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MD2002 - ESA > Circulation of the lower limb > Flashcards

Circulation of the lower limb Flashcards

1
Q

Where does oxygenated blood which supplies the lower limb come from?

A

Oxygenated blood is ejected by the left ventricle
- to the Ascending aorta
- to the aortic arch
- to the descending aorta (thoracic and abdominal)

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2
Q

Where does the abdominal aorta terminate?

A

Into the left and right common iliac arteries

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3
Q

What landmark do the common iliac arteries give rise to external and internal iliac arteries?

A

Sacroiliac joint

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4
Q

What is the function of the external and internal iliac arteries?

A

External iliac artery supplies the majority of the lower limb while Internal iliac also contributes

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5
Q

What are the 4 branches of the internal iliac artery?

A

1) Superior gluteal artery
2) Inferior gluteal artery
3) Internal pudendal artery
4)Obturator artery

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6
Q

Where does the Superior gluteal artery pass through

A

Passes from the pelvic cavity to the gluteal region via the greater sciatic foramen, above piriformis muscle

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7
Q

Where do the inferior gluteal artery pass through?

A

Enters the gluteal region via the greater sciatic foramen, below piriformis muscle

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8
Q

Where do the obturator artery pass through?

A

Lies on lateral wall of pelvis and passes through obturator canal

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9
Q

Where does the external iliac artery?

A

The external iliac artery passes under the inguinal ligament

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10
Q

What does the external iliac artery become?

A

the femoral artery

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11
Q

Where is the pulse of the external iliac artery felt?

A

the pulse is found inferior to the mid-inguinal point

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12
Q

What are the 4 branches of the femoral artery?

A
  • superficial epigastric artery
  • superficial circumflex iliac artery
  • external pudendal arteries
  • profunda femoris artery (deep artery of the thigh)
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13
Q

Where does the femoral artery enter and pass into?

A

enters the adductor canal to pass into the popliteal fossa

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14
Q

What branches does the profunda femoris give off?

A

medial circumflex femoral artery
- lateral circumflex femoral artery
-3 to 4 perforating arteries

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15
Q

Where are there rich number of anastamoses?

A

there are rich anastomoses around the hip with the gluteal vessels (with branches of internal iliac artery) and around the knee

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16
Q

What does the profunda femoris supply?

A

the posterior compartment of the thigh

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17
Q

What are the 4 arteries of the trochanteric anastomosis?

A
  • Medial circumflex femoral artery (and retinacular branches)
  • Lateral circumflex femoral artery
  • Superior gluteal artery
  • Inferior gluteal artery
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18
Q

What do the trochanteric anastomosis provide circulation for?

A

the trochanteric anastomosis provides circulation around the head of the femur

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19
Q

What are the 4 arteries of the cruciate anastomosis?

A
  • First perforator
  • Inferior gluteal artery
  • Lateral circumflex femoral artery
  • Medial circumflex femoral artery
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20
Q

What do the cruciate anastomosis provide circulation?

A

The function of the cruciate anastomosis is to provide an alternative route for the blood supply of the lower limb when there is a blockage of the blood flow between the external iliac and femoral arteries

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21
Q

What are the two possible fractures of the hip joint?

A
  1. Femoral Neck Fracture (Intracapsular Fracture)
  2. Intertrochanteric Fracture (Extracapsular Fracture)
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22
Q

What may be affected by the fracture of the femoral neck?

A

the blood supply of femoral head may be affected by the fracture of the femoral neck

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23
Q

What are retinacular vessels?

A

retinacular arteries are branches of the medial and lateral circumflex femoral arteries that extend to the head of the femur within retinacuar folds of synovial membrane surrounding the neck of the femur. Collectively, these arteries provide the main blood supply to the femoral head.

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24
Q

What structures do the popliteal artery lie between?

