Anatomy of Arteries in Lower Limb
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Questions and Answers

Where does the dorsalis pedis artery begin?

  • At the medial aspect of the foot
  • Behind the inferior extensor retinaculum
  • At the proximal end of the 1st metatarsal bone
  • In front of the ankle joint, midway between the two malleoli (correct)

What is the primary function of the arcuate artery?

  • To run along the talus and navicular bones
  • To anastomose with the lateral tarsal artery and supply digital arteries (correct)
  • To intersect with the extensor hallucis longus tendon
  • To supply blood to the medial 1 ½ toes

Which structure lies medial to the dorsalis pedis artery?

  • Extensor hallucis brevis muscle
  • Tendon of extensor digitorum longus
  • Tendon of extensor hallucis longus (correct)
  • Medial branch of deep fibular nerve

What is the location of the dorsalis pedis pulsation?

<p>Just distal to the midpoint between the two malleoli, lateral to the extensor hallucis longus tendon (D)</p> Signup and view all the answers

What is the main distinguishing characteristic of the first dorsal metatarsal artery?

<p>It arises just before the dorsalis pedis passes to the sole (D)</p> Signup and view all the answers

What is the main purpose of catheterization of the femoral artery?

<p>To perform left heart or renal angiography (D)</p> Signup and view all the answers

Where does the popliteal artery begin?

<p>In the adductor hiatus (B)</p> Signup and view all the answers

What structure overlaps the popliteal artery in the upper part of the popliteal fossa?

<p>Semimembranosus muscle (A)</p> Signup and view all the answers

What happens if there is an obstruction of the external iliac or femoral artery above the origin of the profunda femoris?

<p>Collateral circulation is established through the cruciate anastomosis (C)</p> Signup and view all the answers

Which branches does the popliteal artery give off?

<p>Muscular branches and genicular arteries (C)</p> Signup and view all the answers

At what anatomical location is the popliteal artery pulsation typically felt?

<p>In the center of the popliteal fossa (B)</p> Signup and view all the answers

What is the distal termination of the popliteal artery?

<p>Anterior and posterior tibial arteries (C)</p> Signup and view all the answers

How is the surface anatomy of the popliteal artery represented?

<p>As a line between specific points on the leg (A)</p> Signup and view all the answers

At which point does the femoral artery begin?

<p>At the mid-inguinal point (C)</p> Signup and view all the answers

Where does the femoral artery transition into the popliteal artery?

<p>At the adductor hiatus (A)</p> Signup and view all the answers

Which of the following structures is NOT a posterior relation of the femoral artery?

<p>Sartorius (A)</p> Signup and view all the answers

Which nerve is located lateral to the femoral artery at the base of the femoral triangle?

<p>Femoral nerve (D)</p> Signup and view all the answers

What separates the femoral artery from the head of the femur?

<p>Iliopsoas muscle (A)</p> Signup and view all the answers

In the upper half of the femoral triangle, which structure is found most anteriorly?

<p>Femoral artery (A)</p> Signup and view all the answers

What is the relationship of the femoral vein to the femoral artery at the base of the femoral triangle?

<p>Medial to the femoral artery (B)</p> Signup and view all the answers

At the apex of the femoral triangle, how are the femoral artery and femoral vein organized?

<p>Femoral artery, femoral vein, adductor longus (A)</p> Signup and view all the answers

Where does the great saphenous vein begin?

<p>On the dorsum of the foot (D)</p> Signup and view all the answers

In relation to the femoral artery, where does the adductor canal lie in its lower part?

<p>Postero-lateral to the femoral artery (D)</p> Signup and view all the answers

Which vein is NOT a tributary of the femoral vein?

<p>Internal jugular vein (B)</p> Signup and view all the answers

What structure accompanies the great saphenous vein along the medial aspect of the leg?

<p>Saphenous nerve (D)</p> Signup and view all the answers

Where does the great saphenous vein join the femoral vein?

