Transcript 22.Arterial Supply of the Lower Limb

Dr. Francois du Toit
Department of Diagnostic Radiology
Kimberley Hospital Complex
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Ext Iliac  Common Fem
▪ Crosses under Inguinal Ligament
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BRANCHES
▪ Superficial Circumflex Femoral a.
▪ Superficial Inferior Epigastric a.
▪ Superficial Pudendal a.
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Profunda Femoris a. (biggest branch)
Common Femoral  Superficial Femoral a.
External Iliac Artery
Inguinal Ligament
Common Femoral Artery
Profunda Femoris Artery
Superficial Femoral Artery
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Biggest Branch of Common Femoral a.
5cm distal to Ing. Ligament
6 BRANCHES
▪ 2 Circumflex Femoral
 Medial
 Lateral
▪ 4 Perforating Arteries (4)
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Form ring around upper Femur
Lateral Circumflex has 2 branches
▪ Ascending branch than anastomoses with superior gluteal a.
▪ Descending branch to the knee
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Supply muscles of thigh
Surround Femur
Last is continuation of Profunda a.
Profunda Femoris
Lateral Circumflex
Perforating arteries
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Passes in Adductor Canal
▪ Between Vastus Med / Adductors / Sartorius
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Through Adductor Hiatus
▪ At junction of upper 2/3 and lower 1/3 of femur
▪ Into Popliteal Fossa  Popliteal Artery
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Just before this – descending branch to
genicular anastomosis
Adductor Brevis
Adductor Magnus
Superficial Femoral
Vastus Medialis
Sartorius
Lateral Superior Genicular Artery
Popliteal Artery
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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
Popliteal Artery
Inferior Lateral Genicular Artery
Anterior Tibial Artery
Tibioperoneal Trunk
Peroneal Artery
Posterior Tibial Artery
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Larger of the two
2.5cm from its origin  Peroneal a.
Then descends and becomes more
medial
At the ankle
▪ Medial malleolar branch
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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)
Posterior Tibial Artery
Medial Malleolus
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Descends to lie posteromedially of the
fibula
Runs behind tibiofibular joint
Ends as Calcaneal Branch
Peroneal Artery
Calcaneal Branch of Peroneal artery
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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
ANTERIOR KNEE
POSTERIOR KNEE
Anterior
Tibial
Artery
Anterior Tibial Artery
Dorsalis Pedis Artery
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Superficial System
▪ Long & Short Saphenous
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Deep System
▪ Accompany Arteries
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Normal direction = Superfical  Deep
Valves
 Superficial > Deep
 Distal > Proximal
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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
Great Saphenous Vein
Great Saphenous Vein in
anteromedial thigh
Great Saphenous Vein in
Posteromedial knee
Great Saphenous Vein
Femoral Vein
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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
Short
Saphenous
Lateral Superior Genicular Vein
Popliteal Vein
Small (Short) Saphenous Vein
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Accompany Arteries
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Usually paired … BUT may be more than
two veins that accompany each artery
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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
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Anatomy for Diagnostic Imaging
3rd Edition, Stephanie Ryan
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3D Human Anatomy Atlas
Version 2, Argosy Publishing
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http://www.imaios.com/