L5: Vessels & Nerves of Lower Extremity

Question 1

femoral artery is the continuation of the ?

Answer 1

external iliac artery

Question 2

origin of femoral artery

Answer 2

begins deep to inguinal lig.

enclosed w/in femoral sheath

becomes popliteal artery at adductor hiatus

Question 3

proximal branches of femoral art.

Answer 3

superficial epigastric a
superficial circumflex iliac a
superficial external pudendal a.

Question 4

superficial epigastric artery

Answer 4

passes thru saphenous hiatus

crosses inguinal lig. toward umbilicus

anastomoses w/ inf. epigastric art.

Question 5

superficial circumflex iliac artery

Answer 5

passes thru saphenous hiatus

passes along inguinal lig. towards ASIS

anastomoses w/ deep circumflex iliac artery

Question 6

superficial external pudendal artery

Answer 6

passes thru saphenous hiatus

passes medially toward external genitalia

Question 7

deep branches of femoral artery

Answer 7

deep external pudendal
descending genicular
profundal femoral or deep femoral

Question 8

branches of produnda femora

Answer 8

medial femoral circumflex
lat. femoral circumflex
perforating arteries - 3
descending genicular

Question 9

deep external pudendal

Answer 9

passes medially acros pectineus and adductor longus

becomes superficial to supply external genitalia

Question 10

descending genicular artery

Answer 10

arises in adductor canal

musculoarticular branch – part of genicular anastomoses

saphenous branch – runs w/ saphenous nerve

Question 11

profundal femora artery

Answer 11

arises from deep side of femoral art. w/in f triangle

largest branch of femoral a.

passes post. to adductor longus

terminates as a 4th terminating artery

Question 12

medial femoral circumflex artery

Answer 12

may come directly off femoral a.

leaves femoral triangle between iliopsoas and pectineus

supplies hip joint, upper thigh, glutes

Question 13

branches of medial femoral circumflex artery

Answer 13

ascending branch – anastomose w/ inf. gluteal

transverse branch – anastomose w/ lat. femoral circumflex a.

Question 14

lateral femoral circumflex artery

Answer 14

may come directly off femoral a.

passes laterally deep to rectus femoris and sartorius

supplies hip joint, upper thigh, glutes

Question 15

branches of lateral femoral circumflex artery

Answer 15

ascending branch – anas w/ superior gluteal a.

transverse branch – anas w/ medial femoral circ. a.

descending branch – anas w/ genicular arteries

Question 16

popliteal artery is a continuation of the ?

Answer 16

femoral artery

Question 17

popliteal artery

Answer 17

begins at adductor hiatus

ends at inf. border of popliteus muscle

most anterior structure in popliteal fossa

Question 18

branches of popliteal artery at ending

Answer 18

branches into anterior and posterior tibial arteries

Question 19

branches off popliteal artery

Answer 19

med. and lat. superior genicular arteries
med. and lat. inferior genicular arteries

middle genicular a. and sural(calf) arteries

Question 20

what is the cruciate anastomosis?

Answer 20

joins the internal iliac to femoral artery

a bypass for femoral or external iliac arteries

Question 21

cruciate anastomosis includes branches from ?

Answer 21

medial femoral circumflex

lat. femoral circumflex

inferior gluteal a.

first perforating artery

Question 22

obturator artery

Answer 22

arises from internal iliac in pelvis

enters thigh thru obturator canal

accompanied by ant/post obturator nerve branches

Question 23

obturator artery gives rise to ?

Answer 23

anterior and poster branches

acetabular artery

Question 24

acetabular artery

Answer 24

to head of femur via ligamentum teres

Question 25

contributors to genicular anastomosis

Answer 25

1. genicular branches of popliteal a. 2. descending branches of femoral and deep femoral 3. ascending branches of ant/post tibial arteries

Question 26

where is the genicular anastomosis?

Answer 26

back of the knee between 2 condyles

Question 27

anterior tibial artery

Answer 27

--terminal branch of popliteal artery arises at inf. border of popliteus passes ant. to interosseous memb. between tibia and fibula accompanied by deep peroneal nerve

Question 28

anterior tibial artery is renamed ? and supplies?

Answer 28

renamed dorsalis pedis artery at ankle joint supplies anterior leg compartment

Question 29

branches of anterior tibial artery

Answer 29

ant. tibial recurrent lat. malleolar a. med. malleolar a.

Question 30

dorsalis pedis artery

Answer 30

continuation of anterior tibial artery post ankle

Question 31

branches of dorsalis pedis artery

Answer 31

med. tarsal a. lat. tarsal a. arcuate a. deep plantar a. first dorsal interosseous a.

