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Control and Movement > Neurovasculature of the lower limb > Flashcards

Neurovasculature of the lower limb Flashcards

1
Q

What are the main branches of the internal iliac artery that supplies the gluteal region?

A

Superior & inferior gluteal arteries

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2
Q

What is the cruciate anastomosis?

A
  • Anastamosis between branches of the internal iliac & profound femurs arteries
  • Allows blood to bypass a blockage of the external iliac or proximal femoral arteries
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3
Q

Which arteries supply:

  • Anterior compartment of thigh
  • Posterior compartment of thigh
  • Medial compartment of thigh
A
  • A= femoral artery-continuation of external iliac
  • P= Inferior gluteal & 4 perforating arteries of profunda femoris artery.
  • M= Obturator artery-branch of internal iliac
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4
Q

What is the boundary of the external iliac artery?

A

Inguinal ligament

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5
Q

What is the genicular anastomosis?

A
  • Maintains blood supply to the leg during knee flexion impinging popliteal artery
  • Composed of 5 genicular branches from popliteal artery: Superior lateral, Superior medial, Middle, Inferior lateral & Inferior medial
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6
Q

What arteries supply:

  • Anterior compartment of leg
  • Posterior compartment of leg
  • Lateral compartment of leg
A
  • A= Anterior tibial artery
  • P= Posterior tibial artery
  • L= fibular artery- branch of posterior tibial artery
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7
Q

What are the terminal branches of the popliteal artery?

A
  • Anterior tibial

- Posterior tibial

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8
Q

What arteries supply:

  • Dorsal aspect of the foot
  • Plantar aspect of the foot
  • (Deep) plantar arch of foot
A
  • D=Dorsalis pedis artery- continuation of anterior tibial
  • P=Medial & lateral plantar arteries- bifurcation of posterior tibial
  • PA= anastomosis of deep plantar branch of dorsalis pedis artery with lateral plantar artery
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9
Q

What is the clinical importance of the femoral artery?

A
  • Superficial in femoral triangle
  • Vulnerable to injury/laceration
  • Easily accessed in people: to obtain ABG in emergencies, undertake minimally invasive procedures (coronary angiography, coronary angioplasty, embolisation of berry aneurysm)
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10
Q

What is peripheral vascular disease?

A
  • Arteries of pelvis & lower limbs affected by the same disease processes as other arteries-atherosclerosis
  • Lower limb arteries can be occluded by embolus/thrombus
  • Acute ischaemia= Medical emergency, occlusion by thrombus/emboli/trauma or compartment syndrome
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11
Q

What is the presentation of an acute ischaemic leg?

A
  • Pain
  • Pallor
  • Perishingly cold
  • Paraesthesia
  • Paralysis
  • Pulseless
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12
Q

What is the treatment for an acute ischaemic leg?

A
  • Dependant on cause
  • Revascularisation required to prevent irreversible tissue loss
  • Imaging shows site of occlusion
  • Atherosclerosis often at lower femoral artery
  • Collateral circulation via anatomises between branches of profunda femoris & popliteal
  • Graft from common femoral to popliteal can bypass occluded vessel
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13
Q

What are the stages of chronic ischaemia?

A

1) Asymptomatic
2) Intermittent claudication-mild
3) Intermittent claudication-severe
4) Rest pain/night pain
5) Tissue loss/ulceration/ gangrene

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14
Q

What are the superficial veins of the lower limb? Where are they found generally?

A
  • Great Saphenous vein
  • Short Saphenous vein
  • Lie in subcutaneous tissue, superficial to deep fascia
  • Drain into deep veins
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15
Q

What are the deep veins of the lower limb?

A
  • Popliteal vein
  • Femoral vein
  • Accompany major arteries
  • Anterior & posterior tibial & fibular veins= venae comitantes
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16
Q

How is the popliteal & femoral vein formed?

A
  • Ant, post tibial + fibular vein combine to form popliteal

- This then becomes the femoral vein

17
Q

What is the function of perforating veins?

A
  • Drain blood from the superficial veins to the deep veins

- Contain valves to prevent back flow

18
Q

How is venous return from deep veins aided?

A
  • Muscular contraction- muscle pump

- Deep fascia- compression stocking

19
Q

Why is the femoral vein & great saphenous vein of clinical importance?

A
  • Temporary IV access: trauma, burns
  • Emergency venepuncture
  • Great Saphenous lies immediately in-front of medial malleolus
20
Q

What are varicose veins?

A
  • Inc pressure in saphenous veins by proximal venous obstruction (pregnancy, pelvic tumour)
  • Veins become dilated & incompetent
  • Blood stagnates in the skin- can lead to breakdown & ulceration
  • Complications: bleeding, superficial thrombophelbitis, venous/varicose ulcers- medial ankle, dermatitis & skin thickening
21
Q

What are risk factors for DVT?

A
  • Previous VTE
  • Immobility
  • Recent surgery
  • Malignancy
  • Pregnancy
  • IV drug use (injecting into femoral vein)
  • Sepsis
22
Q

What are the lumbar & sacral plexus formed from? What do they give rise to?

A
  • L= Anterior rami of L1-L4, Obturator & femoral nerve
  • S= Anterior rami of L4-S5, joined by lumbosacral trunk- branch of L4 anterior rams that joins L5. Sciatic, Superior & inferior gluteal nerves
23
Q

Describe what the femoral nerve innervates

A
  • Supplies anterior compartment of thigh
  • Passes under inguinal ligament to enter thigh
  • Terminal branch= saphenous nerve which passes through adductor hiatus to supply skin of medial leg
24
Q

Describe what the Obturator nerve innervates

A
  • Supplies medial compartment of thigh

- Divides into anterior & posterior branches that lie either side of adductor brevis

25
Q

Describe the sciatic nerve and what it innervates

A
  • Motor to: posterior compartment of thigh, leg/foot muscles
  • Sensory: skin of lateral leg, foot & sole of foot
  • Composed of 2 nerves: Tibial nerve (ant division of ant rami), Common fibular nerve (post division of ant rami)
  • Bifurcates in distal thigh
  • Risk of iatrogenic injury in intramuscular injections
  • At risk in hip injuries/dislocations
26
Q

Describe the common fibular (peroneal) nerve and what it’s clinical importance

A
  • Common supplies short head of Biceps Femoris
  • Bifurcates into superficial & deep branches
  • Sup= supplies lateral compartment of leg
  • Deep= Supplies anterior compartment of leg
  • Vulnerable as winds round neck of fibula
  • Injury= paralysis of dorsiflexor muscles= foot drop & altered gait
27
Q

Describe the tibial nerve and what it innervates

A
  • Supplies posterior compartment of leg
  • Passes inferoposteriorly to medial malleolus through tarsal tunnel
  • Bifurcates deep to flexor retinaculum into medial & lateral plantar nerves
  • Medial= supplies 4 muscles & skin to medial 3 1/2 digits
  • Lateral= supplies all other plantar muscles & skin to lateral 1 1/2 digits
28
Q

What does the sciatic nerve divide into in the leg?

A

Common fibular

Tibial

29
Q

What divisions is the common fibular nerve made of?

A

Posterior division of L4-S2

30
Q

What divisions is the tibial nerve made of?

A

Anterior division of L4-S2

31
Q

How does the sciatic nerve enter the posterior thigh?

A

Travels deep to biceps femoris

Control and Movement (19 decks)

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