Blood Vessels of lower limb Objectives Describe topography of major vessels Illustrate clinical relevance of vascular anatomy

Blood Vessels of lower limb They include the following: Femoral, popliteal, obturator, gluteal, tibials and their branches Great and small saphenous veins and their tributaries Deep veins (Femoral, popliteal, tibials)

Gluteal Region Superior gluteal artery Inferior gluteal artery They are branches of the internal iliac artery They supply the gluteal region Obturator artery is abranch of the internal iliac artery It passes through obturator foramen It supplies the medal side of the upper thigh

Femoral Artery It is the contiuation of the external iliac artery at the mid inguinal point It descends in the femoral triangle Then, it continues in the adductor canal It reaches the adductor hiatus where it becomes the popliteal artery It supplies all structures in the thigh

Femoral Artery Superficial circumflex iliac artery In the femoral triangle, it gives the following branches: Superficial circumflex iliac artery Superficial epigastric artery External pudendal artery Deep artery of the thigh Muscular branches

Deep Artery of the Thigh It is the main artery of the thigh It gives the following branches Medial circumflex femoral artery Lateral circumflex femoral artery which gives a descending branch Perforating arteries

Popliteal Artery It is the continuation of the femoral artery at the adductor hiatus It runs through the popliteal fossa It ends at the lower border of the popliteus muscle by dividing into its terminal branches It gives the following branches: Medial superior genicular artery Lateral superior genicular artery Medial inferior genicular artery Lateral inferior genicular artery Middle genicular artery

Popliteal Artery At the lower end of the popliteus muscle, it divides into: Anterior tibial artery Posterior tibial artery which gives the peroneal artery

Anastomosis around the Knee Joint Is made by the following branches: Descending branch of lateral circumflex femoral Descending genicular of femoral Anterior tibial recurrent Five branches of popliteal artery

Anterior Tibial Artery It is one of the two terminal branches of the popliteal artery It supplies all structures in the anterior compartment of the leg and perforating branches to lateral compartment It ends at the midpoint between the malleoli It continues as Drorsalis Pedis Artery It gives anterior medial and lateral malleolar branches

Posterior Tibial Artery It is one of the two terminal branches of the popliteal artery It supplies all structures in the posterior and lateral compartment of the leg It runs behind and inferior to lateral malleolus It then divides into Medial and Lateral plantar branches It gives the following branches: Peroneal artery which gives lateral malleolar and calcaneal branches

Drorsalis Pedis Artery It is the direct continuation of the anterior tibial artery at the midpoint between the malleoli It gives the following branches: Lateral tarsal Medial tarsal Arcuate 1st dorsal metatarsal Deep plantar

Plantar Arteries The posterior tibial artery divides into: Lateral plantar Medial plantar artery which gives the first plantar metatarsal artery Deep plantar arch is formed by the deep plantar branch of dorsalis pedis artery and lateral plantar artery

Anastomosis around the Ankle Joint Is formed by the following branches: Calcanean branches of posterior tibial and peroneal arteries Medial and lateral malleolar branches of anterior tibial artery Malleolar branches of posterior tibial and peroneal arteries

Veins of the Lower Limb Deep veins accompany arteries of the lower limb internal to the deep fascia Superficial veins are not accompanied by arteries in the subcutaneous tissue Deep veins of the foot are drained to the dorsal venous arch Medial and lateral marginal veins emerge from the sides of the arch

Veins of the Lower Limb Cont., The medial marginal vein continues as great (large) saphenous vein It ascends in front of the medial malleolus to the leg and thigh It passes through the saphenous opening to end in the femoral vein

Veins of the Lower Limb Cont., The lateral marginal vein continues as lesser (small) saphenous vein It ascends on the posterior aspect of the leg It ends in the popliteal vein Perforating veins connect the lesser saphenous vein with deep veins (One way valve)

Lower limb Vasculature Applied anatomy Surface anatomy Arteriography and veinography Varicose veins Obstructive vasculopathy Arterial pulse Deep vein thrombosis

Surface Anatomy Femoral Profunda Popliteal Posterior tibial Peroneal Medial plantar Lateral plantar Anterior tibial Dorsalis pedis

Veins

Arteriogram

Varicose veins

Arterial pulse

Lymphatics

Anastomosis in the Lower Limb Anastomosis between different arterial branches To ensure blood circulation in the case of occlusion in any artery Cruciate anastomosis Geniculate anastomosis Plantar anastomosis