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Z Year 2 Anatomy > Vasculature 2 > Flashcards

Vasculature 2 Flashcards

1
Q

Where is the major artery of the arm, the brachial artery found?

A

In anterior compartment

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2
Q

Where does the brachial artery begin and terminate?

A
  1. Beginning as a continuation of the axillary artery at the lower border of the teres major muscle
  2. Terminates just distal to the elbow joint where it divides into the radial and ulnar arteries
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3
Q

In the proximal arm where does the brachial artery lie?

A

on the medial side

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4
Q

In the distal arm where does the brachial artery move?

A

moves laterally to assume a position midway between the lateral epicondyle and the medial epicondyle of the humerus

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5
Q

What happens to the brachial artery at the elbow joint?

A

crosses anteriorly to the elbow joint where it lies immediately medial to the tendon of the biceps brachii muscle.

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6
Q

Where is the brachial artery palpable?

A

along its length

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7
Q

Where can the brachial artery be compressed against?

A

In proximal regions, the brachial artery can be compressed against the medial side of the humerus

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8
Q

What are the branches of the brachial artery?

A
  • include those to adjacent muscles and two ulnar collateral vessels, which contribute to a network of arteries around the elbow joint
  • -Additional branches are the profunda brachii artery and nutrient arteries to the humerus, which pass through a foramen in the anteromedial surface of the humeral shaft
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9
Q

Where are the largest arteries in the forearm?

A

in the anterior compartment pass distally to supply the hand, and give rise to vessels that supply the posterior compartment

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10
Q

How does the brachial artery enter the forearm?

A

from the arm by passing through the cubital fossa

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11
Q

What does the brachial artery do at the apex of the cubital fossa?

A

divides into its two major branches, the radial and ulnar arteries

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12
Q

What is the femoral artery a continuation of?

A

external iliac artery in the abdomen

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13
Q

When does the external iliac artery become the femoral artery?

A

as the vessel passes under the inguinal ligament to enter the femoral triangle in the anterior aspect of the thigh

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14
Q

What do the branches of the femoral artery supply?

A

most of the thigh and all of the leg and foot

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15
Q

Where do the superior and inferior gluteal arteries originate and supply?

A

in the pelvic cavity as branches of the internal iliac artery and supply the gluteal region

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16
Q

How does the superior gluteal artery leave the pelvis?

A

through the greater sciatic foramen above the piriformis muscle

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17
Q

How does the inferior gluteal artery leave the pelvis?

A

through greater scaitic foramen below the piriformis muscle

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18
Q

What does the obturator artery originate from and supply?

A
  1. branch of the internal iliac artery in the pelvic cavity

2. passes through the obturator canal to enter and supply the medial compartment of the thigh

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19
Q

Which arteries interconnect to form a an anastomotic network in the upper thigh and gluteal region?

A

Branches of the:

  1. femoral
  2. inferior gluteal
  3. superior gluteal
  4. obturator arteries
  5. together with branches from the internal pudendal artery of the perineum
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20
Q

Why is the presence of these anastomotic channels important?

A

may provide collateral circulation when one of the vessels is interrupted

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21
Q

What are the two groups of the veins draining the lower limb?

A
  • Superficial

- Deep

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22
Q

What are deep veins path?

A

-generally follow the arteries (femoral, superior gluteal, inferior gluteal, and obturator)

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23
Q

What is the major deep vein draining the lib?

A
  • Femoral vein

- It becomes the external iliac vein when it passes under the inguinal ligament to enter the abdomen

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24
Q

Where are the superficial veins?

A

in the subcutaneous connective tissue and are interconnected with and ultimately drain into the deep veins

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25
Q

What two channels are formed by. the superficial veins and where do they originate?

A
  • Great saphenous vein
  • Small saphenous vein
  • Both veins originate from a dorsal venous arch in the foot
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26
Q

Where does the great saphenous vein originate and pass?

A
  1. Originate from the medial side of the dorsal venous arch
  2. ascends up the medial side of the leg, knee, and thigh to connect with the femoral vein just inferior to the inguinal ligament
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27
Q

Where does the small saphenous vein originate and pass?

