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Body Surface

The primary surface landmarks of the popliteal fossa and posterior leg are associated with the femur (medial and lateral condyles, and epicondyles), tibia (medial and lateral condyles, and medial malleolus), fibula (head and lateral malleolus), calcaneus (tuberosity) and calcaneal tendon. The skin overlying the popliteal fossa and posterior leg is innervated by the saphenous, posterior cutaneous of thigh, sural, lateral cutaneous of calf and medial calcaneal branches of the tibial nerve.

Skeleton and Joints

The bones and joints associated with the popliteal fossa and posterior leg are the femur, patella and tibia articulating at the knee joint, the tibia, fibula and talus articulating at the ankle joint and the tarsals, metatarsals and phalanges articulating at the joints of the foot. The knee joint moves in flexion/extension, and slight medial and lateral rotation (locking and unlocking knee with flexion/extension). The ankle joint moves in dorsiflexion and plantar flexion. The joints of the foot move in inversion/eversion. The phalanges move in abduction/adduction, and flexion/extension.

Fascial Organization

The deep fascia of the leg is continuous with the fascia lata and subdivides the leg into anterior, lateral and posterior compartments. It is very thick anteriorly where it forms attachements for the underlying muscles. There are anterior and posterior intermuscular septa that extend from the deep fascia to the fibula. The anterior intermuscular septum separates the anterior and lateral compartments. The posterior intermuscular septum separates the lateral and posterior compartments. A dense fibrous band, the interosseous membrane, separates the anterior and posterior compartments. A transverse intermuscular septum separates the superficial and deep muscles of the posterior compartment.

The flexor retinaculum is a thickening of the deep fascia in the region of the tibiotalar joint that stabalizes the tendons of the tibialis posterior, flexor digitorum longus and flexor hallucis longus muscles.

Muscles

There are superficial and deep muscles in the posterior compartment of the leg. The superficial muscles are active in flexion of the knee ( gastrocnemius) and plantar flexion of the ankle (gastrocnemius, plantaris and soleus). The deep muscles are active in medial rotation of the tibia during knee flexion ( popliteus), plantar flexion of the ankle ( tibialis posterior, flexor digitorum longus and flexor hallucis longus), inversion of the foot (tibialis posterior), flexion of the 1st toe (flexor hallucis longus) and flexion of the 2nd to 5th toes.

Innervation

Branches of the tibial nerve innervate the muscles of the posterior compartment of the leg.

Blood Supply

The genicular branches of the popliteal artery supply the popliteal fossa. Branches of the posterior tibialand fibular (peroneal) arteries supply the muscles of the posterior compartment of the leg.

Anatomical Spaces or Features

The popliteal fossa is the soft tissue region posterior to the knee joint bounded laterally by the biceps femoris, plantaris and lateral head of the gastrocnemius, and medially by the semitendinosus, semimembranousus and medial head of the gastrocnemius. The popliteus muscle lies in the floor of the fossa and the fossa is bounded posteriorly by the popliteal fascia. The popliteal fossa is traversed by the popliteal artery and vein, and the tibial and common peroneal nerves.

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