l14-Arteries of the Lower Limb-done - Copy

8/10/2019 l14-Arteries of the Lower Limb-done - Copy

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ARTERIES AND VEINS OF

THE LOWER LIMB



Major Blood Vessels of the Lower Limb



FEMORAL ARTERY

- Chief arterial supply of the lower limb

- Continuation of external iliac artery

- Enters the thigh by passing behind theinguinal ligaments

- Ends at the opening in the adductor

magnus muscle- Continues as popliteal artery



• Femoral Artery (1)

• External pudendal (2)

• Superficial iliac circumflex (3)

• Medial femoral circumflex (4)

• Lateral femoral circumflex (5)

• Profunda femoris (6): 3 perforating

• branches (6a-6c)

• Superior (highest) genicular (7)

•



Femoral Triangle



RELATIONS

• Anterioly – skin and superficial fascia

- superficial inguinal lymph

nodes

- fascia lata

- anterior layer of femoral sheath

- medial cutaenous nerve of thethigh

- saphenous nerve



RELATIONS

• Posteriorly – posterior layer of femoral sheath

- pectenous muscle

- psoas muscle

- adductor longus

• Laterally – femoral nerve

- nerve to vastus medialis

- saphenous nerve

• Medially – femoral vein



BRANCHES OF THE FEMORAL

ARTERY1.Superficial circumflex iliac artery

2.Superficial external pudendal artery

3.Deep external pudendal artery

4.Profunda femoris artery

5.Muscular branches to sartorius, vastus medialis andadductor muscles

6.Descending genicular artery

7.Articular branches to anastomosis around the knee joint

8.Saphneous branch

9.Superficial epigastric artery.



POPLITEAL ARTERY

• Continuation of the femoral artery

• Deeply placed in the popliteal fossa

•

Enters the fossa by passing through theopening in the adductor magnus

• Ends at the lower border of popliteus

muscle by dividing into anterior andposterior tibial arteries



RELATIONS

Anterior – from proximal to distal,it lies against

a.Fat on the posterior surface of femur

b.Fibrous capsule of the knee joint

c.Popliteal fossa

Posterior – a.semimembranous muscles

b.popliteal vein

c. tibial nerve

d.gastronemius and plantaris muscles



RELATIONS

Lateralabove a.biceps

b.tibial nerve

c.popliteal vein

d.lateral condyle of femurbelow a.plantaris

b.lateral head of gastrocnaemous

Medial

above a.semimenbranosusb.medial condyle of femur

below a.tibial nerve

b.popliteal vein

c.medial head of gastrocnemius



BRANCHES

1.genicular branches – supply the articular capsule

- ligaments of the knee joint• Superior, middle and inferior genicular arteries

2.muscular branches – supply the hamstring

- gastrocnemius

- soleus

- plantaris

3.cutaenous branches – accompanies the small

saphenous vein



APPLIED ANATOMY

1.Popliteal aneurysm can cause swelling

and pain in the popliteal fossa

2.loss of popliteal pulsation is a sign of

femoral artery obstruction



ANTERIOR TIBIAL ARTERY• Smaller terminal branch of popliteal artery

• Arises at the lower border of popliteus muscle

• Enters the extensor compartment of leg

• Accompanies the deep peroneal nerve

• Passes behind the extensor retinaculum at ankle joint

• Continues as the dorsalis pedis arteryBRANCHES

1.muscular branch – numerous, supply the muscles of the

anterior compartment of the leg

2.anterior and posterior tibial recurrent arteries – joins the

anastomoses around the knee

3.medial and lateral, anterior malleolar arteries – joins the

anastmoses around the ankle



Retinaculum – thickened band of deep fascia attached to distal ends of anterior

border of tibia & fibula

Flexor retinaculum – extends from medial malleolus ,passes downward & backward

Attached to the medial surface of calcaenum



DORSALIS PEDIS ARTERY

• direct continuation of anterior tibial artery

• begins midway between the malleoli

•

runs on the dorsum of the foot to the 1st

interosseous space

• at the posterior end of the space it divides

into deep plantar artery and arcuate artery• deep plantar artery form the deep plantar

