Circulation and Lymphatics of the Lower Limb Flashcards
What are the branches of the internal iliac artery and their routes. (SIIO)
- Superior gluteal artery - Passes from pelvic cavity to gluteal region via greater sciatic foramen above piriformis muscle.
- Interior gluteal artery - Enters the gluteal region via greater sciatic foramen below piriformis muscle
- Internal pudendal artery - via lesser sciatic foramen
- Obturator Artery - Lies on lateral wall of pelvis and passes through obturator canal
Describe some of the features of the external iliac artery
External iliac artery passes under the inguinal ligament and becomes femoral artery.
Pulse is felt inferior to midpoint of inguinal point.
Enters the adductor canal and passes into popliteal artery
What are the branches of the femoral artery just after the inguinal ligament
- Superior epigastric artery
- Superior circumflex iliac artery
- External pudendal arteries
- Profunda femoris artery
What are the branches of the profunda femoris artery
Medial circumflex femoral artery, lateral circumflex femoral artery and 3-4 perforators (pierce muscles)
What is the blood supply of the hip joint?
Trochanteric anastomosis; medial circumflex femoral artery, lateral circumflex femoral artery, superior gluteal artery and the inferior gluteal artery. (MLIS)
Cruciate anastamosis; Medial circumflex femoral artery, lateral circumflex femoral artery and obutrator artery (MLO)
Blood supply to the femoral head may be affected by what?
Fracture of the femoral neck
Blood can still reach the popliteal artery even if there is a blockage between femoral and external iliac artery by?
It can also travel via the anastomoses between obturator artery and branches of profunda femoris
Describe some features of the popliteal artery
It is found from Adductor Hiatus to Inferior Border of Popliteus.
It is the deepest structure of the popliteal fossa so it is difficult to get a pulse.
It gives rise to 5 genicular branches.
Ends as the posterior and anterior tibial arteries
Describe the blood supply of the knee
- 5 Genicular arteries from popliteal artery (Superior, middle and inferior medial genicular artery and the superior and inferior lateral genicular artery)
- Branches of femoral
- Branches of profunda femoris (descending branch of lateral circumflex femoral)
- Branch from Anterior Tibial recurrent artery
What is the anterior tibial artery accompanied by?
What does it supply and where does it become dorsalis pedis?
Crosses above the interosseous membrane into anterior compartment.
The deep fibular nerve as it descends in the anterior leg.
It supplies anterior compartment of muscles and becomes dorsalis pedis inferior to extensor retinaculum (in the foot)
Describe some of the features of dorsalis pedis artery
It has two branches; arcuate branch and the 1st dorsal metatarsal branch which gives rise to dorsal digital arteries.
1st Dorsal Metatarsal also gives rise to Deep Plantar Artery
Dorsalis pedis pulse is felt in the first intermetatarsal space.
Describe the features of the posterior tibial artery
- Accompanies tibial nerve.
- Gives off the fibular, circumflex fibular and nutrient arteries.
- Supplies muscles in posterior compartment
- Terminates as medial and lateral planter arteries after running posterior to medial malleolus
Describe features of the lateral and medial plantar arteries
- Supply sole of feet
- Lateral - gives off deep branch
- Medial - gives of superficial branch
- Deep arch gives rise to plantar metatarsal arteries
Name the two superficial veins?
Great saphenous vein and the small saphenous vein
Describe features of the great saphenous vein
- Ascends 2.5 cm anterior to medial malleolus
- Hand´s width posterior to patela.
- Femoral triangle - pierces the fascia lata to join the femoral vein
Describe features of the short saphenous vein
Ascends posterior to lateral malleolus and penetrates crural fascia in the leg in popliteal fossa to join deep veins and form popliteal vein
Describe the deep veins of the lower limb
Femoral vein
- Vena comitantes mostly have same name as artery they supply.
- Femoral vein ascends in adductor canal from the popliteal vein
- Receives drainage from profunda femoris, great saphenous and other small branches.
What helps venous flow return to the heart against gravity
Arterial pulsation, muscular contraction and negative intra-thoracic pressure
Where do the lymphatic vessels accompanying the great saphenous and small saphenous vein?
Great saphenous - Drain to superficial inguinal lymph nodes and then to external iliac nodes
Small saphenous - drain to popliteal lymph nodes
Describe some features of the superficial inguinal nodes
Found along the inguinal ligament and saphenous vein. They receive lymph from;
- Anterior abdominal wall
- Skin of back
- Perineum
- Gluteal region
- Superficial lower limb
Describe some of the features of deep inguinal nodes
- Found in femoral triangle, medial to femoral vein.
Receives lymph from:
- Lower limb
- Superficial inguinal nodes
- External genitalia
Describe the travel of the lymph from the inguinal nodes
External iliac node, common iliac nodes, lumbar lymph nodes, cisterna chyli, thoracic duct, Pirogov’s venous angle and the venous system.
Thigh summary
Features of fibular artery
