The popliteal fossa is a shallow depression located at the back of the knee joint. Bakers cyst, or popliteal cyst, is a fluidfilled mass that is a distention of a preexisting bursa in the popliteal fossa, most commonly the gastrocnemiosemimembranosus bursa. This article is from annals of the royal college of surgeons of england, volume 95. Apr 15, 2020 because of this, popliteal abscesses usually spread superiorly and inferiorly from the popliteal fossa. The popliteal artery branches off to form five genicular arteries, which supply the ligaments and capsule of the knee joint. Some have complex internal characteristics such as septa and loosebodies. The diagnosis was confirmed by surgical exploration of the popliteal fossa in six patients, who recovered fully after division of the soleus arch, whereas the other three improved spontaneously.
Popliteal fossa article about popliteal fossa by the free. A useful mnemonic to remember popliteal fossa anatomy medialtolateral arrangement is. Deep vein thrombosis dvt with subsequent pulmonary embolus pe is frequently fatal if untreated. Dynamic cine clip through popliteal fossa during ankle plantar flexion and dorsiflexion. The popliteal fossa contains the popliteal vessels, the tibial and the common peroneal nerves, the termination of the small saphenous vein, the lower part of the posterior femoral cutaneous nerve, the articular branch from the obturator nerve, a few small lymph glands, and a considerable quantity of fat. Measured peak systolic velocity psv above level of entrapment or, if no dynamic entrapment, above level of popliteus muscle neutral. Popliteal synovial cysts, also known as bakers cysts, are a common occurrence in adults and children. The popliteal fossa borders contents teachmeanatomy. Popliteal fossa, also known as the popliteal space, is located behind the knee joint. It is the main path in which structures move from the thigh to the leg. These lesions need to be differentiated by the absence of the communicating neck with the joint on ultrasound. A quick tutorial outlining the borders, contents and clinical relevance of the popliteal fossa. This is an unusual case of a retained knife blade in the popliteal fossa from an anterior entry wound without vascular nor ligamentous injury.
In the floor adductor magnus and vastus lateralis lies. The popliteal artery is more susceptible to aneurysm than every other artery within the body. Laterally it is bounded by the biceps femoris above, and by the plantaris and the lateral head of the gastrocnemius below. Popliteal vein injuries should be repaired when possibleby lateral suture or endtoend anastomosis. Bhanu prakash usmle, fmge and neet pg 108,071 views. The knee joint however, there was a striking sparing of the abdominal creases, antecubital fossa and the popliteal fossa figures 1 and 2. Popliteal fossa synonyms, popliteal fossa pronunciation, popliteal fossa translation, english dictionary definition of popliteal fossa. The popliteal artery, a branch of the femoral artery, enters the popliteal fossa by passing under the semimembranosus muscle. Lower limb anatomy popliteal fossa, dr g bhanu prakash duration. Early surgical repair should be performed immediately after the diagnosis is made because.
Ct angiogram of a small seroma in the right popliteal f. A careful en bloc removal of fat tissue and lymph nodes is made to. Any information contained in this pdf file is automatically generated from digital material. Venous thrombosis and pulmonary emboli is the primary presentation in most cases of pvas, hence it is a clinically significant abnormality and a potentially morbid and fatal condition.
Priortoand duringworld war ii,the primarytreatment for this in. The popliteal fossa sometimes referred to colloquially as the knee pit, or poplit is a shallow depression located at the back of the knee joint. More often it is an incidental finding found on duplex ultrasonography. Modified prone position to dissect the popliteal fossa. Popliteal vessels tibial nerve comn peroneal nerve popliteal lymph nodes fat termination of short saph vn genicular br of post divn of obturator nerve post cut nerve of thigh before it becomes cutaneous sural communicating nerve popliteal fossa. Axial pd mri of the popliteal fossa demonstrating the characteristic. A strain of one or more of the distal hamstring tendons is the most likely culprit. However, not all are popliteal cysts and can be aggressive. After surgery, a gradually expanding mass recurred in his popliteal. Jan 15, 2014 a quick tutorial outlining the borders, contents and clinical relevance of the popliteal fossa. Softtissue sarcomas are a rare form of cancer, consisting of 2% of all malignancies. The popliteal fossa is bounded anteriorly by the knee joint, by the biceps femoris.
