Blood Supply of the Lower Extremity

Question 1

What is the inguinal ligament?

Answer 1

anatomic landmark for the division between the external iliac artery and common femoral artery

Question 2

What structures make up the femoral triangle?

Answer 2

Inguinal ligament (superior)

Adductor longus (medial)

Sartorius (lateral)

Iliopsoas & pectineus (floor)

Question 3

What are the contents of the femoral triangle from lateral to medial?

Answer 3

femoral nerve

femoral sheath

common femoral artery

common femoral nerve

Question 4

What muscles are at the floor of the femoral triangle?

Answer 4

iliopsoas and pectineus muscles

Question 5

What is the femoral sheath and what is its role?

Answer 5

extension of the transversalis and iliopsoas fascia

terminates inferiorly and becomes the tunica adventitia

protects the femoral vessels against the constant flexion/extension at the inguinal ligament

Question 6

What are the three compartments of the femoral sheath?

Answer 6

lateral

intermediate

medial

Question 7

What does the common femoral artery (CFA) divide into?

Answer 7

profunda femoral artery (PFA), or deep artery to the thigh

superficial femoral artery (SFA), which continues to the knee

Question 8

What is the profunda femoral artery?

Answer 8

main artery of the thigh

separated from the SFA by the adductor longus

Question 9

Where is the perforator artery located?

Answer 9

branches of the profunda femoral artery that wrap around the posterior aspect of the femur

Question 10

What are the circumflex femoral artery branches? What do these branches do?

Answer 10

medial circumflex artery - supplies blood to head and neck of the femur

lateral circumflex artery - supplies blood to the lateral side of the thigh

Question 11

What branches off of the lateral circumflex artery?

Answer 11

ascending, transverse, and descending branches

Question 12

What compartments of the thigh does the PFA supply?

Answer 12

medial, posterior, and lateral compartments of the thigh

Question 13

Describe the anatomical position of the superficial femoral artery.

Answer 13

leaves the femoral triangle and enters the adductor canal

exits the adductor canal via the addutor hiatus

lies deep to the sartorius muscle in the adductor canal

Question 14

What is the adductor hiatus formed from?

Answer 14

formed from an opening in the distal aponeurosis of the adductor magnus

Question 15

What does the SFA supply blood to?

Answer 15

anterior and anteromedial aspects of the thigh

Question 16

What is the popliteal fossa? What are its borders?

Answer 16

fat-filled diamond-shaped space posterior to the knee. The borders include:
uperolaterally – biceps femoris muscle

Superomedially – semimembranous & semitendinosus muscles

Interiorly – medial and lateral heads of the gastrocnemius muscle

Posteriorly – skin and fascia

Anteriorly – femur & knee joint & popliteus fascia covering the popliteus muscle

Question 17

What are the contents of the popliteal fossa?

Answer 17

popliteal artery

popliteal vein

lesser saphenous vein

tibial nerve (branch of sciatic nerve)

common fibular nerve (branch of sciatic nerve)

lymph nodes and lymphatic vessels

Question 18

What is the popliteal artery?

Answer 18

continuation of SFA after it passes through the adductor hiatus into the popliteal fossa

ends at the inferior border of the popliteus by dividing into the anterior tibial artery and the tibial-peroneal trunk

Question 19

Where is the popliteal vein?

Answer 19

lies posterolateral to the popliteal artery

Question 20

What are the different genicular arteries, and what vessel do they branch from?

Answer 20

Popliteal artery gives off the genicular branches which provide an important collateral circulation:
Superior lateral genicular artery

Superior medial genicular artery

Middle genicular artery

Inferior lateral genicular artery

Inferior medial genicular

Question 21

What does the politeal artery divide into?

Answer 21

anterior tibial (AT) artery (laterally)

tibial-peroneal trunk

Question 22

What does the tibial-peroneal trunk divide into?

Answer 22

posterior tibial (PT) artery (medial)

peroneal artery

Question 23

Where does the AT artery lead to?

Answer 23

courses through the interosseous membrane into the anterior fascial compartment

continues through to the foot where it becomes the dorsalis pedis (DP) artery

Question 24

Where does the PT artery lead to?

