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Medicine Year 1 - Semester 2 - Part 2 > Lower Limb: Blood supply and Lymphatics > Flashcards

Lower Limb: Blood supply and Lymphatics Flashcards

1
Q

Where does the lower limb receive its blood supply from ?

A

The common iliac arteries

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2
Q

Describe the formation of the common iliac arteries

A

Aorta bifurcates at L4 to form 2 common iliac arteries

2 common iliac arteries bifurcate at S1 joint, to form an external and internal iliac artery.

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3
Q

What does the external iliac artery supply ?

A

Major supply to the lower limbs

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4
Q

What does the internal iliac artery supply ?

A

Pelvic Viscera
(gluteal region and anastomosis)

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5
Q

Where is bifurcation of the common iliac arteries ?

A

Bifurcation occurs at S1 joint
At the point of the sacroiliac joint

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6
Q

State the important branches of the internal iliac arteries

A

Superior + Inferior gluteal arteries

Obturator artery

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7
Q

Where do the internal iliac branches come out of ?

A

Pass out through the greater sciatic notch

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8
Q

Where is the external iliac artery located ?

A

Heads towards the lower limb and passes behind the inguinal ligament.

(inguinal ligament runs from the anterior superior iliac spine to the pubic tubercle)

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9
Q

What does the external iliac artery become and when ?

A

After the external iliac artery passes behind the inguinal ligament, it becomes the femoral artery.

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10
Q

Where is the femoral artery located ?

A

Deep to the inguinal ligament

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11
Q

State some branches of the external iliac artery that supply the body wall

A

Deep circumflex iliac artery
Inferior epigastric

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12
Q

State the branches of the femoral artery that are not necessarily involved in the lower limb

(used to be external iliac artery before the inguinal ligament)

A

Superficial circumflex iliac artery
Superficial epigastric

External pudendal artery

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13
Q

What does the external pudendal artery supply ?

A

Supplies the external genitalia.

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14
Q

State the branches of the femoral artery

A

Profunda femoris artery

Femoral artery just continues down the lower limbs

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15
Q

State the major blood supply of the thigh

A

The profunda femoris artery

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16
Q

Where does the femoral artery continue to ?

A

Femoral artery continues to the adductor hiatus

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17
Q

Where can you feel a pulse from the external iliac branches ?

A

Halfway between the anterior superior iliac spine and the pubic symphysis, there is a midpoint called the mid-inguinal point.

The pulse can be felt inferior to the mid-inguinal point.

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18
Q

Describe the location of the obturator artery

A

Obturator artery is a branch of the internal iliac artery.

Heads towards the obturator foramen and passes through a little hole called the obturator canal

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19
Q

State the accessory/branch of the femoral artery

A

Obturator artery passes over the superior pubic ramus to then go through the obturator canal.

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20
Q

Corona Mortis

A

Accessory/Replaced obturator artery - variation

Potential origins:

  • External iliac
  • Femoral
  • Inferior epigastric
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21
Q

Where is the corona mortis found ?

