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Chapter-26 Back of Thigh

BOOK TITLE: Kadasne’s Textbook of Anatomy (Clinically Oriented): Volume 1: Upper and Lower Extremities

Author
1. Kadasne DK
ISBN
9788184484557
DOI
10.5005/jp/books/10433_26
Edition
1/e
Publishing Year
2009
Pages
8
Author Affiliations
1. Pandit Jawaharlal Nehru Medical College, DMIMS (a Deemed University), Sawangi, Wardha, Maharashtra, India, Pandit Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (A Deemed University), Sawangi, Wardha, Maharashtra, India
Chapter keywords

Abstract

Muscles of flexor compartment: They are members of the hamstring group and are supplied by the sciatic nerve. The following muscles are in this compartment. (1) Biceps femoris, (2) Semitendinosus, (3) Semimembranosus and hamstring part of the adductor magnus. Hamstring muscle arise from the ischial tuberosity go to the bones of the legs except the adductor magnus. Origin: From the lower medial part of ischial tuberosity above transverse ridge along with the long head of the biceps femoris. Surgical: Tendon of semitendinosus muscle is used in rupture of the anterior cruciate ligament for repair and replacement. Popliteal fossa: It is the diamond shaped hollow situated at the back of knee. It has roof, floor and four boundaries; floor is formed by Poplitea suface of the femur, back of the capsule of the knee joint and the poplitus muscle from above downwords. Supero-medial boundary: Is formed by semitendinosus, semimembranosus, sartorius, gracilis and adductor magnus. Supro-Iateral border: By tendon of biceps femoris. Which is accompanied by the common peroneal nerve? The tendon of biceps femoris reaches the head of fibula for insertion, while the common peroneal nerve reaches the neck of the fibula where it divides into superficial and deep peroneal nerves. Infero-Iateral border: By lateral head of the gastrocnemius and plantaris. Infero-medial border: By medial head of gastrocnemius. Contents: They are popliteal artery, popliteal vein, tibial and common peroneal nerves. General arrangement of structure: In the popliteal fossa popliteal artery runs obliquely from adductor opening to inferior corner of the fossa and disappears between two heads of gastrocnemius muscle. Popliteal vein follows the artery but lies superficial to it. The tibial nerve runs vertically downwards from superior corner of the fossa to the inferior. It lies superficial to the artery and vein. The common peroneal nerve follows tendon of biceps femoris along supero-Iateral border of the fossa. Popliteal artery: It is the continuation of femoral artery beyond the opening of artery in adductor magnus and ends at the lower border of popliteus by dividing into terminal branches namely anterior and posterior tibial. Most important relation of the back of the knee joint is the popliteal aretery. Branches: Articular branches are five in number, namely, two superior, two inferior and one middle. Anastomosis around the knee is formed by five articular branches of popliteal, descending genicular branch of the femoral artery, anterior tibial recurrent artery and the descending branch of the lateral circumflex femoral artery. Surgical: Localised dilatation of the arterial wall is known as an aneurysm. Its relation with popliteal vein it may cause its thrombosis. Popliteal vein: It is formed at the lower border of popliteus muscle on the medial side of popliteal artery by union of venae comitantes of anterior and posterior tibial arteries. Tibial nerve: It is one of the two terminal branches of sciatic nerve given in the middle of the back of thigh, under cover of long head of biceps femoris; it comes out from undersurface of biceps and further runs downwards crossing popliteal artery and vein from lateral to medial side superficially. At the lower border of popliteus muscle it continues as posterior tibial nerve. Muscular: Branches are given to plantaris, medial, and lateral heads of gastrocnemius and soleus. Nerve to popliteus: It arises from the tibial nerve and after winding round its lower border comes to the anterior surface of the muscle. In addition to this, it gives branches to superior and inferior tibio-fibular joints and interosseous membrane. Common peroneal nerve: (L4, 5, 81, 2). It is one of the two terminal branches of sciatic nerve given at the middle of the back the thigh on the adductor magnus and under the long head of the biceps femoris muscle. As it enters the popliteal fossa it runs downwards and laterally following tendon of biceps femoris and reaches the neck of fibula. Here it divides into superficial and the deep peroneal branches. The nerve is related to the neck of fibula. In the tumor known as osteoclastoma of the head of the fibula, the common peroneal nerve is carefully separated during the excision of the tumor. Branches: It is important to remember that common peroneal nerve does not give any muscular branch in the popliteal fossa as all muscular branches in the fossa come from the tibial nerve alone. However, it gives articular and cutaneous branches. Articular branches: They are three in number namely: Superior lateral genicular, inferior lateral genicular and recurrent genicular. Cutaneous branches: They are: (1) Sural communicating and the (2) lateral cutaneous nerve of calf. The sural communicating arises higher up and joins sural nerve at middle of the back of calf. Popliteal lymph nodes: The deep group of lymph nodes is five to six in numbers and is placed in the fat of popliteal fossa.

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