1. EXTREMITY ARTERIAL ANATOMY
LACKAWANNA COLLEGE
VASCULAR TECHNOLOGY PROGRAM

2. Arterial wall anatomy
Endothelial lining
Intima
Media
Adventitia

3. Capillaries Arterioles Exchange Vessel Thin Walled
Single Layer of the endothelium
Arterioles
Control Flow Resistance
Regulates flow of blood into the capillaries by vasoconstriction and vasodilation

4. Hemodynamics
Flow in peripheral arteries is regulated by vasoconstriction- relaxation in the arterioles.
arterioles

5. Arterial Evaluation
Aorta
Branches
Iliacs
Lower Extremity Arteries

6. LOWER EXTREMITY Common Femoral Artery (CFA)
Superficial Femoral Artery (SFA)
Deep Femoral Artery (DFA)
Popliteal (Pop)
Tibial Peroneal Trunk
Anterior Tibial (ATA)
Dorsalis Pedis (DPA)
Posterior Tibial (PTA)
Peroneal (Per)
Plantar Arch

7. Common Iliac a
Ext iliac a
Int. Iliac a
Common Femoral a
Profunda fem. a
Superficial fem a

8. Lower Extremity CFA SFA Continuation of the EIA
Divides into the SFA and DFA
SFA
Descends along the anteriomedial aspect of the thigh
Courses the length of the thigh passing through an opening in the adductor magnus (adductor canal or Hunter’s canal) and entering the popliteal fossa (behind the knee)

9. Lower Extremity DFA AKA. Profunda Femoris Lateral branch
Main blood supply to the muscles in the leg
It communicates with the IIA, EIA and Pop

10. Lower Extremity Popliteal Continuation of the SFA
As the SFA enters the Popliteal Fossa it becomes the Pop A*
Divides into the Tibioperoneal Trunk and the ATA
Branches:
Cutaneous Superior Muscular
Sural Genicular*

11. Lower Extremity Tibioperoneal Trunk
Second branch off the Pop
Branches into the PTA and Per
PTA begins between the Tibia and Fibula, extending downward and medially to the midpoint between the medial malleous and the heel.
Divides into the medial and plantar ateries

12. Lower Extremity ATA Terminal branch of the Pop
Passes superficial to the interosseous membrane, as it descends it is anterior to the interosseous membrane
Distally it courses anterior to the Tibia
The ATA becomes more superficial as it passes superior to the lateral malleolus as it then becomes the DPA

13. Lower Extremity Peroneal Plantar Arch
Originates at the Tibioperoneal Trunk
Medial aspect of the Fibula
Lies deeper to the PTA
Plantar Arch
Terminal branches of the DP and the PTA
Deep Plantar Arch- DP
Lateral Plantar Arch - PTA

14. Longitudinal View of the Aorta and the RT and LT CIA

15. Crayon venous anatomy EIV EIA CFA CFV SFA DFA CFV GSV CFA CFV DFA GSV
Fem v

16. Longitudinal View of the CFA
Prox SFA
DFA
Longitudinal View of the CFA

17. Longitudinal View of the Bifurcation
Prox SFA
CFA
DFA
Longitudinal View of the Bifurcation

18. P SFA
P FV
DFV
DFA
Longitudinal View of the Femoral Arteries and Veins

19. Transverse Image
SFA
Prox FV
DFV
DFA
Longitudinal Image

20. SFA FV
Longitudinal Image of the SFA and FV

21. Popliteal fossa
LSV
Gastrocs
Pop V
Pop. vein
Pop A
Pop. artery

22. Posterior view

23. Medial
POSTERIOR VIEW

24. Transverse calf Medial side up
GSV
TIB
PTVs
ATVs
LSV
PERs
FIB
Lateral

25. Calf veins
You rarely see all lined up, but nice shot anyway.

26. Aorta 3 sections of the Ao. Largest artery in the body
Root: Originates from the Left Ventricle of the heart
Ascending Ao. – ascends a short distance from the vent and arches superiorly

27. Aorta
Arch- passes to the left in front of the trachea bends dorsally and becomes the descending Ao.
Three major branches
Innominate (Brachiocephalic)
Left Common Carotid
Left Subclavian
Descending- from the Ao arch it courses posteriorly through the thoracic cavity
Pierces the diaphragm at the thoracic cavity

28. Arch anatomy

29. Abdominal Aorta
Retroperitoneal structure enters the abd. at the Ao hiatus of the diaphragm (T-12 and ends at L-4 vertebrae)
Courses anterior to the vertebral bodies and slightly left of the midline
Moves from a posterior and superior position to an anterior and inferior position
Its diameter decreases the more inferior it descends (2-3 cm superiorly at diaphragm and 1-1.5cm inferiorly)
Bifurcates at the level of L-4 into the right and left common iliac arteries/umbilicus

30. ABDOMINAL AORTA Celiac Axis (Trunk) Superior mesenteric artery (SMA)
Inferior mesenteric artery (IMA)
Renal arteries

31. Celiac Axis
In the transverse scan plane its branches forms a seagull or a dove configuration
Left Gastric Artery
Common Hepatic Artery
Splenic Artery

32. Superior Mesenteric Artery (SMA)
Anterior branch of the Abdominal Ao.
Approximately 1cm below the celiac axis at a 10 degree angle
Consists of a short segment that courses anteriorly from the Ao. then runs inferiorly parallel to the Ao. ending in the vicinity of the ileocecal valve
Runs anterior to the Left Renal Vein
Posterior to the pancreatic body
Anterior to the uncinate process of the pancreas and the 2nd portion of the duodenum

33. SMA
Surrounded by a triangular shaped area of retroperitoneal fat- appears echogenic on ultrasound
Lies to the Left of the SMV
Branches Supply:
Jejunum, ileum cecum, ascending colon,
Prox. 2/3rd of the transverse colon, portion of the pancreas and duodenum

34. Inferior Mesenteric Artery (IMA)
Arises from the Ao. anteriorly, 3-4 cm above the bifurcation
Courses inferiorly and slightly left
Often obscured by bowel gas; when visualized- best viewed in the longitudinal plane
Acts as a collateral pathway in the event of SMA, CA occlusion. If the IMA is easily seen on U/S; evaluate the SMA and CA for stenosis or occlusion.

35. Renal Arteries
Lateral branch of the Ao. that arise at or 1-2cm below the origin of the SMA
Supplies blood:
Kidneys
Adrenal glands
Perirenal fat and body wall
Best visualized in the transverse scan plane

36. Gonadal Arteries
Arises anteriolaterally from the aorta just inferior to the renal arteries
Small and difficult to visualize on U/S
Course along the psoas muscle to the respective gonadal area
Testicular arteries course through inguinal canal and are part of the spermatic cords leading to the testicles; supply the testicles
Ovarian arteries enter the pelvic cavity and supply the ovaries

38. ILIAC Common Iliac Arteries Internal Iliac ( IIA; Hypogastric)
Superior Vesical Inferior Vesical
Middle Rectal Uterine
Vaginal Obturator
Internal Pudendal Inf. Gluteal
Superior Gluteal Iliolumbar
Lateral Sacral
External Iliac (EIA)
Inferior Epigastic Deep Circumflex Iliac