Posterior compartment of the thigh

1. Posterior compartment of the thigh

2. Cutaneous innervation

3. Posterior compartment of the thigh the hamstrings They have long course. They reach the ham (popliteal fossa)

4. The hamstrings are: • biceps femoris • semimembranosus • semitendinosus + or - ischial part of the adductor magnus

5. Origin of hamstrings

6. Insertion of hamstrings

8. Nerve supply of hamstrings • The muscles of the posterior compartment of the thigh are innervated by the tibial (medial) part of the sciatic nerve Except The short head of the biceps is innervated by a branch of the common peroneal nerve.

9. Action of hamstrings • Extension of hip joint. • Flexion of knee joint. • semimembranous + semitendinosus: medial rotation of leg. • Biceps femoris---lateral rotation of leg.

12. Sciatic Nerve • thickest nerve in the body • about 2cm in diameter • L4, L5, S1, S2, and S3 Inside the pelvis • Then leave through greater sciatic Foramen, below piriformis. • Descends bet greater troc and ischial tuberosity.

13. Sciatic Nerve • descend to reach popliteal fossa. • it divides into 2 terminal branches -Tibial Nerve (med popliteal) -Common peroneal nerve(lat popliteal). • Level of division is variable.

14. Sciatic Nerverelations

18. Branches of sciatic nerve: • Muscular: • Articular: • Terminal:

19. D- Branches 1- Muscular Branches Adductor Magnus (hamstring portion) Long head of biceps femoris Semitendinosus Semimembranosus Short head of biceps femoris

20. 2- Articular Branches: • To the hip joint • To the knee joint

21. 3- Terminal Branches: Common Peroneal Nerve Tibial Nerve

22. Injury of sciatic nerve • Motor loss: - paralysis of hamstrings----weakness of flexion of knee. - paralysis of muscles of leg- foot----flail foot, foot drop. • Sensory loss: on leg and foot exceptmedial side of leg and foot??

23. Sciatica • When there's pressure on, or inflammation of, the nerve roots, there's usually a burning or electrical-type pain, which can be accompanied by tingling or numbness in the leg or foot.

24. Popliteal FossaThe popliteal fossa is a diamond shaped region behind the knee

25. Definition. • Boundaries. • Roof. • Floor. • contents

26. The boundaries • Sup medial : semitendinosus, semimembranosus. • Sup lateral: biceps femoris (B) • Inf medial: medial head of gastrocnemius (MG) • Inf lateral : lateral head of gastrocnemius (LG)+ Plantaris.

27. Roof of popliteal fossa • Skin. • Superficial fascia: -VEIN---short saphenous vein. -Cutaneous nerve---post cut n of thigh. • Deep fascia (popliteal fascia).

28. Floor of popliteal fossa • Upper 1/3: popliteal surf of femur. • Middle 1/3: capsule of knee joint. • Lower 1/3: popliteus+its fascia.

29. Contents of the popliteal fossa From superficial to deep: • Tibial nerve • Common peroneal nerve. • popliteal vein . • Popliteal artery. • Popliteal Lns. • Popliteal fat.

30. Tibial nerve(medial popliteal nerve) • Larger branch. • L4,5,S1,2,3. • Level of origin is variable. • Enters pop fossa at upper angle. • Leaves at lower angle.

31. Tibial nerve(medial popliteal nerve) • Has a triple relation with the pop vessels: • Upp part: lateral to pop v. • midd part: crosses pop v. • Lower part: medial to pop v. • At distal border of popliteus---post tibial n

32. Tibial nerve(medial popliteal nerve) • Branches: • Cutaneous: sural n: • Muscular: To gastrocnemius, plantaris, soleus popliteus.

33. Tibial nerve(medial popliteal nerve) • Articular: Sup med inf med, middle genicular n.

34. Tibial nerve injury • Weakness of plantar flexion. • Weakness of inversion

35. Sural nerve • Only cutaneous branch of tibial n. • Accompanied by small saphenous v. • Between 2 heads of Gastrocnemius. • Peirces deep fascia

36. Sural nerve • Passes behind below lat malleolus • Ends at the lateral side of little toe.

37. Common Peroneal Nerve(lateral popliteal nerve) Origin • smaller terminal lateral branch of sciatic n L4,5,S1,2. Course & Relations • Enters the fossa at its upper angle. • follows med border of biceps femoris. • leaves fossa at the lat angle of gastrocnemius & soleus. • passes behind head of fibula.

38. Common Peroneal Nerve(lateral popliteal nerve) • winds laterally around neck of fibula • pierces peroneus longus • deep to peroneus longus  divides into 2 terminal branches • supf peroneal n • deep peroneal n

39. Branches • Cutaneous: a- sural communicating n  joins sural n b- lat cutaneous n of calf  supplies skin on lat side of back of leg • Muscular: short head of biceps femoris

40. Articular: sup, inf lat genicular and recurrent genicular n. • Terminal Branches: superficial and deep peroneal n.

41. Injury of common peroneal nerve • Foot drop. WHY? • Loss of cutaneous sensation. WHERE?

44. Popliteal artery • Origin: continuation of femoral art as it passes through opening in adductor magnus muscle. • Course: from its origin it runs downwards & slightly laterally in popliteal fossa

45. Popliteal artery • reaches lower border of popliteus • terminates by dividing into ant & post tibial arteries

46. Branches • Muscular: supplies surrounding muscles • Articular(genicular) : -lat & med sup genicular -middle genicular -lat & med inf genicular

47. Popliteal vein • Formed by union of venae comitantes of ant, post tibial arteries. • At the lower border of popliteus. • Enters pop fossa at lower angle. • Leaves at upp angle. • Continues as femoral vein at adductor opening. • Lies bet tibial n and pop a. • TRIBUTARIES: 1- veines accompany arteries. 2- small saphenous v.

48. Popliteal lymph nodes • Around termination of small saphenous v. • Drain above heel, deep structures of calf. • Drain into deep inguinal LNs.

49. THANK YOU