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COM MSK > Posterior Thigh and Popliteal Fossa > Flashcards

Posterior Thigh and Popliteal Fossa Flashcards

1
Q

Common proximal attachment of posterior thigh muscles

A

Ischial tuberosity- except short head of biceps femoris

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2
Q

Common innervation of posterior thigh muscles

A

Tibial division of sciatic nerve- except short head of biceps femoris

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3
Q

Common functions of posterior thigh muscles

A

Leg flexion at knee

Thigh extension at hip- except short head of biceps femoris

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4
Q

Semitendonosus OINA

A

O: ischial tuberosity
I: pes anserinus - anteromedial superior tibia
N: Tibial division of sciatic nerve
A: extend thigh, flex leg, medially rotate flexed leg

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5
Q

Attachments to pes anserinus listed superficial to deep

A

Sartorius
Gracilis
Semitendonosus

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6
Q

Pes anserine bursitis

A

Inflammation of anserine bursa located between pes anserinus and the MCL
Results in constant, aching pain aggravated by activity such as climbing stairs, specifically flexion and internal/medial rotation of knee

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7
Q

Semimembranosus OINA

A

O: ischial tuberosity
I: posterior part of medial tibial condyle
N: tibial division of sciatic nerve
A: extend thigh, flex leg, medially rotate flexed leg

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8
Q

Semimembranosus distal tendon- explain

A

Divides into 2 main parts, one goes to medial tibial condyle, the other becomes oblique popliteal ligament
This ligament reinforces intercondylar portion of knee joint capsule and forms part of popliteal fossa floor

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9
Q

Biceps femoris long head OINA

A

O: ischial tuberosity
I: lateral aspect of fibular head
N: tibial division of sciatic nerve
A: extend thigh, flex leg, laterally rotate flexed leg

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10
Q

Biceps femoris short head OINA

A

O: lateral lip of linea aspera and lateral supracondylar line
I: lateral aspect of fibular head
N: common fibular division of sciatic nerve
A: flex leg, laterally rotate flexed leg

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11
Q

Grade I hamstring injury

A

Mild
Small disruption in structural integrity
Minor swelling and pain
No or minimal loss of strength

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12
Q

Grade II hamstring injury

A

Moderate
Partial tears with some intact muscle fibers
Pain present
Definite loss of strength

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13
Q

Grade III hamstring injury

A

Severe
Complete tear
Swelling, severe pain and typically with accompanied hematoma
Complete loss of motor function

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14
Q

Perforating arteries of deep femoral/profundal femoral artery

A

There are three perforating branches, and the termination of the deep femoral artery becomes the 4th branch
Supplies posterior thigh muscles and adductor magnus
Courses from anterior from posterior by piercing adductor magnus

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15
Q

Descending branch of lateral femoral circumflex artery

A

Descends anterior thigh

Supplies genicular anastomosis

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16
Q

Descending genicular artery

A

Arises from femoral artery in adductor canal

Supplies genicular anastomosis

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17
Q

Sciatic nerve tibial division innervates

A 
L4-S3
Long head of biceps femoris L5-S2
Semitendinosus L5-S2
Semimembranosus L5-S2
Hamstring portion of adductor magnus (L4)
18
Q

Common fibular division of sciatic nerve innervates

A

L4-S2

Short head of biceps femoris L5-S2

19
Q

Semitendinosus OINA

A

O: ischial tuberosity
I: pes anserinus
N: tibial division of sciatic nerve
A: extend thigh, flex leg and rotate it medially

20
Q

Boundaries of the popliteal fossa

A

Superomedially: semimembranosus, semitendinosus
Superolaterally: Biceps femoris
Inferolaterally: lateral head of gastrocnemius
Inferomedially: medial head of gastrocnemius

21
Q

Contents of popliteal fossa listed superficial to deep

A

Tibial nerve, common fibular nerve, sural nerve
Popliteal vein, branches and lymph nodes
Popliteal artery and branches

22
Q

Popliteal artery

A

Continuation of femoral artery after passing through adductor hiatus
Terminates by dividing into anterior/posterior tibial arteries
Deepest structure in popliteal fossa
Gives rise to genicular branches

23
Q

Genicular anastomosis

A

Important collateral circulating bypassing popliteal artery if knee is fully flexed for long periods of time or if there are narrowed/occluded popliteal vessels
Supplies articular capsule and ligaments of knee joint
Includes: Popliteal artery, descending branch of lateral femoral circumflex artery, descending genicular artery saphenous and articular branches.

