Lecture 4 - Vasculature of the Lower Limb

Question 1

Which arteries branch from abdominal aorta?

Answer 1

the right and left common iliac arteries emerge from the distal end of the abdominal aorta.
The common iliac artery further divides into the internal and external iliac arteries

Question 2

What are the three branches of the internal iliac artery?

Answer 2

the internal iliac artery gives rise to three brances that supple the lower extremity, they are:
obturator artery
superior gluteal artery
inferior gluteal artery

Question 3

Obturator Artery

Answer 3

the acetabular branch provides an artery to the head of the femur through the ligamentum teres

Question 4

superior gluteal artery

Answer 4

supplies gluteal muscles

Question 5

inferior gluteal artery

Answer 5

sends branches to the gluteus maximus and muscles that attach to the ischial tuberosity

Question 6

what is a common site for intramuscular injections?

Answer 6

the gluteal region

Question 7

When performing an intermuscular injection of the gluteal region what 5 structures must be avoided?

Answer 7

superior gluteal artery and nerve
inferior gluteal artery and nerve
and the sciatic nerve
make a line b/w PSIS and greater trochanter, inject superiorly and laterally to this line and you’ll avoid these structures

Question 8

Femoral Artery

Answer 8

the internal iliac artery becomes the femoral artery when it passes under the inguinal ligament.

• passes through the femoral triangle and down the anterior thigh
• penetrates adductor hiatus to enter the posterior aspect of the thigh
• becomes the popliteal artery

Question 9

What are the branches off of the femoral artery?

Answer 9

superficial epigastric arteries
profunda femoris (deep femoral artery)
external pudendal artery

Question 10

superficial epigastric arteries

Answer 10

run subcutaneously and superiorly towards umbilicus

Question 11

profunda femoris (deep femoral artery)

Answer 11

descends to supply much of the adductor compartment

Question 12

external pudendal artery

Answer 12

runs medially over spermatic cord (males) or round ligament of the uterus (females) to supply external genetalia

Question 13

Lateral and Medial femoral circumflex arteries

Answer 13

both the lateral and medial femoral circumflex arteries can arise from either the femoral or deep femoral artery

Question 14

Which circumflex artery is the most important?

Answer 14

the medial femoral circumflex artery is the most important bc it supplies most of the blood for the head and neck of the femur. The lack of blood supply to this area puts the femoral head at risk for avascular (ischemic) necrosis after injury

Question 15

Once the femoral artery passes through the adductor hiatus it becomes?

Answer 15

the popliteal artery

Question 16

politeal artery becomes..

Answer 16

popliteal artery through popliteal fossa posterior to the knee, the popliteal artery becomes the posterior tibial artery once it passes the inferior border fo the popliteus muscle

Question 17

posterior tibial artery supplies

Answer 17

the posterior compartment muscles

Question 18

the fibular artery supplies

Answer 18

the lateral compartment muscles

Question 19

Posterior tibial artery branches to

Answer 19

anterior tibial artery, fibular artery, posterior tibial artery

Question 20

anterior tibial artery

Answer 20

travels through a gap in the interosseus membrane to supple the anterior compartment of the leg

Question 21

fibular artery

Answer 21

supplies lateral compartment of the leg

Question 22

posterior tibial artery

Answer 22

ends when it splits into the medial and lateral plantar arteries after it wraps around the medial malleolus

Question 23

Medial and Lateral Plantar arteries

Answer 23

terminal branches of the posterior tibial artery
supply sole of the foot
neurovascular bundles of the foot pass posteriorly to the medial malleolus

Question 24

Anterior Tibial Artery

Answer 24

-anterior compartment muscles

Question 25

What artery is the palpable pulse on the dorsum of the foot?

Answer 25

doral pedis artery, branching from the anterior tibial artery

Question 26

Popliteal Fossa

Answer 26

between lower tendons of hamstrings and heads of gastrocnemius
Five structures pass through
-popliteal artery and vein
-tibial nerve
-common fibular nerve
-lymph nodes

Question 27

What three structures form the femoral triangle?

Answer 27

Inguinal ligament, sartorius and adductor longus

Question 28

What passes through the femoral triangle?

Answer 28

femoral nerve, artery, vein, inguinal lymph nodes

Question 29

What vein enters the femoral vein?

Answer 29

the great saphenous vein

Question 30

What is the site for femoral hernias?

Answer 30

the femoral canal - the space medial to the femoral vein

Question 31

What is a femoral hernia?

Answer 31

intestinal loop passes through femoral canal, often presents as a lump or bulge in the area of the femoral triangle. There may or may not be pain associated - more often seen in females.
Standard treatment is surgery.

Question 32

Superficial veins of the lower limb?

Answer 32

long saphenous veing:

• long veing along medial aspect of leg and thigh
• used as a source of bypass vessels

Question 33

Deep veins of the lower limb?

Answer 33

venae comitantes follow deep arteries, account for over 99% of veneous return from lower extremeties

Question 34

Perforating veins interconnect what?

Answer 34

interconnects the superficial and deep veins

• valves in the perforating veins become incompetent
• contractions of calf muscles cause a reverse flow externally through the perforating veins
• the superficial and perforating veins become vericose

Question 35

Popliteal lymph nodes

Answer 35

Almost anything below the knee go to the popliteal nodes (step on a nail, ex)

Question 36

Milroy’s disease

Answer 36

congenital absence of lymph nodes in the body