Manual 93-101: Vasculature and Lymphatics of Leg Flashcards
when does the femoral a change its name to the popliteal a?
- once it exits the adductor hiatus to enter the popliteal fossa
where does the popliteal a terminate?
- terminates at the inferior border of the popliteus m by dividing into its two terminal branches, the anterior and posterior tibial a
in the fossa, the popliteal _ lies deep to the ___
artery lies deep to vein
what lies anterior and posterior to the popliteal a in the fossa?
anteriorly - lies against the capsule of the joint
posteriorly - deep to the semimebranosus muscle, popliteal v, tibial n and gastrocnemius m
name the branches of the popliteal a (10)
cutaneous muscular medial superior genicular lateral superior genicular medial inferior genicular lateral inferior genicular middle genicular posterior tibial anterior tibial sural
describe the cutaneous branches of the popliteal a
- 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
describe the muscular branches of the popliteal a
- 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
how many genicular a. are given off by the popliteal a.?
5 total
2 superior, 1 middle, 2 inferior
superior genicular a given off by the popliteal a
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
both the medial and lateral superior genicular a give off…
superficial branch (supplies m. ) and deep branch (supplies knee joint)
what supplies the ACL, PCL and synovial membrane withing the knee joint with blood?
middle genicular a (off popliteal a)
2 inferior genicular branches off popliteal a
- medial inferior genicular and lateral inferior genicular
- originate DISTAL to knee joint
which off the inferior genicular branches is larger?
medial inferior genicular a
- passes below medial collateral ligament
- supplying tibia and knee joint
course of the lateral inferior genicular a
- 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
what a originate from the popliteal a at the knee joint to supply the gastrocnemius, soleus and plantaris m?
sural arteries (2 - medial and lateral) - note that these are superficial compartment m.
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
- 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)
what would be of concern with a sudden popliteal occlusion?
anastomosing branches are not sufficient
- gradual popliteal occlusion = anastomosing branches increase in size and are sufficient to supply knee
artery of anterior crural compartment
anterior tibial a.
smaller of two terminal branches of popliteal a
anterior tibial a
origin of anterior tibial a
- inferior border of politeus m.
- ankle joint, midway between medial and lateral malleoli where it becomes dorsalis pedis a
describe the course of the anterior tibial a
- anteriorly b/w two heads of tibialis posterior m.
- through interosseous membrane to anterior leg
- descends in inferomedial direction
- accompanied by venae comitantes
branches off the anterior tibial a
- posterior tibial recurrent a
- anterior tibial recurrent a
- circumflex fibular
- anterior medial malleolar
- anterior lateral malleolar
- muscular a
what is usually the first branch off anterior tibial a
- posterior tibial recurrent
- incosntant
- origin is before the anterior crural compartment
- joins the genicualr anastomosis
describe the atnerior tibial recurrent a
- origin off the anterior tibial a close to entrance into anterior crural compartment
- supplies the anterior knee
- joins genicular anastomosis
what m does the circumflex fibular supply?
soleus m.
peroneus longus m
what is the origin of the circumflex fibular a ?
- anterior tibial recurrent (40 %)
* some texts say post tib (32%)
origin of the anterior medial malleolar a
- off of anterior tibial a 5 cm proximal to joint
course of the anterior medial malleolar a
- interomedially across proximal extensor retinaculum
- deep to EHL and TA
- ramifies around medial malleolus with posterior tibial and medial plantar a
a branching off anterior tibial a close to where anterior medial malleoalr comes off but running laterally
anterior lateral malleolar a
- courses deep to tendons of EDL and peroneus tertius
- supplies lateral side of ankle joint
muscular branches off anterior tibial a supply …
muscles of anterior and lateral compartments of leg
some branches travel deep and anastomose with post tib
larger of two terminal branches of popliteal a
posterior tibial a
where is the origin of the posterior tibial a.
inferior border of popliteus m
the posterior tibial a is found _____ to the soleus m
deep to origin of soleus m. , travels in an inferomedial direction
how does the posterior tibial a travel around the ankle
- 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
name the branches off the post tibial a
- 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)
muscular branches off post tibial a go to …
FHL peroneus longus peroneus brevis tibialis post soleus
largest branch of post tibial a
peroneal a.
origin and course of post tibial a
- post tibial a 2 cm distal to inferior border of popliteus m
- inferiorly along medial side of fibula
what a gives a nutrient branch to fibula
peroneal a
what supplies muscular branches to posterior and lateral leg compartment
peroneal a
the communicating branch off peroneal a joins …
communicating branch of post tibial a
posterior lateral malleolar branches come off…
peroneal a
- small branches that course toward lateral malleolus and help form lateral malleolar network
terminal branches of peroneal a
- lateral calcaneal branches
largest nutrient a of bone in body
nutrient a to tibia
the nutrient a to tibia is a branch off of …
post tib a
- origin is just inferior to bifurcation of popliteal a
where is the nutrient foramen located?
- immediately distal to soleal line (proximal part of tibia)
what a does the post med malleolar a branch off of
post tib a
where does the communicating a off the post tib a course
- deep to FHL
- joins communicating branch of peroneal a
the medial and lateral plantar a branch off of …
post tib a
the lymphatics of the leg parallel the …
veins of leg
- two systems (like veins) superficial and deep
where do the lymphatics of legs drain into ..
anterior tibial lymph node and popliteallymph node
describe the anterior tibial lymph node
- 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
what lymph vessels travel with the cutaneous vv
superficial lymphatic vessels
what lymphatic vessels travel with course with great saphenous v
medial lymphatic vessels
- drain the medial side of foot
- ends in lower group of superficial inguinal nodes
what lymphatic vessels travel with small saphenous v
lateral lymphatic vessels
- drain the lateral side of foot
- ends in superficial popliteal lymph node
match vessel with node
- dorsalis pedis/ant tib
- medial and lateral plantar
- post tib/ peroneal
- anterior tibial
- popliteal
- popliteal
what v accompanies the post tib a
posterior tibial v as venae comitantes
- located b/w superficial and deep m
what are the fibular venae comitantes
- accompany the fibular a
- drain blood priamrily from lateral leg (post and lateral compartments)
what junction forms the popliteal v.
- posterior tibial v
- anterior tibial v
superior continuation of popliteal v at adductor hiatus
femoral v
what v receives the small saphenous v
popliteal v
at the inferior end of fossa, the popliteal v lies _____ to a; on the upper end of fossa, the popliteal lies ______ to a
- medial
- superficial
continuation of lateral marginal v =
continuation of medial marginal v =
small saphenous v
great saphenous v
what v ascends along lateral border of tendocalcaneus
small saphenous v
how many valves are in the small saphenous v
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