2-posterior compartment of the thigh

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Transcript 2-posterior compartment of the thigh

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



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
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
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
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.

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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

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
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.


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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.
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Around termination of small saphenous v.
Drain above heel, deep structures of calf.
Drain into deep inguinal LNs.
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