Limbs 4 Flashcards
What are the two routes of venous return in the lower limb?
- deep (accompanying arteries)
- superficial (close to limb surface)
What do many of the deep distal veins form?
Venae comitantes
What are the main deep veins of the lower limbs?
- femoral vein
- deep femoral vein
- anterior tibial vein
- posterial tibial vein
- popliteal vein
- peroneal vein
What are venae comitantes?
Multiple veins forming a network of smaller veins with arteries which they accompany
What are the benefits of veins forming venae comitantes?
- heats exchange
- arteries promote venous flow
What allows only distal to proximal blood flow in the lower limb veins?
Valves in the veins
What is the calf pump?
- deep veins are sandwiched between layers of calf muscles
- contraction of muscles squeezes deep veins pushing blood towards heart
What are the main superficial veins of the lower limb?
Long and short saphenous vein
Where do the superficial veins arise from?
Dorsal venous network of the foot
What do the saphenous veins drain into?
- long = femoral vein
- short = popliteal vein
Where does the long saphenous vein run from?
- on medial side of leg
- passes anterior to the medial malleolus at the ankle
- continues superiorly and medially in the leg
- more posteriorly at the knee
- medial in the thigh until the vein passes anterior to the femoral triangle
- drains into the femoral vein through the saphenous opening in fascia lata
Where does the short saphenous vein run from?
- lateral side of leg
- passes posteriorly to the lateral malleolus at the ankle
- runs superiorly on the posterior
- drains into the popliteal vein after piercing the fascia over the popliteal fossa
What can the superficial veins of the lower limb be used for?
Can be harvested for venous grafts, mostly coronoary artery bypass grafts
What happens if the valves which allow blood flow from superficial to deep veins are compromised?
- varicose veins
- blood is pushed from deep to superficial veins
- deep venouse return is slowed down
What do varicose veins increase the risk of?
DVT due to sluggish deep venous return
What are the two areas of nodes on the lower limb?
- popliteal nodes
- inguinal nodes
What do the popliteal nodes drain?
Distal limb (legs, toes)
What do the inguinal nodes drain?
- lower limb
- pudendal region
- perineum
- anus
- parts of lower abdomen
What is the superficial drainage of the lymphnodes?
- posterior lymph vessels run with short saphenous vein
- drain into popliteal nodes in popliteal fossa
- lymph nodes continue in association with femoral vein
- vessels running with long saphenous vein drain into superficial inguinal nodes in inguinal region close to saphenous opening and inguinal ligament
What is the deep lymphatic drainage of the lower limb?
- most drainage of the distal lower limb drains into the deep inguinal nodes
- some also drains into popliteal nodes
Where does lymphatic drainage of the lower limb go up to?
Drainage via iliac vessels passing through iliac nodes
What are the important anatomical spaces of the lower limb?
- femoral triangle
- popliteal fossa
What are the borders of the femoral triangle?
.
What is the femoral triangle covered by?
Skin and deep fascia (fascia lata)
What runs through the opening in the fascia lata?
Long saphenous vein entering the triangle to drain into femoral vein
What does the femoral triangle contain?
- femoral nerve
- femoral artery
- femoral vein
- superficial and deep lymphnodes
What happens when the femoral nerve enters the femoral triangle?
Branches into many smaller nerves to supply its muscular and cutaneous targets
What can be palpated in the femoral triangle?
Arterial pulse
What can the femoral artery and vein be accessed for in the femoral triangle?
Catheterisation for procedures involving coronary arteries or other parts of the heart
What is the popliteal fossa?
Diamond shaped opening in the back of the knee
What are the borders of the popliteal fossa?
.
What does the popliteal fossa contain?
- tibial and common peroneal nerves
- popliteal artery and vein
- popliteal lymph nodes
What can be palpated at the popliteal fossa?
Pulse of the popliteal artery
Which nerve leaves the popliteal fossa at the head of the fibula and what does it divide into?
- common fibular nerve
- divides into superficial and deep fibular nerves
What forms the tibial and common peroneal nerves?
Bifurcation of the sciatic nerve
What is the adductor canal?
- muscle-lined gutter
- starts at the inferior apex of the femoral triangle and ends at the hiatus of adductor magnus
What passes through the adductor canal?
- saphenous nerve
- femoral artery and vein