vessels of the lower extremity
TRANSCRIPT
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VESSELS OF THE
LOWER EXTREMITY
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Femoral Artery
Femoral artery is the continuation of theexternal iliac artery:
Begins deep to the inguinal ligament.Enclosed within the femoral sheath.Becomes the popliteal artery:
At the adductor hiatus.
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Femoral Artery
Proximal branches:Superficial epigastric artery.
Superficial circumflex iliac artery.Superficial external pudendal artery.
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Femoral Artery
Superficial epigastric artery:Passes through or close to the
saphenous hiatus.Crosses inguinal ligament toward the
umbilicus. Anastomoses with inferior epigastric
artery.
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Femoral Artery
Superficial circumflex iliac artery:Passes through or close to the
saphenous hiatus.Passes along inguinal ligament toward
the ASIS. Anastomoses with deep circumflex iliac
artery.
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Femoral Artery
Superficial external pudendal artery:Passes through or close to the
saphenous hiatus.Passes medially toward external
genitalia.
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Femoral Artery
Deep branches:Deep external pudendal.Descending genicular.Profunda femoris (deep femoral):
Medial femoral circumflex.Lateral femoral circumflex.
Perforating arteries (3).Descending genicular.
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Femoral Artery
Deep external pudendal:Passes medially across pectineus and
adductor longus.Becomes superficial to supply external
genitalia.
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Femoral Artery
Descending genicular: Arises in adductor canal.Musculoarticular branch:
Part of genicular anastomosis.Saphenous branch:
Runs with saphenous nerve.
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Femoral Artery
Profunda femoris (deep femoral): Arises from deep side of femoral artery
within femoral triangle.Largest branch of femoral artery.Passes posterior to adductor longus
muscle.
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Femoral Artery
Profunda femoris (deep femoral):Usually gives off medial and lateral femoralcircumflex arteries.Gives rise to three perforating arteries.Terminates as the fourth perforating artery.
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Femoral Artery
Medial femoral circumflex:
May come directly off femoral artery.
Leaves femoral triangle between theiliopsoas and pectineus muscles.
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Femoral Artery
Medial femoral circumflex branches: Ascending branch anastomoses withinferior gluteal artery.Transverse branch anastomoses withlateral femoral circumflex artery.Supplies hip joint, muscles of upper thigh,gluteal region.
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Femoral Artery
Lateral femoral circumflex branches: Ascending branch anastomoses withsuperior gluteal artery.Transverse branch anastomoses withmedial femoral circumflex artery.Descending branch anastomoses withgenicular arteries.Supplies hip joint, muscles of upper thigh,gluteal region.
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Cruciate Anastomosis
Joins internal iliac to femoral:Bypass for femoral or external iliac arteries.
Includes branches from:Medial femoral circumflex.Lateral femoral circumflex.
Inferior gluteal artery.First perforating artery.
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Popliteal Artery
Continuation of femoral artery.Begins at adductor hiatus.Ends at inferior border of popliteusmuscle:
Branches into anterior and posteriortibial arteries.
Most anterior structure in popliteal fossa.
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Popliteal Artery
Branches:Medial and lateral superior geniculararteries.
Medial and lateral inferior genicular arteries.Middle genicular artery and sural arteries.
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Popliteal Artery(imp)
At the lower end ofthe popliteus muscle ,it divides into:Anterior tibial artery
Posterior tibial arterywhich gives the peroneal artery
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Anterior Tibial Artery
Terminal branch of popliteal artery: Arises at inferior border of popliteus muscle.Passes anterior to interosseousmembrane between tibia and fibula.
Accompanied by deep peroneal (fibular)nerve.
Renamed dorsalis pedis artery at ankle joint. OR It continues as Drorsalis PedisArtery
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Anterior Tibial Artery
Supplies anterior compartment of leg.Branches:
Anterior tibial recurrent.Lateral malleolar artery.Medial malleolar artery.
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Dorsalis Pedis Artery
Medial tarsal artery.Lateral tarsal artery.
Arcuate artery.Deep plantar artery.First dorsal interosseous artery.
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Posterior Tibial Artery
Terminal branch of popliteal artery.Begins at inferior border of popliteusmuscle.
Accompanied by tibial nerve.Descends on posterior surface of tibialisposterior muscle.
It supplies all structures in theposterior and lateral compartment ofthe leg (IMP)
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Posterior Tibial Artery
It runs behind and inferior to lateralmalleolus
Terminates deep to flexor retinaculum as:Medial and Lateral plantar branches
It gives the following branches on itsway:Peroneal artery which gives lateral
malleolar and calcaneal branches
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Plantar Arteries
The posterior tibial artery dividesinto:Lateral plantarMedial plantar artery which givesthe first plantar metatarsal arteryDeep plantar arch is formed by thedeep plantar branch of dorsalispedis artery and lateral plantarartery
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Anastomosis around the Knee Joint
Is made by the followingbranches:Descending branch oflateral circumflex femoralDescending genicular offemoralAnterior tibial recurrentFive branches of poplitealartery
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Anastomosis around the Ankle Joint
Is formed by the followingbranches:
Calcanean branches ofposterior tibial and peronealarteriesMedial and lateral malleolar
branches of anterior tibialartery
Malleolar branches ofposterior tibial and peronealarteries
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Lower Limb Venous Drainage
Superficial Veins:Great saphenous:
Drains medial side of dorsal venousarch.
Ascends anterior to medial malleolus.Passes posterior to medial border ofpatella.
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Lower Limb Venous Drainage
Superficial Veins:Great saphenous:
Ascends along medial thigh.Penetrates deep fascia of femoral triangle:
Cribriform fascia.Saphenous opening.
Dumps into femoral vein.
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Lower Limb Venous Drainage
Superficial Veins:Lesser saphenous:
Drains lateral side of dorsal venous arch.
Passes posterior to lateral malleolus. Accompanies sural nerve. Ascends along midline of calf.Empties into popliteal vein in popliteal
fossa.
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Lower Limb Venous Drainage
Deep Veins:Popliteal vein:
Passes through adductor hiatus.
Renamed femoral vein.Communicating veins.
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Lower Limb Lymphatics
Lymphatics draining medial foot: Ascend with great saphenous vein.End in superficial inguinal lymph nodes:
Also drain lower abdominal wall, externalgenitalia, perineum, anal region, uterinefundus.
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Lower Limb Lymphatics
Lymphatics draining lateral foot: Ascend with small saphenous vein.End in lymph nodes in popliteal fossa.
Ascend with femoral vein to deep inguinalnodes.
Drainage pathway:Superficial inguinal to deep inguinal toexternal iliacs.