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

Summary of the arteries of the lower limb. Sourced from the BMJ.
  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)
  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)
      • The femoral triangle made up by the inguinal ligament, sartorius, and adductor longus. Note the order of the Nerve, Artery, and Vein. Taken from sketchymedicine.com.
    • 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
    • Image showing the key branches of the femoral artery (from TeachMeAnatomy).
  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
    • Image from https://basicmedicalkey.com/popliteal-artery/
  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

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

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