Flashcards in Arteries of the Lower Limb Deck (61):
What is the main artery of the lower limb?
The femoral artery
What is the femoral artery a continuation of?
The external iliac artery
What is the external iliac artery?
The terminal branch of the abdominal aorta
When does the external iliac artery become the femoral artery?
When it crosses under the inguinal ligament and enters the femoral triangle
What arises from the femoral artery in the femoral triangle?
The profunda femoris artery
Where does the profunda femoris artery arise from?
The posterolateral aspect of the femoral artery
Where does the profunda femoris artery travel?
Posteriorly and distally
What does the profunda femoris artery give off?
Three main branches, perforating branches, the lateral femoral circumflex artery, and the medial femoral circumflex artery
What do the perforating branches of the profunda femoris artery consist of?
Three or four arteries that perforate the adductor magnus
What do the perforating branches of the profunda femoris artery contribute?
The supply of the muscles in the medial and posterior thigh
What course does the lateral femoral circumflex artery take?
Wraps around the anterior, lateral side of the femur
What does the lateral femoral circumflex artery supply?
Some of the muscles in the lateral side of the thigh
What course does the medial femoral circumflex artery take?
Wraps around the posterior side of the femur
What does the medial femoral circumflex artery supply?
The neck and head of the femur
What happens in a fracture of the femoral neck?
The medial femoral circumflex artery can easily be damaged, and avascular necrosis of the femur head can occur
What happens to the femoral artery after exiting the femoral triangle?
It continues down the anterior surface of the thigh
How does the femoral artery continue down the thigh?
Via a tunnel known as the adductor canal
What does the femoral artery do during its descent?
Supplies the anterior thigh muscles
Where does the adductor canal end?
At an opening in the adductor magnus, called the adductor hiatus
What happens as the femoral artery moves through the adductor hiatus?
It enters the posterior compartment of the thigh, proximal to the knee
What does the femoral artery become once it’s going through the adductor hiatus?
The popliteal artery
Where is the femoral artery located within the femoral triangle?
What is the result of the femoral artery being located superficially within the femoral triangle?
It is easy to access, and therefore suitable for a range of clinical procedures
Give two procedures that the femoral artery can be used for
Coronary artery angiography
Drawing arterial blood gases
What happens in a coronary artery angiography?
The femoral artery is catheterised with a long, thin tube. The tube is navigated up the external iliac artery, common iliac artery, aorta, and into the coronary vessels. A radioactive dye in then ejected into the coronary vessels, and any wall thickening or blockages can be visualised via x-ray imaging
What does the obturator artery arise from?
The internal iliac artery in the pelvic region
What course does the obturator artery take?
It descends via the obturator canal to enter the medial thigh, and then bifurcates
What branches arise from the bifurcation of the obturator artery?
What does the anterior branch of the obturator artery supply?
The pectineus, obturator externus, adductor muscles and gracilis
What does the posterior branch of the obturator artery supply?
Some of the deep gluteal muscles
What is the gluteal region largely supplied by?
The superior and inferior gluteal arteries
What to the gluteal arteries arise from?
The internal iliac artery
How do the gluteal arteries enter the gluteal region?
Via the greater sciatic foramen
Where does the gluteal arteries leave the greater sciatic foramen?
The superior, above the piriformis muscle
The inferior below it
What does the inferior gluteal artery contribute towards?
The vasculature of the posterior thigh
Where does the popliteal artery descend?
Down the posterior thigh
What does the popliteal artery do as it descends down the posterior thigh?
It gives off genicular branches that supply the knee joint
How does the popliteal artery exit the popliteal fossa?
Sandwiched between the gastrocnemius and popliteus muscles
Where does the popliteal artery terminate?
At the lower border of the popliteus muscle
How does the popliteal artery terminate?
By dividing into anterior and posterior tibial arteries
What course does the posterior tibial artery take?
It continues inferiorly, along the surface of the deep muscles (such as tibialis posterior). It then accompanies the tibial nerve in entering the sole of the foot via the tarsal tunnel.
What happens during descent of the posterior tibial artery down the leg?
The fibular artery arises
What course does the fibular artery take?
It moves laterally, penetrating the lateral compartment of the leg
What does the fibular artery supply?
Muscles in the lateral compartment, and adjacent muscles in the posterior compartment
What course does the anterior tibial artery take?
It passes anteriorly between the tibia and fibula, through a gap in the interosseous membrane. It then moves inferiorly down the leg. It runs down the entire length into the leg, and into the foot
What does the anterior tibial artery become in the foot?
The dorsalis pedis artery
How is arterial supply to the foot delivered?
Where does the dorsalis pedis artery begin?
As the anterior tibial artery enters the foot
What course does the dorsalis pedis artery take?
It passes over the dorsal aspect of the tarsal bones, then moves inferiorly, towards the sole of the foot.
What does the dorsalis pedis artery anastomose with?
The lateral plantar artery
What is formed when the dorsalis pedis artery anastomoses with the lateral plantar artery?
It forms the deep plantar arch
What does the dorsalis pedis artery supply?
The tarsal bones and the dorsal aspect of the metatarsals
Via the deep plantar arch, it also contributes to the supply of the toes
How does the posterior tibial artery enter sole of the foot?
Through the tarsal tunnel
What does the posterior tibial artery do once it’s entered the foot?
It splits into the lateral and medial plantar arteries
What do the lateral and medial plantar arteries supply?
The plantar side of the foot
Contributes to the supply of the toes via the deep plantar arch
What are the three main pulse points in the lower limb?
Where the femoral pulse be palpated?
As it enters the femoral triangle, midway between the anterior superior iliac spine of the pelvis, and the pubis symphesis
Where does the popliteal artery pulse lie?
Deep in the popliteal fossa
What does palpation of the popliteal pulse require?
How can palpation of the popliteal pulse be made easier?
Ask the patient to slightly flex their leg, which relaxes the fascia around the popliteal fossa