A

Passing over the superior pubic ramus

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22
Q

State some complications that can occur due to corona mortis

A

Hernia surgery complications

Pelvic trauma

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23
Q

Function of the profunda femoris artery

A

Main arterial supply to the thigh

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24
Q

Branches of the profunda femoris artery

A

Medial circumflex femoral
Lateral circumflex femoral - transverse & descending

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25
How many perforating branches of the profunda femoris are there ?
3-4 perforators They pierce Adductor Magnus
26
What do the perforating branches of the profunda femoris supply ?
Lateral and Anterior thigh
27
State the blood supply to the hip
2 MAIN ANASTOMOTIC SYSTEMS 1. Trochanteric anastomosis 2. Cruciate anastomosis
28
Describe the trochanteric anastomosis
More superficial anastomotic system Comprised of junctions between the : Medial and lateral circumflex arteries AND Superior and inferior gluteal arteries
29
Trochanteric anastomosis
Medial circumflex Lateral circumflex Superior gluteal Inferior gluteal
30
Cruciate anastomosis function
More intimately associated with the bones of the hip joint. Found deeper than the trochanteric anastomosis.
31
Cruciate anastomosis
Medial circumflex Lateral circumflex 1st Perforator Inferior gluteal
32
Neck of femur fracture
Damage to retinacular vessels (avascular) Necrosis of femoral head
33
State the blood supply to the head of the femur
Artery of the head of the femur (from the obturator)
34
Describe a blockage between the external iliac and femoral arteries How can blood get around it ?
Internal iliac Inferior gluteal Perforating branch of profunda femoris Lateral circumflex (descending branch) Superior lateral genicular artery Popliteal artery (Obturator to Profunda femoris)
35
State the lower limb arteries (above the knee)
Aorta Common iliac arteries Internal and external iliac arteries Profunda femoris (deep femoral) Femoral (superficial femoral) Popliteal
36
What is the popliteal artery ?
A continuation of the femoral artery
37
State the boundaries of the popliteal artery
Extends from the adductor hiatus to the inferior border of popliteus.
38
Describe the location of the popliteal artery
Pass along the adductor canal and through the adductor hiatus. The adductor hiatus is a gap in the adductor magnus muscle. Passes deep to the tendinous soleal arch.
39
Popliteal pulse | (also, when is it vulnerable ?)
Deep and Medial (felt in the back of the knee) - Hard to palpate - Vulnerable during knee dislocation and femoral fracture
40
State the branches of the popliteal artery
5 Genicular branches 2 above the knee 2 below the knee 1 in the middle
41
State the 5 Genicular Branches
Superior medial genicular artery Superior lateral genicular artery Middle genicular artery Inferior lateral genicular artery Inferior medial genicular artery
42
After the popliteal artery has passed through the popliteal fossa where does it go ?
Passes deep to the soleus muscle
43
Clinical relevance of the popliteal artery
Potential site of aneurysm 2nd most common site for aneurysms to form.
44
State the blood supply to the knee
5 Genicular arteries Genicular anastomosis Branch from profunda femoris Branch from anterior tibial
45
State the lower limb arteries (below the knee)
Popliteal artery Posterior tibial artery (tibio peroneal trunk) Anterior tibial artery Peroneal (fibular) artery Posterior tibial artery
46
What happens to the posterior tibial artery ?
It trifurcates 1. Anterior tibial artery 2. Peroneal (fibular) artery 3. Posterior tibial
47
Peroneal
Fibular
48
Where does the anterior tibial artery come from ?
The posterior tibial artery behind the knee gives off an anterior tibial artery.
49
Location of the anterior tibial artery
Crosses above the interosseous membrane into the anterior compartment. (supplies the anterior compartment of the leg)
50
What does the anterior tibial artery run with ?
Runs with the deep peroneal nerve
51
What does the anterior tibial artery become ?
Becomes dorsalis pedis in the foot
52
What does the dorsalis pedis terminate as ?
Arcurate artery 1st Dorsal Metatarsal artery
53
Arcurate artery
Dorsal metatarsal --> Dorsal digital arteries
54
1st Dorsal Metatarsal
Deep plantar arteries
55
Function of the posterior tibial artery
Supplies the posterior compartment of the leg
56
Function of the anterior tibial artery
Supplies the anterior compartment of the leg
57
State the branches of the posterior tibial artery
Gives off peroneal, circumflex fibular and nutrient arteries.
58
What does the posterior tibial artery run with ?
Runs with the tibial nerve.
59
What does the posterior tibial artery terminate as ?
Medial and Lateral plantar arteries AFTER the flexor retinaculum
60
Where is the posterior tibial artery pulse ?
Palatable pulse posterior to medial malleolus
61
Location of peroneal (fibular) artery
Runs in the posterior compartment
62
Function of the peroneal (fibular) artery
Supplies lateral compartment - perforating vessels
63
Feature of the peroneal artery
Runs in the posterior compartment Supplies the lateral compartment
64
What does the posterior tibial artery branch into in the foot ?
Medial and Lateral plantar arteries
65
Describe a feature of the sole of the foot
The lateral plantar artery is larger than the medial plantar artery
66
Function of the lateral plantar artery
Comes across and arches across the forefoot, as the deep plantar arch. The deep plantar arch gives plantar metatarsal arteries and perforating arteries (branches into plantar digital arteries)
67
Function of the deep plantar arch
Main blood supply to the toes (including nail beds)
68
Function of the medial plantar artery
Can form the superficial plantar arch (doesn't always occur) - sends off mostly muscular branches
69
State the superficial veins of the lower limb
Dorsal Venous Arch Great Saphenous - runs medially Small (short) Saphenous - runs posterolaterally
70
Location of the great saphenous vein
(2.5cm) Anterior to the medial malleolus (Hands width) Posterior to the patella
71
Location of the small saphenous vein
Posterior to the lateral malleolus Middle of the leg
72
Function of the small (short) saphenous vein
Penetrates the crural fascia to join deep veins and form the popliteal vein.
73
Function of the great saphenous vein
Pierces the fascia late and enters the femoral vein in the femoral triangle
74
What runs alongside the great saphenous vein ?
Saphenous nerve
75
What runs alongside the small saphenous vein ?
Sural nerve
76
Describe deep veins of the lower limb
Deep to deep fascia Vena comitantes - usually paired
77
Deep veins of the lower limb | popliteal femoral
Popliteal vein --> Femoral vein
78
What does the femoral vein receive ?
Receives profunda femoris, great saphenous and other small veins.
79
Where does the femoral vein enter ?
Enters the femoral sheath and becomes the external iliac vein.
80
Describe perforating veins
Perforating veins flow superficial to deep and contain valves.
81
Function of perforating veins | How does venous return occur against gravity ?
Venous return against gravity - arterial pulsation - negative intra-thoracic pressure - contraction of muscles (muscle pump)
82
Varicose veins
Failure of the valves in the perforating veins
83
Rules of lymphatics of the lower limb
Superficial lymph vessels accompany superficial veins Deep lymph vessels accompany deep veins
84
State the lymph nodes of the lower limb
Superficial inguinal lymph nodes Popliteal lymph nodes
85
Where does the great saphenous vein drain ?
Go to the superficial inguinal nodes
86
Where does the small saphenous vein drain ?
Go to the popliteal nodes
87
Where do the deep lymph vessels go ?
Go to the popliteal nodes Onwards with femoral vein to deep inguinal nodes
88
State the 2 groups of inguinal lymph nodes
Superficial Deep
89
Describe the superficial group of inguinal lymph nodes
- Arranged in a T shape - Horizontal and vertical groups Vertical group lies alongside the great saphenous vein Horizontal group runs alongside the inguinal ligament
90
What does the superficial group of inguinal lymph nodes drain ?
Anterior abdominal wall - inferior to umbilicus Skin of back - below iliac crests Perineum Gluteal region Superficial lower limb
91
What do the superficial lymph nodes drain into ?
The deep lymph nodes
92
Where are the deep lymph nodes found ?
Femoral triangle, medial to femoral vein
93
What do the deep lymph nodes drain ?
Lower limb Superficial inguinal External genetalia
94
What is found in the femoral canal ?
Node of Cloquet
95
State where the deep and superficial inguinal lymph nodes drain into
External iliac nodes Common iliac nodes Lumbar lymph nodes Cisterna chyli Thoracic duct Pirogov's venous angle (left) Venous system

Medicine Year 1 - Semester 2 - Part 2 (53 decks)

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