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Blood Supply of the Lower Limb
Dr. Safaa Dr. Sama-ul-Haque
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Objectives
Describe femoral artery and its relations.
Enlist the branches of femoral artery.
Define the trochanteric and cruciate anastomosis.
Describe popliteal artery, its relations and branches.
Discuss the arterial anastomosis around the knee joint.
Discuss the anterior tibial artery, its relations and branches.
Define Dorsalis pedis artery.
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Objectives
Discuss the posterior tibial artery, its relations and branches.
Explain the formation of dorsal venous arch.
Describe the formation of great saphenous vein and enlist its
tributaries.
Discuss the formation of small saphenous vein and enlist its
tributaries.
Describe the formation of popliteal vein and femoral veins.
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Femoral Artery Enters thigh by passing behind inguinal ligament.
Continuation of External iliac artery.
Ends at the opening in the adductor Magnus
muscle and continuous as Popliteal artery.
Relations:
Anteriorly: Skin , Fascia and Sartorius
Posteriorly: Psoas Major
Laterally: Femoral Nerve
Medially: Femoral vein
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Relations of Femoral Artery
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Relations of Femoral Artery
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Branches:
Superficial circumflex iliac artery
Superficial epigastric artery
Superficial external pudendal artery
Deep external pudendal artery
Descending genicular artery
Femoral Artery
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Femoral Artery
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Femoral Artery
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Femoral Artery
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Trochanteric Anastomosis
Anastomosis between the branches of internal iliac
and femoral arteries.
Main supply to the head of Femur.
Branches forming anastomosis:
Superior gluteal artery
Inferior gluteal artery
Medial femoral circumflex artery
Lateral femoral circumflex artery
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Trochanteric Anastomosis
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Cruciate Anastomosis
Anastomosis between the branches of internal iliac
and femoral arteries.
Branches forming anastomosis:
Inferior gluteal artery
Medial femoral circumflex artery
Lateral femoral circumflex artery
First Perforating artery In occlusion of the proximal part of the femoral artery,
blood passes through the cruciate & trochanteric Anastomosis.
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Cruciate
Anastomosis
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Popliteal Artery
Continuation of Femoral artery.
Ends at the lower border of the Popliteus muscle by
dividing into Anterior and Posterior tibial arteries.
Relations:
Anteriorly: Popliteal surface of femur,
Knee joint & Popliteus muscle.
Posteriorly: Popliteal vein & Tibial nerve
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Popliteal Artery
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Relations of Popliteal Artery
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Branches of Popliteal Artery
Muscular branches
Articular branches
Terminal branches
Anterior tibial artery
Posterior tibial artery
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Anastomosis around Knee joint
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Anastomosis
around
Knee joint
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Anterior Tibial Artery
Smaller terminal branch of Popliteal
artery.
Lies on the anterior surface of interosseous
membrane.
In the upper part it lies deep to muscles of
anterior compartment.
In the lower part, it becomes superficial at
the lower end of the tibia.
Then it lies between the tendons of
extensor hallucis longus and extensor
digitorum longus.
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Anterior Tibial
Artery
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Anterior Tibial
Artery
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Anterior Tibial Artery
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Also called Dorsal artery of the foot.
Continuation of anterior Tibial artery.
Terminates by joining the lateral plantar artery and
completes the plantar arch.
On dorsum of the foot it lies between the tendons
of extensor hallucis longus and extensor digitorum
longus.
Its pulsation can be felt here.
Dorsalis Pedis Artery
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Dorsalis Pedis Artery
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Branches:
Lateral tarsal artery
Arcuate artery
Metatarsal branches
First dorsal metatarsal
artery
Dorsalis Pedis Artery
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Dorsalis Pedis Artery
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Posterior Tibial Artery Larger terminal branch of Popliteal
artery.
Lies deep to gastrocnemius and soleus
muscles.
In the lower part of the leg artery is only
covered by skin and fascia.
It passes behind medial malleolus and
terminates by dividing into Medial and
Lateral Plantar arteries.
