Arterial supply of lower limb

Question 1

When does the external iliac artery terminate and what does it become

Answer 1

When it crosses under inguinal ligament and enters femoral triangle it becomes the femoral artery

Question 2

What artery branches off the femoral artery within the femoral triangle
What aspect of the femoral artery does it arise from

Answer 2

Deep artery of thigh/ profundus femoris artery

Arises from posterolateral aspect

Question 3

Course of deep artery of thigh

Answer 3

Travels posteriorly and distally

Question 4

Branches of the deep artery of thigh

Answer 4

Perforating branches
Lateral femoral circumflex artery
Medial femoral circumflex artery

Question 5

Course and function if perforating branches

Answer 5

Perforate adductor Magnus

Supplies muscles in medial and posterior thigh

Question 6

Course and function of lateral femoral circumflex artery

Answer 6

Wraps around anterior lateral femur

Supplies some muscles in lateral side of thigh

Question 7

Course and function of medial femoral circumflex artery

Answer 7

Wraps around posterior femur

Supplies head and neck of femur

Question 8

What artery can be damaged in femoral neck fractures

Consequence of this

Answer 8

Medial femoral circumflex artery

Avascular necrosis of head of femur

Question 9

Course and termination of femoral artery

Answer 9

Arises in femoral triangle
Leaves femoral triangle
Continues down anterior thigh via adductor canal
During descent it supplies anterior thigh muscles
Becomes popliteal artery at border between anterior/posterior thigh (adductor hiatus)

Question 10

What procedures is the femoral artery accessed in

Answer 10

Coronary angiography

Measuring arterial blood gases

Question 11

Describe coronary angiography

Answer 11

Femoral artery is catheterised with a long tube which is navigated by the external iliac artery, common lilac artery, aorta and coronary arteries
Radioactive dye is injected into coronary arteries to visualise blockages/narrowing via X-ray

Question 12

Where is the femoral artery accessed

Answer 12

Within femoral triangle as its superficial and can be easily located

Question 13

Course of obturator artery

Answer 13

Arises from internal iliac artery in pelvic region

Descends via obturator canal to enter medial thigh

Question 14

Termination of obturator artery

Answer 14

Bifurcates within the medial thigh into 2 branches:
Anterior branch
Posterior branch

Question 15

What does the anterior branch of obturator artery supply

Answer 15

Pectineus
Obturator externus
Adductor muscles
Gracilis

Question 16

What does the posterior branch of obturator artery supply

Answer 16

Some deep gluteal muscles

Question 17

What do the superior and inferior gluteal arteries supply

Answer 17

Most of gluteal region

Inferior gluteal artery also contributes to supply of posterior thigh

Question 18

Course of superior gluteal artery

Answer 18

Arises from internal iliac artery
Enters gluteal region via greater sciatic foramen
Leaves this foramen above piriformis

Question 19

Course of inferior gluteal artery

Answer 19

Arises from internal iliac artery
Enters gluteal region via greater sciatic foramen
Leaves this foramen below piriformis

Question 20

Course of popliteal artery

Answer 20

Descends down posterior thigh

Moves through popliteal fossa, exiting between gastrocnemius and popliteus

Question 21

What branch arises from the popliteal artery

What does it supply

Answer 21

Genicular branches

Supply knee joint

Question 22

Termination of popliteal artery

Answer 22

At lower border of popliteal fossa it divides into:
Anterior tibial artery
Posterior tibial artery

Question 23

Course of posterior tibial artery

Answer 23

Continues inferiorly along surface of deep muscles

It accompanies the tibial nerve in entering the sole of the foot via the tarsal tunnel

Question 24

What branch arises from posterior tibial artery

Answer 24

Fibular artery

Question 25

Course and function of fibular artery

Answer 25

Moves laterally and penetrates lateral compartment of leg | Supplies muscles in lateral compartment and adjacent muscles in posterior compartment

Question 26

Course of anterior tibial artery

Answer 26

Passes anteriorly between tibia and fibular through gap in interosseus membrane Moves inferiorly down leg and enters foot

Question 27

Termination of posterior tibial artery

Answer 27

Divides in the foot into: Lateral plantar artery Medial plantar artery

Question 28

Termination of anterior tibial artery

Answer 28

Enters the foot and becomes the dorsal pedis artery

Question 29

Arterial supply of foot

Answer 29

Dorsalis pedis artery | Posterior tibial artery

Question 30

Course of dorsal pedis artery

Answer 30

Passes over dorsal aspect of tarsal bones Moves inferiorly towards sole Anastomoses with lateral plantar artery to form the deep plantar arch

Question 31

What does the dorsal pedis artery supply

Answer 31

Tarsals Dorsal aspect of metatarsals Contributes to supply of toes

Question 32

What do the medial and lateral plantar arteries supply

Answer 32

Plantar aspect of foot | Contributes to supply of toes

Question 33

What are the 3 main pulse points in the lower limb | Where are they palpated

Answer 33

Femoral pulse - mid inguinal point Popliteal pulse - popliteal fossa (easier to palpate if fossa is relaxed - ask patient to slightly flex leg) Dorsalis pedis pulse - dorsum of foot, lateral to extensor hallucis longus tendon

Question 34

What is the main artery of lower limb

Answer 34

Femoral artery

Question 35

What are the genicular arteries

Answer 35

Superior medial Inferior medial Superior lateral Inferior lateral

Question 36

How do you assess arterial occlusion in the lower limb

Answer 36

Ankle-brachial pressure index (ABPI)

Question 37

How do you obtain an ABPI and what is the normal range of values

Answer 37

Lie patient supine to prevent gravity effecting results Use Doppler ultrasound probe to amplify sound of arterial blood flow Measure systolic pressure in arm and ankle ABPI= Pleg/Parm Normal range is 0.9-1.2

Question 38

What does a lower than normal ABPI mean

Answer 38

Arterial peripheral disease (cause of intermittent claudication)

Question 39

Treatment for peripheral arterial disease

Answer 39

Antiplatelets (aspirin) | Risk factor modification

Question 40

Signs of acute ischaemia

Answer 40

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