Anatomy of the vessels of lower limb Ayman Osama

THE FEMORAL ARTERY The femoral artery is the continuation of the external iliac artery. It begins behind the inguinal ligament, descends on the antro-medial aspect of the thigh and becomes the popliteal artery after passing through an opening in the adductor magnus muscle at the junction between the middle and distal thirds of the thigh. Proximally, it lies among the extensor muscles in the femoral triangle with its first 3-4 cm enclosed in the femoral sheath. Distally, it lies in the adductor (sub sartorial) canal.

The profunda femoris artery is the main branch of the common femoral artery arising from its lateral aspect about 3-5 cm distal to the inguinal ligament then the common femoral artery continues as the superficial femoral artery. Other branches of the common femoral artery include the superficial epigastric, superficial circumflex iliac, superficial external pudendal and deep external pudendal arteries.

THE PROFUNDA FEMORIS ARTERY It is the main arterial supply to the thigh arising from the common femoral artery about 3-5cm from the inguinal ligament. At first, it is lateral to the femoral artery then spirals posterior to the femoral artery and vein to the medial side of the femur. It anastomoses with the internal and external iliac arteries above and the popliteal artery below. Its main branches are the lateral circumflex, medial circumflex, and four perforator arteries, the last of which represents the continuation of the profunda.

The popliteal artery It is the continuation of femoral artery extending from the opening in adductor magnus muscle on the medial border of femur inclining obliquely to the distal border of the popliteus muscle where it divides into anterior and posterior tibial arteries. The popliteal vein is superficial to the artery and crosses it so that proximally, the vein is on its lateral aspect while distally; the vein is on its medial aspect.

THE ANTERIOR TIBIAL ARTERY The anterior tibial artery arises from the popliteal artery at the distal border of the popliteus muscle, and then passes through the oval aperture of the interosseous membrane medial to the fibular neck to reach the extensor region. It descends anterior to the interosseous membrane obliquely so that it becomes anterior to the tibia distally. At the ankle, it is midway between the lateral and medial malleoli and continues as the dorsalis pedis artery.

DORSALIS PEDIS ARTERY It is the continuation of the anterior tibial artery. It passes medially along the dorsum of the foot to the proximal end of the first intermetatarsal space where it turns into the sole between the heads of the first dorsal interosseous muscle to complete as the planter metatarsal artery.

POSTERIOR TIBIAL ARTERY The posterior tibial artery originates from the popliteal artery at the distal border of popliteus muscle, descending medial in the flexor compartment to divide midway between the medial malleolus and the medial tubercle of calcaneous into medial and lateral planter arteries

PERONEAL ARTERY It arises about 2.5 cm distal to the popliteus muscle, passes obliquely to the fibula, descending along its medial crest. At the inferior tibio-fibular syndesmosis, it divides into the calcanean branches.