Vessels of the lower limb

Summary

• Arteries of the lower limb
• Veins of the lower limb
  • Deep veins
  • Superficial veins

Arteries of the lower limb

1. Common Iliac arteries (2 on each side)
   • Arise from from the abdominal aortic bifurcation at L4
   • Each CIA further bifurcates to EIA and IIA
     1. External IA => Common Femoral artery (supplies most of the leg)
     2. Internal IA => pudendal, gluteal, obturator arteries (supplies the pelvis/thigh)
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2. Common Femoral artery
   • Terminal branch of EIA
     • Becomes termed the CFA after passing through  the inguinal canal
     • Passes through the femoral triangle
     • Also passes through the adductor hiatus (just posterior to sartorius/vastus medialis)

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   • The femoral artery is easily accessible (e.g. for obtaining blood, inserting lines)
   • Several branches
     • Superficial epigastric
     • Superficial circumflex iliac artery
     • Superficial external pudendal
     • Descending genicular artery
     • Popliteal artery
     • Deep femoral artery comes off within the femoral triangle
       • Travels deep and lateral to the superficial artery within the adductor muscles
         • Ends above the knee
       • Several branches – mainly supplies the thigh
         • Medial circumflex femoral artery
         • Lateral circumflex femoral artery
         • Perforating arteries
   • After giving off the deep femoral artery the common femoral artery continues as the superficial femoral artery after deep femoral artery comes off

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3. Popliteal artery
   • Continuation of the superficial femoral artery through the adductor hiatus (formed by the two heads of adductor magnus)
   • Continues to the popliteal fossa
   • Bifurcates below the knee to form anterior and posterior tibial arteries

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4. Tibial arteries
   • Contribute to the deep plantar arch
   • Often involved in peripheral arterial disease (due to atherosclerosis)
   • Two key arteries to consider
     • Anterior Tibial Artery:
       • Anterior to interosseus membrane – Anterior compartment
       • To the arch of the foot
     • Posterior Tibial Artery:
       • To calf – posterior compartment
       • Gives off the fibular artery shortly after the bifurcation

Veins of the lower limb

Superficial veins of the lower limb

• Mainly consider the two saphenous veins
  • These pass through superficial fascia
• Dorsal venous network in the foot drains into GSV and LSV:
  • Remember, both LSV and GSV are superficial

1. Greater saphenous vein (aka Long saphenous vein)
   • Medial and anterior
   • Joins the femoral vein
2. Lesser saphenous vein (aka Short saphenous vein)
   • Lateral and posterior
   • Joins the popliteal vein

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Varicose veins

• These occur due to incompetent valves in vein causing the pooling of blood
  • ↑blood causes vein dilation (i.e. varicose veins)
  • This can cause oedema and ulceration

Deep veins of the Lower limb

• As in the upper limb, these correspond to arteries – vena comitans

1. Anterior tibial vein
2. Posterior tibial vein (also drains the fibular vein)
3. Popliteal vein
4. Femoral vein

• The Soleal venous plexus
  • Muscle contraction pushes the veins
  • Crucial for venous return – failure can result in lymphoedema or deep vein thrombosis as blood pools and coagulates