vessels of the lower extremity. femoral artery femoral artery is the continuation of the external...

VESSELS OF THE VESSELS OF THE LOWER EXTREMITYLOWER EXTREMITY

Femoral ArteryFemoral Artery

Femoral artery is the continuation of the Femoral artery is the continuation of the external iliac artery:external iliac artery:

Begins deep to the inguinal ligament.Begins deep to the inguinal ligament.

Enclosed within the femoral sheath.Enclosed within the femoral sheath.

Becomes the popliteal artery:Becomes the popliteal artery:

At the adductor hiatus.At the adductor hiatus.


Proximal branches:Proximal branches:

Superficial epigastric artery.Superficial epigastric artery.

Superficial circumflex iliac artery.Superficial circumflex iliac artery.

Superficial external pudendal artery.Superficial external pudendal artery.


Superficial epigastric artery:Superficial epigastric artery:

Passes through or close to the Passes through or close to the saphenous hiatus.saphenous hiatus.

Crosses inguinal ligament toward the Crosses inguinal ligament toward the umbilicus.umbilicus.

Anastomoses with inferior epigastric Anastomoses with inferior epigastric artery.artery.


Superficial circumflex iliac artery:Superficial circumflex iliac artery:


Passes along inguinal ligament toward Passes along inguinal ligament toward the ASIS.the ASIS.

Anastomoses with deep circumflex iliac Anastomoses with deep circumflex iliac artery.artery.


Superficial external pudendal artery:Superficial external pudendal artery:


Passes medially toward external Passes medially toward external genitalia.genitalia.


Deep branches:Deep branches:Deep external pudendal.Deep external pudendal.

Descending genicular.Descending genicular.Profunda femoris (deep femoral):Profunda femoris (deep femoral):

Medial femoral circumflex.Medial femoral circumflex.Lateral femoral circumflex.Lateral femoral circumflex.Perforating arteries (3).Perforating arteries (3).Descending genicular.Descending genicular.


Deep external pudendal:Deep external pudendal:

Passes medially across pectineus and Passes medially across pectineus and adductor longus.adductor longus.

Becomes superficial to supply external Becomes superficial to supply external genitalia.genitalia.


Descending genicular:Descending genicular:

Arises in adductor canal.Arises in adductor canal.

Musculoarticular branch:Musculoarticular branch:

Part of genicular anastomosis.Part of genicular anastomosis.

Saphenous branch:Saphenous branch:

Runs with saphenous nerve.Runs with saphenous nerve.


Profunda femoris (deep femoral):Profunda femoris (deep femoral):Arises from deep side of femoral artery Arises from deep side of femoral artery

within femoral triangle.within femoral triangle.Largest branch of femoral artery.Largest branch of femoral artery.Passes posterior to adductor longus Passes posterior to adductor longus

muscle.muscle.


Profunda femoris (deep femoral):Profunda femoris (deep femoral):Usually gives off medial and lateral femoral Usually gives off medial and lateral femoral circumflex arteries.circumflex arteries.Gives rise to three perforating arteries.Gives rise to three perforating arteries.Terminates as the fourth perforating artery.Terminates as the fourth perforating artery.


Medial femoral circumflex:Medial femoral circumflex:

May come directly off femoral artery.May come directly off femoral artery.

Leaves femoral triangle between the Leaves femoral triangle between the iliopsoas and pectineus muscles.iliopsoas and pectineus muscles.


Medial femoral circumflex branches:Medial femoral circumflex branches:Ascending branch anastomoses with Ascending branch anastomoses with inferior gluteal artery.inferior gluteal artery.

Transverse branch anastomoses with Transverse branch anastomoses with lateral femoral circumflex artery.lateral femoral circumflex artery.

Supplies hip joint, muscles of upper thigh, Supplies hip joint, muscles of upper thigh, gluteal region.gluteal region.


Lateral femoral circumflex:Lateral femoral circumflex:May come directly off femoral artery.May come directly off femoral artery.Passes laterally deep to rectus femoris Passes laterally deep to rectus femoris

andand sartorius muscles.sartorius muscles.


Lateral femoral circumflex branches:Lateral femoral circumflex branches:Ascending branch anastomoses with Ascending branch anastomoses with

superior gluteal artery.superior gluteal artery.Transverse branch anastomoses with Transverse branch anastomoses with medial femoral circumflex artery.medial femoral circumflex artery.Descending branch anastomoses with Descending branch anastomoses with genicular arteries.genicular arteries.Supplies hip joint, muscles of upper thigh, Supplies hip joint, muscles of upper thigh, gluteal region.gluteal region.

Cruciate AnastomosisCruciate Anastomosis

Joins internal iliac to femoral:Joins internal iliac to femoral:

Bypass for femoral or external iliac Bypass for femoral or external iliac arteries.arteries.

Includes branches from:Includes branches from:

Medial femoral circumflex.Medial femoral circumflex.

Lateral femoral circumflex.Lateral femoral circumflex.

Inferior gluteal artery.Inferior gluteal artery.

First perforating artery.First perforating artery.

Obturator ArteryObturator Artery

Arises from internal iliac in pelvis:Arises from internal iliac in pelvis:Enters thigh through obturator canal.Enters thigh through obturator canal.

Accompanied by anterior/posterior Accompanied by anterior/posterior obturator obturator nerve branches.nerve branches.

Gives rise to:Gives rise to:Anterior and posterior branches.Anterior and posterior branches.

Acetabular artery:Acetabular artery:To head of femur via ligamentum teres.To head of femur via ligamentum teres.