<p>At the sapheno-femoral junction (B)</p> Signup and view all the answers

Which of the following veins is likely to be involved in a varicose condition?

<p>Great saphenous vein (C)</p> Signup and view all the answers

Which veins connect the short and long saphenous veins?

<p>Communicating veins (C)</p> Signup and view all the answers

What is the anatomical significance of inserting a catheter into the femoral vein?

<p>It provides access for cardiac angiography. (D)</p> Signup and view all the answers

Which lymph nodes receive lymph from the lower limb?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary function of the horizontal group of superficial lymph nodes?

<p>Drain the anterior abdominal wall below the umbilicus (D)</p> Signup and view all the answers

What anatomical feature does the short saphenous vein accompany on its path in the calf?

<p>Sural nerve (D)</p> Signup and view all the answers

Where does the short saphenous vein end?

<p>Popliteal fossa (D)</p> Signup and view all the answers

What condition arises from obstruction of the lymphatics of the lower limb?

<p>Lymphatic oedema (D)</p> Signup and view all the answers

What is a primary function of the valves in superficial veins?

<p>To direct blood flow from superficial to deep veins (B)</p> Signup and view all the answers

Which group of superficial inguinal lymph nodes drains lymph from the skin and subcutaneous tissues?

<p>Vertical group (B)</p> Signup and view all the answers

What is the term for the enlargement of lymph nodes?

<p>Lymphadenopathy (C)</p> Signup and view all the answers

Which lymph vessels are primarily responsible for draining structures superficial to the deep fascia?

<p>Superficial lymph vessels (C)</p> Signup and view all the answers

What happens to lymph after it is filtered in the lymph nodes?

<p>It exits the nodes via efferent lymphatics (C)</p> Signup and view all the answers

Where do the efferent lymphatics from deep inguinal lymph nodes pass?

<p>Through the femoral canal (A)</p> Signup and view all the answers

Which condition involves inflammation of lymph vessels?

<p>Lymphangitis (A)</p> Signup and view all the answers

What is true about varicose veins?

<p>They are dilated, elongated, tortuous superficial veins (B)</p> Signup and view all the answers

What potential complication arises from injury to the saphenous nerve during surgical procedures?

<p>Sensory loss on the medial aspect of the foot (A)</p> Signup and view all the answers

What is the clinical significance of lymph nodes that are less than 5mm without progressive enlargement?

<p>They are clinically insignificant (A)</p> Signup and view all the answers

Which structure does not drain into the popliteal lymph nodes?

<p>Superficial lymph vessels accompanying the great saphenous vein (B)</p> Signup and view all the answers

Flashcards

What is the femoral artery?

The femoral artery is a major blood vessel in the leg that supplies blood to the thigh and lower leg. It begins at the mid-inguinal point, continues as the external iliac artery, and ends at the adductor hiatus where it becomes the popliteal artery.

What is the femoral triangle?

The femoral triangle is a triangular space in the upper thigh that contains important vessels and nerves. It is bordered by the sartorius, adductor longus, and inguinal ligament.

What is the location of the femoral artery in the femoral triangle?

In the femoral triangle, the femoral artery is superficial and lies within the femoral sheath. This sheath is a fibrous structure that helps protect and organize the artery and vein.

Where does the femoral artery go after the femoral triangle?

As the femoral artery descends into the thigh, it enters the adductor canal. This canal is a narrow space that allows the artery to pass deeper towards the knee.

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What is the relative position of the femoral vein to the femoral artery?

The femoral vein, which carries deoxygenated blood back to the heart, is located medial to the femoral artery at the base of the femoral triangle. As the artery descends, the vein moves behind and then lateral to it.

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What is the relationship of the femoral nerve and the saphenous nerve to the femoral artery?

The femoral nerve is positioned lateral to the femoral artery at the base of the femoral triangle. The saphenous nerve, a branch of the femoral nerve, crosses in front of the artery to become medial to it further down.

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What is the arrangement of vessels and the adductor longus muscle at the apex of the femoral triangle?

