Popliteal Artery
course
• As it continues down,
it runs across the popliteal fossa,
posterior to the knee joint.
• The popliteal artery passes obliquely
through the popliteal fossa
n then travels between
the gastrocnemius and popliteal muscles
of the posterior compartment of the leg.
• The popliteal artery is the continuation of the
femoral artery
that begins at the level of the adductor hiatus
in the adductor magnus muscle
of the thigh.
• It then continues into the deep part
of the posterior compartment of the leg,
passing under the tendinous arch between
the two heads of the gastrocnemius
and immediately bifurcates into
-the anterior
-and posterior tibial arteries.
• The popliteal artery is the deepest vascular structure of the popliteal fossa,
running closely to the knee’s capsule.
branches
• The popliteal artery is the major contributor to the
blood supply of the knee joint. Despite its short
course, the popliteal artery has several branches:
- Anterior tibial artery
- Posterior tibial artery
- Sural artery
- Superior lateral genicular artery
- Superior medial genicular artery
- Middle genicular artery
- Inferior lateral genicular artery
- Inferior medial genicular artery
Anterior Tibial Artery
sural artery
• The sural arteries are large vessels that arise on
each side of the popliteal artery to
suppply
- gastrocnemius,
- soleus
- and plantaris muscle.
course
• originates - from the popliteal artery
near the inferior border of the popliteus muscle.
• In the posterior compartment of the leg, the
anterior tibial artery runs anteriorly
between the heads of the tibialis posterior muscle.
• It then passes through the oval aperture in the
proximal part of the interosseous membrane
and runs medial to the fibular neck, emerging
on the anterior compartment of the leg.
• From here, it descends vertically down the
anterior aspect of the interosseous membrane
towards the distal tibia.
• Upon reaching the ankle joint, it terminates at
the anterior surface of the tibia midway
between the medial and lateral malleoli, and is
continued by the dorsalis pedis artery.
Branches and Supply
1.Posterior recurrent tibial artery:
course
• Arises from the anterior tibial artery soon after
its origin, while it is still in the posterior
compartment of the leg.
• The posterior recurrent tibial artery courses
superiorly, anterior to the popliteus muscle.
• It anastomoses with the inferior genicular
branches of the popliteal artery.
supply
- the superior tibiofibular joint.
2.Anterior recurrent tibial artery:
• Arises near the origin of the posterior recurrent
tibial artery and shortly after, it pierces the
tibialis anterior muscle.
• It gives off several branches anterior and lateral
to the knee joint which anastomose with the
genicular branches of the popliteal and
circumflex fibular arteries, forming the patellar
arterial network.
3.Muscular branches:
Arise as multiple branches that supply
- the muscles of the anterior compartment.
- Some of these branches pierce the deep fascia
and supply the skin of the anterior leg, - others pass through the interosseous membrane
and anastomose with branches of the posterior
tibial and fibular (peroneal) arteries.
4.Perforating branches:
Pass behind the extensor digitorum longus
muscle,
piercing the deep fascia and
- supplying the skin of the anterior leg.
5.Anterior medial malleolar artery:
6.Anterior lateral malleolar artery:
• Arises approximately 5 cm proximal to the ankle
joint and courses posterior to the tendons of
the extensor hallucis longus
and tibialis anterior muscle.
• Upon reaching the medial side of the ankle, it
gives off branches to supply the joint, which
anastomose with branches of the posterior
tibial and medial plantar arteries.
• Courses posterior to the tendons of extensor
digitorum longus and fibularis tertius muscles
towards the lateral side of the ankle.
• Here, it gives off branches that supply the joint
and anastomose with the perforating branch of
the fibular (peroneal) artery, and the ascending
branches of the lateral tarsal artery.
Posterior tibial artery
course
• The posterior tibial artery arises between the
tibia and fibula at the level of the lower margin
of the popliteus muscle.
• It takes an inferomedial course, descending
through the flexor compartment of the leg.
• The artery enters the foot by passing inferiorly
to the medial malleolus.
• Midway between the malleolus and the tubercle
of calcaneus, it ends by splitting into the lateral
and medial plantar arteries.
Branches and Supply
1.The circumflex fibular artery
arises immediately after the
posterior tibial artery origin.
