Download its pulse can be felt

Blood Supply of the
Lower Limb
Dr. Sama-ul-Haque
Dr. Safaa Ahmed
Dr. Rania Gabr
Objectives
 Describe femoral artery and its relations.
 Enlist the branches of femoral artery.
 Define the trochanteric and cruciate anastomosis.
 Describe popliteal artery, its relations and branches.
 Discuss the arterial anastomosis around the knee joint.
 Discuss the anterior tibial artery, its relations and branches.
 Define Dorsalis pedis artery.
Objectives
 Discuss the posterior tibial artery, its relations and branches.
 Explain the formation of dorsal venous arch.
 Describe the formation of great saphenous vein and enlist its
tributaries.
 Discuss the formation of small saphenous vein and enlist its
tributaries.
 Describe the formation of popliteal vein and femoral veins.
Femoral Artery

Enters thigh by passing behind
inguinal ligament.

Continuation of External iliac
artery.

Ends at the opening in the adductor
Magnus
muscle and continuous as Popliteal
artery.
Relations of
Femoral Artery
Relations of Femoral Artery

Relations:
Anteriorly: Skin , Fascia and
Sartorius
Posteriorly: Psoas Major
Laterally: Femoral Nerve
Medially: Femoral vein
Femoral Artery
Branches:

Superficial circumflex iliac artery

Superficial epigastric artery

Superficial external pudendal
artery

Deep external pudendal artery

Profunda femoris artery

Descending genicular artery
Femoral Artery
Branches:

Profunda femoris artery

Large branch enters the medial
compartment of thigh.

Ends by becoming 4th perforating
artery.

Branches:

Medial femoral
circumflex artery

Lateral femoral
circumflex artery

1st, 2nd and 3rd perforating
arteries.
Femoral
Artery
Femoral
Artery
Trochanteric Anastomosis
 Anastomosis between the branches of internal iliac
and femoral arteries.
 Main supply to the head of Femur.
 Branches forming anastomosis:
 Superior gluteal artery
 Inferior gluteal artery
 Medial femoral circumflex artery
 Lateral femoral circumflex artery
Trochanteric Anastomosis
Cruciate Anastomosis

Anastomosis between the branches of internal
iliac
and femoral arteries.


Branches forming anastomosis:

Inferior gluteal artery

Medial femoral circumflex artery

Lateral femoral circumflex artery
 First Perforating artery
In occlusion of the proximal part of the
femoral artery,
blood passes through the cruciate &
trochanteric Anastomosis.
Cruciate
Anastomosis
Popliteal Artery

Continuation of Femoral artery.

Ends at the lower border of the
Popliteus muscle by dividing into
Anterior and Posterior tibial arteries.

Relations:
Anteriorly:
Popliteal surface of femur,
Knee joint & Popliteus muscle.
Posteriorly:
Popliteal vein & Tibial nerve
Popliteal Artery
Relations of Popliteal Artery
Branches of Popliteal Artery
 Muscular branches
 Articular branches
 Terminal branches
 Anterior tibial artery
 Posterior tibial artery
Anastomosis around Knee joint
Anastomosis between the branches of femoral,
popliteal, anterior and posterior tibial arteries.

Branches forming anastomosis:

Branch of femoral artery


Descending genicular
Articular branches of Popliteal artery

Superior genicular (lateral &
medial)

Inferior genicular (lateral &
medial)
 Small branches of anterior and posterior
tibial arteries
Anastomosis
around
Knee joint
Anterior Tibial Artery

Smaller terminal branch of Popliteal artery.

Lies on the anterior surface of interosseous
membrane.

In the upper part it lies deep to muscles of
anterior compartment.

In the lower part, it becomes superficial at
the lower end of the tibia.

Then it lies between the tendons of
extensor hallucis longus and extensor
digitorum longus.
Anterior Tibial Artery
Anterior Tibial Artery
Anterior Tibial Artery
 In front of ankle joint, the artery becomes the Dorsalis
pedis artery.
 Branches:
 Muscular branches to the muscles of anterior
compartment
 Anastomotic branches
 Around Knee and Ankle joints
Dorsalis Pedis Artery
 Also called Dorsal artery of the foot.
 Continuation of anterior Tibial artery.
 Terminates by joining the lateral plantar artery and
completes the plantar arch.
 On dorsum of the foot it lies between the tendons
of extensor hallucis longus and extensor digitorum
longus.
 Its pulsation can be felt here.
Dorsalis Pedis Artery
Dorsalis Pedis Artery
 Branches:
 Lateral tarsal artery
 Arcuate artery
 Metatarsal branches
 First dorsal metatarsal artery
Dorsalis Pedis Artery
Posterior Tibial Artery

Larger terminal branch of Popliteal
artery.

Lies deep to gastrocnemius and
soleus muscles.

In the lower part of the leg artery is
only covered by skin and fascia.

