Manual 93-101: Vasculature and Lymphatics of Leg

Question 1

when does the femoral a change its name to the popliteal a?

Answer 1

• once it exits the adductor hiatus to enter the popliteal fossa

Question 2

where does the popliteal a terminate?

Answer 2

• terminates at the inferior border of the popliteus m by dividing into its two terminal branches, the anterior and posterior tibial a

Question 3

in the fossa, the popliteal _ lies deep to the ___

Answer 3

artery lies deep to vein

Question 4

what lies anterior and posterior to the popliteal a in the fossa?

Answer 4

anteriorly - lies against the capsule of the joint

posteriorly - deep to the semimebranosus muscle, popliteal v, tibial n and gastrocnemius m

Question 5

name the branches of the popliteal a (10)

Answer 5

cutaneous
muscular
medial superior genicular
lateral superior genicular
medial inferior genicular
lateral inferior genicular
middle genicular
posterior tibial
anterior tibial 
sural

Question 6

describe the cutaneous branches of the popliteal a

Answer 6

• directly or indirectly supply the superficial structues of the posterior part of the leg
• can be located b/w heads of gastroc m.
• some follow small saphenous v

Question 7

describe the muscular branches of the popliteal a

Answer 7

• gives rise to two or three muscular branches from its proximal end to supply the lower ends of …
• of adductor magnus and the hamstring m

Question 8

how many genicular a. are given off by the popliteal a.?

Answer 8

5 total

2 superior, 1 middle, 2 inferior

Question 9

superior genicular a given off by the popliteal a

Answer 9

medial superior genicular a and lateral superior genicular a

• wind around superior aspect, femoral condyle
• reach anterior side of knee and help form collateral circulation of knee

Question 10

both the medial and lateral superior genicular a give off…

Answer 10

superficial branch (supplies m. ) and deep branch (supplies knee joint)

Question 11

what supplies the ACL, PCL and synovial membrane withing the knee joint with blood?

Answer 11

middle genicular a (off popliteal a)

Question 12

2 inferior genicular branches off popliteal a

Answer 12

• medial inferior genicular and lateral inferior genicular

- originate DISTAL to knee joint

Question 13

which off the inferior genicular branches is larger?

Answer 13

medial inferior genicular a

• passes below medial collateral ligament
• supplying tibia and knee joint

Question 14

course of the lateral inferior genicular a

Answer 14

• travels laterally, superior to head of fibula
• deep to lateral collateral ligaments and the tendon of biceps femoris
• branches contribute to genicular anastomosis in anterior knee

Question 15

what a originate from the popliteal a at the knee joint to supply the gastrocnemius, soleus and plantaris m?

Answer 15

sural arteries (2 - medial and lateral) 
- note that these are superficial compartment m.

Question 16

arteries involved in the genicular anastomosis on the anterior side around patella

• superficial branches of this network supply soft tissues around joint
• deep branches supply knee joint

Answer 16

• descending genicular a
• medial and lateral superior genicular aa
• medial and lateral inferior genicular aa
• descending branch of lateral femoral circumflex
• circumflex fibular
• anterior and posterior tibial recurrent

(5 genicular, 1 femoral, 1 fibular, 2 tibial)

Question 17

what would be of concern with a sudden popliteal occlusion?

Answer 17

anastomosing branches are not sufficient

- gradual popliteal occlusion = anastomosing branches increase in size and are sufficient to supply knee

Question 18

artery of anterior crural compartment

Answer 18

anterior tibial a.

Question 19

smaller of two terminal branches of popliteal a

Answer 19

anterior tibial a

Question 20

origin of anterior tibial a

Answer 20

• inferior border of politeus m.

- ankle joint, midway between medial and lateral malleoli where it becomes dorsalis pedis a

Question 21

describe the course of the anterior tibial a

Answer 21

• anteriorly b/w two heads of tibialis posterior m.
• through interosseous membrane to anterior leg
• descends in inferomedial direction
• accompanied by venae comitantes

Question 22

branches off the anterior tibial a

Answer 22

• posterior tibial recurrent a
• anterior tibial recurrent a
• circumflex fibular
• anterior medial malleolar
• anterior lateral malleolar
• muscular a

Question 23

what is usually the first branch off anterior tibial a

Answer 23

• posterior tibial recurrent
• incosntant
• origin is before the anterior crural compartment
• joins the genicualr anastomosis

Question 24

describe the atnerior tibial recurrent a

Answer 24

• origin off the anterior tibial a close to entrance into anterior crural compartment
• supplies the anterior knee
• joins genicular anastomosis

Question 25

what m does the circumflex fibular supply?

Answer 25

soleus m. | peroneus longus m

Question 26

what is the origin of the circumflex fibular a ?

