Blood Supply of the Lower Limb

Dr. Safaa Dr. Sama-ul-Haque

Objectives

Describe femoral artery and its relations.

Enlist the branches of femoral artery.

Define the trochanteric and cruciate anastomosis.

Describe popliteal artery, its relations and branches.

Discuss the arterial anastomosis around the knee joint.

Discuss the anterior tibial artery, its relations and branches.

Define Dorsalis pedis artery.

Objectives

Discuss the posterior tibial artery, its relations and branches.

Explain the formation of dorsal venous arch.

Describe the formation of great saphenous vein and enlist its

tributaries.

Discuss the formation of small saphenous vein and enlist its

tributaries.

Describe the formation of popliteal vein and femoral veins.

Femoral Artery Enters thigh by passing behind inguinal ligament.

Continuation of External iliac artery.

Ends at the opening in the adductor Magnus

muscle and continuous as Popliteal artery.

Relations:

Anteriorly: Skin , Fascia and Sartorius

Posteriorly: Psoas Major

Laterally: Femoral Nerve

Medially: Femoral vein

Relations of Femoral Artery

Relations of Femoral Artery

Branches:

Superficial circumflex iliac artery

Superficial epigastric artery

Superficial external pudendal artery

Deep external pudendal artery

Descending genicular artery

Femoral Artery

Femoral Artery

Femoral Artery

Femoral Artery

Trochanteric Anastomosis

Anastomosis between the branches of internal iliac

and femoral arteries.

Main supply to the head of Femur.

Branches forming anastomosis:

Superior gluteal artery

Inferior gluteal artery

Medial femoral circumflex artery

Lateral femoral circumflex artery

Trochanteric Anastomosis

Cruciate Anastomosis

Anastomosis between the branches of internal iliac

and femoral arteries.

Branches forming anastomosis:

Inferior gluteal artery

Medial femoral circumflex artery

Lateral femoral circumflex artery

First Perforating artery In occlusion of the proximal part of the femoral artery,

blood passes through the cruciate & trochanteric Anastomosis.

Cruciate

Anastomosis

Popliteal Artery

Continuation of Femoral artery.

Ends at the lower border of the Popliteus muscle by

dividing into Anterior and Posterior tibial arteries.

Relations:

Anteriorly: Popliteal surface of femur,

Knee joint & Popliteus muscle.

Posteriorly: Popliteal vein & Tibial nerve

Popliteal Artery

Relations of Popliteal Artery

Branches of Popliteal Artery

Muscular branches

Articular branches

Terminal branches

Anterior tibial artery

Posterior tibial artery

Anastomosis around Knee joint

Anastomosis

around

Knee joint

Anterior Tibial Artery

Smaller terminal branch of Popliteal

artery.

Lies on the anterior surface of interosseous

membrane.

In the upper part it lies deep to muscles of

anterior compartment.

In the lower part, it becomes superficial at

the lower end of the tibia.

Then it lies between the tendons of

extensor hallucis longus and extensor

digitorum longus.

Anterior Tibial

Artery

Anterior Tibial

Artery

Anterior Tibial Artery

Also called Dorsal artery of the foot.

Continuation of anterior Tibial artery.

Terminates by joining the lateral plantar artery and

completes the plantar arch.

On dorsum of the foot it lies between the tendons

of extensor hallucis longus and extensor digitorum

longus.

Its pulsation can be felt here.

Dorsalis Pedis Artery

Dorsalis Pedis Artery

Branches:

Lateral tarsal artery

Arcuate artery

Metatarsal branches

First dorsal metatarsal

artery

Dorsalis Pedis Artery

Dorsalis Pedis Artery

Posterior Tibial Artery Larger terminal branch of Popliteal

artery.

Lies deep to gastrocnemius and soleus

muscles.

In the lower part of the leg artery is only

covered by skin and fascia.

It passes behind medial malleolus and

terminates by dividing into Medial and

Lateral Plantar arteries.

