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APMLE LEA > Manual 93-101: Vasculature and Lymphatics of Leg > Flashcards

Manual 93-101: Vasculature and Lymphatics of Leg Flashcards

1
Q

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

A
  • once it exits the adductor hiatus to enter the popliteal fossa
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2
Q

where does the popliteal a terminate?

A
  • terminates at the inferior border of the popliteus m by dividing into its two terminal branches, the anterior and posterior tibial a
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3
Q

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

A

artery lies deep to vein

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4
Q

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

A

anteriorly - lies against the capsule of the joint

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

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5
Q

name the branches of the popliteal a (10)

A 
cutaneous
muscular
medial superior genicular
lateral superior genicular
medial inferior genicular
lateral inferior genicular
middle genicular
posterior tibial
anterior tibial 
sural
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6
Q

describe the cutaneous branches of the popliteal a

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
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7
Q

describe the muscular branches of the popliteal a

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
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8
Q

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

A

5 total

2 superior, 1 middle, 2 inferior

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9
Q

superior genicular a given off by the popliteal a

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
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10
Q

both the medial and lateral superior genicular a give off…

A

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

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11
Q

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

A

middle genicular a (off popliteal a)

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12
Q

2 inferior genicular branches off popliteal a

A
  • medial inferior genicular and lateral inferior genicular

- originate DISTAL to knee joint

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13
Q

which off the inferior genicular branches is larger?

A

medial inferior genicular a

  • passes below medial collateral ligament
  • supplying tibia and knee joint
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14
Q

course of the lateral inferior genicular a

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
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15
Q

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

A 
sural arteries (2 - medial and lateral) 
- note that these are superficial compartment m.
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16
Q

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
A
  • 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)

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17
Q

what would be of concern with a sudden popliteal occlusion?

A

anastomosing branches are not sufficient

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

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18
Q

artery of anterior crural compartment

A

anterior tibial a.

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19
Q

smaller of two terminal branches of popliteal a

A

anterior tibial a

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20
Q

origin of anterior tibial a

A
  • inferior border of politeus m.

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

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21
Q

describe the course of the anterior tibial a

A
  • anteriorly b/w two heads of tibialis posterior m.
  • through interosseous membrane to anterior leg
  • descends in inferomedial direction
  • accompanied by venae comitantes
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22
Q

branches off the anterior tibial a

A
  • posterior tibial recurrent a
  • anterior tibial recurrent a
  • circumflex fibular
  • anterior medial malleolar
  • anterior lateral malleolar
  • muscular a
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23
Q

what is usually the first branch off anterior tibial a

A
  • posterior tibial recurrent
  • incosntant
  • origin is before the anterior crural compartment
  • joins the genicualr anastomosis
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24
Q

describe the atnerior tibial recurrent a

A
  • origin off the anterior tibial a close to entrance into anterior crural compartment
  • supplies the anterior knee
  • joins genicular anastomosis
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25
Q

what m does the circumflex fibular supply?

A

soleus m.

peroneus longus m

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26
Q

what is the origin of the circumflex fibular a ?

A
  • anterior tibial recurrent (40 %)

* some texts say post tib (32%)

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27
Q

origin of the anterior medial malleolar a

A
  • off of anterior tibial a 5 cm proximal to joint
28
Q

course of the anterior medial malleolar a

A
  • interomedially across proximal extensor retinaculum
  • deep to EHL and TA
  • ramifies around medial malleolus with posterior tibial and medial plantar a
29
Q

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

A

anterior lateral malleolar a

  • courses deep to tendons of EDL and peroneus tertius
  • supplies lateral side of ankle joint
30
Q

muscular branches off anterior tibial a supply …

A

muscles of anterior and lateral compartments of leg

some branches travel deep and anastomose with post tib

31
Q

larger of two terminal branches of popliteal a

A

posterior tibial a

32
Q

where is the origin of the posterior tibial a.

A

inferior border of popliteus m

33
Q

the posterior tibial a is found _____ to the soleus m

A

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

34
Q

how does the posterior tibial a travel around the ankle

A
  • 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
35
Q

name the branches off the post tibial a

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)
36
Q

muscular branches off post tibial a go to …

A 
FHL
peroneus longus
peroneus brevis
tibialis post
soleus
37
Q

largest branch of post tibial a

A

peroneal a.

38
Q

origin and course of post tibial a

A
  • post tibial a 2 cm distal to inferior border of popliteus m
  • inferiorly along medial side of fibula
39
Q

what a gives a nutrient branch to fibula

A

peroneal a

40
Q

what supplies muscular branches to posterior and lateral leg compartment

A

peroneal a

41
Q

the communicating branch off peroneal a joins …

A

communicating branch of post tibial a

42
Q

posterior lateral malleolar branches come off…

A

peroneal a

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

43
Q

terminal branches of peroneal a

A
  • lateral calcaneal branches
44
Q

largest nutrient a of bone in body

A

nutrient a to tibia

45
Q

the nutrient a to tibia is a branch off of …

A

post tib a

- origin is just inferior to bifurcation of popliteal a

46
Q

where is the nutrient foramen located?

A
  • immediately distal to soleal line (proximal part of tibia)
47
Q

what a does the post med malleolar a branch off of

A

post tib a

48
Q

where does the communicating a off the post tib a course

A
  • deep to FHL

- joins communicating branch of peroneal a

49
Q

the medial and lateral plantar a branch off of …

A

post tib a

50
Q

the lymphatics of the leg parallel the …

A

veins of leg

- two systems (like veins) superficial and deep

51
Q

where do the lymphatics of legs drain into ..

A

anterior tibial lymph node and popliteallymph node

52
Q

describe the anterior tibial lymph node

A
  • 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
53
Q

what lymph vessels travel with the cutaneous vv

A

superficial lymphatic vessels

54
Q

what lymphatic vessels travel with course with great saphenous v

A

medial lymphatic vessels

  • drain the medial side of foot
  • ends in lower group of superficial inguinal nodes
55
Q

what lymphatic vessels travel with small saphenous v

A

lateral lymphatic vessels

  • drain the lateral side of foot
  • ends in superficial popliteal lymph node
56
Q

match vessel with node

  • dorsalis pedis/ant tib
  • medial and lateral plantar
  • post tib/ peroneal
A
  • anterior tibial
  • popliteal
  • popliteal
57
Q

what v accompanies the post tib a

A

posterior tibial v as venae comitantes

- located b/w superficial and deep m

58
Q

what are the fibular venae comitantes

A
  • accompany the fibular a

- drain blood priamrily from lateral leg (post and lateral compartments)

59
Q

what junction forms the popliteal v.

A
  • posterior tibial v

- anterior tibial v

60
Q

superior continuation of popliteal v at adductor hiatus

A

femoral v

61
Q

what v receives the small saphenous v

A

popliteal v

62
Q

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

A
  • medial

- superficial

63
Q

continuation of lateral marginal v =

continuation of medial marginal v =

A

small saphenous v

great saphenous v

64
Q

what v ascends along lateral border of tendocalcaneus

A

small saphenous v

65
Q

how many valves are in the small saphenous v

A

7-13

APMLE LEA (23 decks)

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