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MSK Exam 2 > Posterior Thigh and Popliteal Fossa > Flashcards

Posterior Thigh and Popliteal Fossa Flashcards

1
Q

Posterior Thigh muscles in general: Common proximal Attachment

A

Ischial Tuberosity

except for the short head biceps femoris

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2
Q

Posterior Thigh muscles in general: Common innervation

A

Tibial division of sciatic nerve

except short head of biceps femoris

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3
Q

Posterior Thigh muscles in general: Common functions

A

Leg flexion at knee

Thigh extension at hip (except short head of biceps femoris)

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4
Q

Semitendinosus Muscle

A

orgin: Ischial Tuberosity
Insertion: anteromedial aspect of superior tibia (pes anserinus

Function: extend the thigh and flex the leg
also medially rotate flexed leg

inn: Tibial division of Sciatic N

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5
Q

Pes anserinus

A 
3 fingered conjoined tendon
 (anterior to posterior)
Sartorius M
Gracilis M
Semitendinosus M

insertion from each three compartments

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6
Q

Pes Anserine Bursitis

A

Inflammation of the anserine bursa which is located between the Pes anserinus and the MCL

constant aching pain, aggrevated by activity specifically flexion and internal/medial rotation of the knee

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7
Q

Semimembranosus M

A

Long flat membranous tendon at proximal attachment

Orgin: ischial tuberosity
insertion: Posterior part of the medial tibial condyle

Function: Extend thigh and flex the leg also can medially rotate flexed leg

inn: Tibial division of sciatic N

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8
Q

Semiomembranosus distal tendon divisions

A

distal tendon divides into two main parts:

Medial tibial condyle (muscle attachment)

Oblique popliteal ligament: reinforce the intercondylar portion of knee joint capsule, forms part of the popliteal fossa floor

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9
Q

Biceps Femoris Muscle: Long head

A

Orgin: ischial tuberosity
insertion: Lateral aspect of the fibular head

Function: Extend thigh, flex leg, and laterally rotate flexed leg

Innervation: Tibial division of sciatic N

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10
Q

Biceps femoris Muscle: short head

A

Orgin: lateral lip of linea aspera and lateral supracondylar line
Insertion: Lateral aspect of fibular head

Function: Flex leg and laterally rotate flexed leg

Innervation: Common fibular division of sciatic N

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11
Q

Adductor Magnus muscle hamstring portion

A

Orgin: ischial tuberosity
Insertion: adductor tubercle on medial condyle

Function: Extend thigh

Innervation: Tibial division of sciatic N

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12
Q

Hamstring Injury: Grade 1

A

muscle strain or tear
can involve avulsion fractures from the ischial tuberosity

Mild
Small disruption in structural integrity
minor swelling
no or minimal loss of strength

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13
Q

Hamstring Injury: Grade 2

A

Muscle strain or tear
can involve avulsion fractures from the ischial tuberosity

Moderate
Partial tears with some intact muscle fibers
pain present
definite loss of strength

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14
Q

Hamstring Injury: Grade 3

A

Severe
complete tear
swelling, severe pain and typically with accompanied hematoma
complete loss of motor function

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15
Q

What supplies the posterior thigh muscles

A

the three perforating branches and terminal deep femoral arteries

also supplies Adductor magnus M

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16
Q

Descending branch of lateral femoral circumflex artery

A

Descends anterior thigh

supplies the genicular anastomosis

17
Q

Descending Genicular Artery

A

arises from the femoral artery
branches out of the anteriomedial muscular septum with the saphenous N

supplies the genicular anastomosis

18
Q

What drains the posterior thigh?