Answer 24

continues to the foot where it is located just posterior to the medial malleolus

terminates near the ankle

Question 25

What are the components of the anterior compartment of the leg (dorsiflexor)

Answer 25

tibialis anterior muscle extensor digitorum longus muscle extensor hallucis longus muscle anterior tibial artery anteriror tibial vein deep peroneal nerve

Question 26

What are the components of the lateral compartment of the leg?

Answer 26

peroneus longus muscle peroneus brevis muscle superficial peroneal nerve

Question 27

What are the components pf the superficial posterior compartment of the leg?

Answer 27

gastrocnemius muscle soleus muscle plantaris muscle medial sural cutaneous nerve

Question 28

What are the components of the deep posterior compartment of the leg?

Answer 28

popliteus flexor digitorum longus muscle flexor hallucic longus muscle tibialis posterior muscle posterior tibial artery posterior tibial vein tibial nerve peroneal artery peroneal vein

Question 29

What are the branches of the DP artery?

Answer 29

lateral tarsal artery medial tarsal arteries arcuate artery deep plantar artery

Question 30

What are the branches of the PT artery?

Answer 30

lateral plantar artery medial plantar artery

Question 31

What arteries form the plantar arch?

Answer 31

deep plantar artery and lateral plantar artery

Question 32

Where do the dorsal metatarsal arteries arise from?

Answer 32

the arcuate artery

Question 33

Where does the plantar metatarsal arteries arise from?

Answer 33

deep plantar arch

Question 34

Where is the DP artery usually located?

Answer 34

between the first and second digit extensors

Question 35

Where is the PT artery located?

Answer 35

deep to the flexor retinaculum and posterior to the medial maleolus

Question 36

Where is the greater saphenous vein located?

Answer 36

anteromedial aspect of the leg posterior to the medial chondyle of the femur anterior to the medial maleolus drans into the common femoral vein at the sapheno-femoral junction about 3 cm distal to the inguinal ligament

Question 37

Where is the lesser saphenous vein located?

Answer 37

posterior to the lateral maleolus ascends up the posterior calf between the two heads of the gastrocnemius muscle

Question 38

Where does the lesser saphenous vein drain into?

Answer 38

the popliteal vein at the sapheno-popliteal junction

Question 39

Where does the greater saphenous vein drain into?

Answer 39

the common femoral vein at the sapheno-femoral junction this occurs about 3 cm distal to the inguinal ligament

Question 40

What are the perforating veins?

Answer 40

veins that penetrate the deep fascia of the leg and drain into the deep venous system have valves that allow unidirectional blood flow pass through the deep fascia at oblique angles, so that when the musculature contracts, the perforators are compressed and do not allow reflux

Question 41

What's the one muscle that separates the femoral artery and deep artery group?

Answer 41

aductor longus muscle

Question 42

What is a common region of atherosclerosis in the thigh?

Answer 42

near the adductor hiatus (SFA) CIA, popliteal artery, and tibial vessels are also very common

Question 43

Where is the adductor canal?

Answer 43

right behind the sartorius muscle

Question 44

What nerve goes with the anterior tibial artery?

Answer 44

deep peroneal nerve

Question 45

What happens due to damage of the deep peroneal nerve?

Answer 45

foot drop due to lack of action of muscle in the anterior conpartment

Question 46

What nerve travels with the posterior tibial artery?

Answer 46

tibial nerve

Question 47

What are the superficial veins in the lower extremities?

Answer 47

saphenous cephalic basilic external jugular

Question 48

What is the role of the penetrating veins?

Answer 48

connect superficial to deep veins

Question 49

Where are the sinusoids found in the venous systems?

Answer 49

within skeletal muscles part of the "bellows" in the muscle pump mechanism

Question 50

What vessel provides collateral for the SFA?

Answer 50

PFA

Question 51

What vessel provides collateral for the popliteal artery?

Answer 51

geniculates

Question 52

What vessel provides collateral for the AT or PT?

Answer 52

peroneal artery

Question 53

What vessel provides collateral for the DP or PT?

Answer 53

tarsals and plantars

Question 54

What are ommon aneurysms in the lower extremities?

Answer 54

common femoral artery superficial femoral artery - usually traumatic politeal artery - most common

Question 55

What compartment is most often involved in compartment syndrome?

Answer 55

anterior compartment

Question 56

What is the most common chronic manifestation of compartment syndrome?

Answer 56

foot drop

Question 57

Which nerve accounts for this finding?

Answer 57

deep peroneal nerve