A
  1. originates from the lateral side of the dorsal venous arch
  2. ascends up the posterior surface of the leg, and then penetrates deep fascia to join the popliteal vein posterior to the knee
  3. proximal to the knee, the popliteal vein becomes the femoral vein
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28
Q

What is the normal flow of blood in the lower limbs like?

A
  1. from the skin and subcutaneous tissues
  2. to the superficial veins
  3. drain via perforating veins
  4. to the deep veins
  5. which in turn drain into the iliac veins and inferior vena cava
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29
Q

What does the normal flow of blood in the venous system depend on?

A

presence of competent valves

30
Q

What do competent valves do?

A

prevent reflux

31
Q

What is venous return supplemented with?

A

contraction of the muscles in the lower limb, which pump the blood toward the heart

32
Q

What happens when venous valves become incompetent?

A
  1. Place extra pressure on more distal valves

2. These may also become incompetent

33
Q

What is varicose veins?

A

dilated tortuous superficial veins in the distribution of the great (long) and small (short) saphenous venous systems

34
Q

When are varicose veins most common?

A
  1. more common in women than in men
  2. symptoms are often aggravated by pregnancy
  3. genetic predisposition to developing varicose veins
35
Q

Wen are valves destroyed in varicose veins?

A
  1. when a deep vein thrombosis occurs if the clot incorporates the valve into its interstices
  2. during the process of healing and recanalization the valve is destroyed, rendering it incompetent
36
Q

What are typical sites for valvular incompetence?

A
  1. Junction between the great (long) saphenous vein and the femoral vein
  2. perforating veins in the midthigh
  3. the junction between the small (short) saphenous vein and the popliteal vein
37
Q

What are long term effects of varicose effects?

A
  1. soft tissue changes may occur
  2. increased venular and capillary pressure damages the cells - blood products extrude into the soft tissue
  3. brown pigmentation in the skin
  4. venous eczema may develop
  5. If the pressure remains high the skin may break down and ulcerate
38
Q

How do you treat varicose veins?

A
  1. tying off the valve
  2. “stripping” (removing) the great (long) and small (short) saphenous systems
  3. valvular reconstruction
39
Q

What is the classic triad that precipitates thrombosis?

A
  1. venous stasis
  2. injury to the vessel wall
  3. hypercoagulable states
40
Q

Where can thrombosis occur?

A
  1. in the deep veins of the lower limb

2. within the pelvic veins

41
Q

When can DVT cause death?

A
  1. DVT in the calf veins propagate into the femoral vein
  2. This clot may break off and pass through the heart to enter the pulmonary circulation
  3. resulting in occlusion of the pulmonary artery
  4. cardiopulmonary arrest, and death
42
Q

What is prophylactic DVT regimen?

A
  1. anticoagulant injections

2. graduated stockings (to prevent deep venous stasis and facilitate emptying of the deep veins).

43
Q

Why is DVT hard to spot?

A
  1. no clinical signs
  2. Calf muscle tenderness
  3. postoperative pyrexia
  4. limb swelling
44
Q

How is the diagnosis of DVT made?

A

duplex Doppler sonograph

45
Q

How do you treat DVT?

A

intravenous and oral anticoagulation are started to prevent extension of the thrombus

46
Q

Where does the popliteal artery enter the posterior compartment of the foot?

A

from the popliteal fossa behind the knee

47
Q

How does the popliteal artery pass into the posterior compartment of the leg?

A

between the gastrocnemius and popliteus muscles

48
Q

What happens to the popliteal artery as it continues inferiorly?

A
  1. passes under the tendinous arch formed between the fibular and tibial heads of the soleus muscle
  2. enters the deep region of the posterior compartment of the leg
  3. immediately divides into an anterior tibial artery and a posterior tibial artery
49
Q

Which branches of the popliteal artery supply the gastrocnemius, soleus, and plantaris muscles?

