Download VESSELS OF THE LOWER EXTREMITY

VESSELS OF THE
LOWER EXTREMITY
Femoral Artery

Femoral artery is the continuation of the
external iliac artery:
Begins deep to the inguinal ligament.
Enclosed within the femoral sheath.
Becomes the popliteal artery:
At the adductor hiatus.
Femoral Artery

Proximal branches:
Superficial epigastric artery.
Superficial circumflex iliac artery.
Superficial external pudendal artery.
Femoral Artery

Superficial epigastric artery:
Passes through or close to the
saphenous hiatus.
Crosses inguinal ligament toward the
umbilicus.
Anastomoses with inferior epigastric
artery.
Femoral Artery

Superficial circumflex iliac artery:
Passes through or close to the
saphenous hiatus.
Passes along inguinal ligament toward
the ASIS.
Anastomoses with deep circumflex iliac
artery.
Femoral Artery

Superficial external pudendal artery:
Passes through or close to the
saphenous hiatus.
Passes medially toward external
genitalia.
Femoral Artery

Deep branches:
Deep external pudendal.
Descending genicular.
Profunda femoris (deep femoral):
Medial femoral circumflex.
Lateral femoral circumflex.
Perforating arteries (3).
Descending genicular.
Femoral Artery

Deep external pudendal:
Passes medially across pectineus and
adductor longus.
Becomes superficial to supply external
genitalia.
Femoral Artery

Descending genicular:
Arises in adductor canal.
Musculoarticular branch:
Part of genicular anastomosis.
Saphenous branch:
Runs with saphenous nerve.
Femoral Artery

Profunda femoris (deep femoral):
Arises from deep side of femoral artery
within femoral triangle.
Largest branch of femoral artery.
Passes posterior to adductor longus
muscle.
Femoral Artery

Profunda femoris (deep femoral):
Usually gives off medial and lateral femoral
circumflex arteries.
Gives rise to three perforating arteries.
Terminates as the fourth perforating artery.
Femoral Artery

Medial femoral circumflex:
May come directly off femoral artery.
Leaves femoral triangle between the
iliopsoas and pectineus muscles.
Femoral Artery
 Medial
femoral circumflex branches:
Ascending branch anastomoses with
inferior gluteal artery.
Transverse branch anastomoses with
lateral femoral circumflex artery.
Supplies hip joint, muscles of upper thigh,
gluteal region.
Femoral Artery

Lateral femoral circumflex:
May come directly off femoral artery.
Passes laterally deep to rectus femoris and
sartorius muscles.
Femoral Artery

Lateral femoral circumflex branches:
Ascending branch anastomoses with
superior gluteal artery.
Transverse branch anastomoses with
medial femoral circumflex artery.
Descending branch anastomoses with
genicular arteries.
Supplies hip joint, muscles of upper thigh,
gluteal region.
Cruciate Anastomosis

Joins internal iliac to femoral:
Bypass for femoral or external iliac arteries.

Includes branches from:
Medial femoral circumflex.
Lateral femoral circumflex.
Inferior gluteal artery.
First perforating artery.
Obturator Artery

Arises from internal iliac in pelvis:
Enters thigh through obturator canal.
Accompanied by anterior/posterior obturator
nerve branches.

Gives rise to:
Anterior and posterior branches.
Acetabular artery:
To head of femur via ligamentum teres.
Popliteal Artery
Continuation of femoral artery.
 Begins at adductor hiatus.
 Ends at inferior border of popliteus
muscle:

Branches into anterior and posterior
tibial arteries.

Most anterior structure in popliteal fossa.
Popliteal Artery

Branches:
Medial and lateral superior genicular
arteries.
Medial and lateral inferior genicular arteries.
Middle genicular artery and sural arteries.
Genicular Anastomosis

Contributors:
Genicular branches of popliteal artery.
Descending branches of femoral and
deep femoral arteries.
Ascending branches of anterior and
posterior tibial arteries.
Anterior Tibial Artery

Terminal branch of popliteal artery:
Arises at inferior border of popliteus muscle.
Passes anterior to interosseous
membrane between tibia and fibula.
 Accompanied by deep peroneal (fibular)
nerve.
 Renamed dorsalis pedis artery at ankle
joint.

Anterior Tibial Artery
Supplies anterior compartment of leg.
 Branches:

Anterior tibial recurrent.
Lateral malleolar artery.
Medial malleolar artery.
Dorsalis Pedis Artery
Medial tarsal artery.
 Lateral tarsal artery.
 Arcuate artery.
 Deep plantar artery.
 First dorsal interosseous artery.

Posterior Tibial Artery
Terminal branch of popliteal artery.
 Begins at inferior border of popliteus
muscle.
 Accompanied by tibial nerve.
 Descends on posterior surface of tibialis
posterior muscle.

Posterior Tibial Artery

Terminates deep to flexor retinaculum as:
Medial plantar artery.
Lateral plantar artery.
Lower Limb Venous Drainage

Superficial Veins:
Great saphenous:
Drains medial side of dorsal venous
arch.
Ascends anterior to medial malleolus.
Passes posterior to medial border of
patella.
Lower Limb Venous Drainage

Superficial Veins:
Great saphenous:
Ascends along medial thigh.
Penetrates deep fascia of femoral triangle:
Cribriform fascia.
Saphenous opening.
Dumps into femoral vein.
Lower Limb Venous Drainage

Superficial Veins:
Lesser saphenous:
Drains lateral side of dorsal venous arch.
Passes posterior to lateral malleolus.
Accompanies sural nerve.
Ascends along midline of calf.
Empties into popliteal vein in popliteal
fossa.
Lower Limb Venous Drainage

Deep Veins:
Venae comitantes:
Accompany deep arteries of the leg.
Unite to form popliteal vein in popliteal
space.
Lower Limb Venous Drainage

Deep Veins:
Popliteal vein:
Passes through adductor hiatus.
Renamed femoral vein.
Communicating veins.
Lower Limb Lymphatics

Lymphatics draining medial foot:
Ascend with great saphenous vein.
End in superficial inguinal lymph nodes:
Also drain lower abdominal wall, external
genitalia, perineum, anal region, uterine
fundus.
Lower Limb Lymphatics

Lymphatics draining lateral foot:
Ascend with small saphenous vein.
End in lymph nodes in popliteal fossa.
Ascend with femoral vein to deep inguinal
nodes.

Drainage pathway:
Superficial inguinal to deep inguinal to
external iliacs.