Arteries of the Lower Limb

Question 1

What is the main artery of the lower limb?

Answer 1

The femoral artery

Question 2

What is the femoral artery a continuation of?

Answer 2

The external iliac artery

Question 3

What is the external iliac artery?

Answer 3

The terminal branch of the abdominal aorta

Question 4

When does the external iliac artery become the femoral artery?

Answer 4

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

Question 5

What arises from the femoral artery in the femoral triangle?

Answer 5

The profunda femoris artery

Question 6

Where does the profunda femoris artery arise from?

Answer 6

The posterolateral aspect of the femoral artery

Question 7

Where does the profunda femoris artery travel?

Answer 7

Posteriorly and distally

Question 8

What does the profunda femoris artery give off?

Answer 8

Three main branches, perforating branches, the lateral femoral circumflex artery, and the medial femoral circumflex artery

Question 9

What do the perforating branches of the profunda femoris artery consist of?

Answer 9

Three or four arteries that perforate the adductor magnus

Question 10

What do the perforating branches of the profunda femoris artery contribute?

Answer 10

The supply of the muscles in the medial and posterior thigh

Question 11

What course does the lateral femoral circumflex artery take?

Answer 11

Wraps around the anterior, lateral side of the femur

Question 12

What does the lateral femoral circumflex artery supply?

Answer 12

Some of the muscles in the lateral side of the thigh

Question 13

What course does the medial femoral circumflex artery take?

Answer 13

Wraps around the posterior side of the femur

Question 14

What does the medial femoral circumflex artery supply?

Answer 14

The neck and head of the femur

Question 15

What happens in a fracture of the femoral neck?

Answer 15

The medial femoral circumflex artery can easily be damaged, and avascular necrosis of the femur head can occur

Question 16

What happens to the femoral artery after exiting the femoral triangle?

Answer 16

It continues down the anterior surface of the thigh

Question 17

How does the femoral artery continue down the thigh?

Answer 17

Via a tunnel known as the adductor canal

Question 18

What does the femoral artery do during its descent?

Answer 18

Supplies the anterior thigh muscles

Question 19

Where does the adductor canal end?

Answer 19

At an opening in the adductor magnus, called the adductor hiatus

Question 20

What happens as the femoral artery moves through the adductor hiatus?

Answer 20

It enters the posterior compartment of the thigh, proximal to the knee

Question 21

What does the femoral artery become once it’s going through the adductor hiatus?

Answer 21

The popliteal artery

Question 22

Where is the femoral artery located within the femoral triangle?

Answer 22

Superficially

Question 23

What is the result of the femoral artery being located superficially within the femoral triangle?

Answer 23

It is easy to access, and therefore suitable for a range of clinical procedures

Question 24

Give two procedures that the femoral artery can be used for

Answer 24

Coronary artery angiography

Drawing arterial blood gases

Question 25

What happens in a coronary artery angiography?

Answer 25

The femoral artery is catheterised with a long, thin tube. The tube is navigated up the external iliac artery, common iliac artery, aorta, and into the coronary vessels. A radioactive dye in then ejected into the coronary vessels, and any wall thickening or blockages can be visualised via x-ray imaging

Question 26

What does the obturator artery arise from?

Answer 26

The internal iliac artery in the pelvic region

Question 27

What course does the obturator artery take?

Answer 27

It descends via the obturator canal to enter the medial thigh, and then bifurcates

Question 28

What branches arise from the bifurcation of the obturator artery?

Answer 28

Anterior branch  | Posterior branch

Question 29

What does the anterior branch of the obturator artery supply?

Answer 29

The pectineus, obturator externus, adductor muscles and gracilis

Question 30

What does the posterior branch of the obturator artery supply?

Answer 30

Some of the deep gluteal muscles

Question 31

What is the gluteal region largely supplied by?

Answer 31

The superior and inferior gluteal arteries

Question 32

What to the gluteal arteries arise from?

