0717-Structure of the arteries and veins of lower limb- CG

Question 1

What regions make up the lower limb and how are they divided

Answer 1

Lower limb consist of gluteal region, thigh, leg, foot

Regions are separated by gluteal fold (bottom line), knee joint (popliteal fossa posteriorly), ankle joint

Question 2

Name the fascia that are found in the lower limb, and describe their function

Answer 2

Subcutaneous superficial fascia-

fascia lata (thigh), crural fascia (leg)

• ‘compression stocking’ that prevents muscle from bulging out
• separates the superficial vessels (outside) and deep vessels (inside)

Question 3

Gluteal region: artery supply

Answer 3

From the Internal iliac a (posterior division)-

• superior gluteal a
• inferior gluteal a

Also supply head of femur and muscles (via trochanteric anastomosis), where it is joined by

• medial circumflex a
• lateral circumflex a

Obturator a is also involved (interial iliac a, ant division)

Question 4

Thigh region: artery

Answer 4

External iliac a –> FEMORAL ARTERY (when it crosses under inguinal ligament and enters femoral triangle, located halfway between ASIS and pubic tubercle)

SPLITS 4cm below inguinal ligament, into

• profunda femoris (deep)- supplies all muscles of thigh
• gives off perforating arteries that wrap around femur
• medial and lateral circumflex a
• [superficial] femoral artery (medial side), which is contained in the adductor canal.

Changes into popliteal artery at adductor hiatus

Question 5

Describe and Name the contents of femoral triangle

Answer 5

Wrapped with femoral sheath (connective tissue)

Borders/roof+base

Inguinal ligament (superior

Sartorius (lateral)

Adductor longus (medial)

Roof- fascia lata

Base- thigh muscles

Contents (VAN medial to lateral, or NAVY if lateral to medial and lymphs added)

Femoral vein, artery, nerve, canal (contain lymph nodes)

Question 6

What is the adductor canal and adductor hiatus?

Answer 6

Adductor canal (intermuscular cleft between adductor longus, sartorius, adductor magus, vastus medialis)

Contain femoral artery, femoral vein, saphenous nerve

Adductor hiatus- gap between adductor magus and femur, transition into popliteal artery

Question 7

Knee region: artery

Answer 7

Popliteal artery runs down popliteal fossa (posterior), becomes posterior tibial artery

Genicular anatstomis around knee (more anterior)

superior lateral, superior medial, inferior lateral, inferior medial

sits behind patella, prevents crushin

Question 8

Briefly outline the compartments of the leg, as well as compartment syndrome

Answer 8

Each has its own artery

popliteal –> posterior tibial and anterior tibial (anterior and posterior compartment respectivly)

Posterior tibial splits into peroneal (=Fibula) and plantar aa

Compartments are separated by fascia- between compartment (interosseous membrane)

and around compartment (crural fascia). However, compartment syndrome can develop when increased pressure within compartment- need to relieve pressure by fasiotomy

Question 9

foot region: artery

Answer 9

Posterior tibial –> plateral plantar, plantar metatarsal, plantar digital

Anterior tibial –> dorsalis pedis, dorsal metatarsal, dorsal digital

Question 10

What are the 3 groups of veins in the lower limb

Answer 10

Generally follow arteries- VEINS HAVE VALVES THAT PREVENT BACKFLOW OF BLOOD

Superficial (subcutaneous tissue)

Dorsal venous arch

Great saphenous vein (goes all the way up, medial)

Small saphenous vein (goes up to knee, lateral)- tributary of popliteal v

Deep veins

Vanae comitantes (a pair of vein that closely accompany an artery, ie anterior/posterior tibial veins)

Popliteal vein

Femoral vein

External iliac vein

Perforating (communicating) veins
Connect deep with superficial

Mostly are in lower part of calf and lower part of thigh, (penetrate deep, crural fascia and muscles

Question 11

Compare pathologies of the deep and superficial veins

Answer 11

Superficial + perforating- varicose veins

Elongated, large, tortous veins- caused by incompetent valves, increasing venous pressure, genetic factor

Tests used are Tredelenburg (occlude saphenofemoral junction to observe filling of long saph), Perthes (test by muscle pumping action)

May be throbbing, painful- not life threatening

DVT (deep vein thrombosis)

clot form, may travel to lungs (emboli)- life threatening

Both can be improved with pressure stockings

Question 12

Basically just print off the flow charts,

also resource used is:

http://teachmeanatomy.info/lower-limb/areas/the-femoral-triangle/