A

Deep femoral Vein

19
Q

What innervates the skin of the posterior thigh

A

Posterior femoral cutaneous nerve

S1-S3

20
Q

Sciatic nerve rami components that innervate the muscles

A

even though tibial division of the sciatic nerve is L4-S3
and the Common fibular division of the sciatic nerve is L4-S2

the muscles of the posterior thigh recieve innervation from L5-S2

except Hamstring portion of adductor magnus which gets L4 of the tibial division of the sciatic Nerve

21
Q

Popliteal Fossa Boundaries: Superiorly

A

Superior medially: Semimembranosus and the semitendinosus

Superior laterally: Biceps femoris m

make up the superior angle of the fossa

22
Q

Popliteal Fossa Boundaries: Inferiorly

A

Inferiorly medially: Medial head of the gastrocnemius m

Inferiorly laterally: Lateral head of the gastrocnemius m

23
Q

Popliteal fossa boundaries: Floor

A

Popliteal surface of femur
Oblique popliteal ligament (from semimembranosus tendon)
Posterior surface of proximal tibia

24
Q

Popliteal Fosssa Contents

A

Superficial to deep:
Nerves
Popliteal vein, branches and lymph nodes
Popliteal artery and branches

25
Q

What does the popliteal artery terminate into

A

Anterior Tibial Artery
Posterior tibial artery

the popliteal artery also gives rise to the genicular branches

26
Q

Genicular Anastamosis

A

these bypass the popliteal artery

supplies the articular capsule and ligaments of the knee joint

Superior lateral genicular artery
Superior medial genicular artery
Middle genicular artery (in joint capsule)
Inferior Lateral genicular artery
Inferior medial genicular artery

the inferior tend to be below the heads of the gastrocnemius heads

27
Q

Genicular anastamosis blood supply

A

Popliteal artery

Descending branch of the lateral femoral circumflex artery
Descending genicular artery from the saphenous branch and the articular branch

28
Q

Popliteal vein

A

formed by union of anterior and posterior tibial veins, usually near inferior border of popliteus muscle

termination point of saphenous vein

becomes femoral vein after traversing the adductor hiatus

29
Q

Where does the sciatic nerve usually end and what does it turn into

A

Sciatic nerve ends at the superior angle of the popliteal fossa

turns into the Tibial Nerve and the common fibular nerve

30
Q

Tibial Nerve

A

larger component of the sciatic nerve

descends centrally through popliteal fossa

Innervates the posterior leg muscles, knee joints, skin on posterior leg as the medial sural cutaneous nerve

31
Q

Common fibular nerve

A

descends obliquely on lateral side of popliteal fossa medial to biceps femoris

winds around the head and neck of the fibula and is susceptible to injury

Innervates: anterior leg muscles via the deep fibular nerve
Lateral leg muscles via the superficial fibular nerve
skin on posterolateral leg via the lateral sural cutaneous nerve

32
Q

Sural Nerve

A

cutaneous nerve of posterior leg and lateral aspect of ankle and foot

runs with small saphenous vein

composed of medial sural cutaneous nerve from tibial nerve and sural communicating branch from the common fibular or lateral sureal cutaneous nerve

33
Q

Metaphyseal fractures

A

Distal femoral fracture
transverse fracture accross the shaft
most common distal femoral fracture
occurs at metaphysis

34
Q

Physeal fractures

A

distal femoral fracture
transverse fracture involving the epiphyseal plate
commonly described by salter harris classification

35
Q

Posterior displacement of distal femoral fractures can lead to?

A

neurovasculature issues due to close proximity to femur in the popliteal fossa

Vascular injury: Swelling in popliteal space, absent posterior tibial or dorsalis pedis pulses, slow distal capillary refill, cold pale feet

Nerve injury: Motor injury with foot drop, sensory deficits to dorsal pr plantar foot

36
Q

Acute compartment syndrome

A

Increased pressure to a closed fascial compartment
due to hemorrhage and or edema

persistent deep ache or burning pain
paresthesia
pain with passive stretch
muscle weakness

37
Q

Popliteal (Bakers) cysts

A

swelling of the popliteal fossa due to enlargement of the gastrocnemius semimembranosus bursa

contain synovial fluid
associated with degenerative and inflammatory joint disease

mostly asymptomatic

38
Q

Peripheral Aneurysm

A

localized enlargement of an artery due to weakening of arterial wall

Popliteal artery aneurysms is a common one

may present with: claudication or ischemic pain at rest
sensory/motor nerve deficit
severe pain behind the knee

39
Q

Peripheral Artery disease

A

Atherosclerosis

lack of blood flow leads to pain in affected muscle groups

may present with: 
Claudication
Ischemic pain at rest
severe diffuse pain
nonhealing ulcer
gangrene

MSK Exam 2 (19 decks)

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