Popliteal artery
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The popliteal artery is a deeply placed continuation of the
femoral artery The femoral artery is a large artery in the thigh and the main arterial supply to the thigh and leg. The femoral artery gives off the deep femoral artery or profunda femoris artery and descends along the anteromedial part of the thigh in the f ...
opening in the distal portion of the adductor magnus muscle. It courses through the popliteal fossa and ends at the lower border of the
popliteus muscle The popliteus muscle in the leg is used for unlocking the knees when walking, by laterally rotating the femur on the tibia during the closed chain portion of the gait cycle (one with the foot in contact with the ground). In open chain movements ...
, where it branches into the
anterior Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek language, Greek roots, describe something in its standard anatomical position. Th ...
and posterior tibial arteries. The deepest (most anterior) structure in the fossa, the popliteal artery runs close to the joint capsule of the knee as it spans the intercondylar fossa. Five genicular branches of the popliteal artery supply the capsule and ligaments of the knee joint. The genicular arteries are the superior lateral, superior medial, middle, inferior lateral, and inferior medial genicular arteries. They participate in the formation of the periarticular genicular anastomosis, a network of vessels surrounding the knee that provides collateral circulation capable of maintaining blood supply to the leg during full knee flexion, which may kink the popliteal artery.


Structure

The popliteal artery is the continuation of the
femoral artery The femoral artery is a large artery in the thigh and the main arterial supply to the thigh and leg. The femoral artery gives off the deep femoral artery or profunda femoris artery and descends along the anteromedial part of the thigh in the f ...
. It exits the popliteal fossa under the fibrous arch of the soleus muscle.


Relations

* Anteriorly: The popliteal surface of the femur, the knee joint, and the popliteus muscle. * Posteriorly: The
popliteal vein The popliteal vein is a vein of the lower limb. It is formed from the anterior tibial vein and the posterior tibial vein. It travels medial to the popliteal artery, and becomes the femoral vein. It drains blood from the leg. It can be assessed ...
and the
tibial nerve The tibial nerve is a branch of the sciatic nerve. The tibial nerve passes through the popliteal fossa to pass below the arch of soleus. Structure Popliteal fossa The tibial nerve is the larger terminal branch of the sciatic nerve with root val ...
, fascia, and skin. * Laterally: The
biceps femoris The biceps femoris () is a muscle of the thigh located to the posterior, or back. As its name implies, it has two parts, one of which (the long head) forms part of the hamstrings muscle group. Structure It has two heads of origin: *the ''long ...
and the lateral condyle of femur in upper part, and plantaris, lateral gastrocnemius in lower part. * Medially: The semimembranosus and the medial condyle of femur in upper part, and
tibial nerve The tibial nerve is a branch of the sciatic nerve. The tibial nerve passes through the popliteal fossa to pass below the arch of soleus. Structure Popliteal fossa The tibial nerve is the larger terminal branch of the sciatic nerve with root val ...
,
popliteal vein The popliteal vein is a vein of the lower limb. It is formed from the anterior tibial vein and the posterior tibial vein. It travels medial to the popliteal artery, and becomes the femoral vein. It drains blood from the leg. It can be assessed ...
, medial head of gastrocnemius in lower part.


Branches

The branches of the popliteal artery are: *
anterior tibial artery The anterior tibial artery is an artery of the leg. It carries blood to the anterior compartment of the leg and dorsal surface of the foot, from the popliteal artery. Structure Course The anterior tibial artery is a branch of the poplitea ...
. *
posterior tibial artery The posterior tibial artery of the lower limb is an artery that carries blood to the posterior compartment of the leg and plantar surface of the foot. It branches from the popliteal artery via the tibial-fibular trunk. Structure The poster ...
. * sural artery. * medial superior genicular artery. * lateral superior genicular artery. *
middle genicular artery The middle genicular artery (azygos articular artery) is a small branch of the popliteal artery. It supplies parts of the knee joint. Structure The middle genicular artery (MGA) arises from the anterolateral surface of the popliteal artery. Thi ...
. * lateral inferior genicular artery. * medial inferior genicular artery. Muscular branches of the popliteal artery supply the hamstring, gastrocnemius, soleus, and plantaris muscles. The superior muscular branches of the popliteal artery have clinically important anastomoses with the terminal part of the deep femoral and gluteal arteries. The cutaneous branches arise either directly by the popliteal artery or indirectly by the muscular branches. Genicular branches are five in number, two superior, two inferior, and one middle. The middle genicular artery supplies the cruciate ligaments and the synovial membrane of knee joint.


Tibial-fibular trunk

The
fibular artery In anatomy, the fibular artery, also known as the peroneal artery, supplies blood to the lateral compartment of the leg. It arises from the tibial-fibular trunk. Structure The fibular artery arises from the bifurcation of tibial-fibular trunk int ...
typically arises from the
posterior tibial artery The posterior tibial artery of the lower limb is an artery that carries blood to the posterior compartment of the leg and plantar surface of the foot. It branches from the popliteal artery via the tibial-fibular trunk. Structure The poster ...
. Therefore, the posterior tibial artery proximal to the fibular artery origin is sometimes called the '' tibial-peroneal trunk'' or ''tibial-fibular trunk'' and it could be said that the popliteal artery bifurcates into the ''tibial-fibular trunk'' and ''anterior tibial artery''.


Clinical significance

* Popliteal pulse: Because the popliteal artery is deep, it may be difficult to feel the popliteal pulse. Palpation of this pulse is commonly performed with the person in the prone position with the knee flexed to relax the popliteal fascia and hamstrings. The pulsations are best felt in the inferior part of the fossa where the popliteal artery is related to the tibia. Weakening or loss of the popliteal pulse is a sign of a femoral artery obstruction. * Popliteal aneurysm and hemorrhage: A popliteal aneurysm (abnormal dilation of all or part of the popliteal artery) usually causes
edema Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels tight, the area ma ...
and pain in the popliteal fossa. A popliteal aneurysm may be distinguished from other masses by palpable pulsations (thrills) and abnormal arterial sounds (bruits) detectable with a stethoscope. Because the artery lies deep to the tibial nerve, an aneurysm may stretch the nerve or compress its blood supply (see
vasa vasorum Vasa vasorum are small blood vessels that comprise a vascular network supplying the walls of large blood vessels, such as elastic arteries (e.g., the aorta) and large veins (e.g., the venae cavae). The name derives . Occasionally two differen ...
). Pain from such nerve compression is usually referred, in this case to the skin overlying the medial aspect of the calf, ankle or foot. Because the artery is closely applied to the popliteal surface of the femur and the joint capsule, fractures of the distal femur or dislocations of the knee may rupture the artery, resulting in hemorrhage. Furthermore, because of their proximity and confinement within the fossa, an injury of the artery and vein may result in an arteriovenous fistula (communication between an artery and a vein). Failure to recognize these occurrences and to act promptly may result in the loss of the leg and foot. If the femoral artery must be ligated, blood can bypass the occlusion through the genicular anastomosis and reach the popliteal artery distal to the ligation.Moore K.L. and Dalley A.F. (2006), Clinically Oriented Anatomy, 5th Edition, Lippincott Williams & Wilkins, Toronto, page 637 * Popliteal artery entrapment syndrome


Additional images

File:Popliteal artery.jpg, Popliteal artery File:Gray551.png, The popliteal, posterior tibial, and peroneal arteries. File:Slide2DADE.JPG, Muscles of thigh. Lateral view.


See also

* Popliteal fossa * Anastamosis


References


External links

* - "Arteries of the lower extremity shown in association with major landmarks."
Image at umich.edu - pulse
{{Authority control Arteries of the lower limb