Posterior Thigh and Popliteal Fossa

Question 1

What muscle’s have an origin at the Ischial Tuberosity

Answer 1

1. Adductor Magnus M
2. Biceps Femoris Long Head
3. Semimembranosus M
4. Semitendinosis M

Question 2

What muslcle inserts on the Adductor Tubercle (above medial epicondyle)

Answer 2

Adductor Magnus M.

Question 3

What muscle inserts on the Head of the Fibula?

Answer 3

Biceps Femoris Muscle

Question 4

What is the action and innervation of the semitendinosus muscle? Where does it attach?

Answer 4

Function

• Extend thigh; flex leg; medially rotate flexed leg

Innervation

• Tibial Division of Sciatic N.

Attachment

• Pes Anserinus

Question 5

A patient presents to the clinic with constant, aching pain that is aggrevated by climbing stairs (flexion and internal/medial rotation of the knee). What is your diagnosis?

Answer 5

Pes Anserine Bursitis

Question 6

What is the function of the Semimembranosus muscle? What is its innervation?

Answer 6

Function

• extend thigh; flex leg; medially rotate flexed leg

Innervation

• tibial division of sciatic n

Question 7

What ligament does the one of the semimembranosus tendons divide into? What is its function?

Answer 7

1) Oblique popliteal ligament
2) reinforces intercondylar portion of knee joint capsule

Question 8

What is the function of the biceps femoris long head? What is it’s innervation?

Answer 8

Function

• Extend thigh; flex leg; laterally rotate flexed knee

Innervation

• Tibial division Sciatic N.

Question 9

What is the function and innervation of the biceps femoris short head?

Answer 9

function

• flex leg; laterally rotate flexed leg

innervation

• common fibular division of sciatec nerve.

**origin is the lateral lip of linea aspera and lateral supracondylar line **

Question 10

What is the function and innervation of the hamstring head of the Adductor Magnus muscle?

Answer 10

Function

• Extend Thigh

Innervation

• Tibial division of sciatic n

Question 11

With hamstring injuries, what can be associated with them that may be worrisome?

Answer 11

Avulsion fractures

Question 12

Starting from the abdominal aorta, name the artery branches supplying the leg.

Answer 12

Abdominal aorta

to

Common illiac

to

External and Internal Illiac

From external illiac you have Femoral Artery (after goes under inguinal ligament)

From femoral artery you have deep femoral artery that gives off perforating branches

at termination of femoral artery you have popliteal artery

popliteal artery gives rise to anterior and posterior tibial artery

Question 13

Lateral Femoral Circumflex artery has what branches?

Answer 13

Ascending, Descending, and Transverse

Question 14

Medial femoral circumflex artery has what branches?

Answer 14

Ascending and transverse

Question 15

What artery pierces the adductor canal?

Answer 15

Descending genicular artery

Question 16

The perforating arteries supply what muscles? How do they travel anterior to posterior?

Answer 16

1) Adductor magnus and posterior thigh muscles
2) pierces the adductor magnus

Question 17

What two arteries supply the genicular anastamosies?

Answer 17

lateral

• lateral femoral circumflex artery

medial

• descending genicular artery

Question 18

What supplies cutaneous innervation of posterior thigh?

Answer 18

posterior femoral cutaneous nerve

Question 19

What supplies cutaneous innervation of lateral lower leg?

Answer 19

lateral sural cutaneous nerve

Question 20

What supplies cutaneous innervation of medial lower leg?

Answer 20

saphenous nerve

Question 21

What are the spinal roots of the Tibial division of the sciatic nerve?

Answer 21

L4-S3

Question 22

What muscles do the tibial division of the sciatic nerve innervate?

Answer 22

Long head of biceps femoris (L5-S2)

Semitendinosus (L5-S2)

Semimembranosus (L5-S2)

“Hamstring” portion of Adductor Magnus (L4)

Question 23

What are the spinal roots of the common fibular division of the sciatic nerve?

Answer 23

L4-S2

Question 24

What muscle(s) does the common fibular division of the sciatic nerve innervate?

Answer 24

short head of biceps femoris (L5-S2)

Question 25

When does the femoral artery become the politeal artery?

Answer 25

after passing thorugh adductor hiatus

Question 26

Popliteal artery gives rise to what branches?

Answer 26

Genicular branches

• Superior medial
• inferior medial
• superior lateral
• inferior lateral
• middle genicular artery

Question 28

What is the termination point of the small saphenous vein?

Answer 28

popliteal vein

Question 29

Cutaneous fluids of the popliteal fossa drain to what nodes?

Answer 29

superficial popliteal nodes (along small saphenous vein)

Question 30

Deep leg and foot drains to what lymph nodes?

Answer 30

Deep popliteal nodes (along popliteal veins)

Question 31

Deep and superficial popliteal nodes both drain to what structure?

Answer 31

Deep Inguinal lymph nodes.

then to

external iliac

then to

common iliac

Question 32

What does the tibial nerve innervate?

Answer 32

posterior leg muscles

knee joint

skin on posterior leg via medial sural cutaneous nerve

Question 33

Where is the common fibular nerve most susceptible to injury?

Answer 33

where it winds around the head and neck of fibula

Question 34

What does the common fibular nerve innervate?

Answer 34

anterior leg muscles via deep fibular nerve

Lateral leg muscles via superificial fibular nerve

Skin on posterolateral leg via lateral sural cutaneous nerve

Question 35

What does the sural nerve innervate and what are its components?

Answer 35

1) cutaneous innervation of posterior leg and lateral aspect of ankle and foot
2) medial sural cutaneous (from tibial n)

Sural communicating branch (from common fibular or lateral sural cutaneous nerve)

Question 36

What is a metaphyseal fracture and where are they most common?

Answer 36

Transverse fracture across the shaft of femur.

most common in distal femoral fracture

Question 37

What is a physeal fracture?

Answer 37

transverse fracture involving epiphyseal plate

Question 38

Distal femoral fractures run the risk of what?

Answer 38

disrupting neurovasculature in the popliteal fossa

Question 39

What is acute compartment syndrome?

Answer 39

Increased pressure due to a closed fascial compartment

• usually due to hemorrhage or edema

Symptoms include

persistent deep ache or burning pain

paresthesia

Pain with passive stretch

muscle weakness

Question 40

What is a popliteal (baker’s) cysts cause by?

Answer 40

enlargemnt of the gastrocnemius-semimebranosus bursa.

**associated with degenerative and inflammatory joint disease or joint injury **

**often contain synovial fluid due to communicating with knee joint**

Question 41

What are some complications of a Baker’s cyst?

Answer 41

enlargement will present similar to DVT

**postive Homan’s sign**

rupture is similar to thrombosis or muscle rupture

Question 42

What is a peripheral aneurysm? Where are they most common? What may they present with?

Answer 42

localized enlargemnt of an artery due to weakening of arterial wall

**popliteal artery aneurysms are the most common**

Severe pain behind the knee