L10.1 LL vessels

Question 1

LL artery branches

Answer 1

• *Profunda femoris goes down → sends perforating vessels through ADD magnus hiatus to reach POS compartment → Goes onto the flexor aspect of knee*

Question 2

Femoral Canal

Answer 2

• Wide mouth superiorly (Femoral ring) - opening to abdominal cavity → coverges inferiorly, funnel shaped
• MED: Lacanar lig
• ANT: IL
• POS: floor of femoral triangle (pectineus)
• LAT: Femoral V
• Canal creates space → potential for a femoral herniation, easy for blood supply to be compromised

Question 3

Positioning of the ANT/POS tibial bundle

Answer 3

• ANT tibial → ANT neurovascular bundle ANT of interosseous membrane
  
  • Dorsali pedis → 1st web space → complete plantar arch
• POS tibial → POS neurovascular bundle POS of interosseous membrane (but not directly)

Question 4

Structures at the flexor/extensor retinaculum

Answer 4

• Extensor: (from MED → LAT) Timothy has a nasty, dirty toe
  
  • TA, EHL, A, N, EDL, FT
• Flexor: (from malleolus → calcaneous) Tom, Dick and very naughty Harry
  
  • TP, FDL, A, V, N (tibial), FHL

Question 5

What happens during a rise in compartmental pressure?

Answer 5

• Injury → oedema/bleeding → ↑ compartmental pressure → ↓BF → ischaemia → cycles back to oedema
• Symptoms: painful, pale, pulseless, paraesthetic (pins/needles), paralysed
• Treatment: fasciotomy

Question 6

What are the 2 main superficial veins in the LL?

Answer 6

• Great Saphaneous Vein: ANT to MED malleolus (accompanied by Saphaneous N) up medially→ Disappears behind patella → Reappears in MED thighs → Saphenous opening
• Small Saphenous Vein: POS to LAT malleolus → POS leg → Penetrates deep fascia → popliteal vein at the popliteal fossa
  
  • Have series of communicating Vein (have valves)
  • Pierces Fascia Lata

Question 7

What is a varicosed vein?

Answer 7

• Incompetent vein valves (especially at termination of GSV, SSV, & perforating veins)
• Dilated tortuous SUP veins (always filled with blood)
• ↑Capillary pressure
• Extrusion of blood in soft tissues
• Brown pigmentation, venous eczema (blood pooling as a result of lack in venous return), ulceration

Question 8

Lymphatics of the LL

Answer 8

• Deep → follows A
• SUP → Follows V
  
  • Divided into horizontal & longitudinal group
    
    • Horizontal also drains ANT ab wall & external genitalia & peroneum
• Series accompanying SSV → into popliteal fossa → popliteal lymph nodes → into inguinal lymph nodes