Question 32

posterior tibial artery

Answer 32

terminal branch of popliteal artery arises at inf. border of popliteus passes post. to interosseous memb. accompanied by tibial nerve descends on post. surface of tibialis posterior

Question 33

termination of posterior tibial artery

Answer 33

terminates deep to flexor retinaculum as: med. plantar a. lat. plantar a.

Question 34

superficial veins of lower limb

Answer 34

great saphenous | lesser saphenous

Question 35

great saphenous vein

Answer 35

drains medial side of dorsal venous arch passes post. patella ascends medial thigh penetrates deep fascia of femoral triangle dumps into femoral vein

Question 36

lesser saphenous vein

Answer 36

drains lateral side of dorsal venous arch accompanies sural n. ascends midline of calf dumps into popliteal vein in popliteal fossa

Question 37

deep veins of lower limb

Answer 37

venae comitantes popliteal vein communicating veins

Question 38

venae comitantes

Answer 38

accompany deep arteries of leg unite to form popliteal vein in popliteal space

Question 39

popliteal vein

Answer 39

passes thru adductor hiatus renamed femoral vein

Question 40

lymphatics draining medial foot

Answer 40

ascend w/ great saphenous vein end in superficial inguinal lymph nodes

Question 41

superficial inguinal lymph nodes also drain?

Answer 41

``` lower ab wall external genitalia perineum anal region uterine fundus ```

Question 42

lymphatics draining lateral foot

Answer 42

ascend w/ small saphenous vein end in lymph nodes in popliteal fossa ascend w/ femoral vein to deep inguinal nodes

Question 43

drainage pathway of lymph

Answer 43

superficial inguinal ---> deep inguinal ---> external iliacs

Question 44

origins of lower plexuses

Answer 44

lumbar L1-L4 lumbosacral trunk L4-5 sacral plexus S1-4

Question 45

lumbar plexus

Answer 45

formed in psoas major -- branches emerge from lat. and med. sides of muscle to connect to sympathetic trunk

Question 46

lumbar plexus 2 branches emerging

Answer 46

from psoas muscle 1. Iliohypogastric 2. ilioingual

Question 47

Iliohypogastric

Answer 47

to side of buttock and pubis

Question 48

ilioingual

Answer 48

to anterior thigh, scrotum and labia majora

Question 49

genitofemoral nerve

Answer 49

emerges on ant. surface of psoas major genital branch enters inguinal canal -- scrotum and labia majora, cremaster muscle femoral branch enters femoral sheath supplies skin over f triangle

Question 50

femoral nerve

Answer 50

L2-4 largest branch of lumbar plexus emerges from lat. side of psoas major enters thigh behind inguinal lig.

Question 51

femoral nerve supplies

Answer 51

in iliac fossa --- iliacus and pectineus, femoral artery distally --- sartorius, quadriceps femoris, anterior thigh

Question 52

femoral nerve terminates as

Answer 52

saphenous nerve to medial thigh and foot

Question 53

obturator nerve

Answer 53

L2-4 emerges med. side of psoas descends along lateral pelvis wall enters thigh thru obturator foramen

Question 54

obturator nerve to obturator foramen

Answer 54

in the obturator groove it divides into 1. anterior branch to adductor brevis 2. post. branch to adductor brevis posteriorly

Question 55

obturator nerve supplies

Answer 55

medial thigh muscles skin on medial thigh

Question 56

nerves of the sacral plexus

Answer 56

superior gluteal n post. femoral cutaneous n nerves to lat. thigh sciatic n

Question 57

superior gluteal nerve

Answer 57

L4-S1 passes thru greater sciatic notch above piriformis supplies lat. gluteal

Question 58

posterior femoral cutaneous nerve

Answer 58

runs w/ gluteal nerves deep to gluteus max then runs w/ sciatic nerve and gluteal artery

Question 59

post. femoral cutaneous nerve supplies

Answer 59

skin on buttock -- via inf. cluneal n. skin of external genitalia -- via perineal branches skin on back of thigh

Question 60

nerves to lateral thigh

Answer 60

inferior gemellus quadratus femoris piriformis

Question 61

sciatic nerve

Answer 61

fusion of common peroneal and tibial nerves largest physical nerve in body exits pelvis thru greater sciatic foramen descends between gluteus max, greater trochanter, ischial tuberosity

Question 62

sciatic nerve lies on

Answer 62

ischium gemelli obturator internus quadratus femoris

Question 63

peripheral nerve injuries

Answer 63

all motor function and sensations suppled by nerves distal to injury is lost total muscle function lost sensation over more than one dermatome is lost

Question 64

nerve root injuries

Answer 64

sensory impairment over 1 dermatome muscle weakening may only affect one root or the other

Question 65

nerve root injuries usually affected by ?

Answer 65

disc herniation immediately superior to it