Lecture 5: Vessels and Nerves of the lower extremity and femoral triangle

Question 1

Where does the femoral artery…

1. begin?
2. what is it enclosed in?
3. what are the proximal branches?

Answer 1

1. deep to the inguinal ligament
2. enclosed in the femoral sheath
3. -Superficial epigastric artery
   - superficial circumflex iliac artery
   - superficial external pudendal artery

Question 2

Where does the femoral artery become the popliteal artery?

Answer 2

at the abductor hiatus

Question 3

Which of the superficial branches of the femoral artier crosses the inguinal ligament toward the umbilicus?

Answer 3

Superficial epigastric artery

Question 4

Which artery is the femoral artery a continuation of?

Answer 4

external iliac artery

Question 5

What are the deep branches of the femoral artery?

Answer 5

• deep external pudendal
• descending vehicular
• profunda femora

Question 6

Which is the largest branch of the femoral artery?

Answer 6

Profunda femoris

Question 7

Which of the branches of the femoral artery supplies the hip joint, muscles of the upper thigh and gluteal region?

Answer 7

Medial femoral circumflex

Question 8

Describe the beginning and the end of the popliteal artery

Answer 8

begins at the abductor hiatus and ends at the inferior border of the popliteus muscle

Question 9

What joins the internal iliac to the femoral?

Answer 9

cruciate anastomosis: bypass for femoral or external iliac arteries

Question 10

What are the 3 contributors of the vehicular anastomosis?

Answer 10

1. genicular branches of the popliteal artery
2. descending branches of femoral and deep femoral arteries
3. ascending branches of anterior and posterior tibial arteries

Question 11

Describe the great saphenous vein

Answer 11

• drains the medial side of the dorsal venous arch
• ascends anterior to medial malleolus
• passes posterior to medial border of patella
• ascends along the medial thigh
• dumps into the femoral vein

Question 12

Describe the lesser saphenous vein

Answer 12

• drains the lateral side of the dorsal venous arch
• passes posterior to lateral malleolus
• accompanies the sural nerve
• ascends along the midline of the calf
• empties into the popliteal vein in the popliteal fossa

Question 13

What are the deep veins of the lower limb?

Answer 13

venae comitantes
popliteal vein
communicating veins

Question 14

Describe the lymphatics draining the medial foot?

Answer 14

• ascend with the great saphenous vein
• end in the superficial inguinal lymph nodes
• drain into the lower abdominal wall, external genitalia, and region, uterine funds

Question 15

Describe the lymphatics draining the lateral foot

Answer 15

ascend with the small saphenous vein

• end in the lymph nodes in the popliteal fossa
• ascend with the femoral vein to the deep inguinal nodes

Question 16

Describe the drainage pathway of the lower limb lymphatics

Answer 16

superficial inguinal to the deep inguinal to the external iliac

Question 17

What are the 3 components and levels of the lumbosacral plexus?

Answer 17

1. lumbar plexus L1-L4
2. lumbosacral trunk L4-L5
3. sacral plexus S1-S4

Question 18

What are the three branches of the L1 portion of the lumbar plexus?

Answer 18

Iliohypogastric
Ilioinguinal
Genitofemoral nerce

Question 19

Which two branches emerge from the lateral side of the psoas major? And where do they go?

Answer 19

The iliohypogastric goes to the side of the buttock and the pubis and the ilioingual goes to the anterior thigh, scrotum, and labia major

Question 20

Which branch of L1 emerges on the anterior side of the psoas major?

Answer 20

The genitofemoral nerve which supplies the scrotum, labia majora (GSA) and cremaster muscle (GSE)

This also goes to the skin over the femoral triangle

Question 21

Describe the femoral nerve

Answer 21

from L2 to L4 and it is the largest branch of the lumbar plexus

emerges from the lateral side of psoas major

Question 22

What does the femoral nerve supply in the iliac fossa?

Answer 22

The iliacus (GSE and pectinous (GSE) and the femoral artery (GVE)

Question 23

What does the femoral nerve supply distally?

Answer 23

The saritorius, quadriceps femoris and the anterior thigh

Question 24

What does the femoral nerve terminate as?

Answer 24

saphenous nerve (GSA) to the medial thigh and foot

Question 25

Describe the obturator nerve

Answer 25

L2-L4

emerges from the medial side of the psoas major and descends along the lateral wall of the pelvis

Question 26

What does the obturator nerve supply?

Answer 26

medial thigh muscles (GSE) and the skin on the medial thigh ( GSA)

Question 27

Describe the superior gluteal nerve

Answer 27

L4 to S1

-passes through the greater sciatic notch above the piriforms which supplies the lateral gluteal compartment

Question 28

Describe the posterior femoral cutaneous nerve

Answer 28

runs with the gluteal nerves deep to the gluteus maximus

supplies: skin on the buttock, skin of the external genitalia, and the skin of the back thigh

Question 29

Describe the sciatic nerve

Answer 29

fusion of the common perineal and tibial nerves

hes a big boiiii

exits the pelvis through the greater sciatic foramen

Question 30

Describe peripheral nerve injury

Answer 30

all motor function and sensation that is supplied by the nervy DISTAL to the injury is lost

total muscle function is lost

sensation over more than one dermatome is lost

Question 31

Describe a nerve root nerve injury

Answer 31

usually by a disc herniation

sensory impairment over one dermatome

muscle weakening