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They have long course. They reach the ham (popliteal fossa) biceps femoris semimembranosus semitendinosus + or - ischial part of the adductor magnus 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. 1. 2. 3. 4. Extension of hip joint. Flexion of knee joint. semimembranous + semitendinosus: medial rotation of leg. Biceps femoris---lateral rotation of leg. Muscle 1-biceps femoris, a-long head b-short head 2semitendinos us 3semimembra nosus Origin Insertion Head of Low medial fibula (apex) Linea aspera Low medial Upp part of med s of tibia Nerve Supply Action the tibial Lateral (medial) rotation of Common leg peroneal the tibial (medial) part Medial rotation of leg Upp lateral Back of the tibial med (medial) condyle of part tibia Medial rotation of leg 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. 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. 1. 2. 3. Muscular: Articular: Terminal: 1- Muscular Branches Adductor Magnus (hamstring portion) Long head of biceps femoris Semitendinosus Semimembranosus Short head of biceps femoris 2- Articular Branches: To the hip joint To the knee joint 3- Terminal Branches: Tibial Nerve Common Peroneal Nerve 1. 2. 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 except medial side of leg and foot?? When there's pressure on, or inflammation of, the nerve roots, there's usually a burning or electricaltype pain, which can be accompanied by tingling or numbness in the leg or foot. Definition. Boundaries. Roof. Floor. contents Sup medial : semitendinosus, semimembranosus. Sup lateral: biceps femoris (B) Inf medial: medial head of gastrocnemius (MG) Inf lateral : lateral head of gastrocnemius (LG)+ Plantaris. Skin. Superficial fascia: -VEIN---short saphenous vein. -Cutaneous nerve--post cut n of thigh. Deep fascia (popliteal fascia). 1. 2. 3. Upper 1/3: popliteal surf of femur. Middle 1/3: capsule of knee joint. Lower 1/3: popliteus+its fascia. From superficial to deep: • Tibial nerve • Common peroneal nerve. • popliteal vein . • Popliteal artery. • Popliteal Lns. • Popliteal fat. Larger branch. L4,5,S1,2,3. Level of origin is variable. Enters pop fossa at upper angle. Leaves at lower angle. 1. 2. 3. 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 1. 2. Branches: Cutaneous: sural n: Muscular: To gastrocnemius, plantaris, soleus popliteus. 3. Articular: Sup med inf med, middle genicular n. Weakness of plantar flexion. Weakness of inversion Only cutaneous branch of tibial n. Accompanied by small saphenous v. Between 2 heads of Gastrocnemius. Peirces deep fascia Passes behind below lat malleolus Ends at the lateral side of little toe. 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. winds laterally around neck of fibula pierces peroneus longus deep to peroneus longus divides into 2 terminal branches supf peroneal n deep peroneal n Branches 1. Cutaneous: a- sural communicating n joins sural n b- lat cutaneous n of calf supplies skin on lat side of back of leg 2. Muscular: short head of biceps femoris 3. 4. Articular: sup, inf lat genicular and recurrent genicular n. Terminal Branches: superficial and deep peroneal n. Foot drop. WHY? Loss of cutaneous sensation. WHERE? Tibial nerve Common peroneal nerve Larger branch. smaller terminal lateral L4,5,S1,2,3. L4,5,S1,2 Enters pop fossa at upper at sup angle of popliteal angle. fossa. Leaves at lower angle. leaves fossa at the lat angle. winds laterally around Has a triple relation with neck of fibula the pop vessels. deep to peroneus longus At distal border of superficial peroneal n popliteus---post tibial n deep peroneal n Tibial nerve Cutaneous: sural n Common peroneal nerve Cutaneous: sural communicating n lat cutaneous n of calf Muscular: Muscular: short head of biceps To gastrocnemius, plantaris,soleus,popliteu femoris Articular: Articular: Sup lat, Sup med inf lat genicular, inf med, recurrent genicular n. middle genicular n. 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 reaches lower border of popliteus terminates by dividing into ant & post tibial arteries 1. 2. Branches Muscular: supplies surrounding muscles Articular(genicular) : -lat & med sup genicular -middle genicular -lat & med inf genicular 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. Around termination of small saphenous v. Drain above heel, deep structures of calf. Drain into deep inguinal LNs. THANK YOU