Anatomy of Lower Extremity arteries Nketi Forbang, MD, MPH Good afternoon. Today, I will be discusing the anatomy of the lower extremity arteries

Outline Review the thoracic and abdominal aorta Follow the lower extremity arterial tree Discuss atherosclerosis and claudication

Lower Extremity Arteries Where we have been Where we are going Sonia has previously discussed the thoracic aorta which receives blood from the heart. It has an ascending portion, and arch with branches that supply blood to the head, neck and upper extremities, and a descending portion that travels behind the heart. The descending thoracic aorta crosses into the abdominal cavity at the diaphragm and becomes the abdominal aorta which has branches that supply the abdominal organs. Today we discuss the arterial blood supply to the pelvis, leg, and foot, supplied by the lower portion of the abdominal aorta.

Lower Extremity arteries The abdominal aorta travels caudally down along the spine and bifurcates or divides into right and left common iliac arties. As we saw with the carotid artery, when and artery has the prefix common, it generally means it has two major branches. So the common iliac artery gives of an external and internal branch. The internal branch supplies the reproductive organs and pelvic muscles.

Lower extremity arteries The external iliac artery then travels under the inguinal ligament, located in the groin area, and becomes the common femoral artery.

Lower extremity arteries The common femoral artery, then branches into the profunda or deep femoral artery, and the superficial femoral artery, also know as the SFA. The profunda or deep femoral artery has tributaries that supply blood to the femoral head and thigh muscle.

Lower extremity arteries The SFA then travels along the front of the thigh, through an opening just above the top of the knee known as the adductor canal, which begins anteriorly at the femoral triangle, and ends posteriorly at the adductor hiatus.

Lower Extremity arteries We are now behind the knee joint where the SFA exits the adductor canal and becomes the popliteal artery.

Lower extremity arteries The popliteal artery give off genicular branches that supply the knee joint.

Lower extremity arteries The popliteal artery (in brown), travels between the calf muscle, and branches into the anterior tibial artery (in purple), and the posterior tibial artery (in red). The posterior tibial artery then gives off the peroneal or fibular artery.

Lower extremity arteries We are back to a side view of the knee which shows the anterior tibial artery, the first branch from the peroneal artery.

Lower Extremity arteries The anterior tibial artery gives off the posterior and anterior tibial recurrent arteries (not shown) and terminates as the dorsalis pedis (yellow arrow which supplies the top of the foot).

Lower extremity arteries The popliteal artery (in brown), travels between the calf muscle, and branches into the anterior tibial artery (in purple), and the posterior tibial artery (in red). The posterior tibial artery then gives off the peroneal or fibular artery.

Lower Extremity arteries We go back to the posterior tibial artery which travels behind the medial ankle (shown in the side view) and branches into lateral and medial plantar arteries the supply the bottom of the foot.

Lower Extremity Arteries This is an image of the lateral and medial plantar arteries, branches from the posterior tibial artery.

Lower Extremity Artries Here is a cartoon drawing of the major lower extremity artries.

Lower Extremity arteries Atherosclerosis Aorto-iliac arteries Butt claudication Erectile dysfunction Femoral arteries Thigh claudication Popliteal and upper Tibal arteries Calf claudication Lower Tibial arteries Foot claudication Atherosclerotic lesions in the lower extremity arteries can lead to ischemia and claudication symptoms that give clues to where the lesions might be located. Claudication is defined as cramping pain with movement that resolves when at rest. Lesions in the aorto iliac arteries can lead to butt claudiction, and erectile dysfunction in men. Those in the femoral arteries can lead to thigh claudication. Those in the popliteal and upper tibial arteries can lead to classic calf claudication, and those in the lower tibial arteries can lead to foot claudication.

The End References http://AnatomyZone.com http://ultrasoundpeaedia.com