Neurovascular supply of the knee

 

Neurovascular supply of the knee

Blood supply

The main supply of blood to the knee is the popliteal artery which is a continuation of the femoral artery. Popliteal artery starts at the adductor hiatus. It passes inferiolaterally through the fossa and ends at the popliteus where it divides into anterior and posterior tibial arteries. It is the closest structure to the joint capsule. It gives five branches called the genicular arteries which supply the ligaments and capsule of knee joint.

The branches are the superior lateral, superior medial, inferior lateral, inferior medial and middle. They form the periarticular genicular anastomosis which surround the knee and enable the blood to flow even when the knee is fully flexed. It also supplies the gastrocnemius, soleus and plantaris.

The popliteal vein starts at the distal border of popliteus as a continuation of the posterior tibial vein. Throughout its course it lies next to the popliteal artery and superficial to it in the same fibrous sheath. It runs posteromedially to the artery and lateral to the tibial nerve.

Nerves

The sciatic nerve ends at the superior angle of the popliteal fossa by dividing into the common peroneal and tibial nerves. The tibial nerve is the medial and big branch of the sciatic nerve derived from the anterial/preaxial division of the L4-S3 spinal nerves. It is the most superficial of the main structures of the pop fossa. It bisects the pop fossa as it runs from the superior to the inferior angle. It innervates the soleus, gastrocnemius, plantaris and popliteus muscles. The medial sural cutaneous is derived from the tibial nerve from the pop fossa and is joined by the sural communicating branch of the common peroneal nerve.

The common fibular nerve is the lateral smaller branch of the sciatic nerve derived from the posterior division of L4-S2 spinal nerves. It starts at the superior angle of the pop fossa and follows closely the medial border of the biceps femoris along the superolateral border of the pop fossa. It leaves the fossa by passing superficial to the lateral head of gastrocnemius and then passes over the posterior aspect of the head of fibula. It then wounds around the fibular neck and divides into its terminal branches.

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~ by pcl4 on September 25, 2008.

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