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Flashcards in Arterial supply of lower limb Deck (40):
1

When does the external iliac artery terminate and what does it become

When it crosses under inguinal ligament and enters femoral triangle it becomes the femoral artery

2

What artery branches off the femoral artery within the femoral triangle
What aspect of the femoral artery does it arise from

Deep artery of thigh/ profundus femoris artery
Arises from posterolateral aspect

3

Course of deep artery of thigh

Travels posteriorly and distally

4

Branches of the deep artery of thigh

Perforating branches
Lateral femoral circumflex artery
Medial femoral circumflex artery

5

Course and function if perforating branches

Perforate adductor Magnus
Supplies muscles in medial and posterior thigh

6

Course and function of lateral femoral circumflex artery

Wraps around anterior lateral femur
Supplies some muscles in lateral side of thigh

7

Course and function of medial femoral circumflex artery

Wraps around posterior femur
Supplies head and neck of femur

8

What artery can be damaged in femoral neck fractures
Consequence of this

Medial femoral circumflex artery
Avascular necrosis of head of femur

9

Course and termination of femoral artery

Arises in femoral triangle
Leaves femoral triangle
Continues down anterior thigh via adductor canal
During descent it supplies anterior thigh muscles
Becomes popliteal artery at border between anterior/posterior thigh (adductor hiatus)

10

What procedures is the femoral artery accessed in

Coronary angiography
Measuring arterial blood gases

11

Describe coronary angiography

Femoral artery is catheterised with a long tube which is navigated by the external iliac artery, common lilac artery, aorta and coronary arteries
Radioactive dye is injected into coronary arteries to visualise blockages/narrowing via X-ray

12

Where is the femoral artery accessed

Within femoral triangle as its superficial and can be easily located

13

Course of obturator artery

Arises from internal iliac artery in pelvic region
Descends via obturator canal to enter medial thigh

14

Termination of obturator artery

Bifurcates within the medial thigh into 2 branches:
Anterior branch
Posterior branch

15

What does the anterior branch of obturator artery supply

Pectineus
Obturator externus
Adductor muscles
Gracilis

16

What does the posterior branch of obturator artery supply

Some deep gluteal muscles

17

What do the superior and inferior gluteal arteries supply

Most of gluteal region
Inferior gluteal artery also contributes to supply of posterior thigh

18

Course of superior gluteal artery

Arises from internal iliac artery
Enters gluteal region via greater sciatic foramen
Leaves this foramen above piriformis

19

Course of inferior gluteal artery

Arises from internal iliac artery
Enters gluteal region via greater sciatic foramen
Leaves this foramen below piriformis

20

Course of popliteal artery

Descends down posterior thigh
Moves through popliteal fossa, exiting between gastrocnemius and popliteus

21

What branch arises from the popliteal artery
What does it supply

Genicular branches
Supply knee joint

22

Termination of popliteal artery

At lower border of popliteal fossa it divides into:
Anterior tibial artery
Posterior tibial artery

23

Course of posterior tibial artery

Continues inferiorly along surface of deep muscles
It accompanies the tibial nerve in entering the sole of the foot via the tarsal tunnel

24

What branch arises from posterior tibial artery

Fibular artery

25

Course and function of fibular artery

Moves laterally and penetrates lateral compartment of leg
Supplies muscles in lateral compartment and adjacent muscles in posterior compartment

26

Course of anterior tibial artery

Passes anteriorly between tibia and fibular through gap in interosseus membrane
Moves inferiorly down leg and enters foot

27

Termination of posterior tibial artery

Divides in the foot into:
Lateral plantar artery
Medial plantar artery

28

Termination of anterior tibial artery

Enters the foot and becomes the dorsal pedis artery

29

Arterial supply of foot

Dorsalis pedis artery
Posterior tibial artery

30

Course of dorsal pedis artery

Passes over dorsal aspect of tarsal bones
Moves inferiorly towards sole
Anastomoses with lateral plantar artery to form the deep plantar arch

31

What does the dorsal pedis artery supply

Tarsals
Dorsal aspect of metatarsals
Contributes to supply of toes

32

What do the medial and lateral plantar arteries supply

Plantar aspect of foot
Contributes to supply of toes

33

What are the 3 main pulse points in the lower limb
Where are they palpated

Femoral pulse - mid inguinal point
Popliteal pulse - popliteal fossa (easier to palpate if fossa is relaxed - ask patient to slightly flex leg)
Dorsalis pedis pulse - dorsum of foot, lateral to extensor hallucis longus tendon

34

What is the main artery of lower limb

Femoral artery

35

What are the genicular arteries

Superior medial
Inferior medial
Superior lateral
Inferior lateral

36

How do you assess arterial occlusion in the lower limb

Ankle-brachial pressure index (ABPI)

37

How do you obtain an ABPI and what is the normal range of values

Lie patient supine to prevent gravity effecting results
Use Doppler ultrasound probe to amplify sound of arterial blood flow
Measure systolic pressure in arm and ankle
ABPI= Pleg/Parm
Normal range is 0.9-1.2

38

What does a lower than normal ABPI mean

Arterial peripheral disease (cause of intermittent claudication)

39

Treatment for peripheral arterial disease

Antiplatelets (aspirin)
Risk factor modification

40

Signs of acute ischaemia

Pain
Paraesthesia
Pulseless
Pale
Paralysed
Cold

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