The pulse of the popliteal artery is difficult to feel as the artery is not superficial and does not cross a prominent bone. Its pulse may be palpated by various methods. All should be attempted before concluding that it is absent:
1) The knee is flexed to 135 degrees with the heel resting on the couch. The examiner's thumbs are placed on the tibial tuberosity and his fingers are placed over the lower part of the popliteal fossa. The examiner then attempts to catch the neurovascular bundle between his fingers by moving them from side to side - the bundle feels like a taut rubbery cord. The popliteal pulse can be felt when the bundle is pressed against the lower surface of the tibia.
2) The patient's leg is straight and lying on the couch. The examiner hyperextends the leg (gently) whilst placing one hand behind the knee with the finger tips along the midline of the popliteal fossa.
3) The patient lies prone. The examiner feels along the line of the artery with the finger tips of both hands.
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