24
Q

Popliteal vein

A

Lies superficial to and in same fibrous sheath as popliteal artery
Termination point of small saphenous vein
Formed by union of anterior/posterior tibial veins, usually near inferior border of popliteus muscle
Becomes femoral vein after traversing adductor hiatus

25
Q

Popliteal fossa lymphatics

A

Cutaneous fluid drains to superficial popliteal nodes along small saphenous vein
Deep leg and foot drains to deep popliteal nodes along popliteal vein
Proximal drainage accompanies femoral vein to deep inguinal nodes
Continued drainage follows venous return

26
Q

Tibial nerve

A

Larger of sciatic nerve (which divides into tibial/fibular nerves near superior angle of popliteal fossa)
Descends centrally through popliteal fossa
Most superficial relative to popliteal vein/artery
Runs distally with posterior tibial artery/vein

27
Q

Tibial nerve innervates

A

Posterior leg muscles
Knee joint
Skin on posterior leg via medial sural cutaneous nerve

28
Q

Common fibular nerve

A

Descends obliquely on lateral side of popliteal fossa, medial to biceps femoris
Leaves popliteal fossa by passing superficially to lateral head of gastrocnemius
Winds around head and neck of fibula (susceptible to injury)

29
Q

Common fibular nerve innervates

A

Anterior leg muscles via deep fibular nerve
Lateral leg muscles via superficial fibular nerve
Skin on posterolateral leg via lateral sural cutaneous nerve

30
Q

Sural nerve

A

Cutaneous nerve of posterior leg and lateral aspect of ankle and foot
Runs inferiorly with small saphenous vein, passes inferior to lateral malleolus to lateral side of foot
Composed of medial sural cutaneous nerve from tibial, and sural communicating branch from common fibular or lateral sural cutaneous nerve

31
Q

Superficial fibular nerve innervates

A

Fibularis longus/brevis and skin on distal third of anterior surface of leg and dorsum of foot

32
Q

Deep fibular nerve innervates

A

Anterior muscles of leg, dorsum of foot, skin of first interdigital cleft, sends articular branches to joints it crosses

33
Q

Metaphyseal distal femoral fracture

A

Traverse fracture across the shaft

Most common distal femoral fracture

34
Q

Physeal distal femoral fracture

A

Transverse fracture involving epiphyseal plate
Commonly described by Salter-Harris classification:
I- through growth plate
II- through growth plate and metaphysis
III- through growth plate and epiphysis
IV- through all three elements
V- crush injury of growth plate

35
Q

Distal femoral fracture may disrupt what and how

A

Posterior displacement can disrupt neurovasculature due to close proximity to femur in popliteal fossa

36
Q

Distal femoral fracture nerve injury

A

Motor injury with foot drop

Sensory deficits to dorsal or plantar foot

37
Q

Acute compartment syndrome

A

Increased pressure in a closed fascial compartment
Most commonly due to hemorrhage and/or edema
Symptoms- persistent deep ache/burning pain
Paresthesia
Pain with passive stretch
Muscle weakness

38
Q

Popliteal (bakers) cysts

A

Swelling in the popliteal fossa due to enlargement of the gastrocnemius-semimembranosus bursa
Often communicates with knee joint space, and contain synovial fluid
Associated with degenerative inflammatory joint disease or joint injury
Very asymptomatic and typically detected by imaging studies performed for other reasons

39
Q

Complications of popliteal cysts- enlargement

A 
Presents similar to DVT
Erythema and edema due to vein compression
Ischemia due to arterial compression
Nerve entrapment
Positive Homans sign
40
Q

Complications of popliteal cysts- rupture

A 
Simulates thrombosis or muscle rupture
Warmth, tenderness and erythema
Ecchymoses
Compartment syndromes
My be indolent with only edema
41
Q

Peripheral aneurysm

A

Localized enlargement of an artery due to weakening of arterial wall
Popliteal artery aneurysms are most common true peripheral aneurysm
Symptoms: claudication or ischemic pain at rest, sensory/motor nerve deficit, severe pain behind knee

42
Q

Peripheral artery disease

A

Atherosclerosis leading to peripheral artery occlusion
Lack of blood flow leads to pain in affected muscle groups
Symptoms: ischemic pain at rest, non-healing ulcer, gangrene

COM MSK (35 decks)

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