It surrounds the neck of fibula and
anastomoses with the inferior medial and
lateral genicular and
anterior tibial recurrent arteries.
2.The nutrient artery of tibia
arises distally to the circumflex fibular artery.
It enters the tibia below the soleal line, being the
`3.The muscular branches
stem serially from the
trunk of the artery and supplies
supplies
- soleus muscle and the
- deep flexors of the leg;
-popliteus, - flexor hallucis longus,
-flexor digitorum longus
-and tibialis posterior.
supplies
main vessel
that supplies tibia
supplies
proximal end of fibula.
4.The perforating branches
arise between the soleus and
flexor digitorum longus muscle.
There are usually 5 of them, each dividing
into anterior and posterior divisions that
together supply:
supply
the skin and fascia of the
posterior leg.
5.The communicating branch
emerges above the
distal end of tibia deep to flexor hallucis longus
muscle. It anastomoses with the communicating
branch of the fibular artery.
6.The medial malleolar branches
surround the
medial malleolus and contribute to the medial
malleolar vascular network
supply
the skin of this area.
7.The calcaneal branches
arise just proximally to
the terminal bifurcation of the posterior tibial
artery.They anastomose
with medial malleolar arteries and calcaneal
branches of the fibular artery.
They perforate the flexor retinaculum
and supply
supply
supply the
- skin over the calcaneal tendon
- and calcaneus,
- and the muscles of the medial
part of the sole of the foot.
Genicular Arteries
• The popliteal artery gives off 5 genicular
branches that contribute to the periarticular
genicular anastamosis that supply
the knee joint capsule and ligaments.
• The superior lateral and medial genicular
arteries arise from the popliteal artery and
curve around their respective femoral condyles,
supplying
- the bone of the femoral condyles,
- the adjacent synovium of the knee joint
- and the superior part of the patella.
• The single and smaller middle genicular artery
branches off the popliteal artery behind the
distal femoral intercondylar region where it
runs anteriorly and penetrates the posterior
part of the knee joint capsule.
• It supplies the
- posterior cruciate ligament,
- the posterior part of the anterior cruciate ligament
- and the posterior aspects of the menisci.
• The inferior lateral and medial genicular
arteries branch off the popliteal artery and run
around the tibial condyles, deep to the
collateral ligaments of the knee.
• These arteries supply the
- adjacent areas including the joint capsule
of the knee, - the collateral ligaments and tendons,
- the anterior part of the anterior cruciate ligament
- and the inferior part of the patella.
Clinical Notes
Popliteal pulse
• Although the popliteal artery is difficult to
palpate, a popliteal pulse can be felt.
• The pulsing of the popliteal artery can then be
felt at the inferior aspect of the popliteal fossa.
• This is important since a weak or absent
popliteal pulse may indicate obstruction of the
femoral artery and vascular compromise.
Popliteal artery hemorrhage
• Following knee dislocation, there is a high
chance that the popliteal artery may become
damaged due to its close proximity to the joint.
• When the knee is dislocated, it can stretch the
popliteal artery causing it to contuse, tear,
rupture or break completely.
• This can then lead to damage of the popliteal
vein and, furthermore, damage to the calf
muscles.
Popliteal artery entrapment syndrome (PAES)
• The popliteal artery runs between the two
heads of the gastrocnemius muscle of the leg.
Any variations that occur here can lead to
intermittent claudication during muscle
contraction.
• This leads to repetitive trauma to the popliteal
artery which in turn may result in arterial
thrombosis and thromboembolism or formation
of aneurysms.
• The popliteal artery entrapment syndrome can
be classified based on what caused the
popliteal artery to become compressed.
• Types 1 and 4 are due to abnormalities in the
course of the popliteal artery, while types 2
and 3 are due to an abnormal insertion of the
medial head of the gastrocnemius muscle.
• Type 5 is entrapment of both the popliteal
artery and popliteal vein whereas type 6 is
compression of the popliteal artery during leg
movements but in the absence of any anatomic
abnormality.
• Treatment involves surgically releasing the
popliteal artery by myotomy (removal of
muscle) of either the medial or lateral head of
the gastrocnemius.