Blood Supply of the Lower Extremity Flashcards

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1
Q

What is the inguinal ligament?

A

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

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2
Q

What structures make up the femoral triangle?

A

Inguinal ligament (superior)

Adductor longus (medial)

Sartorius (lateral)

Iliopsoas & pectineus (floor)

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3
Q

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

A

femoral nerve

femoral sheath

common femoral artery

common femoral nerve

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4
Q

What muscles are at the floor of the femoral triangle?

A

iliopsoas and pectineus muscles

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5
Q

What is the femoral sheath and what is its role?

A

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

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6
Q

What are the three compartments of the femoral sheath?

A

lateral

intermediate

medial

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7
Q

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

A

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

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

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8
Q

What is the profunda femoral artery?

A

main artery of the thigh

separated from the SFA by the adductor longus

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9
Q

Where is the perforator artery located?

A

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

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10
Q

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

A

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

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

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11
Q

What branches off of the lateral circumflex artery?

A

ascending, transverse, and descending branches

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12
Q

What compartments of the thigh does the PFA supply?

A

medial, posterior, and lateral compartments of the thigh

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13
Q

Describe the anatomical position of the superficial femoral artery.

A

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

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14
Q

What is the adductor hiatus formed from?

A

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

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15
Q

What does the SFA supply blood to?

A

anterior and anteromedial aspects of the thigh

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16
Q

What is the popliteal fossa? What are its borders?

A

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

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17
Q

What are the contents of the popliteal fossa?

A

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

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18
Q

What is the popliteal artery?

A

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

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19
Q

Where is the popliteal vein?

A

lies posterolateral to the popliteal artery

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20
Q

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

A

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

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21
Q

What does the politeal artery divide into?

A

anterior tibial (AT) artery (laterally)

tibial-peroneal trunk

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22
Q

What does the tibial-peroneal trunk divide into?

A

posterior tibial (PT) artery (medial)

peroneal artery

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23
Q

Where does the AT artery lead to?

A

courses through the interosseous membrane into the anterior fascial compartment

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

24
Q

Where does the PT artery lead to?

A

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

terminates near the ankle

25
Q

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

A

tibialis anterior muscle

extensor digitorum longus muscle

extensor hallucis longus muscle

anterior tibial artery

anteriror tibial vein

deep peroneal nerve

26
Q

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

A

peroneus longus muscle

peroneus brevis muscle

superficial peroneal nerve

27
Q

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

A

gastrocnemius muscle

soleus muscle

plantaris muscle

medial sural cutaneous nerve

28
Q

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

A

popliteus

flexor digitorum longus muscle

flexor hallucic longus muscle

tibialis posterior muscle

posterior tibial artery

posterior tibial vein

tibial nerve

peroneal artery

peroneal vein

29
Q

What are the branches of the DP artery?

A

lateral tarsal artery

medial tarsal arteries

arcuate artery

deep plantar artery

30
Q

What are the branches of the PT artery?

A

lateral plantar artery

medial plantar artery

31
Q

What arteries form the plantar arch?

A

deep plantar artery and lateral plantar artery

32
Q

Where do the dorsal metatarsal arteries arise from?

A

the arcuate artery

33
Q

Where does the plantar metatarsal arteries arise from?

A

deep plantar arch

34
Q

Where is the DP artery usually located?

A

between the first and second digit extensors

35
Q

Where is the PT artery located?

A

deep to the flexor retinaculum and posterior to the medial maleolus

36
Q

Where is the greater saphenous vein located?

A

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

37
Q

Where is the lesser saphenous vein located?

A

posterior to the lateral maleolus

ascends up the posterior calf between the two heads of the gastrocnemius muscle

38
Q

Where does the lesser saphenous vein drain into?

A

the popliteal vein at the sapheno-popliteal junction

39
Q

Where does the greater saphenous vein drain into?

A

the common femoral vein at the sapheno-femoral junction

this occurs about 3 cm distal to the inguinal ligament

40
Q

What are the perforating veins?

A

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

41
Q

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

A

aductor longus muscle

42
Q

What is a common region of atherosclerosis in the thigh?

A

near the adductor hiatus (SFA)

CIA, popliteal artery, and tibial vessels are also very common

43
Q

Where is the adductor canal?

A

right behind the sartorius muscle

44
Q

What nerve goes with the anterior tibial artery?

A

deep peroneal nerve

45
Q

What happens due to damage of the deep peroneal nerve?

A

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

46
Q

What nerve travels with the posterior tibial artery?

A

tibial nerve

47
Q

What are the superficial veins in the lower extremities?

A

saphenous

cephalic

basilic

external jugular

48
Q

What is the role of the penetrating veins?

A

connect superficial to deep veins

49
Q

Where are the sinusoids found in the venous systems?

A

within skeletal muscles

part of the “bellows” in the muscle pump mechanism

50
Q

What vessel provides collateral for the SFA?

A

PFA

51
Q

What vessel provides collateral for the popliteal artery?

A

geniculates

52
Q

What vessel provides collateral for the AT or PT?

A

peroneal artery

53
Q

What vessel provides collateral for the DP or PT?

A

tarsals and plantars

54
Q

What are ommon aneurysms in the lower extremities?

A

common femoral artery

superficial femoral artery - usually traumatic

politeal artery - most common

55
Q

What compartment is most often involved in compartment syndrome?

A

anterior compartment

56
Q

What is the most common chronic manifestation of compartment syndrome?

A

foot drop

57
Q

Which nerve accounts for this finding?

A

deep peroneal nerve