MSK - Arteries of the Lower Limb

Question 1

What is the main artery of the lower limb?

Answer 1

Femoral Artery

Question 2

What is the femoral artery a continuation of?

Answer 2

The exernal iliac artery

Question 3

When does the external iliac artery become the femoral artery?

Answer 3

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

Question 4

What artery arises in the femoral triangle?

Where does it arise from?

In what direction does it travel?

Answer 4

The profunda femoris artery

Arises Pasterolaterally

Travels posteriorly and distally

Question 5

How many branches does the **profunda femoris artery **give off?

Name them

Answer 5

3

Perforating Branches

Lateral Femoral Circumflex Artery

Medial Femoral Circumflex Artery

Question 6

How many arteries make up the Perforating Branches?

What muscle does they perforate?

What muscles does it contribute arterial supply to?

Answer 6

Consists of 3-4

Perforates the Adductor Magnus

Muscles of the Medial and Posterior Thigh

Question 7

Describe the course of the Lateral Femoral Circumflex Artery

What muscles does it supply?

Answer 7

Wraps around the anterior, lateral side of the femur

Supplies muscles in the lateral side of the thigh

Question 8

Describe the course of the Medial Femoral Circumflex Artery

What does it supply?

In what time of injury can it be damaged and what is a consequence of this?

Answer 8

Wraps around the posterior side of the femur

Supplies head and neck of the femur

Fracture of the Femoral Neck

Avascular necrosis of the femur head

Question 9

What is the course of the femoral artery after it exits the femoral triangle?

What does it supply as it descends?

Answer 9

Travels down the anterior surface of the thigh via a tunnel known as the adductor canal

Supplies the anterior thigh muscles

Question 10

Where does the adductor canal end?

Where does the femoral artery continue after this?

What is the femoral artery known as after it exits the adductor canal?

Answer 10

At an opening in the adductor magnus called the adductor hiatus

Enters posterior compartment of the thigh, proximal to the knee

Popliteal Artery

Question 11

Where can the **Femoral Pulse **be felt?

Where does it cross?

What does it mean if it can be felt?

Answer 11

Just inferior to where the **femoral artery **crosses the inguinal ligament

crosses exactly midway between the **pubis symphysis **and anteior superior iliac spine

Means blood is reaching lower extremity

Question 12

Why is the **femoral artery **easy to access?

Answer 12

Runs superficially

Question 13

What procedure can be performed via the femoral artery?

Describe the procedure

Answer 13

Coronary Angiography

“One such procedure is coronary angiography. Here, the femoral artery is catheterised with a long, thin tube. This tube is navigated up the external iliac artery, common iliac artery, aorta, and into the coronary vessels. A radioactive dye is then ejected into the coronary vessels, and any wall thickening or blockages can be visualised via x-ray imaging”

Question 14

The femoral artery can be catherised to draw blood for what?

Answer 14

Arterial blood gases

Question 15

Where does the obturator artery arise from?

Where does it descend?

Answer 15

Arises from internal iliac artery in the pelvic region

Descends via the obturator canal to enter the medial thigh

2

Question 16

Name the two branches of the obturaor artery

Where does each branch supply?

Answer 16

**Anterior Branch - **Supplies the pectineus, obturator externus, adductor muscles and gracilis

Posterior Branch **- **Supplies some of the deep gluteal muscles

Question 17

What is the gluteal region largely supplied by?

Where do they arise from and how do they enter the gluteal region?

Answer 17

The superior and inferior gluteal arteries

Also arise from the internal iliac artery

Enter via the greater sciatic foramen

Question 18

Where does the superior gluteal artery leave the foramen?

What other area does the inferior gluteal artery supply?

Answer 18

Above the pisiform muscle

Vasculature of the posterior thigh

Question 19

What artery descends down the posterior thigh?

What does it supply?

Answer 19

The popliteal artery

The Knee Joint

Question 20

Describe the course of the popliteal artery

At what point does the popliteal artery terminate and what does it divide into?

Answer 20

Descends down the posterior thigh, giving off genicular branches that supply the knee joint. It moves through the popliteal fossa, exiting sandwiched between the gastrocnemius and popliteus muscles

At the lower border of the popliteus

Divides into anterior and posterior tibial arteries

Question 21

In what direction does the posterior tibial artery continue?

What does it accompany into the sole of the foot with and what structure does it travel through?

Answer 21

Continues inferiorly along the surface of the deep muscles

Accompanies the tibial nerve in entering the sole of the foot via the tarsal tunnel

Question 22

What other artery arises from the posterior tibial artery during its descent?

Where does this artery travel and what does it supply?

Answer 22

Moves laterally, penetrating the lateral compartment of the leg

Supplies muscles in the lateral compartment and adjacent muscles in the posterior compartment

Question 23

In what direction does the anterior tibial artery travel, and through what?

What does it become in the foot?

Answer 23

Passes anteriorly between the tibia and fibula through a gap in the interosseous membrane and the moves inferiorly down the leg

Dorsalis Pedis Artery

Question 24

What is an aneurysm?

Answer 24

A dilation of an artery which is greater than 50% of the normal diameter

Question 25

In a popliteal artery aneurysm, what structures can be affected and why?

Answer 25

Other contents of the **popliteal fossa** because the popliteal fascial layer (roof of the popliteal fossa) is **tough** and non extensible

Question 26

What stucture is particularly suscetible to compression from the popliteal artery? How would this present?

Answer 26

**Tibeal Nerve** Leg **anethesia** or loss of leg motor function

Question 27

How would a popliteal artery aneurysm be detected?

Answer 27

An obvious palpable pulsation in the popliteal fossa with abnormal arterial sounds

Question 28

Arterial supply in the foot is delivered by what two arteries?

Answer 28

**Dorsalis Pedis** (a continuation of the anterior tibial artery) **Posterior Tibial** **Artery**

Question 29

Describe the course of the **Dorsalis Pedis**

Answer 29

Passes over the dorsal aspect of the tarsal bones then moves inferiorly towards the sole of the foot Then **anastamoses** with the **lateral plantar artery** to form the **deep plantar arch**

Question 30

What does the dorsalis pedis artery supply?

Answer 30

Tarsal bones and dorsal aspect of the metatarsals Via the deep plantar arch it also contributes to the supply of the toes

Question 31

Describe the course of the **posterior tibial artery**

Answer 31

Enters the sole of the foot through the tarsal tunnel and then splits into the lateral and medial plantar arteries

Question 32

What does the **posterior tibial artery **supply?

Answer 32

Plantar side of the foot and contributes to the supply of the toes via the **deep plantar arch**

Question 33

What are the three main pulse points of the lower limb?

Answer 33

**Femoral** **Popliteal** **Dorsalis Pedis**

Question 34

Where can the **femoral pulse** be palpated?

Answer 34

As it enters the femoral triangle, midway between the anterior superior iliac spine of the pelvis, and the pubis synthesis *(the mid-inguinal point)*

Question 35

The **popliteal artery** is the hardest pulse to find, but where can it be palpated and how can it be made easier to find?

Answer 35

Lies deep in the popliteal fossa and requires deep palpation Slight flexion of the leg (this relaxes the fascia around the popliteal fossa)

Question 36

Where can the **dorsalis pedis** pulse be found?

Answer 36

Palpating on the dorsum of the foot, just lateral to extensor hallucis longus tendon