Arterial supply of lower limb Flashcards
When does the external iliac artery terminate and what does it become
When it crosses under inguinal ligament and enters femoral triangle it becomes the femoral artery
What artery branches off the femoral artery within the femoral triangle
What aspect of the femoral artery does it arise from
Deep artery of thigh/ profundus femoris artery
Arises from posterolateral aspect
Course of deep artery of thigh
Travels posteriorly and distally
Branches of the deep artery of thigh
Perforating branches
Lateral femoral circumflex artery
Medial femoral circumflex artery
Course and function if perforating branches
Perforate adductor Magnus
Supplies muscles in medial and posterior thigh
Course and function of lateral femoral circumflex artery
Wraps around anterior lateral femur
Supplies some muscles in lateral side of thigh
Course and function of medial femoral circumflex artery
Wraps around posterior femur
Supplies head and neck of femur
What artery can be damaged in femoral neck fractures
Consequence of this
Medial femoral circumflex artery
Avascular necrosis of head of femur
Course and termination of femoral artery
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)
What procedures is the femoral artery accessed in
Coronary angiography
Measuring arterial blood gases
Describe coronary angiography
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
Where is the femoral artery accessed
Within femoral triangle as its superficial and can be easily located
Course of obturator artery
Arises from internal iliac artery in pelvic region
Descends via obturator canal to enter medial thigh
Termination of obturator artery
Bifurcates within the medial thigh into 2 branches:
Anterior branch
Posterior branch
What does the anterior branch of obturator artery supply
Pectineus
Obturator externus
Adductor muscles
Gracilis
What does the posterior branch of obturator artery supply
Some deep gluteal muscles
What do the superior and inferior gluteal arteries supply
Most of gluteal region
Inferior gluteal artery also contributes to supply of posterior thigh
Course of superior gluteal artery
Arises from internal iliac artery
Enters gluteal region via greater sciatic foramen
Leaves this foramen above piriformis
Course of inferior gluteal artery
Arises from internal iliac artery
Enters gluteal region via greater sciatic foramen
Leaves this foramen below piriformis
Course of popliteal artery
Descends down posterior thigh
Moves through popliteal fossa, exiting between gastrocnemius and popliteus
What branch arises from the popliteal artery
What does it supply
Genicular branches
Supply knee joint
Termination of popliteal artery
At lower border of popliteal fossa it divides into:
Anterior tibial artery
Posterior tibial artery
Course of posterior tibial artery
Continues inferiorly along surface of deep muscles
It accompanies the tibial nerve in entering the sole of the foot via the tarsal tunnel
What branch arises from posterior tibial artery
Fibular artery
Course and function of fibular artery
Moves laterally and penetrates lateral compartment of leg
Supplies muscles in lateral compartment and adjacent muscles in posterior compartment
Course of anterior tibial artery
Passes anteriorly between tibia and fibular through gap in interosseus membrane
Moves inferiorly down leg and enters foot
Termination of posterior tibial artery
Divides in the foot into:
Lateral plantar artery
Medial plantar artery
Termination of anterior tibial artery
Enters the foot and becomes the dorsal pedis artery
Arterial supply of foot
Dorsalis pedis artery
Posterior tibial artery
Course of dorsal pedis artery
Passes over dorsal aspect of tarsal bones
Moves inferiorly towards sole
Anastomoses with lateral plantar artery to form the deep plantar arch
What does the dorsal pedis artery supply
Tarsals
Dorsal aspect of metatarsals
Contributes to supply of toes
What do the medial and lateral plantar arteries supply
Plantar aspect of foot
Contributes to supply of toes
What are the 3 main pulse points in the lower limb
Where are they palpated
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
What is the main artery of lower limb
Femoral artery
What are the genicular arteries
Superior medial
Inferior medial
Superior lateral
Inferior lateral
How do you assess arterial occlusion in the lower limb
Ankle-brachial pressure index (ABPI)
How do you obtain an ABPI and what is the normal range of values
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
What does a lower than normal ABPI mean
Arterial peripheral disease (cause of intermittent claudication)
Treatment for peripheral arterial disease
Antiplatelets (aspirin)
Risk factor modification
Signs of acute ischaemia
Pain Paraesthesia Pulseless Pale Paralysed Cold
