ANAT20006 Lecture Notes - Lecture 20: Deep Artery Of The Thigh, Posterior Tibial Artery, Anterior Tibial Artery
12 Jun 2018
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LECTURE 20
LOWER LIMBS (3) NERVES & VESSELS
LOWER LIMB ARTERIES
•(1) we have a descending aorta in the abdomen which
branches once it reaches the pelvis, creating 2 arteries; the
right and left iliac arteries. Within the pelvis itself, the
internal iliac artery provides nutrients and blood flow to
organs within the pelvis and the external iliac artery
continues on relatively superficially and exit the pelvis to
anteriorly enter the lower limb. As the artery crosses the
inguinal ligament, it becomes known as the the femoral
artery. It is quite superficial; it is surgically often used to
access the heart. It is very superficial so it wants to be
protected; will slide under quadriceps muscle (sartorius
muscle). It enters the lower limb and arches its way
medially down the inside of the leg.
•Arteries like to be on flexor surfaces (like the upper limb).
Because of the rotation that occurs during development,
the anterior surfaces are extensor surfaces. So it works its
way medially from the anterior to medial compartment. The
femoral artery goes through the adductor hiatus medially to
end up on the posterior aspect of the lower leg.
•As the femoral artery enters the lower limb it branches into a
deep branch known as the profunda femoris.
•Arteries of the femoral neck:
•Anastomoses between profunda femoris artery branches
•Pass across the neck, bound down by capsular fibres
•Susceptible to damage in fractured NOF
•(2) femoral artery now more distal in the thigh.
It is about to go through the adductor hiatus and
now is behind the knee.
As it goes behind the
knee its name changes
again to become the
popliteal artery, which
crosses the knee and as it
comes into the leg it
branches again into
posterior tibial artery in
the posterior
compartment and the
anterior tibial artery
which pokes through the
osseous membrane.
•Posterior tibial artery goes down the leg and joins with tendons from
tarsal tunnel to provide blood supply to the foot.
•So it is 1 continuous tube down the lower limb with different names.
LOWER LIMB VEINS
•(3) bold is returned to central circulation via a series of veins. There are
both superficial and deep veins. There are 2 main superficial veins.
Lecture 20 - Wednesday 6 September 2017
ANAT20006 - HUMAN STRUCTURE & FUNCTION
1
•No veins on soles of feet as our weight would squash them. So they tend to
arch around at the top of out foot with 2 ascending, one medially and one
laterally.
•Superficial Veins
•Dorsal venous arch
•Great saphenous
•Small saphenous
(all in superficial fascia)
•Deep Veins
•Venae comitantes
•Venous sinuses in soleus
•Muscular venous pump
•Note: valves ensure unidirectional flow
•Varicose veins are engorged veins of the superficial fascia.
•Superficial fascia veins communicate with deeper veins via
perforating veins. If these become incompetent then blood can
spread either way and the pressure from deep veins will often
push the blood out to the superficial veins. Varicose veins are a
sign of this.
•Clinical significance:
•Varicose veins
•Venous thrombus/
thromboembolus
•Saphenous vein grafts
•Venous sinuses in the sileous
muscles.
LOWER LIMB LYMPHATICS
•(4) Lymphatics of the Lower Limb
•drainage follows superficial veins of the
lower limb:
•Inguinal nodes
•Drain to thoracic duct
•Left side
•Following fascia. Lymphatic drainage from both lower limbs
ends up on the left side. The right upper limb drains to the
right side.
LOWER LIMB NERVES
•(5) as the spinal nerve emerges from the
intervertebral foramen it branches to form a
posterior and anterior rami. Anterior aim give
rise to nerves for lower limbs.
•Anterior rami give rise to plexuses
•Major nerves arise from Lumbosacral plexus.
•Compression of spinal nerve roots may cause
pain peripherally
•Upper limb muscles are compartmentalized roughly by nerve
& functions. Same principle for lower limb. So roughly 1 nerve
per compartment.
•Lumbrosacral plexus: nerves arising from lumbar and sacral
nerve roots.
Lecture 20 - Wednesday 6 September 2017
ANAT20006 - HUMAN STRUCTURE & FUNCTION
Document Summary
Lower limb arteries: (1) we have a descending aorta in the abdomen which branches once it reaches the pelvis, creating 2 arteries; the right and left iliac arteries. Within the pelvis itself, the internal iliac artery provides nutrients and blood flow to organs within the pelvis and the external iliac artery continues on relatively superficially and exit the pelvis to anteriorly enter the lower limb. As the artery crosses the inguinal ligament, it becomes known as the the femoral artery. It is quite superficial; it is surgically often used to access the heart. It is very superficial so it wants to be protected; will slide under quadriceps muscle (sartorius muscle). It enters the lower limb and arches its way medially down the inside of the leg: arteries like to be on flexor surfaces (like the upper limb). Because of the rotation that occurs during development, the anterior surfaces are extensor surfaces.