A

Two large sural arteries

50
Q

What other branches does the popliteal artery give rise to?

A

branches that contribute to a collateral network of vessels around the knee joint

51
Q

What is the journey of the anterior tibial artery?

A
  1. passes forward through the aperture in the upper part of the interosseous membrane
  2. enters and supplies the anterior compartment of the leg
52
Q

How does the anterior tibial artery continue in the foot?

A

continues inferiorly onto the dorsal aspect of the foot

53
Q

What does the posterior tibial artery supply?

A

the posterior and lateral compartments of the leg

54
Q

How does the posterior tibial artery continue in the foot?

A

passes through the tarsal tunnel behind the medial malleolus and into the sole of the foot

55
Q

How does the posterior tibial artery descend through the deep region of the posterior compartment of the leg?

A

on the superficial surfaces of the tibialis posterior and flexor digitorum longus muscles

56
Q

What are the two major branches of the posterior tibial artery?

A
  1. circumflex fibular artery

2. fibular artery

57
Q

What is the path of the circumflex fibular artery?

A
  1. passes laterally through the soleus muscle

2. around the neck of the fibula to connect with the anastomotic network of vessels surrounding the knee

58
Q

What is the path of the fibular artery?

A
  1. parallels the course of the tibial artery
  2. but descends along the lateral side of the posterior compartment
  3. adjacent to the medial crest on the posterior surface of the fibula
  4. which separates the attachments of the tibialis posterior and flexor hallucis longus muscles
59
Q

What does the fibular artery supply?

A
  1. adjacent muscles and bone in the posterior compartment of the leg
  2. has branches that pass laterally through the intermuscular septum to supply the fibularis muscles in the lateral compartment of the leg
60
Q

How does the fibular artery and anterior tibial artery join?

A
  1. Aperforating branchthat originates from the fibular artery distally in the leg
  2. passes anteriorly through the inferior aperture in the interosseous membrane
  3. to anastomose with a branch of the anterior tibial artery
61
Q

How does the fibular artery move to the calcaenous?

A

passes behind the attachment between the distal ends of the tibia and fibula and terminates in a network of vessels over the lateral surface of the calcaneus

62
Q

What is the path of deep veins in the posterior compartment. of the keg?

A

generally follow the arteries

63
Q

What are the major arteries in the lateral compartment of the leg?

A

No major artery passes vertically through the lateral compartment of the leg

64
Q

What is the lateral compartment of the leg supplied by?

A

branches (mainly from the fibular artery in the posterior compartment of the leg) that penetrate into the lateral compartment

65
Q

Where does the anterior tibial artery.originate?

A
  1. From the popliteal artery in the posterior compartment of the leg
  2. Passes forward into the anterior compartment of the leg through an aperture in the interosseous membrane
66
Q

How does the anterior tibial artery descend?

A

through the anterior compartment on the interosseous membrane

67
Q

Where is the anterior tibial artery in the distal leg?

A

lies between the tendons of the tibialis anterior and extensor hallucis longus muscles

68
Q

How does the anterior tibial artery leave the leg and enter the foot?

A
  1. Leaves the leg by passing anterior to the distal end of the tibia and ankle joint
  2. continues onto the dorsal aspect of the foot as the dorsalis pedis artery
69
Q

What are the branches of the anterior tibial artery like in the proximal leg?

A

recurrent branch, which connects with the anastomotic network of vessels around the knee joint

70
Q

Along its course what does the anterior tibial artery supply?

A
  1. numerous branches to adjacent muscles
  2. joined by the perforating branch of the fibular artery
  3. which passes forward through the lower aspect of the interosseous membrane from the posterior compartment of the leg
71
Q

Distally what does the anterior tibial artery gives rise to?

A
  1. Ananterior medial malleolar artery: pass posteriorly around distal ends of tibia
  2. Anterior lateral malleolar artery: pass posteriorly around distal ends of fibula
    - connect with vessels from the posterior tibial and fibular arteries to form an anastomotic network around the ankle

Z Year 2 Anatomy (16 decks)

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