At the apex of the femoral triangle, the vessels and adductor longus muscle are arranged in the following order from anterior to posterior: femoral artery, femoral vein, adductor longus, profunda vein, and profunda artery.

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What is the location of the saphenous nerve relative to the femoral artery in the adductor canal?

The saphenous nerve is a sensory nerve that supplies the skin on the medial side of the leg. It becomes medial to the femoral artery in the lower part of the adductor canal.

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What is the Dorsalis Pedis Artery?

The Dorsalis Pedis Artery is a major artery in the foot, supplying blood to the dorsum (top) of the foot and partly the toes. It runs directly over the bones of the foot, making it easy to feel its pulse.

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Where does the Dorsalis Pedis Artery begin and end?

The Dorsalis Pedis Artery originates from the Anterior Tibial Artery just below the ankle and then ends by supplying blood to the plantar arch on the sole of the foot.

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What is the location and accessibility of the Dorsalis Pedis Artery?

The Dorsalis Pedis Artery runs along the top of the foot, supplying blood to the toes. It lies close to the surface and can be easily felt.

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What are the major branches of the Dorsalis Pedis Artery?

The main branches of the Dorsalis Pedis Artery include the medial and lateral tarsal arteries, the arcuate artery, and the 1st dorsal metatarsal artery. These branches supply blood to the different parts of the foot and toes.

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How do you locate the Dorsalis Pedis pulse?

The Dorsalis Pedis Artery pulsation can be felt just below the ankle, on the side of the tendons, and near the base of the big toe.

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Femoral Artery Catheterization

A long, slender tube inserted into the femoral artery to access the left heart or kidney blood vessels for imaging. Contrast material is injected, and X-rays are taken to visualize the vessels.

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Cruciate Anastomosis

A group of blood vessels that connect the external iliac and profunda femoris arteries to supply blood to the lower limb if the external iliac or femoral artery is blocked above the origin of the profunda femoris.

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Popliteal Artery

The main artery in the back of the knee, continuing from the femoral artery.

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Location of the Popliteal Artery

The deepest structure within the popliteal fossa, residing in the back of the knee.

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Popliteal Artery: Upper Relations

The popliteal artery is overlapped by the semimembranosus muscle in the upper part of the popliteal fossa.

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Popliteal Artery: Middle Relations

The popliteal vein and tibial nerve cross over the popliteal artery from lateral to medial and from above downwards.

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Popliteal Artery: Lower Relations

The plantaris and gastrocnemius muscles overlap the popliteal artery in the lower part of the popliteal fossa.

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Terminal Branches of Popliteal Artery

The popliteal artery branches into the anterior and posterior tibial arteries, which supply the lower leg.

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Where is the femoral vein relative to the femoral artery in the femoral triangle?

The femoral vein is located medial to the artery at the base of the femoral triangle.

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What happens to the femoral vein's position relative to the artery as it descends?

As the femoral artery descends, the vein moves behind and then lateral to it.

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What's the position of the femoral vein to the femoral artery in the adductor canal?

In the lower part of the adductor canal, the femoral vein is in a posterior-lateral position to the artery.

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What does the femoral vein do?

The femoral vein is a major vein in the leg, carrying deoxygenated blood back to the heart.

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Where is the femoral vein relative to the femoral artery at the apex of the femoral triangle?

At the apex of the femoral triangle, the vein is positioned behind the artery.

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What is the long saphenous vein?

The long saphenous vein is the longest vein in the body, starting on the foot and ending by joining the femoral vein.

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What is the path and endpoint of the long saphenous vein ?

The long saphenous vein runs along the medial aspect of the leg and thigh, and it ends by joining the femoral vein at the sapheno-femoral junction.

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What is the sapheno-femoral junction?

This is where the long saphenous vein joins the femoral vein.

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Superficial Inguinal Lymph Nodes

Superficial lymph nodes located in the groin region, forming a T-shape along the great saphenous vein and below the inguinal ligament.

