The back of the thigh and popliteal fossa

1. Anatomy
BackoftheThigh
Dr Dalia Saleh

2. ObjectivesObjectives
Bony featuresBony features
Muscles of the back of the thighMuscles of the back of the thigh
Sciatic nerveSciatic nerve
Dr. Dalia Saleh (Anatomy Dept)
Popliteal fossaPopliteal fossa
BoundariesBoundaries
ContentsContents

4. 1.1.Ischial tuberosity Ischial tuberosity
(upper lateral)(upper lateral)
2.2.Ischial tuberosity Ischial tuberosity
(lower medial)(lower medial)
3.3.Ischial tuberosity Ischial tuberosity
Dr. Dalia Saleh (Anatomy Dept)
3.3.Ischial tuberosity Ischial tuberosity
(sitting area)(sitting area)
4.4.Ischial ramusIschial ramus
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22
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5. 1.1.Linea Linea asperaaspera
2.2.GlutealGluteal tuberositytuberosity..
3.3.Medial Medial supracondylarsupracondylar lineline
4.4.Adductor tubercleAdductor tubercle
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22
55
66
77
Dr. Dalia Saleh (Anatomy Dept)
5.5.Lateral Lateral epicondyleepicondyle
6.6.PoplitealPopliteal groovegroove
7.7.Pit for lateral head of Pit for lateral head of gastrocnemiusgastrocnemius
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6. 1.1.Back of the medial tibial condyle Back of the medial tibial condyle
(groove)(groove)
2.2.Styloid process.Styloid process.
3.3.Fibular headFibular head
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33
Dr. Dalia Saleh (Anatomy Dept)
4.4.Tibial tuberosityTibial tuberosity
5.5.Upper ¼ of medial surface of Upper ¼ of medial surface of
tibiatibia
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55

7. BackoftheThighBackoftheThigh

8. Back of the ThighBack of the Thigh
Content:Content:
1.1.Hamstring Hamstring
IschialIschial head of adductor head of adductor magnusmagnus
SemitendinosusSemitendinosus
SemimembranosusSemimembranosus
Long head of biceps Long head of biceps femorisfemoris
Dr. Dalia Saleh (Anatomy Dept)
Long head of biceps Long head of biceps femorisfemoris
2.2.Short head of biceps Short head of biceps femorisfemoris
3.3.Sciatic nerveSciatic nerve
4.4.Posterior Posterior cutaneouscutaneous nerve of the thighnerve of the thigh
5.5.Vessels Vessels

9. MUSCLESMUSCLES

10. IschialHead Adductor MagnusIschialHead Adductor Magnus
Origin:Origin:
IschialIschial tuberositytuberosity and and ischialischial ramusramus
Insertion: Insertion:
Adductor tubercle of the femurAdductor tubercle of the femur
Nerve supply:Nerve supply:
Dr. Dalia Saleh (Anatomy Dept)
IschialIschial part part Sciatic nerveSciatic nerve
Action:Action:
Extends hip and flexes kneeExtends hip and flexes knee

11. Hamstring Muscles Hamstring Muscles
1.1.SemimembranosusSemimembranosus
2.2.SemitendinosusSemitendinosus
3.3.Long head of biceps femorisLong head of biceps femoris
Origin: Origin: Ischial tuberosity.Ischial tuberosity.
Dr. Dalia Saleh (Anatomy Dept)
Insertion: Insertion: Upper end of fibula or tibia.Upper end of fibula or tibia.
N.S: N.S: tibial division of sciatic nerve.tibial division of sciatic nerve.
Action: Action:
Extend the thigh at hip joint.Extend the thigh at hip joint.
Flex and rotate the leg at knee joint.Flex and rotate the leg at knee joint.

12. Origin:Origin:
By a flat tendon from the By a flat tendon from the
upper & lateral part of upper & lateral part of
ischial tuberosity.ischial tuberosity.
Semimembranosus Semimembranosus
Dr. Dalia Saleh (Anatomy Dept)
Insertion:Insertion:
By a rounded tendon into By a rounded tendon into
the horizontal groove the horizontal groove
behind medial condyle of behind medial condyle of
the tibia.the tibia.

