Vessels of lower limb

Question 1

Give an overview of the vessels of the lower limb?

Answer 1

Question 2

Describe the pathway of the profunda femoris artery?

Answer 2

Sits deep, running on adductor magnus

Sends a perforating branch through each of the holes in adductor magnus > posterior compartment of thigh

Also gives rise to anastamoses around proximal shaft of femur

Question 3

Describe how the femoral artery transitions posteriorly to become the politeal artery?

Answer 3

Travels through the adductor hiatus

Question 4

Which artery do the genicular anastamoses arise from?

Answer 4

Politeal artery

Question 5

Describe where the anterior and posterior tibial arteries run?

Answer 5

Run either side of interosseous membrane

Question 6

Where do arteries always run at joints?

Answer 6

On flexor aspect

Question 7

Describe the arrangement of neurovascular structures in the inguinal region?

Answer 7

Medial to lateral: VAN

Question 8

Describe the anatomy of the femoral sheath?

Answer 8

Medial to lateral: dead space, vein, artery

Question 9

Describe the anatomy of the femoral ring?

Answer 9

Femoral vein is lateral

Lacunar ligament is medial

Inguinal ligament is anterior

Pectineus is posterior

Question 10

Why is a femoral hernia more likely to strangulate than an inguinal hernia?

Answer 10

Very rigid boundaries

Question 11

Which vessek runs through the adductor hiatus?

Answer 11

Femoral artery

(going posteriorly to form politeal artery)

Question 12

Which structure runs with the femoral artery through the adductor hiatus?

Answer 12

Femoral vein

Question 13

Describe how the tibial nerve, politeal artery and popliteal vein are related to each other anatomically?

Answer 13

Tibial nerve superifical to popliteal vein

Popliteal vein superificial to politeal artery

Superficial to deep: NVA

Question 14

Describe the pathway of the anterior tibial artery as it passes onto the dorsum of the foot?

Answer 14

Passes under extensor retinaculum (between EHL and tibial nerve) > becomes dorsalis pedis > heads towards first web space

Question 15

Describe the pathway of the posterior tibial artery as it passes onto the sole of the foot?

Answer 15

Passes under flexor retinaculum (between FDL and posterior tibial vein) > divides into medial and lateral plantar and fibular arteries

Question 16

Describe compartment syndrome?

Answer 16

Increased pressure in muscular compartment > unable to be relieved due to rigid boundaries

Leads to ischaemia > infarction > oedema > greater increase in pressure…

Question 17

Describe the signs and symptoms of compartment syndrome?

Answer 17

Painful

Pale

Pulseless

Paraesthetic (pins and needles, loss of sensation)

Paralysed

Question 18

Describe the pathway of the great saphenous vein?

Answer 18

Dorsal venous arch > anterior to medial malleolus > medial side of leg > hands breadth behind patella > medial thigh > saphenous opening (in fascia lata, just below inguinal ligament)

Question 19

Which vein drains the superficial lower limb?

Answer 19

Anterior: great saphenous vein

Posterior: short saphenous vein

Question 20

Describe the pathway of the short saphenous vein?

Answer 20

Dorsal venous arch > posterior to lateral malleolus > posterior leg > popliteal fossa > pierces deep fascia > joins venae comitantes of anterior and posterior tibial veins

Question 21

Describe how varicose veins develop?

Answer 21

Incompetent valves > dilated, tortuous superificial veins > increased capillary pressure > extrusion of blood and products into soft tissue > brown pigmentation, venous eczema, ulceration

Occurs when blood is visible in superificial veins

Blood should only flow superficial to deep, so superificial should be empty most of the time