Answer 32

The internal iliac artery

Question 33

How do the gluteal arteries enter the gluteal region?

Answer 33

Via the greater sciatic foramen

Question 34

Where does the gluteal arteries leave the greater sciatic foramen?

Answer 34

The superior, above the piriformis muscle  | The inferior below it

Question 35

What does the inferior gluteal artery contribute towards?

Answer 35

The vasculature of the posterior thigh

Question 36

Where does the popliteal artery descend?

Answer 36

Down the posterior thigh

Question 37

What does the popliteal artery do as it descends down the posterior thigh?

Answer 37

It gives off genicular branches that supply the knee joint

Question 38

How does the popliteal artery exit the popliteal fossa?

Answer 38

Sandwiched between the gastrocnemius and popliteus muscles

Question 39

Where does the popliteal artery terminate?

Answer 39

At the lower border of the popliteus muscle

Question 40

How does the popliteal artery terminate?

Answer 40

By dividing into anterior and posterior tibial arteries

Question 41

What course does the posterior tibial artery take?

Answer 41

It continues inferiorly, along the surface of the deep muscles (such as tibialis posterior). It then accompanies the tibial nerve in entering the sole of the foot via the tarsal tunnel.

Question 42

What happens during descent of the posterior tibial artery down the leg?

Answer 42

The fibular artery arises

Question 43

What course does the fibular artery take?

Answer 43

It moves laterally, penetrating the lateral compartment of the leg

Question 44

What does the fibular artery supply?

Answer 44

Muscles in the lateral compartment, and adjacent muscles in the posterior compartment

Question 45

What course does the anterior tibial artery take?

Answer 45

It passes anteriorly between the tibia and fibula, through a gap in the interosseous membrane. It then moves inferiorly down the leg. It runs down the entire length into the leg, and into the foot

Question 46

What does the anterior tibial artery become in the foot?

Answer 46

The dorsalis pedis artery

Question 47

How is arterial supply to the foot delivered?

Answer 47

Dorsalis pedis  | Posterior tibial

Question 48

Where does the dorsalis pedis artery begin?

Answer 48

As the anterior tibial artery enters the foot

Question 49

What course does the dorsalis pedis artery take?

Answer 49

It passes over the dorsal aspect of the tarsal bones, then moves inferiorly, towards the sole of the foot.

Question 50

What does the dorsalis pedis artery anastomose with?

Answer 50

The lateral plantar artery

Question 51

What is formed when the dorsalis pedis artery anastomoses with the lateral plantar artery?

Answer 51

It forms the deep plantar arch

Question 52

What does the dorsalis pedis artery supply?

Answer 52

The tarsal bones and the dorsal aspect of the metatarsals | Via the deep plantar arch, it also contributes to the supply of the toes

Question 53

How does the posterior tibial artery enter sole of the foot?

Answer 53

Through the tarsal tunnel

Question 54

What does the posterior tibial artery do once it’s entered the foot?

Answer 54

It splits into the lateral and medial plantar arteries

Question 55

What do the lateral and medial plantar arteries supply?

Answer 55

The plantar side of the foot  | Contributes to the supply of the toes via the deep plantar arch

Question 56

What are the three main pulse points in the lower limb?

Answer 56

Femoral  Popliteal  Dorsalis pedis

Question 57

Where the femoral pulse be palpated?

Answer 57

As it enters the femoral triangle, midway between the anterior superior iliac spine of the pelvis, and the pubis symphesis

Question 58

Where does the popliteal artery pulse lie?

Answer 58

Deep in the popliteal fossa

Question 59

What does palpation of the popliteal pulse require?

Answer 59

Deep palpation

Question 60

How can palpation of the popliteal pulse be made easier?

Answer 60

Ask the patient to slightly flex their leg, which relaxes the fascia around the popliteal fossa

Question 61

How is the dorsalis pedis pulse found?

Answer 61

By palpated on the dorsum of the foot, just lateral to the extensor hallucis longus tendon