It passes behind medial malleolus
and terminates by dividing into
Medial and Lateral Plantar arteries.

Between the medial malleolus and
heel, its pulse can be felt.
Posterior Tibial Artery
Posterior Tibial Artery
Posterior Tibial Artery
 Branches:
 1-Peroneal or Fibular artery
 Larger branch arise close to the origin
 Muscular branches
 Nutrient artery to the Fibula
 Perforating branch
Posterior Tibial Artery

Branches:

2- Muscular branches to
muscles of posterior
compartment

3- Nutrient artery to the
Tibia

4- Medial plantar artery

5- Lateral plantar artery

6-Anastomotic branches

Around Ankle joint
Posterior Tibial Artery
Posterior Tibial Artery
Medial Plantar Artery
 SMALLER terminal branch
of Posterior tibial artery.
 Supply medial side of the big
toe.
 Branches:
 Muscular
 Cutaneous
 Articular
Medial Plantar Artery




Lateral Plantar Artery
LARGER terminal branch of Posterior tibial
artery.
On the base of 5th metatarsal bone, it forms
Plantar Arch by joining Dorsalis pedis artery.
Branches:

Muscular , Cutaneous and
Articular
Branches of Plantar Arch:

Plantar metatarsal arteries

 Plantar digital arteries
Three perforating arteries
(anastomose with vessels on the
dorsal aspect of the foot.
Later Plantar Artery
and Plantar Arch
Areas of Lower Limb Arteries Pulsation
Veins of the Lower Limb
Veins of the Lower Limb
 Superficial veins
 Lie in the superficial fascia
 Having Thick muscular wall
 Deep veins
 Accompany the arteries
 Having Thin muscular wall
Superficial Veins of the Lower Limb
 Dorsal Venous Arch
 Great Saphenous Vein
 Small Saphenous Vein
Deep Veins of the Lower Limb
 Venae Comitantes
 Popliteal Vein
 Femoral Vein
Veins of the Lower Limb
Superficial Veins of the
Lower Limb
Dorsal Venous Arch
 Lies on the dorsum of the foot.
 The blood from the whole foot
drains into this arch via digital
veins and communicating veins.
 Drains on the medial side into
the Great Saphenous vein
 Drains on the lateral side into the
Small Saphenous vein
Dorsal
Venous
Arch
Great Saphenous vein

Longest vein in the body.

Drains medial side of the dorsum venous
arch.

Passes upward in front of medial malleolus.

Then runs upward in superficial fascia over
the medial side of the leg.

Passes behind the knee and curves forward
around the medial side of the thigh.
Great Saphenous vein

It contains 10-20 valves.

Connected to small saphenous vein behind
knee.

Perforating veins connect the great
saphenous vein with the deep veins.

Passes through saphenous opening.

Finally drains into femoral vein
Great Saphenous
Vein
Great
Saphenous
Vein
Great
Saphenous
Vein

Great Saphenous Vein
Tributaries:
 Subcutaneous tributaries
 Superficial circumflex iliac
vein
 Superficial epigastric vein
 Superficial external
pudendal vein
 Accessory vein
Tributaries of Great Saphenous Vein
Perforating vein connecting great saphenous vein
with a deep vein
Small Saphenous vein

Drains lateral side of the dorsum venous arch.

Passes upward behind lateral malleolus.

Reaches middle of the back of leg.

Then it pierces deep fascia.

In the lower part of popliteal fossa ends in the popliteal

vein.
Contains numerous valves.
Small Saphenous Vein
 Tributaries:
 Numerous small veins from the back of the leg.
 Communicating veins with deep veins of the foot.
 Anastomotic branches that join the great saphenous
vein.
Small Saphenous Vein
Deep Veins of the
Lower Limb





Venae Comitantes
Deep veins accompany the arteries are
called venae comitantes.
The deep plantar venous arch gives medial
and lateral plantar veins.
Medial and lateral plantar veins forms
posterior tibial vein behind the medial
malleolus.
Peroneal vein drain into posterior tibial
vein.
Venae comitantes of anterior and posterior
tibial arteries unite in the popliteal fossa to
form the popliteal vein.
Popliteal Vein
 Formed by the venae comitantes of the anterior and
posterior tibial arteries.
 Ends at the adductor hiatus and continuous upward
as Femoral vein.
Tributaries:

Veins accompany arteries.

Small saphenous vein.
Popliteal
Vein
Femoral Vein

Continuation of popliteal vein at
adductor hiatus.

Enters in the intermediate
compartment of femoral sheath.

Then passes behind inguinal
ligament and continuous as
External Iliac Vein.
Femoral Vein
Femoral Vein
 Tributaries:
 Great saphenous vein
 Tributaries corresponding to the perforating
branches of the profunda femoris artery.
 Medial and lateral femoral circumflex veins.
Femoral
Vein
Varicose Veins
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