Presentation on theme: "Blood Supply of the Lower Limb"— Presentation transcript:
1 Blood Supply of the Lower Limb Dr. Safaa Dr. Sama-ul-Haque
2 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.
3 ObjectivesDiscuss 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.
5 Femoral Artery Enters thigh by passing behind inguinal ligament. Continuation of External iliac artery.Ends at the opening in the adductor Magnusmuscle and continuous as Popliteal artery.Relations:Anteriorly: Skin , Fascia and SartoriusPosteriorly: Psoas MajorLaterally: Femoral NerveMedially: Femoral vein
12 Trochanteric Anastomosis Anastomosis between the branches of internal iliacand femoral arteries.Main supply to the head of Femur.Branches forming anastomosis:Superior gluteal arteryInferior gluteal arteryMedial femoral circumflex arteryLateral femoral circumflex artery
14 Cruciate AnastomosisAnastomosis between the branches of internal iliacand femoral arteries.Branches forming anastomosis:Inferior gluteal arteryMedial femoral circumflex arteryLateral femoral circumflex arteryFirst Perforating arteryIn occlusion of the proximal part of the femoral artery,blood passes through the cruciate & trochantericAnastomosis.
16 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
20 Anastomosis around Knee joint Anastomosis between the branches of femoral,popliteal, anterior and posterior tibial arteries.Branches forming anastomosis:Branch of femoral arteryDescending genicularArticular branches of Popliteal arterySuperior genicular (lateral & medial)Inferior genicular (lateral & medial)Small branches of anterior and posteriortibial arteries
22 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.
25 Anterior Tibial Artery In front of ankle joint, the artery becomes the Dorsalis pedis artery.Branches:Muscular branches to the muscles of anterior compartmentAnastomotic branchesAround Knee and Ankle joints
26 Dorsalis Pedis 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 tendonsof extensor hallucis longus and extensor digitorumlongus.Its pulsation can be felt here.
30 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.
39 Lateral Plantar Artery Larger terminal branch of Posterior tibial artery.On the base of 5th metatarsal bone, it forms Plantar Arch by joining Dorsalis pedis artery.Branches:Muscular , Cutaneous and ArticularBranches of Plantar Arch:Plantar metatarsal arteriesPlantar digital arteriesThree perforating arteries (anastomose with vessels on the dorsal aspect of the foot.
47 Dorsal Venous Arch Lies on the dorsum of the foot. The blood from the whole foot drains into this archvia digital veins and communicating veins.Drains on the medial side into the Great Saphenous veinDrains on the lateral side into the Small Saphenous vein
49 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.
50 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
56 Perforating vein connecting great saphenous vein with a deep vein
57 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.
58 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.
61 Venae ComitantesDeep veins accompany the arteries are called venae comitantes.The deep plantar venous arch gives medial and lateralplantar 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.
62 Popliteal VeinFormed by the venae comitantes of the anterior and posterior tibial arteries.Ends at the adductor hiatus and continuous upwardas Femoral vein.Tributaries:Veins accompany arteries.Small saphenous vein.