14. Vessels of the thigh and gluteal region

Question 1

What is the main artery of the lower limb?

Answer 1

femoral artery

Question 2

What is the common femoral artery?

Answer 2

A continuation of the external iliac artery which becomes known as the common femoral artery when it crosses under the inguinal ligament and enters the femoral triangle

Question 3

What does the profunda femoris (or deep femoral) artery branch from and into in the femoral triangle?

Answer 3

• it branches from the posterolateral aspect of the common femoral artery
• it travels posteriorly and distally to give off three branches
  1) lateral femoral circumflex artery: wraps around the anterolateral aspect of the proximal femur to contribute to the extracapsular arterial ring. A descending branch supplies some of the muscles of the lateral thigh
  2) medial femoral circumflex artery: wraps around the posterior aspect of the proximal femur, making the major contribution to the extracapsular arterial ring
  3) perforating branches: three or four perforate the adductor magnus and contribute to the blood supply of the muscles of the medial and posterior thigh

Question 4

After giving off the profunda femoris branch, what does the common(deep) femoral artery change into?

Answer 4

Superficial femoral artery

Question 5

What does the superficial femoral artery supply?

Answer 5

• after exiting the apex of the femoral triangle, it enters the adductor canal
• supply anterior thigh muscles during descent down adductor canal
• passes through hiatus and enters posterior compartment of thigh proximal to knee joint
• now becomes known as the popliteal artery

Question 6

What artery is the medial compartment of the thigh supplied by

Answer 6

Obturator artery

Question 7

Where does the obturator artery arise from and where does it enter?

Answer 7

• Arises from the internal iliac artery in the pelvic region

- Enters the medial compartment of the thigh via the obturator canal

Question 8

What arteries is the gluteal region supplied by?

Answer 8

Superior and inferior gluteal arteries

Question 9

Where do the gluteal arteries arise from and where do they enter?

Answer 9

• arise from the internal iliac artery
• enter gluteal region via the greater sciatic foramen
• superior leaves the greater sciatic foramen above the piriformis
• inferior leaves below the muscle

Question 10

What else does the inferior gluteal artery contribute to?

Answer 10

Blood supply of the posterior thigh

Question 11

Once the popliteal vein has entered the thigh via the hiatus what is it known as?

Answer 11

Femoral vein

Question 12

Where does the femoral vein ascend?

Answer 12

In the adductor accompanying the femoral artery

Question 13

What is the profunda femoris vein?

Answer 13

Deep vein of the thigh

Question 14

Where does the profunda femoris vein enter?

Answer 14

• follows the course of the profunda femoris artery
• Via perforating veins, it drains blood from the thigh
  muscles. It drains into the distal section of the femoral vein

Question 15

Where does the common femoral vein leave the thigh?

Answer 15

By passing deep to the inguinal ligament, medial to the femoral artery, at which point it becomes known as the external iliac vein

Question 16

By which veins is the gluteal region drained by?

Answer 16

Inferior and superior gluteal veins, which follow the course of the inferior and superior gluteal arteries

Question 17

Where do gluteal veins empty into?

Answer 17

The internal iliac vein

Question 18

Where does the obturator vein enter and drain into?

Answer 18

• follows the course of the obturator artery and drains into medial thigh
• enters the pelvis through the obturator foramen, along with the obturator artery and nerve
• terminates by draining into the internal iliac vein

Question 19

In what tissue does the superficial veins of the lower limbs run in?

Answer 19

Subcutaneous tissue

Question 20

What are the superficial veins of the lower limb?

Answer 20

great saphenous vein and small saphenous vein

Question 21

What is the great saphenous vein formed by?

Answer 21

The dorsal venous arch of the foot and the dorsal vein of the great toe

Question 22

Where does the great saphenous vein travel and terminate?

Answer 22

• passes anteriorly to the medial malleolus at the ankle
• ascends the medial leg, medial to and then posterior to the medial aspect of the tibia
• passes a hands breadth posterior to the medial border of the patella
• ascends in the medial thigh
• pierces the saphenous opening of the fascia lata, 1-3 cm distal to the inguinal ligament
• drains into the femoral vein at the saphenofemoral junction in the femoral triangle

Question 23

What is the small saphenous vein formed by?

Answer 23

The dorsal Venus arch of the foot and the dorsal vein of the lil toe

Question 24

Where does the small saphenous vein pass and enter?

Answer 24

• passes posterior to the lateral malleolus, alone the lateral border of the Achilles’ tendon
• ascends posterior leg
• passes between the two heads of the gastrocnemius muscle to drain into the popliteal vein at the saphenopopliteal junction in the popliteal fossa

Question 25

What does the lymphatic system drain?

Answer 25

• Tissue fluid, plasma proteins and other cellular debris into the bloodstream
• Also involved in immune defence
• Lymph is subsequently filtered by lymph nodes and directed into the venous system

Question 26

What are the lymphatic vessels in the lower limb?

Answer 26

• superficial: medial and lateral

- deep

Question 27

Where are the superficial lymphatic vessels?

Answer 27

• medial: follow the course of the great saphenous vein and drain into the inferior group of superficial inguinal lymph nodes in femoral triangle
• lateral: follow course of small saphenous vein and either drain into popliteal lymph nodes in the popliteal fossa or cross to join the medial group below the knee and drain into the superficial inguinal lymph nodes. The efferent lymphatic vessels from the popliteal nodes follow the femoral vein and drain into the deep inguinal nodes

Question 28

Where are the deep lymphatic vessels located?

Answer 28

• accompany deep arteries of the leg
• They are found in three main groups:anterior tibial, posterior tibial and peroneal, following the corresponding artery
• enter popliteal lymph nodes