MSK The adductor canal and popliteal fossa

Question 1

What is the adductor canal?

Answer 1

Narrow tunnel located in the thigh
It is 15cm long and extends from apex of femoral triangle to the adductor hiatus of the adductor magnus.
Serves as a passageway for structures moving between anterior and posterior thigh

Question 2

What are the borders of the adductor canal?

Answer 2

All muscular
Anterior border - sartorius
Posterior border - adductor longus and magnus
Lateral border - vastus medialis

Question 3

What are the contents of the adductor canal?

Answer 3

Femoral artery and vein (as they exit the adductor canal they become the popliteal artery and vein)

Nerve to the vastus medialis

Saphenous nerve (largest cutaneous nerve of the femoral nerve)

Question 4

What is adductor canal block and why is it used?

Answer 4

Local anaesthetic is administered to the adductor canal to block the saphenous nerve (on its own or with the vastus medialis nerve).
This procedure is used to provide sensory anaesthesia for procedures to distal thigh and femur, knee or lower leg on medial side

Question 5

What is adductor canal compression syndrome?

Answer 5

Rare
Entrapment of the neurovascular bundle within the adductor canal caused by hypertrophy of adjacent muscles e.g. vastus medialis

Most common in young males who present with claudication (cramping pain during exercise) due to femoral artery occlusion, or neurological symptoms due to entrapment of saphenous nerve

Question 6

Where is the popliteal fossa and what shape is it?

Answer 6

A diamond shaped area on the posterior side of knee

Question 7

What are the borders, floor and roof of the popliteal fossa?

Answer 7

Superiomedial border - semimebranosus
Superiolateral border - biceps femoris
Inferiomedial border - medial head of gastrocnemius
Inferiolateral border - lateral head of gastrocnemius and plantaris

Floor - posterior surface of knee joint capsule and femur
Roof - popliteal fascia (continuous with fascia lat of leg) and skin

Question 8

What are the contents of the popliteal fossa? and which are deepest and most superficial?

Answer 8

Medial to lateral:
Artery - popliteal (deepest)
Vein - popliteal
Nerve - tibial (most superficial)
Nerve - common fibular (most superficial)

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Question 9

What are the 2 major causes of swelling in the popliteal fossa?

Answer 9

Bakers cyst
Inflammation and swelling of the semimebranosus bursa
Usually arises with r/o arthritis of the knee
Usually resolves with no intervention

Popliteal anurysm
The roof of the popliteal fossa in tough so an aneurysm can compress other contents
The tibial nerve can be compresses causing loss of sensation and motor loss to the leg
Detected by an obvious pulsation with abnormal arterial sounds