Popliteal Artery

Overview

The popliteal artery is a continuation of the superficial femoral artery as it exits the adductuor hiatus and enters the popliteal fossa. It is the primary supply of blood to the distal lower extremity.

Origin

Continuation of the superficial femoral artery as it passes into the popliteal fossa through the adductor canal at the junction of the middle and lower thirds of the thigh.

Course

• Descends as the deepest structure on the floor of the popliteal fossa, superficial to the popliteus muscle

Termination

• At the lower border of the popliteus, it divides into the anterior tibial and tibial-fibular (tibial-peroneal) trunk
• The tibial-fibular trunk divides to the posterior tibial artery and fibular trunk

Branches

• Anterior tibial artery – supplies the anterior compartment of the leg and dorsal surface of the foot
• Posterior tibial artery – supplies the posterior compartment of the leg
• Tibial-fibular trunk – the fibular artery typically arises from the posterior tibial artery
• Sural artery – medial and lateral branches, supplies structures within the popliteal fossa, gastrocnemius, soleus and plantaris muscle

Five genicular branches of the popliteal artery supply the capsule and ligaments of the knee joint, forming the periarticular genicular anastomoses.

• Superior medial and lateral genicular arteries – course around the femoral condyles. Supplies the knee joint, distal femur, muscles of the medial and lateral knee
• Inferior medial and lateral genicular arteries – course around the tibial condyles. Supplies the knee joint, muscles of the medial and lateral knee and proximal tibia
  • The inferior medial genicular artery anastomoses with the saphenous branch of the descending genicular artery (derived from the femoral artery before it enters the adductor canal).
• Middle genicular artery – pierces oblique popliteal muscle. Supplies the cruciate ligaments and synovial membrane of the knee

Additionally, there are other branches:

• Muscular branches – supply hamstrings, adductor magnus, and triceps surae
• Cutaneous branches – may arises directly from the popliteal artery or indirectly by the muscular branches. It supplies skin over knee joint

Relations

• Popliteal artery starts medial to tibial nerve and ends lateral to it; the popliteal vein always between the two
• Deep/anterior: popliteal surface of the femur (separated by fat), knee joint capsule, and popliteus
• Superficial/posterior: popliteal vein, tibial nerve (most superficial)
• Lateral:
  • Above: biceps femoris and lateral condyle of the femur
  • Below: plantaris and lateral head of the gastrocnemius
• Medial:
  • Above: semimembranosus and medial condyle of the femur
  • Below: medial head of the gastrocnemius

Development

• The vascular system derives from the mesoderm after about 17 days of gestation

Anatomical Variants

• Popliteal artery arising off a persistent sciatic artery

Variant branching pattern:

• Hypoplastic infrapopliteal vessels (i.e. posterior tibial artery and anterior tibial artery)
• Trifurcation (no tibioperoneal trunk)
• High bifurcation (above popliteus, normally bifurcates at lower border)
• High origin of anterior tibial artery
• High origin of posterior tibial artery
• Fibular artery arising off the anterior tibial artery
• Anterior tibiofibular trunk