A

Between Hiatus tendineus and lower border of popliteus muscle

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25
What is a main characteristic of the popliteal artery?
Deepest structure in the popliteal fossa and so it is therefore difficult to get the pulse
26
Where can the pulse be felt?
it can be found at the medial aspect of the popliteal fossa
27
What does the popliteal artery give rise to?
5 genicular branches
28
How does the popliteal artery exit the popliteal fossa?
Exit the popliteal fossa by passing through tendinous arch of soleus
29
how does the popliteal artery become?
the posterior and anterior tibial arteries.
30
What does the popliteal artery supply?
Supplies the knee joint
31
When may the popliteal artery be compromised?
may be compromised in dislocation of the knee and in fractures of the lower femur, it is also the second most common site of aneurysm
32
What are the 5 genicular branches pf the popiteal artery?
- superior lateral genicular artery - inferior lateral genicular artery - superior medial genicular artery - middle genicular artery - inferior medial genicular artery
33
What branches off of the profunda femoris?
Descending branch of the lateral circumflex femoral artery
34
What branches off of anterior tibial artery?
anterior tibial recurrent artery
35
What does the anterior tibial recurrent artery form?
genicular anastamosis
36
in what two ways, does blood continue to reach the popliteal artery when there is a blockage between the external iliac artery and femoral artery?
1) iliac artery >> inferior gluteal artery>> a perforating branch of the profunda femoris artery>> the lateral circumflex femoral artery >> its descending branch>> the superior lateral genicular artery the popliteal artery 2) via the anastomoses between the obturator artery and branches of profunda femoris
37
What is the anterior tibial artery accompanied by?
the anterior tibial artery descends, deep to the anterior compartment muscles accompanied by the deep fibular (peroneal) nerve
38
What does the anterior tibial artery supply?
Anterior compartment muscles
39
Where does the anterior tibial artery become the dorsalis pedis artery?
inferior to the extensor retinaculum
40
What kind of branch is the dorsalis pedis?
the dorsalis pedis is an arcuate branch as well as the the 1st dorsal metatarsal branch and flows into dorsal digital arteries
41
Where is the dorsalis pedis felt?
the dorsalis pedis pulse is felt in the first intermetatarsal space
42
What does the posterior tibial artery accompany?
the posterior tibial artery accompanies the tibial nerve as it descend deep to the soleus muscle
43
What branches off of the posterior tibial artery?
- Fibular artery - Circumflex fibular artery - Nutrient arteries
44
What does the posterior tibial artery supply?
it supplies the muscles of the posterior compartment of the leg (plantar flexors)
45
What does the posterior tibial artery terminate and become?
t terminates and becomes the medial and lateral plantar arteries after running posterior to the medial malleolus
46
Where can the pulse of the posterior tibial artery be felt
the pulse of the posterior tibial artery can be felt behind the medial malleolus
47
What do the medial and lateral plantar arteries supply?
the medial and lateral plantar arteries supply the sole of the foot along with their branches: superficial plantar arches (medial plantar arteries) and deep plantar arches (lateral plantar arteries)
48
What does the deep plantar arch give rise to?
The deep arch gives rise to plantar digital arteries of the phalanges
49
Where do the superficial veins originate from
superficial veins originate from the dorsal venous network of the foot and dorsal veins of foot
50
Where does the great saphenous vein ascend and pierce through?
Great (long) saphenous vein ascends 2.5 cm anterior to the medial malleolus, posterior to medial condyle of femur (Hands breadth behind the patella) and pierces the fascia lata to join the femoral vein.
51
Where does the small saphenous vein ascend and penetrate through and merge with?
Small (short) saphenous vein ascends posterior to lateral malleolus and penetrates the deep fascia of the leg in the popliteal fossa and merges with deep veins to form the popliteal vein
52
Where do the deep veins of the lower limb ascend to?
They ascend internal to the deep fascia of the lower limb
53
Where does the femoral vein ascend to and terminate as?
Femoral vein ascends in the adductor canal from the popliteal vein, it enters the femoral sheath and ends as the external iliac vein.
54
Where does the femoral vein receive drainage from?
It receives drainage from profunda femoris, great saphenous and other small branches.
55
What is the order of venous flow?
Venous flow is from superficial to deep veins, via perforators
56
What 3 things help venous return to the heart, against gravity
Arterial pulsation, negative intra-thoracic pressure and contraction of muscles
57
What do valves do?
Prevent backflow
58
What do superficial lymph vessels accompany?
Superficial lymph vessels accompany the superficial veins
59
where do the lymph vessels accompanying the great saphenous vein drain to? and eventually lead to?
The lymph vessels accompanying the great saphenous vein drain to the superficial inguinal lymph nodes leading to the deep inguinal nodes then the external iliac nodes
60
where do the lymph vessels accompanying the small saphenous vein drain to?
popliteal lymph nodes.
61
where do the deep lymph vessels drain to?
Deep lymph vessels accompany deep veins and enter the popliteal lymph nodes, accompany femoral vein to the deep inguinal nodes.
62
What structure is formed by the superficial inguinal nodes?
“T” along inguinal ligament and saphenous vein
63
What 5 places do superficial inguinal nodes receive lymph nodes?
Anterior abdominal wall (under umbilicus) Skin of back below iliac crests Gluteal region Perineum Superficial Lower limb
64
What is the femoral canal?
a short and conical space between the medial wall of the femoral sheath and the femoral vein
65
What does the femoral contain?
deep inguinal lymph nodes
66
Where are deep inguinal nodes located?
In the femoral triangle, medial to femoral vein
67
What 3 places are deep inguinal nodes located?
- Lower limp - Superficial inguinal nodes - External genitalia
68
What do deep and superficial inguinal nodes drain to?
1. external iliac nodes 2. common iliac nodes 3. lumbar lymph nodes 4. cisterna chyli 5. thoracic duct 6. Pirogov’s venous angle (left) 7. venous system

MD2002 - ESA (33 decks)

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