Lower Extremity Vasculature

Question 1

Femoral Triangle Boundaries

Answer 1

Inguinal ligament (superior). Adductor Longus (Medial). Sartorius Muscle (Lateral). Pectineus/adductor longus/Iliopsoas (Floor). Fascia Lata (Roof).

Question 2

Contents of Femoral Triangle

Answer 2

Femoral nerve/sheath

Question 3

Contents of femoral sheath

Answer 3

Femoral artery/vein/canal

Question 4

Contents of femoral canal

Answer 4

Lymphatics

Question 5

What is the superior border of the femoral artery?

Answer 5

The inguinal ligament (superior is the external iliac artery)

Question 6

Path of the femoral artery

Answer 6

Becomes femoral below the inguinal ligament, runs thru the anterior compartment of the thigh, runs thru the femoral triangle, thru the adductor canal, into the popliteal fossa, changing into the popliteal artery.

Question 7

What branches of the femoral artery supply the cutaneous regions of the upper thigh, lower abdomen, and perineum?

Answer 7

Superficial circumflex iliac A. Superficial epigastric A. Superficial external pudendal A. Deep External pudendal A.

Question 8

What path does the deep artery of the thigh take?

Answer 8

Is parallel, but posterior to femoral artery. Runs between pectineus and adductor longus, penetrates adductor magnus to anastamose with branches of the popliteal artery behind the knee.

Question 9

Path of Media Circumflex Femoral Artery

Answer 9

Passes posteriomedially around the shaft of the femur between pectineous and iliopsoas, then between obturator externus and adductor brevis muscles. Small branch enters hip joint to supply femur head/neck then anastamoses with acetabular branch of obturator artery/inferior gluteal artery/1st perforating artery/lateral circumflex femoral artery

Question 10

Path/Brances of Lateral Circumflex Femoral Artery

Answer 10

Arises from deep artery of the thigh, passes laterally deep to the sartorius and rectus femoris. Gives rise to Ascending, Transverse, and Descending branches.

Question 11

Ascending branch of lateral circumflex femoral artery

Answer 11

Ascends deep to tensor fascia latae. Anastamoses with superior gluteal artery/branch of medial circumflex femoral artery. Supplies head/neck of femur

Question 12

Transverse branch of lateral circumflex femoral artery

Answer 12

Passes deep to rectus femoris muscle. Anastamoses with medial circumflex femoral artery/inferior gluteal artery/1st perforating artery to form cruciate anastomoses around the hip

Question 13

Descending branch of lateral circumflex femoral artery

Answer 13

Passes deep to rectus femoris. Anastomoses with medial circumflex femoral artery. Passes inferiorly on vastus intermedius to anastomose with genicular arteries at the knee

Question 14

Perforating arteries

Answer 14

Branch from deep artery of the thigh. All branches penetrate the adductor magnus to supply the posterior compartment of the thigh. Have both ascending and descending branches that anastomose

Question 15

Internal Iliac Artery: Arises from where and usual divisions

Answer 15

Arises from common iliac artery. Commonly divides into anterior and posterior divisions

Question 16

Anterior division of Internal Iliac Artery branches

Answer 16

Umbilical, Obturator, Inferior vesical/vaginal, Middle rectal, Internal pudendal, Inferior Gluteal

Question 17

Umbilical Artery

Answer 17

Is only present en utero. Turns into the medial umbilical ligament

Question 18

Superior Vesicular Artery

Answer 18

Arises from inferior surface of umbilical artery. Descends to supply the supolateral bladder. Can also supply ductus deferens in males

Question 19

Obturator Artery

Answer 19

Enters medial compartment of thigh via obturator canal. Bifurcates into anterior/posterior. Anastomoses with inferior gluteal artery/medial circ femoral artery. Acetabular branch comes off to supply fovea of head of femur

