Leg Anatomy

Question 1

What nerve runs alongside the anterior tibial artery?

Answer 1

Deep peroneal nerve

Question 2

What structures are found in the anterior compartment?

deep posterior compartement?

Lateral compartment?

Answer 2

Deep peroneal nerve, ant tib artery and vein

Peroneal artery, post tib artery, tibial nerve

superficial peroneal nerve

Question 3

What are the surgical approaches to the politeal artery?

Answer 3

Medial suprageniculate

Lateral Suprageniculate

Medial infrageniculate

Lateral Infrageniculate

Question 4

Why is infrageniculate pop better for bypass then proximal pop?

Answer 4

Less affected by atherosclerotic disease

Question 5

Describe medial infrageniculate pop approach incision?

what structure is nearby incision?

Describe dissection?

How do you gain more proximal exposure from here?

How do you gain distal exposure from here?

What structures are encountered once the dissection is complete?

How do you rout bypass to this level?

Answer 5

Longitudinal incision approx 1cm behind posterior border of the tibia, extending 1/3 distance down from medial tibial condyle

Greater saphenous vein (retract it posteriorly)

Incise crural fascia 1 cm posterior to tibia and extend proximal to semitendinosus muscle. retract medial head of gastroc retracted posteriorly

divide tendons of semitendinosus, gracilis, sartorius

divide tibial attachement of the soleus muscle

popliteal vein (usually paired), popliteal artery, tibial nerve (posteo-med). popliteal branches aren’t important at this level

Throught the abbductor canal, then tunneled posterior to knee between femoral condyles (bring between heads of the gastroc to avoid compression during contraction)