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Popliteal Lymph Nodes

Deep lymph nodes situated in the popliteal fossa along the popliteal vessels. They receive lymph from the foot and leg and connect to the deep inguinal lymph nodes.

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Deep Inguinal Lymph Nodes

Deep lymph nodes located along the medial side of the femoral vein, receiving lymph from superficial and deep tissues of the lower limb.

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Lymphatic Edema

A condition caused by obstruction of the lymphatic system, leading to swelling of the limb, often in the leg.

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Elephantiasis

A severe form of lymphatic edema where the limb becomes significantly enlarged.

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Lymphadenopathy

Swelling of the lymph nodes, often indicating an underlying infection or disease process.

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Lymphangitis

Inflammation of the lymphatic vessels, usually caused by a bacterial infection.

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Lymphadenitis

Inflammation of the lymph nodes, usually caused by an infection.

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Short saphenous vein trajectory

The short saphenous vein begins on the foot as a continuation of the dorsal venous arch. It travels along the lateral side of the leg, behind the lateral malleolus, and up the back of the calf, accompanied by the sural nerve. This vein then goes deeper, passing through the gastrocnemius muscle, and finally joins the popliteal vein in the popliteal fossa.

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Clinical significance of the short saphenous vein

Varicose veins are dilated, tortuous superficial veins, usually found in the lower limbs. They are not present in the deep veins, which are supported by surrounding muscles. The short saphenous vein can be used in arterial bypass grafting due to its accessibility and length.

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Lymphatic system function

The lymphatic system is a network that collects and filters excess fluid (lymph) from tissues. It's made up of lymph vessels and lymph nodes. The lymph vessels contain valves that prevent the backflow of lymph.

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Lymphatic drainage in the lower limb

The lymph vessels in the lower limb follow the veins, draining lymph from different regions. The superficial vessels drain the skin and subcutaneous tissue and run medially alongside the great saphenous vein or laterally alongside the small saphenous vein. The deep vessels drain structures under the deep fascia and travel with the deep veins.

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Superficial lymphatic drainage

Superficial lymph vessels collect excess fluid from the skin and subcutaneous tissue. They mainly accompany the great saphenous vein and drain into the superficial inguinal lymph nodes. A smaller portion follows the small saphenous vein to the popliteal lymph nodes.

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Deep lymphatic drainage

Deep lymph vessels collect fluid from structures beneath the fascia. These vessels travel with the deep veins and drain into the deep inguinal lymph nodes.

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Lymphatic filtration

Lymph is filtered within lymph nodes. It enters the nodes through afferent lymphatics and exits through efferent lymphatics. After being processed, the collected lymph eventually drains into the veins.

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Lymph flow in the lower limb

The flow of lymph is driven by the contraction of muscles, changes in pressure in surrounding tissues, and the valves within the lymphatic vessels. The lymph channels and veins work together to maintain fluid balance and transport important molecules throughout the body.