Question 20

Anterior branch of obturator artery

Answer 20

Supplies pectineus, obturator externus, adductor muscles, gracilis

Question 21

Posterior branch of obturator artery

Answer 21

Supplies some deep gluteal muscles

Question 22

Inferior Vesical Artery/Vaginal Artery

Answer 22

Courses towards fundus of bladder. Supplies bladder, seminal vesicles, and prostate

Question 23

Middle Rectal Artery

Answer 23

Courses medially to supply the rectum. Anastomoses with superior rectal/inferior rectal

Question 24

Internal Pudendal Artery

Answer 24

Passes thru greater sciatic foramen inferior to piriformis muscle, passes lesser sciatic foramen to enter perineum (main artery). Supplies erectile tissue of clitoris and penis

Question 25

Inferior Gluteal Artery

Answer 25

Passes b/t anterior rami of S1/2 OR S2/3. Leaves pelvic cavity via greater sciatic foramen inferior to piriformis. Large/terminal branch of anterior trunk of internal iliac artery

Question 26

Posterior Division of Internal Iliac Artery Branches

Answer 26

Iliolumbar, Lateral Sacral, Superior Gluteal

Question 27

Iliolumbar Artery

Answer 27

Supplies posterior abdominal wall, psoas, quadratus lumborum, cauda equine, iliac fossa

Question 28

Lateral Sacral Arteries

Answer 28

Runs along pelvic wall, gives rise to branches that pass anterior to sacral foramina

Question 29

Superior Gluteal Artery

Answer 29

Largest branch of internal iliac artery. Terminal continuation of posterior trunk. Runs posteriorly, passing thru lumbosacral trunk/anterior ramus S1, enters gluteal region via greater sciatic foramen

Question 30

Adductor Canal

Answer 30

Fascial compartment deep to sartorius muscle. Descends from apex of femoral triangle, medially down thigh, posteriorly thru aperature in adductor magnus, into popliteal fossa. Contains femoral artery/vein and 2 branches of femoral nerve

Question 31

Popliteal Fossa Contents

Answer 31

Popliteal artery/vein, Tibial nerve, common fibular nerve, Plantaris/popliteus muscles, popliteal lymph nodes

Question 32

Popliteal artery pathway

Answer 32

Continuation of femoral artery, passes from adductor canal, thru hiatius, divides into anterior/posterior tibial arteries.

Question 33

Popliteal vein

Answer 33

Extends into the adductor hiatus to become femoral vein, receives small saphenous vein

Question 34

Boundaries of popliteal Fossa

Answer 34

Superolateral: biceps femoris. Superomedial: semitendinosus and semimembranosus. Interior: gastrocneumius heads (lateral/medial). Posterior: Popliteal fascia/skin. Anterior: Femur, joint capsule, tibia.

Question 35

Genicular Arteries

Answer 35

Branches of popliteal arteries. Form arterial anastomoses around the knee joint.

Question 36

Posterior Tibial Artery

Answer 36

Larger of the 2 popliteal artery branches. Supplies posterior/lateral compartments of the leg. Distal between superficial and deep compartments of posterior leg. Passes thru tarsal tunnel behind medial malleolus into the sole of the foot

Question 37

Fibular artery

Answer 37

Arises from posterior tibial artery distal to inferior border of popliteus muscle. Runs between tibilais posterior and flexor hallucis.

Question 38

Medial Plantar Artery

Answer 38

Runs under abductor hallucis, then b/t it and flexor digitorum brevis.

Question 39

Anterior Tibial Artery

Answer 39

Horizontal portion of bifurcation of popliteal artery. Passes thru IO membrane to run anteriorly b/t tibialis anterior and extensor hallucis longus. Becomes dorsalis pedis artery in the foot

Question 40

Small Saphenous Vein

Answer 40

Formed posterior to lateral malleolus, ascends posteriorly up the leg.

Question 41

Great Saphenous Vein

Answer 41

Anterior to medial malleolus, ascends along medial aspect of leg/thigh until it pierces fascia lata of femoral triangle