13. Origin:Origin:
In common with long head In common with long head
of biceps from the medial of biceps from the medial
part of part of ischialischial tuberositytuberosity..
Semitendenosus Semitendenosus
Dr. Dalia Saleh (Anatomy Dept)
Insertion:Insertion:
By a cord like tendon into By a cord like tendon into
the upper part of medial the upper part of medial
surface of the tibia.surface of the tibia.

14. Origin:Origin:
In common tendon with In common tendon with semitendinosissemitendinosis
from the lower medial part of from the lower medial part of ischialischial
tuberositytuberosity..
Biceps Femoris (Long Head) Biceps Femoris (Long Head)
Dr. Dalia Saleh (Anatomy Dept)

15. Biceps Femoris (Short Head) Biceps Femoris (Short Head)
Origin:Origin:
Linea aspera.Linea aspera.
Lateral supracondylar line.Lateral supracondylar line.
Insertion:Insertion:
Dr. Dalia Saleh (Anatomy Dept)
Insertion:Insertion:
Joins long head into the head of the fibula.Joins long head into the head of the fibula.

16. POPLITEALFOSSAPOPLITEALFOSSA

17. BoundariesBoundaries
Diamond shaped Diamond shaped
Upper lateral boundary: Upper lateral boundary:
Biceps femoris Biceps femoris
Upper medial boundary:Upper medial boundary:
Dr. Dalia Saleh (Anatomy Dept)
Semimembranosus Semimembranosus
Semitendinosus Semitendinosus
Two lower boundariesTwo lower boundariesare the are the
heads of gastrocnemius heads of gastrocnemius

18. RoofRoof
Skin, superficial fascia Skin, superficial fascia
containing containing cutaneouscutaneous nerves and nerves and
vesselsvessels
Deep fascia Deep fascia
Dr. Dalia Saleh (Anatomy Dept)
FloorFloor
PoplitealPopliteal surface of the femursurface of the femur
Capsule of the knee jointCapsule of the knee joint
Fascia over the Fascia over the popliteuspopliteus musclemuscle

19. PopliteusMusclePopliteusMuscle
Origin:Origin:
By a tendon from anterior end By a tendon from anterior end
of popliteal groove on lateral of popliteal groove on lateral
femoral condyle.femoral condyle.
Dr. Dalia Saleh (Anatomy Dept)
Its tendon passes under Its tendon passes under
lateral collateral ligament of lateral collateral ligament of
the kneethe knee

20. PopliteusMusclePopliteusMuscle
Insertion:Insertion:
Tendon passes within the knee Tendon passes within the knee
capsule under arcuate popliteal capsule under arcuate popliteal
ligamentligament
Dr. Dalia Saleh (Anatomy Dept)
Into a triangular area on the Into a triangular area on the
posterior surface of the tibia posterior surface of the tibia
above the soleal line.above the soleal line.
Knee capsuleKnee capsule
Lateral meniscusLateral meniscus

21. PopliteusMusclePopliteusMuscle
N.S:N.S:
Tibial nerve.Tibial nerve.
Action:Action:
Unlock the knee to start Unlock the knee to start
Dr. Dalia Saleh (Anatomy Dept)
Unlock the knee to start Unlock the knee to start
flexion.flexion.
Retraction of lateral Retraction of lateral
meniscus during flexion. meniscus during flexion.

22. Contents Contents
Popliteal artery and its branches Popliteal artery and its branches
Popliteal vein and its tributariesPopliteal vein and its tributaries
Popliteal lympn nodesPopliteal lympn nodes
Tibial and common peroneal Tibial and common peroneal
Dr. Dalia Saleh (Anatomy Dept)
Tibial and common peroneal Tibial and common peroneal
nerves and their branchesnerves and their branches
Fatty tissueFatty tissue

23. PoplitealArteryPoplitealArtery
Beginning:Beginning:
Continuation of femoral a. @ Continuation of femoral a. @
adductor magnus hiatusadductor magnus hiatus
Termination:Termination:
Dr. Dalia Saleh (Anatomy Dept)
Termination:Termination:
Divide into anterior and posterior Divide into anterior and posterior
tibial arteries @ lower border of tibial arteries @ lower border of
poplituspoplitus

24. PoplitealArteryPoplitealArtery
Course:Course:
It is the deepest of the structures It is the deepest of the structures
of the popliteal fossaof the popliteal fossa
Anterior relations = floor of the Anterior relations = floor of the fossafossa
Dr. Dalia Saleh (Anatomy Dept)
fossafossa
Branches:Branches:
1.1.Superior, inferior, and middle Superior, inferior, and middle
genicular arteries genicular arteries
2.2.Muscular branches (sural) Muscular branches (sural)

