Arteries of the Lower Extremity and Back

Question 1

Superior Gluteal Artery

Answer 1

Origin: Internal Iliac Artery

Course:
Emerges from the greater sciatic foramen superior to the piriforms

Runs with the nerve and vein of the same name. (these are the only structures that emerge superior to piriformis)

Runs between gluteus medius and gluteus minimus.

Question 2

Inferior Gluteal Artery

Answer 2

Origin: Internal Iliac Artery

Course:
Emerges from the greater sciatic foramen inferior to the piriforms

Runs with the nerve and vein of the same name.

Runs between gluteus medius and gluteus maximus.

Question 3

Internal Pudendal Artery

Answer 3

Origin: Internal Iliac Artery

Course:
Emerges from the greater sciatic foramen inferior to the piriforms

Runs around the sacrospinous ligament and then enters the lesser sciatic foramen towards the perineum

Takes this course along with the Pudendal Nerve and the Nerve to Obturator Internus.

Runs between gluteus medius and gluteus minimus.

Question 4

Femoral Artery

Answer 4

Origin: External Iliac Artery

Course:
Continuation of the external iliac artery from the abdomen (changes names at the inguinal ligament)

Passes deep to the inguinal ligament midway between the ASIS and the pubic tubercle.

Descends into the femoral triangle where it runs between the femoral nerve and femoral vein.

At the apex of the femoral triangle, it passes deep to sartorius and runs in the subsartorial (aka adductor) canal.

Gives off many branches in the thigh (see following cards)

Ends at the Adductor hiatus by becoming the popliteal artery.

Question 5

Superficial Circumflex Iliac Artery

Answer 5

Origin: Femoral Artery

Course:
Branches off of the femoral artery just as it enters the femoral triangle

Runs laterally towards the ASIS

Question 6

Superficial and Deep External Pudendal Arteries

Answer 6

Origin: Femoral Artery

Course:
Branch off the Femoral Artery just after it emerges from deep to the inguinal ligament in the femoral triangle

Run medially towards the perineum

Can either originate as one trunk that splits into the superficial and deep branches or original separately from the femoral artery

Question 7

Superficial Epigastric

Answer 7

Origin: Femoral Artery

Course:
Branches off the femoral artery just after it passes into the femoral triangle.

Runs up toward the umbilicus

Question 8

Descending Genicular

Answer 8

Origin: Femoral Artery

Course:
Branches off the femoral artery just proximal to the popliteal fossa after the femoral artery emerges from the subsartorial canal and passes through the adductor canal

Contributes to the genicular anastomoses

Question 9

Profunda Femoris

Answer 9

AKA deep artery of the thigh

Origin: Femoral Artery

Course:
LARGE branch from the femoral artery that branches off in the femoral triangle

Passes between pectineus and adductor longus and descends posterior to adductor longus on medial side of the femur

Gives off: perforating branches and the medial and lateral femoral circumflex arteries

Question 10

Medial Femoral Circumflex

Answer 10

Origin: Profunda Femoris

Course:
Branches off profunda femoris in the femoral triangle

Runs between iliopsoas and pectineus

Gives off an ASCENDING BRANCH that runs toward the hip joint

Gives off a TRANSVERSE BRANCH

Question 11

Lateral Femoral Circumflex

Answer 11

Origin: Profunda Femoris

Course:
Branches off profunda femoris in the femoral triangle

Runs laterally deep to sartorius and rectus femoris

Gives off an ASCENDING BRANCH

Gives off a TRANSVERSE BRANCH

Gives off a DESCENDING BRANCH, which contributes to the genicular anastomoses

Question 12

Perforating Branches of Profunda Femoris

Answer 12

Origin: Profunda Femoris

Course:
4 perforating arteries arise from profunda femoris. 3 of them are branches and 1 is the termination of profunda femoris.

They perofate the adductor magnus muscle and pass into the posterior compartment of the thigh

Question 13

Obturator Artery

Answer 13

Origin: Internal Iliac Artery

Course:
Emerges in the medial thigh via the obturator canal

Enters the medial compartment of the thigh, where it gives off anterior and posterior branches that run on either side of adductor brevis with the anterior and posterior branches of the obturator nerve

Question 14

Popliteal Artery

Answer 14

Origin: Femoral Artery

Course:
Continuation of the femoral artery (changes names at the level of the popliteal fossa)

Emerges from the adductor hiatus

It is the deepest structure int he popliteal fossa (it is in a protected position)

Gives off several genicular branches that form the anastomoses around the knee

Question 15

Genicular Arteries

Answer 15

Origin: Popliteal Artery

Course:
Branch off of the popliteal artery and anastomose around the knee. There are superior medial, superior lateral, middle, inferior medial, and inferior lateral branches

The superior medial and inferior medial branches anastomose with each other.

