Skin Structure and Function 6 - Anatomy of Leg Circulation Flashcards
What are the names of the 2 types of fascia that are located below the skin?
Superficial fascia
Deep fascia
What is another name for the superficial fascia?
Subcutaneous tissue
What is the superficial fascia composed of? (2)
Loose connective tissue and fat
What is the deep fascia composed of?
Dense connective tissue
What are intermuscular septum?
Extensions of the deep fascia that splits the muscle in the limbs into different compartments
How does inter muscular septa affect venous return?
It aids it
What is the order of the arterial supply in the arm from proximal to distal?
Subclavian Axillary Brachial Ulnar + Radial Superficial palmar arch + deep palmar arch
What are the names for the veins that can be seen on the posterior aspect of the hand?
Dorsal venous network
What is the distal vein located on the medial side of the arm?
Basilic vein
What is the distal vein located on the lateral side of the arm?
Cephalic vein
What is the vein connecting the cephalic and basilic vein?
Median cubital vein
What is the name of the veins that accompany the brachial artery?
Venae comitantes (pulsation of artery aids venous return)
What is the name for the vein under the armpit?
Axillary vein
What is the name of the vein proximal to the axillary vein?
Subclavian vein
What is distal to the radial artery?
Deep palmar arch
What is distal to the ulnar artery?
Superficial palmar arch
What is the name of the artery that the profunda femoris branches off?
Superficial femoral artery
What is the name for the deep artery of the thigh that branches off of the superficial femoral artery?
Produnda femoris
What is the adductor hiatus?
A gap between the adductor magnus muscle and femor that allows the passage of the femoral good vessels
What is the name of the continuation of the femoral artery after the knee?
Popliteal artery
What does the popliteal artery dive into?
posterior and anterior tibial arteries
What branches from the posterior tibial artery above the ankle joints?
Fibular artery
what doe the posterior tibial artery branch into after the ankle joint?
Medial plantar and lateral plantar arteries
What does the anterior tibial artery branch into after the ankle joint?
Dorsalis pedis and arcuate artery
What are the 2 main superficial veins of the leg?
Great saphenous vein
Small saphenous vein
Where does the great saphenous vein arise from?
Dorsal venous arch along medial aspect of limb
What are the 2 main deep veins of the leg - running proximal to distal?
Femoral vein
Popliteal vein
Where does the small saphenous vein run?
From dorsal venous arch along posterior midline of leg
Does the great saphenous vein run infront or behind the medial or lateral malleolus?
Infront of the medial malleolus
where does the great saphenous vein drain into?
Femoral vein around the femoral triangle
Where does the small saphenous vein drain to?
Popliteal vein posterior to the knee
How does blood flow from superficial veins into deep veins?
through perforating veins
what helps to push blood back towards the heart?
musculovenous pump
What do venous valves ensure?
Unidirectional blood flow against gravity
What does incompetent valves cause?
Reverse blood flow into superficial veins = weak and dilated vessels = varicose veins
Does the small saphenous vein lie infront or behind the medial or lateral malleolus?
Behind the lateral malleolus
What is an end artery?
The only blood supply to a given area of the body (no collaterals)
what type of arteries are digital arteries?
End arteries
what does untreated occlusion of an end artery result in?
infarction of the area of tissue it supplies
What type of local anaesthetic should you not use near end arteries?
Adrenaline-containing local anaesthetic
What are the 2 pulse points on the upper limb?
Brachial
Radial
What are the 4 pulse points on the lower limb?
Femoral
Popliteal
Posterior tibial
Dorsalis pedis
What is iscahemia?
Inadequate oxygenation of cells/ tissues. organ due to an interruption to blood supply (venous or arterial)
What can cause reduced arterial perfusion pressure?
Left ventricular failure
Arterial bleed (injury)
Arterial rupture (aneurysm)
Occlusion of lumen (atherosclerosis: PVD)
Arterial spasm
Extrenal compression of arterial supply e.g. tumour
What causes increased venous drainage pressure?
Right (or congestive) cardiac failure
DVT
External compression
How is DVT caused?
Immobility/ venous failure of any cause ->
Chronic venous insufficiency ->
Deep venous stasis
How is skin ulceration caused?
Immobility of any cause/ venous valve failure of any cause ->
Chronic venous insufficiency ->
Superficial microcirculatory deficiencies ->
Skin ulceration
How does increased venous pressure lead to venous ulceration?
Increased pressure causes damaged blood vessels in skin
Skin becomes dry, itchy and inflamed
This cannot heal well due to poor blood supply
Begins to breakdown
Where is the most common site of venous ulceration?
the gaiter area - medial aspect of distal leg
What does the lymphatics generally follow in the limbs?
Veins
Name for lymph nodes around the median cubital vein?
Cubital nodes
Name for the 2 types of lymph nodes in the arm pit?
Lateral axillary nodes (lower)
Apical axillary nodes (Higher)
Name for lymph nodes behind the knee?
Popliteal nodes
Name for lymph nodes in the groin?
superficial and deep inguinal nodes
What is the standard method of removal of small skin lesions?
Elliptical excision
Complications of elliptical incision? (2)
Nerve injury
Bleeding (superficial veins)
What are the lines that can be used to map the skin showing the orientation of the collagen fibres and therefore skin tension?
Langer lines
What degree angle should be left between the 2 incision of an elliptical excision?
30 degrees
At what angle should the scalpel blade cut to the skin when making an elliptical excision?
90 degrees
When making an elliptical excision, what should be done once the sides of the ellipse are cut?
Base should be cut through using scissors and pulling ellipse gently with skin hooks
How is the wound closed when carrying out an elliptical excision?
with simple interrupted sutures
What structure does lymphatics tend to follow in the limbs?
Veins
what structure does lymphatics tend to follow in the trunk?
Arteries
