Where do the arteries of the lower limb begin?
Junction between hip and thigh
Artery from which lower limb arteries split
External iliac artery
Arteries splitting from external iliac artery: 1) 2) 3) 4)
1) Femoral 2) Popliteal 3) Anterior tibial 4) Posterior tibial
Main branch of femoral artery
Superficial veins of lower limb 1) 2) 3)
1) Dorsal venous arch 2) Great saphenous 3) Small saphenous
Deep veins of the lower limb 1) 2)
1) Venous sinuses in soleus 2) Venae comitantes
Path of lower limb lymph drainage
Follows venous vessels
Path of lower limb lymph drainage through lymph nodes
Superficial inguinal node --> Deep inguinal node --> Drains through nodes beside aorta to thoracic duct
Major plexus supplying lower limb
Structure giving rise to lumbosacral plexi
Nerves arising from lumbosacral plexi 1) 2) 3) 4)
1) 2 x Gluteal nerves 2) Femoral nerve 3) Obdurator nerve 4) Sciatic nerve
Nerve segments supplying femoral nerve
L2m L3, L4
Muscles innervated by femoral nerve
Skin innervated by femoral nerve
Medial thigh, medial border of foot
How does the femoral nerve enter the thigh?
Passing inferior to inguinal ligament
Spinal segments supplying the obdurator nerve
L2, L3, L4
Muscles innervated by obdurator nerve
Adductor muscles of thigh
Skin innervated by obdurator nerve
Medial thigh, patch not innervated by femoral nerve
Clinical significance of obdurator nerve
Conveys referred pain from the ovaries to medial thigh
Which nerve conveys referred pain form the ovaries?
How does obdurator nerve enter the thigh?
Through the obdurator canal of the hip bone
Spinal segments supplying sciatic nerve
L4, L5, S1, S2, S3
Muscles innervated by sciatic nerve
Posterior thigh muscles
Structures into which the sciatic nerve splits 1) 2)
1) Tibial nerve 2) Common fibular nerve
Where does the sciatic nerve split into two major branches?
Major popliteal fossa
Where do injections into the buttock need to be administered?
Upper, outer quadrant
Why do injections into the buttock need to be administered to the outer, upper quadrant?
So that the sciatic nerve isn't accidentally pricked
Spinal segments supplying tibial nerve
T5, S1, S2, S3
Where does the tibial nerve originate?
Muscles innervated by tibial nerve
All posterior leg
Nerve from which medial and lateral plantar nerves arise from
What does the tibial nerve split into at the ankle?
Lateral, medial plantar nerves
Where does the tibial nerve split into the medial and lateral plantar nerves?
Tarsal tunnel syndrome
Compression of tibial nerve in tarsal tunnel
Compression of plantar nerves below medial arch
What does compression of plantar nerves below plantar arch result in?
What does compression of tibial nerve in the tarsal tunnel result in?
Tarsal tunnel syndrome
Spinal segments supplying common fibular nerve
L4, L5, S1, S2
Where does the common fibular nerve originate?
Where does the common fibular nerve travel
Behind the fibular head, down the lateral compartment of the leg
Muscles supplied by common fibular nerve
Lateral, anterior muscles of leg
How does the common fibular nerve innervate lateral and anterior muscles of leg?
Deep, superficial fibular nerves
What can anterior compartment syndrome lead to?
Compression of the common fibular nerve
How can the common fibular nerve be compressed?
Anterior compartment syndrome in leg
Effects of compressed common fibular nerve
What can cause foot drop?
Compression of common fibular nerve
Most common intervertebral disc to prolapse
L4,L5 or L5/S1
Effects of L4/L5, L5/S1 disc prolapse
Irritation of sciatic nerve
Clinical symptoms of compression of sciatic nerve
1) Plantar flexion, flexion of big toe might be affected 2) Muscle wastage of gastrocnemius, soleus 3) Ankle jerk diminished or absent