Nerves, Blood Vessels, and Lymphatics Flashcards
What is the difference between the points where the femoral artery and femoral nerve pass to enter the thigh?
Femoral artery: mid-inguinal point
Femoral nerve: mid-point of inguinal ligament
Which structure DOES NOT pass through the adductor hiatus?
Femoral nerve; goes through adductor canal only
How does the order of vessels and nerves change in the adductor canal?
From VAN to NAV (medial to lateral); saphenous nerve becomes most medial by crossing the femoral vessels; femoral artery crosses vein to become medial to it
What is the order of the popliteal vessels and the sciatic nerve in the posterior of the thigh?
From NAV to AVN (medial to lateral)
How does the order of the popliteal vessels and the sciatic nerve change at the lower end of the popliteal fossa?
From AVN to ANV; at this point sciatic nerve has split; tibial nerve comes to lie in between artery and vein
How many branches does the femoral artery give off?
6; 5 in the femoral triangle; 1 in the adductor canal
Name the 5 branches given off by the femoral artery in the femoral triangle
- superficial epigastric artery
- superficial circumflex iliac artery
- superficial external pudendal artery
- deep external pudendal artery
- profunda femoris
What structures pierce the cribiform fascia?
- great saphenous vein
- superficial external pudendal artery
- lymphatic vessels
- superficial epigastric artery
- Accessory saphenous vein/posteromedial vein of thigh
How many centimeters below the inguinal ligament does the profunda femoris artery arise?
~3.5 cm
The descending genicular artery of the femoral artery anastomoses with the……. of the knee joint.
superior medial genicular artery
At which point does the medial circumflex femoral artery give off its branches?
brevis upper border
True or false: The Medial Circumflex Femoral artery is the highest branch of the profunda femoris artery
True
Which division of the profunda femoris artery is below the lateral circumflex iliac artery?
The first perforating branch
What is the 4th perforating artery usually known as?
fourth perforating Artery of Elliot
From which perforating artery does the nutrient artery of femur arise?
Second perforating artery usually
What are the branches of the descending branch of the medial circumflex femoral artery?
Superficial, Deep, and Acetabular
What structures are supplied by the superficial branch of the descending branch of the medial circumflex femoral artery?
The femoral head; it joins the cruciate anastomosis
Where does the deep branch of the descending branch of the medial circumflex femoral artery supply?
- The gluteal region; anastomoses with gluteal arteries
2. Femur; terminates as posterosuperior and posteroinferior nutrient arteries of femur
What is the main artery of the lower limb?
The common femoral artery
State the main branches of the common femoral artery.
- Descending geniculate branch
2. Profunda femoris
State variations of the popliteal artery
- Tibioperoneal trunk may be absent if it terminates as a trifurcation
- Absence of or undeveloped posterior tibial artery (hypoplastic-aplastic PT artery)
- Absence of or undeveloped anterior tibial artery (hypoplastic-aplastic AT artery)
- High origin of AT artery
- High origin of P artery
- Anterior tibioperoneal trunk
Where does the perforating branch of the fibular artery arise?
5 cm above lateral malleolus
What is the name of the perforating branch of the fibular artery?
Anterior malleolar artery
What 2 compartments of the leg are supplied by the fibular artery?
- Lateral compartment
2. Deep compartment of posterior leg.
Is there a major nerve that accompanies the fibular artery?
NO.
How does the fibular artery terminate?
As the lateral calcaneal artery and the perforating branch (anterior malleolar artery)
How does the fibular artery communicate with the posterior tibial artery?
gives off communicating branch to anastomose with a branch of posterior tibial artery, 5 cm above the ankle
Which areas and muscles of the foot are supplied by the medial plantar artery?
Medial aspect; Flexor Digitorum brevis
Abductor Hallucis
Flexor Hallucis brevis
Adductor Hallucis
Big toe
State the muscles of the foot supplied by the lateral plantar artery.
Abductor digiti minimi
Flexor digiti minimi brevis
Flexor digitorum brevis
Plantar interossei
What nerve accompanies the medial plantar nerve on its lateral side?
Medial plantar nerve
What forms the plantar arch?
LATERAL PLANTAR ARTERY + DORSALIS PEDIS ARTERY
-Direct continuation of lateral plantar artery anastomosing with Dorsalis Pedis Artery
True or False; The lateral plantar nerve lies lateral to the lateral plantar artery.
FALSE: lies medial
What are the branches of the plantar arch?
4 metatarsal arteries that travel in the 4 intermetatarsal spaces
The plantar digital arteries are formed from….
Divisions of the 4 metatarsal arteries
When does the dorsalis pedis artery begin?
Just distal to infeior extensor retinaculum
State a variation of the dorsalis pedis artery?
It can be a branch of the fibular artery as a continuation of the anterior malleolar branch when the anterior tibial artery ends early
What is paraplegia?
Paralysis of lower limbs
What is the clinical significance of dermatomes?
Used to determine site and extent of spinal cord damage.
What structures are innervated by the femoral nerve?
Anterior Thigh Muscles and Iliacus
What causes entrapment of the obturator nerve?
Large adductor muscles
What is the abberant obturator artery?
A variation of the obturator artery in which obturator artery is missing and replaced by inferior epigastric artery pubic branch
True or false: The obturator artery is damaged by posterior dislocation of the hip.
FALSE: damaged by anterior dislocation of the hip (sciatic nerve damaged by posterior dislocation)
State 4 variations of the sciatic nerve.
- Can pass through piriformis
- Peroneal division passes through piriformis and tibial passes under piriformis and then they join
- Peroneal division passes ontop of piriformis and tibial division passes under piriformis and they join
- High division; peroneal division passes on top of piriformis and tibial passes under BUT they don’t reunite
Which veins are connected by the paratibial perforators?
Great saphenous vein and posterior tibial veins
Where do the superior and inferior gluteal veins drain into?
the internal iliac vein
Define a tributary.
Smaller branch draining into a larger branch
State the tributaries of the great saphenous vein.
- Posteriomedial vein of thigh (accessory vein of thigh)
- Superficial epigastric vein
- Superficial external pudendal vein
- Deep external pudendal vein
- Superficial circumflex iliac vein
- Anterolateral vein of thigh / Anterior femoral cutaneous vein
Name the 4 tributaries of the femoral vein.
- Profunda femoris vein
- Great saphenous vein
- Medial circumflex femoral vein
- Lateral circumflex femoral vein
Which nerves of the gluteal region show both anterior and posterior division of ventral rami?
Sciatic nerve (L2-S3) Posterior cutaneous nerve of thigh (S1-S3)
What is the division and nerve roots of the pudendal nerve?
Anterior division; roots S2-S4
Which two nerves in the gluteal region have the same nerve roots but different divisions?
Inferior gluteal nerve (posterior division)
Nerve to obturator internus (anterior division)
Which nerve in the gluteal region only has 2 roots?
Nerve to quadratus femoris
What is the anterior tarsal tunnel syndrome?
Compression of the deep fibular nerve as it crosses infront of the ankle joint
At which point does the deep fibular nerve become cutaneous?
The first intermetatarsal space
At which points can the superficial fibular nerve become entrapped?
- Within the fibular tunnel
2. Just as it’s exiting the fibular tunnel
What structures can compress the superficial fibular nerve?
- Herniating muscle
- Varicose veins
- Anterior or lateral compartment syndrome
- Trauma to lateral compartment
What is the relation of the posterior tibial artery and the tibial nerve?
Superiorly, posterior tibial nerve is medial to artery
Inferiorly, posterior tibial nerve is lateral to artery
