The back of the thigh and popliteal fossa

Anatomy

Back of the Thigh

Dr Dalia Saleh

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

1.1. Ischial tuberosity Ischial tuberosity

(upper lateral)(upper lateral)


(lower medial)(lower medial)




(sitting area)(sitting area)

4.4. Ischial ramusIschial ramus

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1.1. Linea Linea asperaaspera

2.2. GlutealGluteal tuberositytuberosity..

3.3. Medial Medial supracondylarsupracondylar lineline

4.4. Adductor tubercleAdductor tubercle11

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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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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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4.4. Tibial tuberosityTibial tuberosity

5.5. Upper ¼ of medial surface of Upper ¼ of medial surface of

tibiatibia

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Back of the ThighBack of the Thigh

Back of the ThighBack of the ThighContent:Content:

1.1. Hamstring Hamstring IschialIschial head of adductor head of adductor magnusmagnus SemitendinosusSemitendinosus SemimembranosusSemimembranosus

Long head of biceps Long head of biceps femorisfemoris


Long head of biceps Long head of biceps femorisfemoris

2.2. Short head of biceps Short head of biceps femorisfemoris3.3. Sciatic nerveSciatic nerve4.4. Posterior Posterior cutaneouscutaneous nerve of the thighnerve of the thigh5.5. Vessels Vessels

MUSCLESMUSCLES

Ischial Head Adductor MagnusIschial Head 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:


IschialIschial part part Sciatic nerveSciatic nerve

Action:Action: Extends hip and flexes kneeExtends hip and flexes knee

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.


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.

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


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.

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



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.

Origin:Origin:

In common tendon with In common tendon with semitendinosissemitendinosisfrom the lower medial part of from the lower medial part of ischialischialtuberositytuberosity..

Biceps Femoris (Long Head) Biceps Femoris (Long Head)


Biceps Femoris (Short Head) Biceps Femoris (Short Head)

Origin:Origin:

Linea aspera.Linea aspera.

Lateral supracondylar line.Lateral supracondylar line.




Joins long head into the head of the fibula.Joins long head into the head of the fibula.

POPLITEAL FOSSAPOPLITEAL FOSSA

BoundariesBoundaries Diamond shaped Diamond shaped

Upper lateral boundary: Upper lateral boundary:

Biceps femoris Biceps femoris

Upper medial boundary:Upper medial boundary:


Semimembranosus Semimembranosus

Semitendinosus Semitendinosus

Two lower boundariesTwo lower boundaries are the are the heads of gastrocnemius heads of gastrocnemius

RoofRoof Skin, superficial fascia Skin, superficial fascia

containing containing cutaneouscutaneous nerves and nerves and vesselsvessels

Deep fascia Deep fascia


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

Popliteus MusclePopliteus MuscleOrigin: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.


Its tendon passes under Its tendon passes under lateral collateral ligament of lateral collateral ligament of the kneethe knee

Popliteus MusclePopliteus MuscleInsertion:Insertion:

Tendon passes within the knee Tendon passes within the knee capsule under arcuate popliteal capsule under arcuate popliteal ligamentligament


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

Popliteus MusclePopliteus MuscleN.S:N.S:

Tibial nerve.Tibial nerve.

Action:Action:

Unlock the knee to start Unlock the knee to start


Unlock the knee to start Unlock the knee to start flexion.flexion.

Retraction of lateral Retraction of lateral meniscus during flexion. meniscus during flexion.

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


Tibial and common peroneal Tibial and common peroneal nerves and their branchesnerves and their branches

Fatty tissueFatty tissue

Popliteal ArteryPopliteal Artery

Beginning:Beginning:

Continuation of femoral a. @ Continuation of femoral a. @ adductor magnus hiatusadductor magnus hiatus

Termination:Termination:



Divide into anterior and posterior Divide into anterior and posterior tibial arteries @ lower border of tibial arteries @ lower border of poplituspoplitus

Popliteal ArteryPopliteal ArteryCourse: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


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)

Popliteal VeinPopliteal VeinFormation: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


the popliteus musclethe popliteus muscle


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

Popliteal VeinPopliteal VeinCourse: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


1.1. Veins that accompany the branches Veins that accompany the branches of the arteryof the artery

2.2. Small Small saphenoussaphenous vein vein

Small Saphenous VeinSmall Saphenous VeinFormation:Formation: From the lateral side of dorsal venous From the lateral side of dorsal venous

arch of footarch of footCourse:Course: Ascends behind lateral malleolus Ascends behind lateral malleolus


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

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

Popliteal Lymph NodesPopliteal Lymph Nodes


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

Sciatic NerveSciatic Nerve 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


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

Tibial NerveTibial Nerve 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


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

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:

Common Peroneal NerveCommon Peroneal Nerve


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

Education

The back of the thigh and popliteal fossa