25. PoplitealVeinPoplitealVein
Formation:Formation:
Union of the venae comitantes of Union of the venae comitantes of
the anterior and posterior tibial the anterior and posterior tibial
arteries near the lower border of arteries near the lower border of
the popliteus musclethe popliteus muscle
Dr. Dalia Saleh (Anatomy Dept)
the popliteus musclethe popliteus muscle
Termination:Termination:
Pass through adductor magnus Pass through adductor magnus
hiatus into adductor canal and hiatus into adductor canal and
continues as femoral veincontinues as femoral vein

26. PoplitealVeinPoplitealVein
Course:Course:
Along its course, lies between Along its course, lies between
poplitealpopliteal artery and artery and tibialtibial nervenerve
Tributaries:Tributaries:
1.1.Veins that accompany the branches Veins that accompany the branches
Dr. Dalia Saleh (Anatomy Dept)
1.1.Veins that accompany the branches Veins that accompany the branches
of the arteryof the artery
2.2.Small Small saphenoussaphenous vein vein

27. SmallSaphenousVeinSmallSaphenousVein
Formation:Formation:
From the lateral side of dorsal venous From the lateral side of dorsal venous
arch of footarch of foot
Course:Course:

Ascends behind lateral malleolus Ascends behind lateral malleolus
Dr. Dalia Saleh (Anatomy Dept)
Ascends behind lateral malleolus Ascends behind lateral malleolus
Then upward in the calfThen upward in the calf
Drains the lateral side of the foot and Drains the lateral side of the foot and
ankle and the back of the leg.ankle and the back of the leg.
Termination:Termination:
Pierces the deep fascia and drains into Pierces the deep fascia and drains into
the popliteal veinthe popliteal vein

28. Few nodes just under the deep Few nodes just under the deep
fascia fascia
Embedded in the fatty connective Embedded in the fatty connective
tissue of popliteal fossa, close to tissue of popliteal fossa, close to
PoplitealLymphNodesPoplitealLymphNodes
Dr. Dalia Saleh (Anatomy Dept)
the popliteal vessels the popliteal vessels
Drain the deep tissues of the leg, Drain the deep tissues of the leg,
foot and knee joint foot and knee joint
Efferents to the deep inguinal LNEfferents to the deep inguinal LN

29. SciaticNerveSciaticNerve
Leaves gluteal region to back of thigh Leaves gluteal region to back of thigh
midway between the greater trochanter midway between the greater trochanter
and ischial tuberosity.and ischial tuberosity.
Lying deep to long head of biceps femorisLying deep to long head of biceps femoris
Usually divides into tibial and common Usually divides into tibial and common
Dr. Dalia Saleh (Anatomy Dept)
Usually divides into tibial and common Usually divides into tibial and common
peroneal nerves just above popliteal fossaperoneal nerves just above popliteal fossa
Innervates muscles of the back of the Innervates muscles of the back of the
thigh thigh
Has articular branches to hip and kneeHas articular branches to hip and knee

30. TibialNerveTibialNerve
Passes vertically in the fossaPasses vertically in the fossa
Leaves between the Leaves between the 2 2 heads of heads of
gastrocnemiusgastrocnemius
Gives:Gives:Muscular Muscular to muscles arising to muscles arising
Dr. Dalia Saleh (Anatomy Dept)
Muscular Muscular to muscles arising to muscles arising
from the popliteal fossafrom the popliteal fossa
Articular Articular 3 3 genicular nervesgenicular nerves
Cutaneous Cutaneous sural nervesural nerve

31. Passes medial to biceps femorisPasses medial to biceps femoris
Disappears into peroneus longusDisappears into peroneus longus
Lie on neck of fibulaLie on neck of fibula
Gives:Gives:
CommonPeronealNerveCommonPeronealNerve
Dr. Dalia Saleh (Anatomy Dept)
Muscular Muscular NONE in the fossaNONE in the fossa
Articular Articular 3 3 genicular nervesgenicular nerves
Cutaneous Cutaneous sural communicating sural communicating
nerve and lateral cutaneous nerve and lateral cutaneous
nerve of the calfnerve of the calf