Answer 26

- anterior tibial recurrent (40 %) | * some texts say post tib (32%)

Question 27

origin of the anterior medial malleolar a

Answer 27

- off of anterior tibial a 5 cm proximal to joint

Question 28

course of the anterior medial malleolar a

Answer 28

- interomedially across proximal extensor retinaculum - deep to EHL and TA - ramifies around medial malleolus with posterior tibial and medial plantar a

Question 29

a branching off anterior tibial a close to where anterior medial malleoalr comes off but running laterally

Answer 29

anterior lateral malleolar a - courses deep to tendons of EDL and peroneus tertius - supplies lateral side of ankle joint

Question 30

muscular branches off anterior tibial a supply ...

Answer 30

muscles of anterior and lateral compartments of leg | some branches travel deep and anastomose with post tib

Question 31

larger of two terminal branches of popliteal a

Answer 31

posterior tibial a

Question 32

where is the origin of the posterior tibial a.

Answer 32

inferior border of popliteus m

Question 33

the posterior tibial a is found _____ to the soleus m

Answer 33

deep to origin of soleus m. , travels in an inferomedial direction

Question 34

how does the posterior tibial a travel around the ankle

Answer 34

- posterior to the medial malleolus it is separated from malleolus by tibialis post and FDL tendons - inferior to the medial malleolus it is between the tendons of FDL and FHL

Question 35

name the branches off the post tibial a

Answer 35

- muscular - peroneal a - nutrient a to tibia - posterior medial malleolar a - communicating a - medial calcaneal - medial plantar - lateral plantar circumflex fibular (* usually off of ant tib a)

Question 36

muscular branches off post tibial a go to ...

Answer 36

``` FHL peroneus longus peroneus brevis tibialis post soleus ```

Question 37

largest branch of post tibial a

Answer 37

peroneal a.

Question 38

origin and course of post tibial a

Answer 38

- post tibial a 2 cm distal to inferior border of popliteus m - inferiorly along medial side of fibula

Question 39

what a gives a nutrient branch to fibula

Answer 39

peroneal a

Question 40

what supplies muscular branches to posterior and lateral leg compartment

Answer 40

peroneal a

Question 41

the communicating branch off peroneal a joins ...

Answer 41

communicating branch of post tibial a

Question 42

posterior lateral malleolar branches come off...

Answer 42

peroneal a | - small branches that course toward lateral malleolus and help form lateral malleolar network

Question 43

terminal branches of peroneal a

Answer 43

- lateral calcaneal branches

Question 44

largest nutrient a of bone in body

Answer 44

nutrient a to tibia

Question 45

the nutrient a to tibia is a branch off of ...

Answer 45

post tib a | - origin is just inferior to bifurcation of popliteal a

Question 46

where is the nutrient foramen located?

Answer 46

- immediately distal to soleal line (proximal part of tibia)

Question 47

what a does the post med malleolar a branch off of

Answer 47

post tib a

Question 48

where does the communicating a off the post tib a course

Answer 48

- deep to FHL | - joins communicating branch of peroneal a

Question 49

the medial and lateral plantar a branch off of ...

Answer 49

post tib a

Question 50

the lymphatics of the leg parallel the ...

Answer 50

veins of leg | - two systems (like veins) superficial and deep

Question 51

where do the lymphatics of legs drain into ..

Answer 51

anterior tibial lymph node and popliteallymph node

Question 52

describe the anterior tibial lymph node

Answer 52

- inconsistent - located within anterior compartment of leg near interosseous membrane, inferior to the hiatus where ant tibial vessels pass throug interosseous membrnae - receives lymph coursing with ant tib a and v - efferent vessels from ant tib lymph node pass to popliteal group of lymp nodes

Question 53

what lymph vessels travel with the cutaneous vv

Answer 53

superficial lymphatic vessels

Question 54

what lymphatic vessels travel with course with great saphenous v

Answer 54

medial lymphatic vessels - drain the medial side of foot - ends in lower group of superficial inguinal nodes

Question 55

what lymphatic vessels travel with small saphenous v

Answer 55

lateral lymphatic vessels - drain the lateral side of foot - ends in superficial popliteal lymph node

Question 56

match vessel with node - dorsalis pedis/ant tib - medial and lateral plantar - post tib/ peroneal

Answer 56

- anterior tibial - popliteal - popliteal

Question 57

what v accompanies the post tib a

Answer 57

posterior tibial v as venae comitantes | - located b/w superficial and deep m

Question 58

what are the fibular venae comitantes

Answer 58

- accompany the fibular a | - drain blood priamrily from lateral leg (post and lateral compartments)

Question 59

what junction forms the popliteal v.

Answer 59

- posterior tibial v | - anterior tibial v

Question 60

superior continuation of popliteal v at adductor hiatus

Answer 60

femoral v

Question 61

what v receives the small saphenous v

Answer 61

popliteal v

Question 62

at the inferior end of fossa, the popliteal v lies _____ to a; on the upper end of fossa, the popliteal lies ______ to a

Answer 62

- medial | - superficial

Question 63

continuation of lateral marginal v = | continuation of medial marginal v =

Answer 63

small saphenous v | great saphenous v

Question 64

what v ascends along lateral border of tendocalcaneus

Answer 64

small saphenous v

Question 65

how many valves are in the small saphenous v

Answer 65

7-13