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

In the femoral triangle, it gives the following branches:

Superficial circumflex iliac arterySuperficial epigastric arteryExternal pudendal arteryDeep artery of the thighMuscular 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

1. Femoral

2. Profunda

3. Popliteal

4. Posterior tibial

5. Peroneal

6. Medial plantar

7. Lateral plantar

8. Anterior tibial

9. 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