1. Blood Supply of the Lower Limb
Dr. Francois du Toit
Department of Diagnostic Radiology
Kimberley Hospital Complex
Blood Supply of the Lower Limb

2. ARTERIES OF THE LOWER LIMB

3. Arteries of the Lower Limb
Ext Iliac  Common Fem
Crosses under Inguinal Ligament
BRANCHES
Superficial Circumflex Femoral a.
Superficial Inferior Epigastric a.
Superficial Pudendal a.
Profunda Femoris a. (biggest branch)
Common Femoral  Superficial Femoral a.

4. External Iliac Artery
Inguinal Ligament
Common Femoral Artery
Profunda Femoris Artery
Superficial Femoral Artery

5. Profunda Femoris Artery
Biggest Branch of Common Femoral a.
5cm distal to Ing. Ligament
6 BRANCHES
2 Circumflex Femoral
Medial
Lateral
4 Perforating Arteries (4)

6. Circumflex Femoral aa. Form ring around upper Femur
Lateral Circumflex has 2 branches
Ascending branch than anastomoses with superior gluteal a.
Descending branch to the knee

7. Perforating aa. Supply muscles of thigh Surround Femur
Last is continuation of Profunda a.

8. Profunda Femoris
Lateral Circumflex
Perforating arteries

9. Superficial Femoral Artery
Passes in Adductor Canal
Between Vastus Med / Adductors / Sartorius
Through Adductor Hiatus
At junction of upper 2/3 and lower 1/3 of femur
Into Popliteal Fossa  Popliteal Artery
Just before this – descending branch to genicular anastomosis

10. Adductor Brevis
Adductor Magnus
Superficial Femoral
Vastus Medialis
Sartorius
Lateral Superior Genicular Artery
Popliteal Artery

11. Popliteal Artery Branches to Genicular Anastomosis and Knee Joint
Divides at lower border of Knee Joint
Posterior Tibial artery (which gives off Peroneal a.)
Anterior Tibial artery

12. Popliteal Artery
Inferior Lateral Genicular Artery
Anterior Tibial Artery
Tibioperoneal Trunk
Peroneal Artery
Posterior Tibial Artery

13. Posterior Tibial Artery
Larger of the two
2.5cm from its origin  Peroneal a.
Then descends and becomes more medial
At the ankle
Medial malleolar branch
Then passes posterior to medial malleolus
Halfway between tip of malleolus and midline
Branches  medial and lateral plantar aa (the principal supply of the foot)

14. Posterior Tibial Artery
Medial Malleolus

15. Peroneal Artery Descends to lie posteromedially of the fibula
Runs behind tibiofibular joint
Ends as Calcaneal Branch

16. Peroneal Artery
Calcaneal Branch of Peroneal artery

17. Anterior Tibial Artery
Passes above upper margin of interosseus membrane
Descends anterior to membrane
Becomes superficial at ankle midway between malleoli
Continues as Dorsalis Pedis Artery
Passes between 1st and 2nd metatarsals to join plantar arch

18. POSTERIOR KNEE
ANTERIOR KNEE
Anterior
Tibial
Artery

19. Anterior Tibial Artery
Dorsalis Pedis Artery

20. VEINS OF THE LOWER LIMB

21. Veins of the Lower Limb Superficial System Deep System
Long & Short Saphenous
Deep System
Accompany Arteries
Normal direction = Superfical  Deep
Valves
Superficial > Deep
Distal > Proximal

22. Superficial System Long (Great) Saphenous
Starts on medial side of dorsum of foot
Passes anterior to medial malleolus
Ascends to
posterior side of medial knee
anterior side of medial upper thigh
Drains to Femoral vein

23. Great Saphenous Vein

24. Great Saphenous Vein in anteromedial thigh
Posteromedial knee

25. Great Saphenous Vein
Femoral Vein

26. … Superficial System Short Saphenous
Begins lateral side of dorsum of foot
Passes posterior to lateral malleolus
Ascends on back of calf
Pierces deep fascia over popliteal fossa
Drains to Popliteal Vein

27. Short
Saphenous

28. Lateral Superior Genicular Vein
Popliteal Vein
Small (Short) Saphenous Vein

29. Deep System Accompany Arteries
Usually paired … BUT may be more than two veins that accompany each artery

30. Perforating (communicating) vv.
Connects Superficial to Deep vv.
Variable in site and number
>2 in medial aspect of lower leg above ankle
Also found in medial aspect of lower thigh

32. References Anatomy for Diagnostic Imaging 3rd Edition, Stephanie Ryan
3D Human Anatomy Atlas Version 2, Argosy Publishing