This document describes the major arteries, veins and lymphatic drainage of the lower limb. It discusses the gluteal, internal pudendal, obturator, femoral, profunda femoris, popliteal, anterior tibial, posterior tibial arteries and their branches. It also describes the great saphenous vein, small saphenous vein, femoral vein and lymphatic drainage of the lower limb.
2. A.Gluteal vessels
1- superior gluteal vessels
Superior gluteal artery is a branch of the posterior
division of of the internal iliac artery .
Leaves the pelvis through greater sciatic foramen above
the pirifomis muscle.
Divides into superficial and deep
3. Gluteal vessels cont..
The superficial division supplies the gluteus maximus
The deep division supplies the gluteus medius and
minimus.
The upper branch of the deep division extends to ASIS
to anastomose with ascending branch of lateral
circumflex femoral artery and deep circumflex iliac
artery.
4.
5. Gluteal vessels cont..
The lower branch anastomose with the inferior gluteal
artery in the region of trochantric fossa where they are
joined by asending branch of medial circumflex artery.
This anastomosis is called the trochntric anastomosis.
In addition to adjacent muscles, the superior gluteal
artery contributes to the supply of the hip joint
6.
7. Gluteal vessels cont..
2-Inferior gluteal artery
The inferior gluteal artery originates from the anterior
trunk of the internal iliac artery in the pelvic cavity
It leaves the pelvic cavity with the inferior gluteal nerve
through the greater sciatic foramen inferior to the
piriformis muscle
8. Gluteal vessels cont..
The inferior gluteal artery supplies adjacent muscles
descends through the gluteal region and into the
posterior thigh where it supplies adjacent structures
and anastomoses with perforating branches of the
femoral artery.
It also supplies a branch to the sciatic nerve.
9.
10.
11. One branch of inferior gluteal artery shares in the
cruciate anastomosis.
12.
13. Cruciate anastomosis
Occurs between four arteries in the upper most part of
the back of the thigh
Resembles the cross
Medial horizontal limb is branch of medial circumflex
femoral artery
Lateral horizontal limb is branch of lateral circumflex
femoral artery
The upper sagital limb is branches of supperior and
inferior gluteal aretries
The lower limb is branch of profunda femoris artery
14.
15. The cruciate anastomosis forms a connection between
the internal iliac artery and the femoral artery
16. Veins supply
Inferior and superior gluteal veins follow the inferior
and superior gluteal arteries into the pelvis where they
join the pelvic plexus of veins.
Peripherally, the veins anastomose with superficial
gluteal veins, which ultimately drain anteriorly into
the femoral vein.
17. B. Internal pudendal vessels
The internal pudendal artery is a branch of anterior
division of the internal iliac artery
Leaves the pelvis through the great sciatic formen
below the piriformis .
18.
19. c.Obturator vessels
The obturator artery originates as a branch of the
internal iliac artery in the pelvic cavity and enters the
medial compartment of thigh through the obturator
canal
As it passes through the canal, it bifurcates into an
anterior branch and a posterior branch, which
together form a channel that circles the margin of the
obturator membrane and lies within the attachment of
the obturator externus muscle.
20.
21. Vessels arising from the anterior and posterior
branches supply adjacent muscles and anastomose
with the inferior gluteal and medial circumflex
femoral arteries.
22. Femoral artery
The femoral artery is the continuation of the external
iliac artery .
Provides main aretrial supply to The lower limb.
begins as the external iliac artery passes under the
inguinal ligament to enter the femoral triangle on the
anterior aspect of the upper thigh
23. The femoral artery is palpable in the femoral triangle
just inferior to the inguinal ligament midway between
the anterior superior iliac spine and the pubic
symphysis
The femoral artery passes vertically through the
femoral triangle and then continues down the thigh in
the adductor canal
24. It leaves the canal by passing through the adductor
hiatus in the adductor magnus muscle and becomes
the popliteal artery behind the knee.
25. Branches of femoral artery
1- deep external pudendal artery
Arise about one and half inch below the ingiunal
ligament
Passes medialy behind the spermatic cord or round
ligament of the uterus to supply the external genital
organs
26. Branches of femoral artery
2-A cluster of four small branches-
superficial epigastric artery,
superficial circumflex iliac artery,
superficial external pudendal artery, and
Deep external pudendal artery-
originate from the femoral artery in the femoral
triangle and
supply cutaneous regions of the upper thigh, lower
abdomen, and perineum
27. Branches of femoral artery
3- profunda femoris artery
is the largest branch of the femoral artery and the chief
artery to the thigh.
