Flashcards in M: Neurovasculature of the lower limb Deck (69)
The superior and inferior gluteal arteries are branches of which artery?
The internal iliac arteries
How do the internal and external iliac arteries arise?
1) The abdominal aorta divides into 2 common iliacs
2) The common iliacs each divide into an internal and external iliac
The cruciate anastomosis around the hip is made up of which 5 arteries and where does each arise?
From the internal iliacs:
1) Superior gluteal artery
2) Inferior gluteal artery
From the profunda femoris artery:
3) The lateral circumflex femoral artery
4) The medial circumflex femoral artery
5) 1st perforating artery
Why is the cruciate anastomosis around the hip clinically important?
Allows blood to bypass a blockage of the internal iliac artery or proximal femoral artery
Which artery supplies the anterior compartment of the thigh and where does it arise?
Continuation of external iliac (boundary = inguinal ligament)
Which arteries supply the posterior compartment of the thigh, where do they aris?
4 perforating arteries
Arise from the profunda femoris artery
The profunda femoris artery is a branch of which artery?
The femoral artery
Which artery supplies the medial compartment of the thigh, where does it arise?
Branch of the internal iliac
From where does the popliteal artery arise?
Femoral artery passes from the anterior compartment to enter the popliteal fossa via the adductor hiatus
Once its entered the popliteal fossa, the femoral artery becomes the popliteal artery
In what position is the popliteal artery best palpated?
Knee in flexion
Where is the genicular anastomosis found?
Around the knee
What is the function of the genicular anastomosis?
Maintains blood supply to the leg during knee flexion which may impinge the popliteal artery
What 5 arteries is the genicular anastomosis comprised of, where do they arise from?
All arise from the popliteal artery, 5 genicular branches:
1) Superior lateral
2) Superior medial
4) Inferior lateral
5) Inferior medial
At the back of the leg, the popliteal artery divides to form what 2 terminal branches?
The anterior and posterior tibial arteries
Which artery supplies the anterior compartment of the leg, from where does it arise?
Anterior tibial artery
Terminal branch of the popliteal artery
Which artery supplies the posterior compartment of the leg, from where does it arise?
Posterior tibial artery
Terminal branch of the popliteal artery
Which artery supplies the lateral compartment of the leg, from where does it arise?
Branch of the posterior tibial artery
Which artery supplies the dorsal aspect of the foot, from where does it arise?
Dorsalis pedis artery
Continuation of the anterior tibial artery
Which 2 arteries supply the plantar aspect of the foot, from where do they arise?
Medial and lateral plantar arteries
Formed by bifurcation of posterior tibial artery
The deep plantar arch is what?
Anastamosis of deep plantar branch of dorsalis pedis artery with lateral plantar artery
In what percentage of the population is the superficial plantar arch present?
Which 4 pulses should be palpated in an examination of the lower limb, where are they located?
1) Femoral - superficial in the femoral triangle
2) Popliteal - popliteal fossa with knee flexed
3) Posterior tibial - behind medial malleolus
4) Dorsalis pedis - Dorsum of foot between 1st and 2nd metatarsals
What is the clinical importance of the femoral artery? 3
1) Superficial in the femoral triangle so vulnerable to laceration
2) Site to obtain ABG in emergencies in people with poor peripheral perfusion/pulses
3) Site to undertake minimally invasive procedures - eg. coronary stent placing
Why is the femoral artery an important access point?
A catheter can be placed in to the femoral artery which can then be advanced up the arterial tree to a target organ eg. heart or brain
The femoral artery provides minimally invasive access for which 3 common procedures?
1) Coronary angiogram - imaging of heart with die
2) Coronary angioplasty - PCI
3) Embolisation of berry aneurysms
Peripheral vascular disease is common in lower limb, what is the treatment for acute limb ischaemia?
Medical emergency requiring revascularisation
What are the 6P's of the presentation of an acute ischaemic leg?
3) Perishingly cold
Atherosclerotic changes in the lower limb commonly occur where?
Lower femoral artery
When atherosclerotic changes occur in the lower femoral artery, how does the body compensate?
Collateral circulation via anastomoses between branches of profundus femoris and popliteal arteries