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Study Notes

Vessels of the Lower Limb

  • The femoral artery begins at the mid-inguinal point, behind the inguinal ligament, as a continuation of the external iliac artery.
  • It ends at the junction of the upper two-thirds and lower one-third of the thigh, passing through the adductor hiatus into the popliteal fossa to continue as the popliteal artery.
  • The upper half of the femoral artery lies superficially in the femoral triangle, while the lower half is deep within the adductor canal.
  • The upper 1.5 inches of the artery lies within the lateral compartment of the femoral sheath.
  • Anterior relations in the femoral triangle include the skin, superficial fascia, deep fascia, and anterior wall of the femoral sheath.
  • In the adductor canal, the sartorius muscle is an anterior relation.
  • Posterior relations in the femoral triangle and adductor canal include the iliopsoas muscle (which separates the artery from the head of the femur), pectineus muscle, separated by profunda femoris vessels, adductor longus, and adductor magnus.
  • The femoral vein is medial to the artery in the femoral triangle. It lies behind and posterolateral to the artery in the lower adductor canal.
  • The femoral nerve and genitofemoral nerve branches are lateral to the femoral artery at the base of the femoral triangle.
  • The saphenous nerve is lateral to the femoral artery in the femoral triangle, and crosses in front of the artery in the adductor canal to become medial to the artery in the lower adductor canal.
  • The femoral artery gives rise to several branches, including superficial and deep branches.
  • Superficial branches pierce the cribriform fascia to supply the skin, such as the superficial circumflex iliac artery and superficial epigastric artery.
  • Superficial external pudendal arteries run medially superficial to the femoral vein and spermatic cord, reaching the external genital organs.
  • Deep branches include the deep external pudendal and descending genicular arteries, alongside the critical profunda femoris artery.
  • The profunda femoris is the largest and most important branch, supplying the thigh, arising from the posterolateral aspect of the femoral artery, 4 cm below the inguinal ligament.
  • It ends by piercing the adductor magnus to become the 4th perforating branch.
  • The profunda femoris artery curves downwards and medially between femoral vessels and pectineus, adductor longus and adductor brevis, then adductor longus and adductor magnus.
  • Branches of the profunda femoris include the lateral circumflex femoral artery and several perforating branches.
  • The popliteal artery begins in the adductor hiatus as a continuation of the femoral artery and terminates at the lower border of the popliteus muscle, dividing into the anterior and posterior tibial arteries.
  • The superficial relations of the popliteal artery include the semimembranosus muscle in the upper part, the popliteal vein and tibial nerve in the center, and the plantaris and gastrocnemius muscles in the lower part.
  • Branches of the popliteal include the superior and inferior lateral and medial genicular arteries and the recurrent branches of the anterior and posterior tibial arteries, which anastomose around the knee joint.
  • The anterior tibial artery begins as one of the terminal branches of the popliteal artery, behind the lower border of the popliteus muscle.
  • It terminates by entering the front of the ankle joint and continuing as the dorsalis pedis artery.
  • The artery is accompanied by veins, and passes deep to the superior extensor retinaculum. The deep fibular nerve is lateral to it in the upper one-third and middle third of the leg.
  • Branches of the anterior tibial artery include anterior and posterior tibial recurrent and muscular branches that serve the anterior compartments of the leg.
  • The posterior tibial artery arises as the other terminal branch of the popliteal artery. It ends by branching into the lateral and medial plantar arteries.
  • The artery runs in between tibia and fibula, deep to the tibial nerve, in the upper two-thirds of the leg.
  • In the lower one-third, the posterior tibial artery is superficial, lying on the posterior surface of the tibia. The tibial nerve is medial to the artery.
  • Branches of the posterior tibial artery include the muscular branches and the medial and lateral malleolar and calcaneal branches.
  • The dorsalis pedis artery begins as a continuation of the anterior tibial artery. It travels in front of the ankle joint, midway between the malleoli.
  • It passes to the sole of the foot through the first interosseous space and anastomoses with the plantar arch.
  • Branches of the dorsalis pedis artery include medial and lateral tarsal arteries and the arcuate artery, plus the first, second, and third dorsal metatarsal arteries.
  • The medial and lateral plantar arteries, branches of the posterior tibial artery, lie on the sole of the foot, converging to form the plantar arch.
  • Branches of the plantar arteries include the plantar metatarsal and digital arteries.
  • There are several lymphatic vessels and lymph nodes that drain the lower limb, including superficial and deep vessels and nodes.
  • Superficial vessels accompany the superficial veins and drain the superficial tissues of the leg.
  • Deep vessels accompany the deep veins and drain the deep tissues of the leg.
  • The superficial inguinal nodes are arranged in a vertically oriented group and a horizontally oriented group.
  • Deep inguinal nodes lie along the medial side of the ending femoral vein and collect lymph from the lower leg.

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Description

This quiz focuses on the anatomy and physiological functions of various arteries in the lower limb, including the dorsalis pedis, femoral, and popliteal arteries. Test your knowledge on their origins, functions, and related structures through a set of detailed questions.

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