arch



POSTERIOR TIBIAL ARTERY

• Larger terminal branch of popliteal artery

• Begins at the lower border of popliteus muscle

• Passes deep to flexor retinaculum

• Terminates by dividing into medial and lateral plantar

arteries

• BRANCHES

1.medial and lateral plantar arteries

2.peroneal artery – gives nutrient artery to fibular

3.nutrient artery to tibia

4.muscular and anastomotic branches



• PERONEAL ARTERY

- largest and most important branch

- begins inferior to the distal border ofpopliteus muscle

- gives off branches to the popliteus muscle

- muscles in the posterior

- lateral compartments of the leg



ARTERIES OF THE SOLE OF THE

FOOT1.Medial plantar artery2.Lateral plantar artery

- terminal branches of posterior tibial artery

MEDIAL PLANTAR ARTERY

- Smaller of the two terminal branches

- Passes distally on the medial side of the foot

- Supplies branches to the medial side of the toe- Gives off muscular, cutaneous, articular

branches during its course



Medial Plantar Artery

Plantar Arch

Digital Branch

Plantar Metatarsal

Arteries

Plantar Digital Arteries

Deep Branch ofDorsal Pedalis

Artery

Anterior Tibial Artery

Posterior Tibial Artery

Lateral Plantar Artery

Lateral Tarsal

ArteryArcuate Artery



LATERAL PLANTAR ARTERY

• Larger of the two terminal branches

• Runs obliquely across the sole on the

lateral side of the lateral plantar nerve

• Gives off calcaeneal, muscular, cutaenous

branches

• Terminates by joining the deep plantar

branch of the dorsalis pedis artery to form

the plantar arch



CLINICAL CORRELATES

• Arterial pulsations in the lower limb

1.Femoral pulse - just below the inguinal groove at

mid inguinal point

2.Popliteal pulse - popliteal fossa

3.Posterior tibial - pulse half way between the

posterior surface of medial malleous and medial

border of tendocalcaneus4.Dorsalis pedis pulse - felt along a line mid point

between 2 malleoli to the 1st meta tarsal space



VEINS

• 1. SUPERFICIAL

- SAPHENOUS VEINS

• 2.DEEP

- FEMORAL VEIN

- POPLITEAL VEIN- TIBIAL VEINS



SUPERFICIAL AND DEEP GROUP

Blood from superficial will drain into

deep veins through communicating

veins

SUPERFICIAL

foot and leg veins drain into two

major trunks :

small saphenous veingreat saphenous vein

VEINS



Common digital dorsal veins

Dorsal digital veins

Dorsal venous arch

(dorsum of foot)

medial lateral

Small saphenous veinLarge saphenous vein

SUPERFICIAL VEINS



SMALL SAPHENOUS

VEIN

- lateral side of dorsal

venous arch

- ascends on the lateral

side of the foot

- along the back popliteal

fossa

- empty into the popliteal

vein.



• GREAT SAPHENOUS VEIN

- Longest vein in the body- begins in the dorsum of the foot (medial side of

dorsal venous arch)

- extends along the medial side of leg and thigh

- receives many tributaries along the way.- Just below the medial aspect of the inguinal

ligament

- it pierces the deep fascia of the thigh

- to enter the femoral vein via the saphenousopening 2.5cm below the inguinal ligament

- has 10-20 valves



Great saphenous vein



TRIBUTARIES

• Posterior arch vein.

• A tributary from the small saphenous vein.

• The lateral and medial accessory saphenous

veins• The superficial veins -

external pudendal (genital area)

superficial epigastric (abdomen)

superficial circumflex iliac (upper lateral thigh)

enter the vein at the groin.



Varicose veins

-Torturous dilated veins

-Due to incompetence of the

valves



DEEP VEINS

Plantar digital vein

(upward continuation from

venecomitanties of dorsalis pedis

artery)

• DEEP VEINS

C



- Correspond to the arteries in each region. Have thesame names

PLANTAR DIGITAL VEINS

- unite to form 4 plantar meta tarsal veins

- again unite to form the deep plantar arch

Medial lateral plantar vein

posterior tibial vein

- Anterior tibial veins are the upward continuation of thevenae comitanties of the dorsalis pedis artery



ANTERIOR AND POSTERIOR TIBIAL VEINS

- Begin at the lower end of the leg

- Ascend upward to the popliteal fossa.- To form popliteal vein

POPLITEAL VEIN

- Formed by the union of the anterior andposterior tibial veins

- at the distal border of popliteus muscle

- Passes upward accompanying the poplitealartery

- Ends at the adductor opening to become thefemoral vein



FEMORAL VEIN

• continuation of the popliteal vein in the thigh

• ends posterior to the inguinal ligament

• drains into the external iliac vein.

• in the femoral triangle, lies medial to femoralartery

• it receives - the profunda femoris vein

- great saphenous vein- and other tributaries.

l14-Arteries of the Lower Limb-done - Copy

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