The superior lateral and inferior lateral branches anastomose with each other.

The middle genicular pierces the joint capsule to supply the cruciate ligaments, synovial membrane, and peripheral third of the menisci.

Question 16

Anterior Tibial Artery

Answer 16

Origin: Popliteal Artery

Course:
Continuation of the Popliteal Artery just after the popliteal fossa

Passes between the tibia and the fibual into the anterior compartment of the leg through a gap in the interosseous membrane

Descends along the interosseous membrane

Runs with the deep fibular nerve between tibialis anterior and extensor digitorum longus

Crosses over and runs between Tibialis anterior and Extensor Hallucis Longus

Gives off:
ANTERIOR TIBIAL RECURRENT - contributes to the periarticular anastomoses around the knee

ANTERIOR MEDIAL MALLEOLAR and ANTERIOR LATERAL MALLEOLAR - supply the ankle and are analogous to the carpal branches at the wrist

Ends by becoming the DORSALIS PEDIS artery after the anterior tibial artery passes under the extensor retinaculum

Question 17

Posterior Tibial Artery

Answer 17

Origin: Popliteal Artery

Course:
Continuation of the popliteal artery from the popliteal fossa

Passes through the posterior compartment of the leg between the superficial and deep layers, just deep to the transverse intermuscular septum

Runs with the tibial Nerve

Gives off:
CIRCUMFLEX FIBULAR ARTERY, which branches and then wraps anteriorly around the head of the fibula; this branch can also give off the FIBULAR RECURRENT artery

FIBULAR ARTERY –> Branches off the posterior tibial artery and runs parallel to the posterior tibal artery laterally (deep to FHL); it gives off the POSTERIOR LATERAL MALLEOLAR ARTERY

POSTERIOR MEDIAL MALLEOLAR ARTERY

Ends deep to Abductor Hallucis where it spilts into MEDIAL PLANTAR and LATERAL PLANTAR arteries

Question 18

Medial Plantar Artery

Answer 18

Origin: Posterior Tibial Artery

Course:
Posterior tibial artery splits into medial and lateral plantar branches deep to abductor hallucis

Runs with the Medial Plantar Nerve between Abductor Hallucis and Flexor Hallucis Brevis (Between layers 1 and 2 of the foot muscles)

Gives off:
PLANTAR DIGITAL ARTERIES

BRANCH to DEEP PLANTAR ARCH

Question 19

Lateral Plantar Artery

Answer 19

Origin: Posterior Tibial Artery

Course:
Posterior Tibial Artery splits into lateral and medial plantar arteries deep to abductor hallucis

The Lateral plantar artery then runs with the lateral plantar nerve depp to abductor hallucis and deep to flexor digitorum brevis obliquely across the foot between layers 1 and 2

Winds up on the lateral side of the foot just medial to abductor digiti minimi

Gives rise to the DEEP PLANTAR ARCH, which gives off PLANTAR METATARSAL ARTERIES which give off COMMON PLANTAR DIGITAL ARTERIES, which give off PROPER PLANTAR DIGITAL ARTERIES

Question 20

Dorsalis Pedis

Answer 20

Origin: Anterior Tibial Artery

Course:
After the anterior tibial artery passes deep to the inferior extensor retinaculum, it becomes the dorsalis pedis artery (AKA dorsal artery of the foot)

It runs lateral to the tendon of Extensor Hallucis Longus, between EHL and EDL

It gives off:
MEDIAL AND LATERAL TARSAL ARTERIES that supply the tarsus

ARCUATE ARTERY - forms the arch on the dorsum of the foot

Question 21

Arcuate Artery

Answer 21

Origin: Dorsalis Pedis

Course:
Branches off the dorsalis pedis in the dorsum of the foot after the medial and lateral tarsal branches come off.

Forms the arterial arch on the dorsum of the foot

Anastamoses with the lateral tarsal artery laterally to complete the arch

It gives off:
1st DORSAL DIGITAL ARTERY

DORSAL METATARSAL ARTERIES which split into DORSAL DIGITAL ARTERIES

Question 22

Vertebral Artery

Answer 22

Origin: Subclavian Artery

Course:
Branches off of the subclavian artery then travels superiorly in the transverse foramina of the cervical vertebrae

When it reaches CV1, it travels horizontally in a groove along its posterior arch

We see is in the suboccipital triangle with the suboccipital nerve (Dorsal Ramus C1)

It then turns superiorly to enter the skull via the foramen magnum of the occiput and contributes to the blood supply of the brain.