastomosis arteries arise? what arteries are contributing to the anastomosis of the knee?
the anastomosis of the knee is composed of ten vessesl which arise from:
-lateral femoral circumflex
-femoral a.
popliteal a.
anterior and posterior tibial aa.
what does the superficial plexus of the genicular anastomosis supply?
provides blood to the muscles in the area of the knee
what does the deep plexus of the genicular anastomosis supply?
lies directly upon the capsule of the knee joint itself
what are the branches off the fibular a.
muscular
nutrient a. (to fibula)
communicating branch (to posterior tibial)
perforating a.
posterior lateral malleolar a. which gives way to the lateral calcaneal
in what muscle substance does the fibular a descend within?
the substance of the flexor hallucis longus muscle on the posterior surface of the fibula
through what tunnel does the posterior tibial artery pass?
tarsal tunnel
what does the perforating a. of the fibular a anastomose with and where does it pass through?
passes inferior to interosseous membrane to enter anterior compartment
anastomoses with lateral malleolar and tarsal network of arteries
what does the sciatic nerve split into?
tibial n
common fibular
what are the cord levels of the common fibular n.
L4,5 S 1, 2
where does the common fibular nerve course within the popilteal fossa? and when it leaves ?
courses superficially and laterally (hugs the medial surface of the biceps femurs)
when it leaves the popliteal fossa it continues to follow the course of the biceps femurs tendon to the head of the fibula
what is the branch of the common fibular that provides a cutaneous branch to the posterior leg?
lateral sural cutaneous nerve
what muscle does the common fibular pierce inferior to the head of the fibula?
fibularis longus muscle
this is where it divides into the superficial and deep fibular nerves!
what is the cord levels of superficial fibular n.
L5- S1,2
what muscles does the superficial fibular n provide branches?
fibularis longus and brevis
where does the superificial fibular n actual become superficial
in the distal third of the leg to innervate the anterior distal third of the leg and divides into medial and intermediate dorsal cutaneous nerves
what does the medial and intermediate dorsal cutaneous nerves provide ?
dorsal digitial branches to all the toes except those provided by the deep fibular n.
what are the cord levels of the deep fibular n.
L4 5
what is the course of the deep fibular nerve
branches off the common fibular within the substance of the fibularis longs
passes into the anterior compartment by piercing the extensor digitorum longus muscle
in the anterior compartment it sits lateral to the anterior tibial
innervates ALL muscles of the anterior compartment
passes deep to the extensor retinaculum
what is the path of the deep fibular n. in the distal foot
lies anterior to the dorsalis pedis a.
divides into lateral and medial terminal branches
where does the medial terminal branch of the deep fibular nerve go?
follows the course of the first dorsal metatarsal artery to cutaneously innervate the web between the first and second toes
what does the lateral branch of the deep fibular nerve go and do
deep to the extensor digitorum brevis (which it innervates) then contributes to the sensory fibers to the joints of foot
what are the cord levels of the tibial nerve
L 4 5
S 1 2 3
while in the popliteal fossa what does the tibial n. give branches to?
to the plantar is and gastrocnemius muscles
as well as a cutaneous nerve to the posterior leg (the medial sural cutaneous)
medial (from tibial n) and lateral cutaneous (from common fibular) nerves fuse near the musculotendinous junction of the gastrocnemius muscle via what? and then to form what?
fuse via the communicating branch of the lateral sural cutaneous n.
form the sural n. which provides the lateral dorsal cutaneous n AND
the lateral calcaneal branch to the lateral posterior surface of the heel
when the tibial nerve leaves the popliteal fossa what muscles does it give innervation to?
popliteus
soleus
ALL THE MUSCLES OF THE POSTERIOR LEG
where does the tibial nerve exit the leg?
behind the medial malleolus between the posterior tibial artery and tendon of the flexor hallucis longus
as structures of the deep posterior compartment exit the leg they pass beneath the flexor retinaculum in what order from ANTEROMEDIAL to POSTEROLATERAL
TOM DICK a.n. HARRY
Tibialis posterior flexor digitorum longus posterior tibial artery with veins tibial nerve flexor hallucis longus
what nerve supplies cutaneous innervation to the medial surface of the foot and the medial posterior surface of the heel
saphenous nerve (distal most extension of the femoral nerve)
