Peripheral Vasculature of the Limbs Flashcards
what are the two branches found in palmar arches?
where do they come from?^
- *superficial & deep palmar arches**
- Branches of both radial and ulnar arteries
i) Superficial arch mainly from ulnar artery.
ii) Deep arch mainly from radial artery.
which pumps help venous return agaisnt gravity? (2)
what else helps to return blood ?
- Respiratory pump changes inter-thoracic pressure to draw blood up
- Muscular pump. Deep veins are surrounded by muscle, and as muscles contract they squeeze vein and push blood up.
- Also:
- smooth muscle (vasoconstriction)
- valves
where is most of the blood: the arteries / veins? (%)?
what happens in arteries if hypoxia occurs?
arteries: 20%
veins: 80%
bc veins are under much less pressure - store
arteries under hypoxia: will reform under hypoxic influence. If a tissue becomes hypoxic it will induce angiogenesis to allow arteries to grow and expand in hypoxic areas so areas that are deficient to have a blood supply.
what is peripheral vascular (arterial) disease?
what can cause it?
Peripheral vascular disease is caused by Arterial narrowing. This will result in decreased blood flow, meaning there’s pain. Pain results from an imbalance between supply and demand.
Lower limb has bigger oxygen demand for muscle, so atherosclerosis can cause pain due to ischaemia (imbalance between supply and demand of oxygen)
Most common cause is Atherosclerosis, arteritis, aneurysm and embolism
what is allen test?
how do you perform?
allen test: assess hand vascularisation and impaired blood flo
- compress both ulnar and radial arteries supplying wrist, then make a fist.
- open hand, should look pale / white (keep compression).
- Pressure released of either radial or ulnar arteries individually
- capillary refill of entire hand indicates patent artery and palmar arches
what is the profunda femoris?
what are its branches & what do they supply?
- *- deep artery of the thigh
- supplies:quads, hamstrings and adductors**
- branches: lateral and medial circumflex arteries = neck and head of femur
label 1-6 of femoral triangle
- Femoral artery
- Femoral nerve to supply anterior muscle group of the thigh, all the way down to the knee. lateral to femoral artery
- Femoral vein is to th_e medial side_ of the femoral artery.
- start of inguinal ligament
- inguinal ligamentt & (lateral femoral cutannous nerve)
These vessels are superficial and a regular anatomical arrangement so if you find the artery, you know where the nerve and vein is if they are needed. Relatively large vessels so you can get a cannula in, so a lot of heart operations are done via femoral vein.
which is this?
deep palmar arch artery?
what branches off the ulnar artery?
where do u find the flexors and extensors of the forearm?
ulnar artery -> common interosseous (supplies the deep flexors and extensors of forearm) -> posterior & anterior interosseous arteries
flexors: anterior compartment
extensors: posterior compartment
which are these veins?
where do u find dorsalis pedis and posterior tibial pulses?
which artery is this?
axillary artery
at which point does subclavian turn into axillary artery? where does it finish? (turn into brachial?)
what does the axillary artery branch off into ? (3)
subclavian -> axillary:
- starts at lateral border of 1st rib
- ends at lateral border of teres major (a muscle on the back)
- sends branches to external chest wall & shoulder girdle
i) major branch = humeral circumflex
-
what is the one major branch of of brachial artery?
is the brachial artery superficial / deep / posteror / anterior?
where does it start / end?
major branch: profunda brachii (deep artery of the arm - runs down posterior side and supplies triceps)
location: superficial on anterior side
i) starts: inferior border of the teres major tendon
ii) ends: 1cm below to the elbow joint (goes through the cubital fossa)
which is the most common vein for venipuncture?
medial cubital vein, across cubital fossa
?
what does it supply?
turn into?
anterior tibial artery
supplies dorsiflexors and extensors on ankle and foot
turns into dorsalis pedis: Supplies the dorsum of the foot giving off branches to the arcuate artery from which the metatarsal arteries arise
what does chronic venous insufficiency cause? (5)
- causes strains of veins: varicose veins, itiching, hyperpigmentation, oedema, venous ulceration
which artery is in green?
anterior circumflex humeral artery
where does the abdomina aorta end? path from abdominal aorta -> femoral artery? and at which vert levels are these?
ends at L4 = top of iliac crest (pelvis)
abdominal artery -> common iliac artery (S1), at sacroiliac joint -> internal iliac atery & external iliac artery
when does femoral artery -> popliteal artery?
what does popiteal split into?
- The femoral artery passes through a gap in the adductor magnus muscle known as the adductor hiatus:
- Enters the popliteal fossa (back of the knee)
- Changes its name to popliteal artery once it passes through the adductor hiatus
changes into:
- anterior tibial artery ( has horizontal bit)
- *- posterior tibial artery**
describe pathway of obturator artery & what it supplies?
internal common iliac -> obturator artery -> (passes through the obturator foramen) acetabular branch
acetabular supplies the hip joint
where do u palpate to find:
a) brachial pulse?
b) radial pulse?
brachial pulse: medial side of elbow, push gently bicep brachii tendon.
radial pulse: lateral to tendon of FCR
ulnar pulse: lateral to tendon of FCU. more difficult to palpal bc runs deeper
at what point does external iliac artery –> femoral artery?
as soon it passes under the inguinal ligament
what do the internal iliac (3) & external iliac artery supply? (1)
what does the internal iliac branch into? (3)
internal iliac: pelvic walls & pelvic viscera, gluteal region
- interna iliac -> superior gluteal artery & inferior gluteal artery
- > obturator artery: supplies head of femur and the medial muscle groups of the thigh
external iliac: lower limbs
where exactly are the superior and deep palmar arches?
Superficial arch: Curves across palm at the level of the distal border of the extended thumb
Deep arch: Lies across metacarpals at their bases. This supplies more of the intrinsic muscles of your hands and your fingers
which out of postieror tibial or anterior tibial is bigger?
what does posterior tibial subdivide into?
posterior tibial is bigger
posterior tibial artery: divides at the ankle into the lateral plantar and medial plantar artery
- These two arteries loop and anastomose with each other
- Supply the plantar surface of the foot (sole)
- Lateral plantar forms lateral end of plantar arch from which the digital arteries arise.
??
obturator artery
what are the superficial veins in the legs?
what do they drain into?
small saphenous drains into the popliteal vein
great saphenous drains into the femoral vein
both have valves !!!! :)
which is more superficial / deep out of ulnar and radial?
Ulnar is much deeper than the radial, which is fairly superficial.
Ulnar is covered and runs under the wrist flexors
posterior interosseous artery
where is femoral pulse found?
below inguinal ligament and mid-ingual point. This is half way between pubic symphysis and anterior superior iliac spine
