Arterial Tree of Lower Limb, Varicose Veins, DVT & Compartment Syndrome Flashcards
Define flexor muscles.
Muscles that act to reduce the angle subtended at the joint on which they act.
Define extensor muscles.
Muscles that act to increase the angle subtended at the joint on which they act.
List the compartments of the arm.
- The anterior compartment.
- The posterior compartment.
List the compartments of the forearm.
- The anterior compartment.
- The posterior compartment.
List the compartments of the thigh.
- The anterior compartment.
- The posterior compartment.
- The medial compartment.
List the compartments of the leg.
- The anterior compartment.
- The superficial posterior compartment.
- The deep posterior compartment.
- The lateral compartment.
List the 4 classes of tissues of the body.
1 - Epithelia.
2 - Connective tissue.
3 - Muscle.
4 - Nervous tissue.
From which classes of tissues of the body is vascular derived?
- Epithelia.
- Connective tissue.
- Muscle.
Describe the organisation of muscle tissue.
Striated:
- Skeletal.
- Cardiac.
Non-striated:
- Smooth.
List the layers of a generic blood vessel from deep to superficial.
1 - Tunica intima.
2 - Tunica media.
3 - Tunica adventitia.
What layers compose the tunica intima?
- Squamous epithelium (endothelium).
- An internal elastic membrane.
What layers compose the tunica media?
- Muscle.
- An external elastic membrane.
What composes the tunica adventitia?
Connective tissue.
List the histological differences between arteries and veins.
1 - The tunica media of arteries is thicker than that of veins.
2 - As a result arteries have a more uniform circular shape.
3 - The lumen of veins is larger than that of arteries (relative to the thickness of the wall).
At which point in systemic circulation of blood do components of the fluid phase of blood leave circulation to form interstitial fluid and lymph?
Where venules become veins.
What are the names of the peaks found on a graph of arterial pressure over time?
- A systolic peak.
- A diastolic peak.
Define dicrotic notch.
The interval between the two peaks found on a graph of arterial pressure over time.
What does the dicrotic notch represent?
The closure of the semilunar valve at the onset of diastole.
What are the names of the waves on a graph of arterial pressure over time?
In which phases do they occur?
- The ejected wave (systolic phase).
- The reflected wave (diastolic phase).
List the branches that arise from the ascending aorta.
The right and left coronary arteries.
List the branches that arise from the arch of the aorta.
On the right:
- The brachiocephalic artery.
On the left:
- The left common carotid artery.
- The left subclavian artery.
What does the brachiocephalic artery give rise to?
- The right common carotid artery.
- The right subclavian artery.
List the segments of the aorta.
1 - Ascending aorta.
2 - Aortic arch.
3 - Descending aorta.
What is the sternal angle of Louis?
An imaginary, oblique plane that joins the manubriosternal joint anteriorly to the T4/5 intervertebral disc posteriorly.
List 4 anatomical features for which the sternal angle of Louis is a landmark.
1 - The 2nd costal cartilages.
2 - The bifurcation of the trachea.
3 - The point at which the vagus nerve gives rise to the left recurrent laryngeal nerve.
4 - The division of the mediastinum into superior and inferior mediastini.
List the segments of the descending aorta.
- The thoracic aorta.
- The abdominal aorta.
List the superior and inferior boundaries of the thoracic aorta.
- Superiorly: The sternal angle of Louis.
- Inferiorly: The aortic hiatus of the diaphragm (T12).
List the structures that receive blood supply from the thoracic aorta.
- Muscles of the chest wall.
- The spinal cord.
List the superior and inferior boundaries of the abdominal aorta.
- Superiorly: The aortic hiatus of the diaphragm (T12).
- Inferiorly: The L3/4 intervertebral disc.
List the two phases of the abdominal aorta.
- The suprarenal segment.
- The infrarenal segment.
What separates the two phases of the aorta?
The point at vertebral level L1/2 where the abdominal aorta gives rise to the renal arteries.
What does the abdominal aorta give rise to?
The left and right common iliac arteries.
List 4 anatomical landmarks that mark the end of the abdominal aorta.
- The L4/5 intervertebral disc.
- The supracristal plane of the pelvis.
- The vertebral level of the umbilicus.
- The T10 dermatomal level.
List 4 major arteries that arise from the abdominal aorta.
1 - The coeliac artery.
2 - The mesenteric arteries.
3 - The renal arteries.
4 - The common iliac arteries.
At which vertebral level does the coeliac artery arise?
L1.
At which vertebral level does the superior mesenteric artery arise?
L1.
At which vertebral level does the inferior mesenteric artery arise?