Popliteal ArteryPopliteal Artery

Continuation of femoral artery.Continuation of femoral artery.Begins at adductor hiatus.Begins at adductor hiatus.Ends at inferior border of popliteus Ends at inferior border of popliteus

muscle:muscle:Branches into anterior and posterior Branches into anterior and posterior

tibial arteries.tibial arteries.Most anterior structure in popliteal fossa.Most anterior structure in popliteal fossa.

Popliteal ArteryPopliteal Artery

Branches:Branches:Medial and lateral superior genicular Medial and lateral superior genicular

arteries.arteries.Medial and lateral inferior genicular Medial and lateral inferior genicular

arteries.arteries.Middle genicular artery and sural arteries.Middle genicular artery and sural arteries.

Genicular AnastomosisGenicular Anastomosis

Contributors:Contributors:

Genicular branches of popliteal Genicular branches of popliteal artery.artery.

Descending branches of femoral and Descending branches of femoral and deep femoral arteries.deep femoral arteries.

Ascending branches of anterior and Ascending branches of anterior and posterior tibial arteries.posterior tibial arteries.

Anterior Tibial ArteryAnterior Tibial Artery

Terminal branch of popliteal artery:Terminal branch of popliteal artery:Arises at inferior border of popliteus muscle.Arises at inferior border of popliteus muscle.

Passes anterior to interosseous Passes anterior to interosseous membrane between tibia and fibula.membrane between tibia and fibula.

Accompanied by deep peroneal (fibular) Accompanied by deep peroneal (fibular) nerve.nerve.

Renamed dorsalis pedis artery at ankle Renamed dorsalis pedis artery at ankle joint.joint.

Anterior Tibial ArteryAnterior Tibial Artery

Supplies anterior compartment of leg.Supplies anterior compartment of leg.Branches:Branches:

Anterior tibial recurrent.Anterior tibial recurrent.

Lateral malleolar artery.Lateral malleolar artery.

Medial malleolar artery.Medial malleolar artery.

Dorsalis Pedis ArteryDorsalis Pedis Artery

Medial tarsal artery.Medial tarsal artery.Lateral tarsal artery.Lateral tarsal artery.Arcuate artery.Arcuate artery.Deep plantar artery.Deep plantar artery.First dorsal interosseous artery.First dorsal interosseous artery.

Posterior Tibial ArteryPosterior Tibial Artery

Terminal branch of popliteal artery.Terminal branch of popliteal artery.Begins at inferior border of popliteus Begins at inferior border of popliteus

muscle.muscle.Accompanied by tibial nerve.Accompanied by tibial nerve.Descends on posterior surface of tibialis Descends on posterior surface of tibialis

posterior muscle.posterior muscle.

Posterior Tibial ArteryPosterior Tibial Artery

Terminates deep to flexor retinaculum as:Terminates deep to flexor retinaculum as:Medial plantar artery.Medial plantar artery.Lateral plantar artery.Lateral plantar artery.

Lower Limb Venous DrainageLower Limb Venous Drainage

Superficial Veins:Superficial Veins:Great saphenous:Great saphenous:

Drains medial side of dorsal venous Drains medial side of dorsal venous arch.arch.Ascends anterior to medial malleolus.Ascends anterior to medial malleolus.Passes posterior to medial border of Passes posterior to medial border of patella.patella.


Superficial Veins:Superficial Veins:Great saphenous:Great saphenous:

Ascends along medial thigh.Ascends along medial thigh.Penetrates deep fascia of femoral triangle:Penetrates deep fascia of femoral triangle:

Cribriform fascia.Cribriform fascia.Saphenous opening.Saphenous opening.

Dumps into femoral vein.Dumps into femoral vein.


Superficial Veins:Superficial Veins:Lesser saphenous:Lesser saphenous:

Drains lateral side of dorsal venous arch.Drains lateral side of dorsal venous arch.Passes posterior to lateral malleolus.Passes posterior to lateral malleolus.Accompanies sural nerve.Accompanies sural nerve.Ascends along midline of calf.Ascends along midline of calf.Empties into popliteal vein in popliteal Empties into popliteal vein in popliteal fossa.fossa.


Deep Veins:Deep Veins:Venae comitantes:Venae comitantes:

Accompany deep arteries of the leg.Accompany deep arteries of the leg.

Unite to form popliteal vein in popliteal Unite to form popliteal vein in popliteal space.space.


Deep Veins:Deep Veins:Popliteal vein:Popliteal vein:

Passes through adductor hiatus.Passes through adductor hiatus.

Renamed femoral vein.Renamed femoral vein.

Communicating veins.Communicating veins.

Lower Limb LymphaticsLower Limb Lymphatics

Lymphatics draining medial foot:Lymphatics draining medial foot:

Ascend with great saphenous vein.Ascend with great saphenous vein.

End in superficial inguinal lymph nodes:End in superficial inguinal lymph nodes:Also drain lower abdominal wall, external Also drain lower abdominal wall, external genitalia, perineum, anal region, uterine genitalia, perineum, anal region, uterine fundus.fundus.

Lower Limb LymphaticsLower Limb Lymphatics

Lymphatics draining lateral foot:Lymphatics draining lateral foot:Ascend with small saphenous vein.Ascend with small saphenous vein.

End in lymph nodes in popliteal fossa.End in lymph nodes in popliteal fossa.

Ascend with femoral vein to deep inguinal Ascend with femoral vein to deep inguinal nodes.nodes.

Drainage pathway:Drainage pathway:Superficial inguinal to deep inguinal to Superficial inguinal to deep inguinal to

external iliacs.external iliacs.

vessels of the lower extremity. femoral artery femoral artery is the continuation of the external...

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