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Popliteal Fossa

Contents

Introduction 

The popliteal fossa is a diamond-shaped depression located posterior to the knee joint. Important nerves and vessels pass from the thigh to the leg by traversing through this fossa and the muscles of the thigh and the leg form its boundaries. This article will discuss the anatomical structure and the contents of the popliteal fossa, followed by any relevant clinical pathology. 

Recommended video: Posterior muscles of the leg
Origins, insertions, innervation and functions of the superficial and deep flexors.

Boundaries

The superomedial aspect of the popliteal fossa is bounded by the semimembranosus and the semitendinosus muscles, whilst the biceps femoris forms the lateral border of the superior fossa.

Inferiorly, the medial and lateral heads of the gastrocnemius form the medial and lateral borders. The capsule of the knee joint, the distal femur and the proximal tibia form the floor of the popliteal fossa. More inferiorly, the popliteus muscle also forms the floor.

Popliteal fossa - dorsal view

The popliteal fascia, which is continuous with the fascia lata superiorly and the fascia crusis inferiorly, forms the roof of the fossa. This dense fascia is reinforced by transverse fibres and forms a protective sheath for the structures passing through the fossa.

The short saphenous vein and the sural nerve often pierce the fascia and are both important landmarks in surgery involving the posterior aspect of the knee joint. 

Nerves 

Common fibular nerve - dorsal viewThe popliteal fossa is 2.5 cm wide and mainly consists of fat tissue. There are many important neurovascular structures, however, which pass through the fossa. The nerves are the most superficial of these structures and include:

Tibial Nerve

The sciatic nerve bifurcates into the tibial and common fibular nerves at the superior angle of the popliteal fossa. The larger medial branch, the tibial nerve, passes through the fossa inferiorly, before it exits deep to the plantaris muscle and enters the posterior compartment of the leg. While in the fossa, the tibial nerve and its branches supply the soleus, gastrocnemius, plantaris and popliteus muscles. One of its branches, the medial sural cutaneous nerve, joins with the sural communicating branch of the common fibular nerve to form the sural nerve

Common Fibular Nerve

The other branch of the sciatic nerve, the common fibular nerve, traverses the fossa close to the medial border of the biceps femoris muscle before it exits the fossa superficial to the lateral head of the gastrocnemius muscle. It then crosses the posterior aspect of the head of the fibula before it winds around the neck of the fibula and divides into its terminal branches. 

Blood Vessels

Blood vessels are located deep to the nerves within the fossa and include the popliteal artery, the popliteal vein and the short saphenous vein. The short saphenous vein is located within the popliteal fascia and the popliteal vessels are held together by dense areolar tissue. 

Popliteal Artery

Popliteal artery - dorsal viewThe popliteal artery, a branch of the femoral artery, enters the popliteal fossa by passing under the semimembranosus muscle. It travels through the fossa inferolaterally before entering the posterior compartment of the leg. The popliteal artery branches off to form five genicular arteries, which supply the ligaments and capsule of the knee joint. These arteries include:

  • superior medial
  • superior lateral
  • middle
  • inferior medial
  • inferior lateral

These arteries anastomose to form the genicular anastomosis, a collateral circulation surrounding the knee joint. The popliteal artery also gives off muscular branches, which supply the soleus, gastrocnemius, plantaris and hamstring muscles

Popliteal Vein

The popliteal vein, a continuation of the posterior tibial vein, lies superficial to the popliteal artery within the same fibrous sheath. After it exits the fossa superiorly, it becomes the femoral vein as it passes through the adductor hiatus. 

Short Saphenous Vein

The short saphenous vein travels superiorly in the posterior aspect of the leg from the lateral part of the dorsal venous arch, before entering the popliteal fossa. It travels within the popliteal fascia before penetrating it and anastomosing with the popliteal vein

Lymph Nodes

Superficial

There are two main groups of lymph nodes located within the popliteal fossa: the superficial popliteal and the deep popliteal. The superficial popliteal lymph nodes lie within the subcutaneous tissue and receive lymph from the lymphatic vessels accompanying the short saphenous vein.

Superficial popliteal nodes

Deep

The deep popliteal lymph nodes surround the popliteal vessels and receive lymph from the superficial popliteal lymph nodes as well as from the leg and the foot. The lymph from these nodes then drains into the deep inguinal lymph nodes

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Show references

References:

  • K.L. Moore, A.F. Dalley, A.M.R. Agur: Clinically Oriented Anatomy, 5th Edition, Lippincott Williams & Wilkins (2006), p.632-6.
  • M. Schuenke, E. Schulte, U. Schumacher: General Anatomy And Musculoskeletal System (THIEME Atlas Of Anatomy) (2010), p.469.
  • S. Standring: Gray’s Anatomy The Anatomical Basis Of Clinical Practice, 40th Edition, Elsevier Health Sciences UK (2008), p.2533-34.
  • R.L. Drake, A. Wayne, A.W.M. Mitchell: Gray’s Anatomy For Students, 2nd Edition, Churchill Livingstone (2010), p.814-6.

Author, Review and Layout:

  • Charlotte O'Leary
  • Ryan Sixtus
  • Catarina Chaves

Illustrators

  • Popliteal fossa - dorsal view - Irina Münstermann
  • Common fibular nerve - dorsal view - Liene Znotina
  • Popliteal artery - dorsal view - Liene Znotina
  • Superficial popliteal nodes - Begoña Rodriguez
© Unless stated otherwise, all content, including illustrations are exclusive property of Kenhub GmbH, and are protected by German and international copyright laws. All rights reserved.

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