Between the medial malleolus and heel,

its pulse can be felt.

Posterior Tibial

Artery

Posterior Tibial Artery

Posterior Tibial Artery

Posterior Tibial Artery

Posterior Tibial

Artery

Posterior Tibial

Artery

Medial Plantar Artery

Smaller terminal branch of Posterior tibial artery.

Supply medial side of the big toe.

Branches:

Muscular

Cutaneous

Articular

Medial Plantar Artery

Lateral Plantar Artery

Later Plantar Artery

and Plantar Arch

Areas of Lower Limb Arteries Pulsation

Veins of the Lower Limb

Veins of the Lower Limb

Superficial veins

Lie in the superficial fascia

Having Thick muscular wall

Deep veins

Accompany the arteries

Having Thin muscular wall

Superficial Veins of the Lower Limb Dorsal Venous Arch

Great Saphenous Vein

Small Saphenous Vein

Venae Comitantes

Popliteal Vein

Femoral Vein

Deep Veins of the Lower Limb

Veins of the Lower Limb

Superficial Veins of the Lower Limb

Dorsal Venous Arch

Lies on the dorsum of the foot.

The blood from the whole foot drains into this arch

via digital veins and communicating veins.

Drains on the medial side into the Great Saphenous vein

Drains on the lateral side into the Small Saphenous vein

Dorsal

Venous

Arch

Great Saphenous vein

Longest vein in the body.

Drains medial side of the dorsum venous arch.

Passes upward in front of medial malleolus.

Then runs upward in superficial fascia over the medial

side of the leg.

Passes behind the knee and curves forward around the

medial side of the thigh.

Great Saphenous vein

It contains 10-20 valves.

Connected to small saphenous vein behind knee.

Perforating veins connect the great saphenous vein with

the deep veins.

Passes through saphenous opening.

Finally drains into femoral vein

Great

Saphenous

Vein

Great

Saphenous

Vein

Great

Saphenous

Vein

Great Saphenous Vein

Tributaries:

Subcutaneous tributaries

Superficial circumflex iliac vein

Superficial epigastric vein

Superficial external pudendal vein

Accessory vein

Tributaries of Great Saphenous Vein

Perforating vein connecting great saphenous vein with a deep vein

Small Saphenous vein

Drains lateral side of the dorsum venous arch.

Passes upward behind lateral malleolus.

Reaches middle of the back of leg.

Then it pierces deep fascia.

In the lower part of popliteal fossa ends in the popliteal

vein.

Contains numerous valves.

Small Saphenous Vein

Tributaries: Numerous small veins from the back of the leg.

Communicating veins with deep veins of the foot.

Anastomotic branches that join the great saphenous

vein.

Small Saphenous Vein

Deep Veins of the Lower Limb

Venae Comitantes Deep veins accompany the arteries are called venae

comitantes.

The deep plantar venous arch gives medial and lateral

plantar veins.

Medial and lateral plantar veins forms posterior tibial

vein behind the medial malleolus.

Peroneal vein drain into posterior tibial vein.

Venae comitantes of anterior and posterior tibial arteries

unite in the popliteal fossa to form the popliteal vein.

Popliteal Vein

Formed by the venae comitantes of the anterior and

posterior tibial arteries.

Ends at the adductor hiatus and continuous upward

as Femoral vein.

Tributaries:

Veins accompany arteries.

Small saphenous vein.

Popliteal

Vein

Femoral Vein

Continuation of popliteal vein at adductor hiatus.

Enters in the intermediate compartment of femoral

sheath.

Then passes behind inguinal ligament and continuous as

External Iliac Vein.

Femoral

Vein

Femoral Vein

Tributaries:

Great saphenous vein

Tributaries corresponding to the perforating

branches of the profunda femoris artery.

Medial and lateral femoral circumflex veins.

Femoral

Vein

Varicose Veins

Thank You