Between the medial malleolus and heel,
its pulse can be felt.
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Posterior Tibial
Artery
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Posterior Tibial Artery
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Posterior Tibial Artery
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Posterior Tibial Artery
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Posterior Tibial
Artery
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Posterior Tibial
Artery
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Medial Plantar Artery
Smaller terminal branch of Posterior tibial artery.
Supply medial side of the big toe.
Branches:
Muscular
Cutaneous
Articular
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Medial Plantar Artery
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Lateral Plantar Artery
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Later Plantar Artery
and Plantar Arch
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Areas of Lower Limb Arteries Pulsation
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Veins of the Lower Limb
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Veins of the Lower Limb
Superficial veins
Lie in the superficial fascia
Having Thick muscular wall
Deep veins
Accompany the arteries
Having Thin muscular wall
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Superficial Veins of the Lower Limb Dorsal Venous Arch
Great Saphenous Vein
Small Saphenous Vein
Venae Comitantes
Popliteal Vein
Femoral Vein
Deep Veins of the Lower Limb
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Veins of the Lower Limb
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Superficial Veins of the Lower Limb
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Dorsal Venous Arch
Lies on the dorsum of the foot.
The blood from the whole foot drains into this arch
via digital veins and communicating veins.
Drains on the medial side into the Great Saphenous vein
Drains on the lateral side into the Small Saphenous vein
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Dorsal
Venous
Arch
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Great Saphenous vein
Longest vein in the body.
Drains medial side of the dorsum venous arch.
Passes upward in front of medial malleolus.
Then runs upward in superficial fascia over the medial
side of the leg.
Passes behind the knee and curves forward around the
medial side of the thigh.
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Great Saphenous vein
It contains 10-20 valves.
Connected to small saphenous vein behind knee.
Perforating veins connect the great saphenous vein with
the deep veins.
Passes through saphenous opening.
Finally drains into femoral vein
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Great
Saphenous
Vein
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Great
Saphenous
Vein
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Great
Saphenous
Vein
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Great Saphenous Vein
Tributaries:
Subcutaneous tributaries
Superficial circumflex iliac vein
Superficial epigastric vein
Superficial external pudendal vein
Accessory vein
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Tributaries of Great Saphenous Vein
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Perforating vein connecting great saphenous vein with a deep vein
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Small Saphenous vein
Drains lateral side of the dorsum venous arch.
Passes upward behind lateral malleolus.
Reaches middle of the back of leg.
Then it pierces deep fascia.
In the lower part of popliteal fossa ends in the popliteal
vein.
Contains numerous valves.
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Small Saphenous Vein
Tributaries: Numerous small veins from the back of the leg.
Communicating veins with deep veins of the foot.
Anastomotic branches that join the great saphenous
vein.
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Small Saphenous Vein
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Deep Veins of the Lower Limb
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Venae Comitantes Deep veins accompany the arteries are called venae
comitantes.
The deep plantar venous arch gives medial and lateral
plantar veins.
Medial and lateral plantar veins forms posterior tibial
vein behind the medial malleolus.
Peroneal vein drain into posterior tibial vein.
Venae comitantes of anterior and posterior tibial arteries
unite in the popliteal fossa to form the popliteal vein.
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Popliteal Vein
Formed by the venae comitantes of the anterior and
posterior tibial arteries.
Ends at the adductor hiatus and continuous upward
as Femoral vein.
Tributaries:
Veins accompany arteries.
Small saphenous vein.
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Popliteal
Vein
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Femoral Vein
Continuation of popliteal vein at adductor hiatus.
Enters in the intermediate compartment of femoral
sheath.
Then passes behind inguinal ligament and continuous as
External Iliac Vein.
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Femoral
Vein
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Femoral Vein
Tributaries:
Great saphenous vein
Tributaries corresponding to the perforating
branches of the profunda femoris artery.
Medial and lateral femoral circumflex veins.
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Femoral
Vein
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Varicose Veins
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Thank You