Skin Structure and Function 6 - Anatomy of Leg Circulation

Question 1

What are the names of the 2 types of fascia that are located below the skin?

Answer 1

Superficial fascia

Deep fascia

Question 2

What is another name for the superficial fascia?

Answer 2

Subcutaneous tissue

Question 3

What is the superficial fascia composed of? (2)

Answer 3

Loose connective tissue and fat

Question 4

What is the deep fascia composed of?

Answer 4

Dense connective tissue

Question 5

What are intermuscular septum?

Answer 5

Extensions of the deep fascia that splits the muscle in the limbs into different compartments

Question 6

How does inter muscular septa affect venous return?

Answer 6

It aids it

Question 7

What is the order of the arterial supply in the arm from proximal to distal?

Answer 7

Subclavian
Axillary
Brachial
Ulnar + Radial
Superficial palmar arch + deep palmar arch

Question 8

What are the names for the veins that can be seen on the posterior aspect of the hand?

Answer 8

Dorsal venous network

Question 9

What is the distal vein located on the medial side of the arm?

Answer 9

Basilic vein

Question 10

What is the distal vein located on the lateral side of the arm?

Answer 10

Cephalic vein

Question 11

What is the vein connecting the cephalic and basilic vein?

Answer 11

Median cubital vein

Question 12

What is the name of the veins that accompany the brachial artery?

Answer 12

Venae comitantes (pulsation of artery aids venous return)

Question 13

What is the name for the vein under the armpit?

Answer 13

Axillary vein

Question 14

What is the name of the vein proximal to the axillary vein?

Answer 14

Subclavian vein

Question 15

What is distal to the radial artery?

Answer 15

Deep palmar arch

Question 16

What is distal to the ulnar artery?

Answer 16

Superficial palmar arch

Question 17

What is the name of the artery that the profunda femoris branches off?

Answer 17

Superficial femoral artery

Question 18

What is the name for the deep artery of the thigh that branches off of the superficial femoral artery?

Answer 18

Produnda femoris

Question 19

What is the adductor hiatus?

Answer 19

A gap between the adductor magnus muscle and femor that allows the passage of the femoral good vessels

Question 20

What is the name of the continuation of the femoral artery after the knee?

Answer 20

Popliteal artery

Question 21

What does the popliteal artery dive into?

Answer 21

posterior and anterior tibial arteries

Question 22

What branches from the posterior tibial artery above the ankle joints?

Answer 22

Fibular artery

Question 23

what doe the posterior tibial artery branch into after the ankle joint?

Answer 23

Medial plantar and lateral plantar arteries

Question 24

What does the anterior tibial artery branch into after the ankle joint?

Answer 24

Dorsalis pedis and arcuate artery

Question 25

What are the 2 main superficial veins of the leg?

Answer 25

Great saphenous vein | Small saphenous vein

Question 26

Where does the great saphenous vein arise from?

Answer 26

Dorsal venous arch along medial aspect of limb

Question 27

What are the 2 main deep veins of the leg - running proximal to distal?

Answer 27

Femoral vein | Popliteal vein

Question 28

Where does the small saphenous vein run?

Answer 28

From dorsal venous arch along posterior midline of leg

Question 29

Does the great saphenous vein run infront or behind the medial or lateral malleolus?

Answer 29

Infront of the medial malleolus

Question 30

where does the great saphenous vein drain into?

Answer 30

Femoral vein around the femoral triangle

Question 31

Where does the small saphenous vein drain to?

Answer 31

Popliteal vein posterior to the knee

Question 32

How does blood flow from superficial veins into deep veins?

Answer 32

through perforating veins

Question 33

what helps to push blood back towards the heart?

Answer 33

musculovenous pump

Question 34

What do venous valves ensure?

Answer 34

Unidirectional blood flow against gravity

Question 35

What does incompetent valves cause?

Answer 35

Reverse blood flow into superficial veins = weak and dilated vessels = varicose veins

Question 36

Does the small saphenous vein lie infront or behind the medial or lateral malleolus?

Answer 36

Behind the lateral malleolus

Question 37

What is an end artery?

Answer 37

The only blood supply to a given area of the body (no collaterals)

Question 38

what type of arteries are digital arteries?

Answer 38

End arteries

Question 39

what does untreated occlusion of an end artery result in?

Answer 39

infarction of the area of tissue it supplies

Question 40

What type of local anaesthetic should you not use near end arteries?

Answer 40

Adrenaline-containing local anaesthetic

Question 41

What are the 2 pulse points on the upper limb?

Answer 41

Brachial | Radial

Question 42

What are the 4 pulse points on the lower limb?

Answer 42

Femoral Popliteal Posterior tibial Dorsalis pedis

Question 43

What is iscahemia?

Answer 43

Inadequate oxygenation of cells/ tissues. organ due to an interruption to blood supply (venous or arterial)

Question 44

What can cause reduced arterial perfusion pressure?

Answer 44

Left ventricular failure Arterial bleed (injury) Arterial rupture (aneurysm) Occlusion of lumen (atherosclerosis: PVD) Arterial spasm Extrenal compression of arterial supply e.g. tumour

Question 45

What causes increased venous drainage pressure?

Answer 45

Right (or congestive) cardiac failure DVT External compression

Question 46

How is DVT caused?

Answer 46

Immobility/ venous failure of any cause -> Chronic venous insufficiency -> Deep venous stasis

Question 47

How is skin ulceration caused?

Answer 47

Immobility of any cause/ venous valve failure of any cause -> Chronic venous insufficiency -> Superficial microcirculatory deficiencies -> Skin ulceration

Question 48

How does increased venous pressure lead to venous ulceration?

Answer 48

Increased pressure causes damaged blood vessels in skin Skin becomes dry, itchy and inflamed This cannot heal well due to poor blood supply Begins to breakdown

Question 49

Where is the most common site of venous ulceration?

Answer 49

the gaiter area - medial aspect of distal leg

Question 50

What does the lymphatics generally follow in the limbs?

Answer 50

Veins

Question 51

Name for lymph nodes around the median cubital vein?

Answer 51

Cubital nodes

Question 52

Name for the 2 types of lymph nodes in the arm pit?

Answer 52

Lateral axillary nodes (lower) | Apical axillary nodes (Higher)

Question 53

Name for lymph nodes behind the knee?

Answer 53

Popliteal nodes

Question 54

Name for lymph nodes in the groin?

Answer 54

superficial and deep inguinal nodes

Question 55

What is the standard method of removal of small skin lesions?

Answer 55

Elliptical excision

Question 56

Complications of elliptical incision? (2)

Answer 56

Nerve injury | Bleeding (superficial veins)

Question 57

What are the lines that can be used to map the skin showing the orientation of the collagen fibres and therefore skin tension?

Answer 57

Langer lines

Question 58

What degree angle should be left between the 2 incision of an elliptical excision?

Answer 58

30 degrees

Question 59

At what angle should the scalpel blade cut to the skin when making an elliptical excision?

Answer 59

90 degrees

Question 60

When making an elliptical excision, what should be done once the sides of the ellipse are cut?

Answer 60

Base should be cut through using scissors and pulling ellipse gently with skin hooks

Question 61

How is the wound closed when carrying out an elliptical excision?

Answer 61

with simple interrupted sutures

Question 62

What structure does lymphatics tend to follow in the limbs?

Answer 62

Veins

Question 63

what structure does lymphatics tend to follow in the trunk?

Answer 63

Arteries