L3.
At which vertebral level do the renal arteries arise?
L1/L2.
At which vertebral level do the left and right common iliac arteries arise?
L4/5.
List the arteries of the lower limb in order from superior to inferior, ignoring small terminating branches.
1 - Common iliac.
2 - External iliac.
3 - Femoral.
4 - Popliteal.
5 - Tibial (anterior and posterior).
From which artery does the internal iliac artery arise?
The common iliac artery.
From which artery does the profunda femoris artery arise?
The femoral artery.
From which artery does the peroneal artery arise?
The posterior tibial artery.
List 3 anatomical landmarks that mark the beginning of the common iliac artery.
- The L3/4 intervertebral disc.
- The umbilicus.
- The supracristal plane.
Which anatomical landmark marks the beginning of the external iliac artery?
The L5/S1 intervertebral disc.
Which anatomical landmark marks the beginning of the femoral artery?
The lower border of the inguinal ligament.
Which anatomical landmark marks the beginning of the popliteal artery?
The point of the adductor canal where the femoral artery exits.
Which anatomical landmark marks the beginning of the anterior and posterior tibial arteries?
The lower border of popliteus.
What is the adductor canal?
An opening in adductor magnus at the apex of the femoral triangle.
Where can the femoral artery be palpated?
At the pubic tubercle.
What is the adductor hiatus?
A gap between the adductor magnus muscle and the femur that allows the passage of the femoral vessels from the anterior thigh to the posterior thigh
Which arteries supply the knee joint?
Branches of the popliteal artery.
List 2 locations at which the pulse of the dorsalis pedis artery can be palpated.
1 - Above the navicular.
2 - Medial to the tendon of extensor hallucis longus.
Which artery gives rise to the dorsalis pedis artery?
The anterior tibial artery.
Which artery gives rise to the medial and lateral plantar arteries?
The posterior tibial artery.
Which arteries constitute the blood supply to the foot?
- The medial & lateral plantar arteries.
- The dorsalis pedis arteries.
Which artery passes behind the medial malleolus?
The posterior tibial artery.
Where can the pulse of the posterior tibial artery be palpated?
Behind and below the malleolus of the ankle.
Where can the pulse of the popliteal artery be palpated?
In the popliteal fossa.
List the types of capillaries.
1 - Continuous capillaries.
2 - Fenestrated capillaries.
3 - Discontinuous / sinusoid capillaries.
List 3 typical locations of continuous capillaries.
1 - Fat.
2 - Muscle.
3 - The nervous system.
List 3 typical locations of fenestrated capillaries.
1 - Intestinal villi.
2 - Endocrine glands.
3 - Kidney glomeruli.
List 3 typical locations of discontinuous / sinusoid capillaries.
1 - The liver.
2 - Bone marrow.
3 - The spleen.
How does the basement membrane of sinusoid capillaries differ from that of continuous and fenestrated capillaries?
- It is incomplete (as is the endothelial layer) in discontinuous / sinusoid capillaries.
- It is complete in continuous and fenestrated capillaries.
What is the name of the cells that wrap around endothelial cells to facilitate angiogenesis?
Pericytes.
Define longitudinal conduction.
The conduction of venous blood from venules to the right atrium.
Why is longitudinal conduction not enough to transmit venous blood to the aorta?
- It is a low pressure system.
- Venous blood tends to pool in the lower extremities as a result of gravity.
What helps with the transmission of venous blood from venules to the right aorta?
The musculovenous pump (rhytmic contraction of skeletal muscles).
What is the name of the veins that connect deep veins to superficial veins?
Perforating veins.
In which direction does blood flow through perforating veins?
From superficial to deep.
What is the advantage of allowing superficial venous blood to flow into deep veins?
- Superficial veins will collapse if there is no hydrostatic pressure in them.
- Deep veins will have a higher hydrostatic pressure.
What are vaso vasorum?
The veins that drain the walls of large blood vessels.
What are venae commitante?
The veins that accompany their corresponding arteries.
What causes varicose veins?
- Failure of valves of perforating veins, causing backflow of venous blood to superficial veins and resulting in stasis.
- Veins become swollen and enlarged, as with varicose veins.
How can varicose veins be treated?
By stripping the affected veins.
When does compartment syndrome occur?
- When tissue pressure exceeds perfusion pressure (when pressure in an anatomical compartment is too high).
- Due to decreased compartment size or increased fluid content.
List 4 causes of increased fluid content in an anatomical compartment.
1 - Burns.
2 - Intra-arterial injections.
3 - Haemorrhages.
4 - Venom.
What is the major risk of compartment syndrome?
Necrosis.
