Henry Gray (18251861). Anatomy of the Human Body. 1918.
The Perforating Arteries(Fig. 544), usually three in number, are so named because they perforate the tendon of the Adductor magnus to reach the back of the thigh. They pass backward close to the linea aspera of the femur under cover of small tendinous arches in the muscle. The first is given off above the Adductor brevis, the second in front of that muscle, and the third immediately below it.
The first perforating artery (a. perforans prima) passes backward between the Pectineus and Adductor brevis (sometimes it perforates the latter); it then pierces the Adductor magnus close to the linea aspera. It gives branches to the Adductores brevis and magnus, Biceps femoris, and Glutæus maximus, and anastomoses with the inferior gluteal, medial and lateral femoral circumflex and second perforating arteries.
The second perforating artery (a. perforans secunda), larger than the first, pierces the tendons of the Adductores brevis and magnus, and divides into ascending and descending branches, which supply the posterior femoral muscles, anastomosing with the first and third perforating. The second artery frequently arises in common with the first. The nutrient artery of the femur is usually given off from the second perforating artery; when two nutrient arteries exist, they usually spring from the first and third perforating vessels.
The third perforating artery (a. perforans tertia) is given off below the Adductor brevis; it pierces the Adductor magnus, and divides into branches which supply the posterior femoral muscles; anastomosing above with the higher perforating arteries, and below with the terminal branches of the profunda and the muscular branches of the popliteal. The nutrient artery of the femur may arise from this branch. The termination of the profunda artery, already described, is sometimes termed the fourth perforating artery.
Numerous muscular branchesarise from the profunda; some of these end in the Adductores, others pierce the Adductor magnus, give branches to the hamstrings, and anastomose with the medial femoral circumflex artery and with the superior muscular branches of the popliteal.
The highest genicular artery (a. genu suprema; anastomotica magna artery) (Fig. 550)arises from the femoral just before it passes through the opening in the tendon of the Adductor magnus, and immediately divides into a saphenous and a musculo-articular branch.
The saphenous branch pierces the aponeurotic covering of the adductor canal, and accompanies the saphenous nerve to the medial side of the knee. It passes between the Sartorius and Gracilis, and, piercing the fascia lata, is distributed to the integument of the upper and medial part of the leg, anastomosing with the medial inferior genicular artery.
The musculo-articular branch descends in the substance of the Vastus medialis, and in front of the tendon of the Adductor magnus, to the medial side of the knee, where it anastomoses with the medial superior genicular artery and anterior recurrent tibial artery. A branch from this vessel crosses above the patellar surface of the femur, forming an anastomotic arch with the lateral superior genicular artery, and supplying branches to the knee-joint.
6b. The Popliteal Fossa
Boundaries.The popliteal fossa(Fig. 551) or space is a lozenge-shaped space, at the back of the knee-joint. Laterally it is bounded by the Biceps femoris above, and by the Plantaris and the lateral head of the Gastrocnemius below; medially it is limited by the Semitendinous and Semimembranosus above, and by the medial head of the Gastrocnemius below. The floor is formed by the popliteal surface of the femur, the oblique popliteal ligament of the knee-joint, the upper end of the tibia, and the fascia covering the Popliteus; the fossa is covered in by the fascia lata.