ANATOMY AND APPLIED ASPECTS OF POPLITEAL FOSSA FINAL.ppt

THIS PRESENTATION WILL GIVE DETAILED KNOWLEDGE ABOUT ANATOMY AND CLINICAL IMPORTANCE OF POPLITEAL FOSSA

1. POPLITEAL FOSSA
Dr.M.VASANTHAKOHILA
POSTGRADUATE
DEPARTMENT OF ANATOMY -KMC
AN 16.6 (ECE)
DATE: 22.11.23

2. INDEX
INTRODUCTION
BOUNDARIES, ROOF& FLOOR
CONTENTS& RELATIONS
ANASTOMOSES
APPLIED ANATOMY

3. POPLITEAL FOSSA
It is an important area of
transition between thigh
and leg .
It is major route by
which structures pass
from one region to the
other.

4. BOUNDARIES NEXT
It is a diamond shaped fossa
Superomedially-
semimembranosus &
semitendinosus.
Superolaterally-Biceps
femoris
Inferolaterally-lateral
head of gastrocnemius with
plantaris
Inferomedially-medial
head of gastrocnemius

5. ROOF OF THE FOSSA
Popliteal fascia
Superficial fascia with
(a)small saphenous vein
(b)posterior cutaneous
nerve of thigh
(c)posterior division of
medial cutaneousnerve
of thigh
(d)suralcommunicating
nerve.

6. FLOOR OF POPLITEAL FOSSA
Popliteal surface of femur
Capsule of knee joint with
oblique popliteal ligament
Fascia covering the
popliteus

7. CONTENTS OF THE FOSSA
Popliteal artery & branches.
Popliteal vein & tributaries.
Tibial nerve & branches.
Common peroneal nerve &
branches
Posterior Cutaneousnerve of
thigh( terminal part)
Descending genicularbranch
of obturatornerve.
Popliteal lymph nodes
Fat

8. Conti contd

10. POPLITEAL ARTERY
Continuation of femoral
artery
Begins at hiatus
magnus
Runs downwards &
slightly laterally
At lower border of
popliteus, divides into
anterior & posterior
Tibial arteries.

11. BRANCHES OF POPLITEAL ART.
Several muscular branch
to hamstrings, adductor
magnus, gastrocnemius,
soleus & plantaris.
Genicular-2 superior, 2
inferior &1 middle
geniculararteries.
Cutaneousbranch arising
either directly from the
artery Or from the
muscular branches

12. Relations of Popliteal Artery
Anteriorly: The popliteal
surface of the femur, the
knee joint, and the
popliteus muscle
Posteriorly: The popliteal
vein and the tibial nerve,
fascia and skin
Branches: Muscular
branches and articular
branches,cutaneous

13. POPLITEAL VEIN
Begins at lower border of
popliteus by the union of
veins (anterior & posterior
tibial )
Receives
(a)small saphaneous vein
(b)veins corresponding to
branch of popliteal artery.
Continues above as femoral
vein

14. Tributaries of Popliteal Vein
Veins that
correspond to
branches given off
by the popliteal
artery
Small saphenous
vein

15. TIBIAL NERVE
Larger terminal branch
of sciatic nerve.
Superficial or posterior
to popliteal vessels
crossing them lateral to
medial side.

16. Branches of Tibial Nerve
Cutaneous: Sural Nerve
Muscular
Gastrocnemius
Plantaris,
Soleus
Nerve to Popliteus
Genicular –3 branches
Vascular –T10 -L2

17. Common Peroneal
Nerve
Smaller terminal branch
of sciatic nerve.
Extends from superior
angle to lateral angle of
the fossa.
Winds around the
posterolateral aspect of
neck of fibula.

18. Branches of Common
Peroneal Nerve
Cutaneous:
1. Sural communicating
nerve
2. Lateral cutaneous
nerve/lateral sural
nerve.
Articular branches :
1. Superior lateral
2. Inferior lateral
3. Recurrent genicular
nerves.

19. ANASTOMOSIS AROUND
KNEE JOINT

20. ANASTOMOSES
Complicated arterial network around patella, lower end of
femur & upper end of tibia
Formed, medially by
(a)descending genicularbranch of femoral artery
(b)superior Medial genicularartery
(c)inferior Medial genicularartery
Laterally by
(a)descending branch of lateral circumflex femoral artery
(b)superior Lateral genicularartery
(c)inferior lateral genicularartery
These longitudinal anastomoses are interconnected to form
transverse anastomoses

21. ANASTOMOSES
Inferior lateral genicular artery anastomosis with
a) Superior lateral genicular artery
b) Anterior and posterior recurrent branches of
posterior tibial artery
c) Circumflex branch of posterior tibial artery
Inferior medial genicular artery anastomosis with
a) Superior medial genicular artery
b) Saphaneous artery –a branch of descending
genicular artery (branch of femoral artery)

22. Arterial Anastomosis Around
Knee Joint
To compensate for the narrowing of
the popliteal artery which occurs
during extreme flexion of the knee

23. POPLITEAL LYMPH NODES
3 to 4 nodes lie at the
termination of small
saphenous vein
Afferents
(a) territory of small
saphaneous Vein.
(b) deep parts of leg
(c) knee jt.
Efferents run along
popliteal & femoral; vessels
to terminate into deep
inguinal lymph nodes

24. APPLIED ANATOMY
Popliteal aneurysms
Popliteal abscess & tumors
cysts
Foot drop
Semimembranosus bursa swelling
Palpation of popliteal pulse
Damage to tibial nerve

25. POPLITEAL ANEURYSMS
Aneurysm is the
abnormal dilation of the
arterial wall
These cause oedema &
pain in the fossa
Constant pulsations of
the artery against
tendon of adductor
magnus may contribute
to cause of aneurysm

26. Popliteal abscess
Because the fascia over
the popliteus is strong &
limits expansion, pain
from an abscess or tumor
is severe
It tends to spread
superiorly or inferiorly
because of toughness of
popliteal fascia

27. POPLITEAL CYSTS
Also called as BAKER’S CYST
It is a cystic swelling which occurs in
the popliteal fossa due to inflammation
on of synovial bursa underneath the
tendon of semimembranous or
protrusion of synovial membrane of
the cavity of knee joint through the
fibrous capsule if the joint
since the cyst contains inflammatory
fluid, if it ruptures, entire calf will get
red, swollen and painful.Knee pain
which gets relieved but then the calf
begins to hurt is classic

28. BURSA SWELLING
Semimembranosus bursa swelling is the most
common swelling in the fossa
Made tense by extending knee joint &
become flaccid on flexing
Should be distiguished from baker’s cysts,
which is a centrally located pathologic
diverticulum of synovial membrane through a
hole in the back of the knee joint.

29. PALPATION OF POPLITEAL
ARTERY
Popliteal artery is palpated
for pulse & also used for
measuring B.P in the lower
limb.
As it is one of the deepest
area in the fossa it is best
felt by pressing the patella
from the front &fingertips
of both the hands in to
middle of the fossa

30. Damage to Tibial nerve
This is usually rare because of
its protected position in the
fossa.
However the nerve may be
injured by deep lacerations or
wounds in the fossa. Also
posterior dislocation of knee jt
may damage tibial nerve
Damage may cause paralysis of
flexor muscles in the leg &
intrinsic muscles of the sole.

31. Injury to common peroneal
nerve
Can get easily injured at
the neck of fibula
Paralysis of evertors of
foot & dorsiflexors
Unapposed action of
plantar flexors leading to
foot drop
CPN. can be palpated at
the neck of the fibula. In
leprosy it becomes
thickened, nodular &
hypersensitive.