Arterial Supply of the Posterior Thigh and Popliteal Fossa

00:02 Now let's move on to the posterior thigh and popliteal fossa.

00:06 So here we can have a look at the vascular supply of the posterior thigh.

00:10 We can see we've got the femoral artery here.

00:12 We see as branching off to give the deep femoral artery.

00:16 And here we can see a number of these perforating arteries.

00:19 Remember that first perforating artery will go up and form an anastomoses around the hip joint.

00:26 We can then see that last perforating artery is actually the terminal end of the deep artery of the thigh.

00:31 It doesn't continue any further into the leg region.

00:35 Here we're gonna see adductor magnus which has the femoral artery running alongside it.

00:39 And then we can remind ourselves if we look at the more posterior aspect.

00:43 Here we have those femoral arteries penetrating through adductor magnus to go and supply deep structures.

00:50 We can also see the inferior gluteal artery, which forms this an important anastomosis with those perforating arteries.

00:57 And we can also see here the popliteal artery, which can form an inferior anastomosis with these perforating arteries.

01:05 So we've got very important anastomotic loops around the thigh, and the hip joint helping to ensure their blood is appropriately distributed.

01:14 We can see these now all interconnected as we remind ourselves of the perforating arteries here.

01:20 This is the terminal end of the deep artery of the thigh.

01:23 And here we can see some anastomoses between these perforating arteries.

01:28 We can also see the popliteal artery is now in connection via these perforating arteries with the terminal end of that deep artery.

01:36 This anastomoses is really important to make sure that if there's any occlusions, somewhere along this pathway, there's redundancy in the system, so blood can find an alternative route.

01:47 If we have a look at the medial circumflex artery, which remember, is this branch that came off the deep artery of the thigh.

01:54 We can now see that it's got its descending branch, which is going to anastemose with this first perforating artery.

02:01 So we've got an additional connection here.

02:03 We've got the inferior gluteal artery, and this is also going to provide an anastomoses with the first perforating arteries.

02:10 And here we really appreciating this really complex picture, a number of arteries interconnected around the deep thigh around the hip joint.

02:20 Essentially meaning if there's an occlusion of the femoral artery, halfway down through the femoral artery, let's say.

02:26 If blood can already make its way into the deep artery of the site, then via these anastomoses and perforating arteries, it can find an old alternative route to paths into the popliteal artery.

02:38 So if the femoral artery is damaged halfway along its course, as long as the deep artery the thigh remains open, can still receive some blood, then although the blood is occluded through the femoral, it can pass through the deep artery of the thigh, and then ride these blood vessels, perforating branches can pass through the popliteal.

02:59 There's also the contribution of the inferior gluteal, the direct branch from the internal iliac artery that can support this and anastomotic system as well.

03:09 A really complicated anastomotic ring around the hip joint, the gluteal region and the thigh.

03:16 Now let's look at the popliteal artery.

03:19 We've spoken about the popliteal artery before, within the popliteal fossa.

03:23 Here we have the femoral artery passing through adductor hiatus and where that femoral artery then changes its name into the popliteal artery.

03:32 If we then return one of the upper borders of that superior triangle of the popliteal fossa, semimembranosus muscle, we can see the popliteal fossa here, with the popliteal artery sitting in the middle of it.

03:45 It's accompanied by its sibling, the popliteal vein.

03:50 Let's not forget that we're running alongside these structures, but taking a different course to get there.

03:54 We have the tibial nerve, and we have the common fibula nerve, and these are branching down from the sciatic.

04:02 So now let's remove some of these structures and have a look at the various blood supply within the popliteal fossa.

04:08 So here we're looking at the posterior knee, and we moved some of the soft structures around this space.

04:14 Here we can see the popliteal artery passing down within the popliteal fossa.

04:19 And then as it passes over popliteus, it's giving rise to the anterior tibial artery.

04:25 We can see its bifurcation also gives rise to the posterior tibial artery.

04:31 So as the popliteal artery descends, but it's not really the level of the condyles, we can see here, it gives rise to two superior genicular arteries - the medial and lateral versions.

04:43 Now as we have superior genicular arteries, we're also going to have inferior genicular arteries, and these are both named lateral and medial.

04:51 So four arteries that supply the joint capsule around the knee, superior medial, superior lateral, inferior, medial, and inferior lateral.

05:01 Four arteries coming off the popliteal that helped to supply the knee joint.