Popliteal pulse is the most challenging pulse to sense amongst all the peripheral pulses. The tibial nerve enters the popliteal fossa lateral to the popliteal artery and approximately in the middle of the fossa, it crosses the artery to its medial aspect and. He had a puncture wound by a nail 11 years ago and a gradually expanding mass occurred in his popliteal fossa. Applied anatomy for students and junior doctors 14th edition pdf free download. Pronunciation of popliteal fossa with 2 audio pronunciations, 1 meaning, 10 translations and more for popliteal fossa. The main mass of the buttock consists of a variable amount of fat and the gluteus maximus muscle. Popliteal fossa definition of popliteal fossa by medical.
It travels through the fossa inferolaterally before entering the posterior compartment of the leg. Ultrasound findings of popliteal artery entrapment and us. Pdf chronic expanding hematoma in the popliteal fossa after. Pierces the deep fascia and drains into the popliteal vein. This may produce a palpable pulsation, a thrill, or an abnormal arterial sound, a bruit. Exploratory surgery revealed an abnormal fibrous band between the heads of the gastrocnemius muscle that was compressing both the tibial nerve and popliteal artery.
Applied anatomy for students and junior doctors 14th edition pdf using our direct links mentioned at the end of this article. The bones of the popliteal fossa are the femur and the tibia. This region can develop many clinical complications in the vascular, nervous, lymphatics, adipose. Back of thigh and popliteal fossa it extends from lower part of gluteal region to back of knee joint up to popliteal fossa. A strain of the tendinous origins of one of the gastrocnemius heads may also be at fault. Chronic expanding hematoma in the popliteal fossa after pseudoaneurysm surgery because of nail puncture article pdf available in case reports in orthopedics 2014. It lies in between laterally lateral intermuscular septum and medially posterior intermuscular compartment which is incomplete. Any information contained in this pdf file is automatically generated from digital material submitted to epos by third parties in the form of scientific presentations. Initially, an sshaped incision is made to gain access to the popliteal fossa. A cystic mass in the popliteal fossa and its differential. Details are presented of nine cases of tibial nerve entrapment by the tendinous arch of origin of the soleus muscle.
Popliteal cysts are common and present as asymptomatic lumps in the medial popliteal fossa. Objectives demonstrate the effect of dynamic ankle plantar flexion and dorsiflexion on popliteal artery doppler waveforms in patients with clinically suspected fpaes and no structural abnormality. Pedunculated subcutaneous lipoma in the popliteal fossa. Popliteal fossa syndrome advanced therapy institute. The level of division of the sn sheath into tn and cpn above the knee was measured in 28 cadaver leg specimens. Describe the preliminary data comparing the ultrasound findings of fpaes to. The oblique popliteal ligament forms part of the floor of the popliteal fossa, and the popliteal artery rests upon it. The retained knife blade is a seldomreported injury with the majority of. We conclude that this technique, with a modified direction of the needle and a double stimulation, provides a very high rate of success for sn blockade in the popliteal fossa. Imaging features that suggest malignancy include large lesion size, presence of thick and enhancing septa, presence of nodular andor globular nonadipose areas and decreased percentage of fat. Healthtap does not provide medical advice, diagnosis, or treatment. Pdf anatomical approach to clinical problems of popliteal fossa. Deep vein thrombosis and bilateral pulmonary embolism. Pedunculated subcutaneous lipoma in the popliteal fossa causing eczema med j malaysia vol 70 no 1 february 2015 35 are nonencapsulated.
The cyst squeezes out toward the back part of the knee in the area called the popliteal fossa, the inden. Popliteal fossa syndrome the popliteal fossa syndrome is a pain syndrome of unknown cause or etiology. Chronic expanding hematoma in the popliteal fossa after. The popliteal fossa is a diamond shaped area found on the posterior side of the knee. Lateral approach to the sciatic nerve in the popliteal fossa. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Musculoskeletal and vascular pathology of the popliteal fossa poster no c1700 congress. A case of popliteal entrapment syndrome is reported, in which the patient experienced symptoms of tibial nerve entrapment. Ct angiogram of a small seroma in the right popliteal fossa taken prior to seroma biopsy and removal of the femoralpopliteal eptfe bypass graft. May 18, 2016 structures in roof of popliteal fossa 12. A pseudoaneurysm was detected and operated a year later. A cystic mass arising in the popliteal fossa can be either a meniscal cyst, a synovial cyst bakers cyst, or a ganglionic cyst. Few nodes just under the deep fascia embedded in the fatty connective tissue of popliteal fossa, close to the popliteal vessels drain the deep tissues of the leg,foot and knee joint efferents to the deep inguinal ln 14.
We present a rare case report of a 45yearold man with a large, painful swelling in his left popliteal fossa. Softtissue popliteal masses can be evaluated using physical examinations and imaging studies, such as computed tomography ct or magnetic resonance imaging mri. The popliteal fossa sometimes referred to as the hough, 1 or kneepit in analogy to the armpit is a shallow depression located at the back of the knee joint. Effective analgesia was obtained for a minimum of 15 h first analgesic demand. A patient afflicted with the popliteal fossa syndrome will complain of a great deal of pain behind that knee, usually describing it as a feeling of great pressure and swelling. Medically, popliteal aneurysm shows as a pulsatile midline swelling in the popliteal fossa. They present as swelling in the popliteal fossa due to enlargement of the gastrocnemiussemimembranosus bursa, which lies between these two muscles on the medial side of the fossa slightly distal to the center crease in the back of the knee. Musculoskeletal and vascular pathology of the popliteal fossa.
Ultrasound report of popliteal fossa showed lipomas. We report an adult male hockey player with no classic risk factors for dvt who presented with a dvt and bilateral pe following minor popliteal blunt trauma. Pathologies occurring within the popliteal fossa are of osseous, neruovascular, lymph, muscular and other mesenchymal origin, and the development is often related to the. Thorough understanding of the appearance and location of the popliteal fossa masses one can reach a specific differential diagnosis in the majority of cases. Alright, now in this part of the article, you will be able to access the free pdf download of clinical anatomy.
Popliteal venous pseudoaneurysm and arteriovenous fistula. Patient presented after an assault complaining of left knee pain and inability to flex his knee. Thorough understanding of the appearance and location of the popliteal fossa masses one can reach a specific differential diagnosis in the majority of. The space is extremely dynamic, allowing for its neurovascular contents to move during the extreme range of motion produced by knee flexion and extension. Popliteal fossa anatomy mnemonic radiology reference. Dec 14, 2012 lower limb anatomy popliteal fossa, dr g bhanu prakash duration. Popliteal fossa definition of popliteal fossa by the. The popliteal fossa or space is a lozengeshaped space, at the back of the kneejoint.
The extra fluid builds up and pushes through the back part of the joint capsule, forming a cyst. Popliteal artery entrapment anatomic screen to exclude anatomic paes before and after exercise. Popliteal fossa article about popliteal fossa by the. Pain in the popliteal fossa can also be due to a popliteal aneurysm, an abnormal dilation of the popliteal artery. Structures contained within the popliteal fossa include the popliteal artery, popliteal vein, tibial nerve, common peroneal nerve, lymph nodes. The division of the sciatic nerve in the popliteal fossa. We describe a new lateral approach to the sciatic nerve in the popliteal fossa. The sn was invariably formed of independent trunks. Popliteal lymph node dissection is performed when grossly metastatic nodal disease is encountered in the popliteal fossa or after microscopic metastasis is found in interval sentinel nodes during clinical staging of cutaneous malignant melanoma. We present a case of a 63yearold male who presented with a retained knife blade in the popliteal fossa. Popliteal fossa anatomy mnemonic assoc prof frank gaillard and dr mohammad taghi niknejad et al. The gluteal region, back of the thigh and popliteal fossa. Popliteal fossa definition of popliteal fossa by the free. In any anatomical area such as this, it is important to look at the borders, contents, and any clinical relevance.
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