It arises from the femoral artery in the femoral triangle
in the middle third of the thigh,
it is separated from the femoral artery and vein by the
adductor longus
28. Branches of the deep artery of thigh( profunda
femoris) are
lateral circumflex
medial circumflex femoral and
perforating branches
29. The medial circumflex femoral artery is clinically
important because it supplies most the blood to the
head and neck of the femur.
The lateral circumflex femoral artery gives branches
that supply the muscles on the lateral side of the thigh
and head of femur.
30. The perforating artery are four in number
First- cruciate anastomosis
Second- nutrient artery to the femur
Third-
Fourth– anastomoses with branches of popliteal artery
31.
32. The popliteal artery
It is a continuation of the femoral artery at the opening
in the adductor magnus.
It is the deepest of the contents of the popliteal fossa
At the distal border of the popliteus ,the popiliteal
artery ends by dividing into anterior and posterior
tibial artery.
34. 1- muscular branches
Supply hamstring muscles
Muscles of the calf
2- cutaneous branches
Supply the skin
35. 3- articula branches
Five branches suppling the knee joint
Share in the anastomosis around the knee joint
36. Anterior tibial artery
One of the two terminal branch of popliteal artery
Originate at the distal border of the popliteus in the
posterior compartment of the leg.
passes forward into the anterior compartment of leg
through an aperture in the interosseous membrane.
37.
38.
39. It leaves the leg by passing anterior to the distal end of
the tibia and ankle joint and continues onto the dorsal
aspect of the foot as the dorsalis pedis artery
In the proximal leg, the anterior tibial artery has a
recurrent branch, which connects with the
anastomotic network of vessels around the knee joint
40. the anterior tibial artery supplies numerous branches
to adjacent muscles and is joined by the perforating
branch of the fibular artery, which passes forward
through the lower aspect of the interosseous
membrane from the posterior compartment of leg.
41. Distally, the anterior tibial artery gives rise to an
anterior medial malleolar artery and
an anterior lateral malleolar artery
42. Posterior tibial artery
Origin at the distal border of the popliteus
Branches
1- circumflex fibular artery
2-peroneal artery
3-medial malleolar branch
4-calcanean branch
43.
44. Peroneal artery
Largest branch of posterior tibial artery
Branches –to soleus
Flexor hallucis longus
Tibialis posterior
Peroneal muscles etc
The terminal branch of posterior tibial artery are the
medial and lateral plantar arteries
45. Dorsal venous arch
Network of veins on the dorsum of the foot
Lies in the superficial fascia of the distal part of
dorsum of the foot
The medial end of the arch unite with the medial
dorsal digital vein of the big toe to form the great
saphenous vein.
46.
47.
48. The lateral end of the arch unites with the lateral
dorsal digital vein of the little toe to form the samll
saphenous vein
49. The great saphenous vein
Begins at the medial end of the dorsal veins arch
Ascends infront of the medial malleolus
Ascends along the medial side of the leg and knee after
crossing the medial surface of the tibia obliquely
In the thigh it ascendes upward and lateral to reach
the saphenous opening…..ends in the femoral vein
50.
51. Popliteal vein
Formed at the distal border of the popliteus by the
union of the venae comitantes of the anterior and
posterior tibial arteries
Receives tributary from the small saphenous vein
52. The small saphenous vein
Arise from the lateral end of the dorsal venous arch of
the foot
Runs backwards along the lateral border of the foot
Ascends upwards in te superficial fascia of the back of
the leg.
Ends in the popliteal vein
53.
54.
55. The femoral vein
Continuation of the popliteal vein
Tributaries of the femoral vein are
Muscular vein
Deep external pudendal vein
Profunda femoris vein
Medial circumflex femoral vein
Lateral circumflex femoral vein
Great saphenous vein
56. The femoral vein cont…
It ascends behind the ingiunal ligament where it
continues as external iliac vein.
57. Lymphatic Drainage of the Lower
Limb
The lower limb has superficial and deep lymphatic
vessels
The superficial lymphatic vessels converge on and
accompany the saphenous veins and their tributaries
The lymphatic vessels accompanying the great
saphenous vein end in the vertical group of superficial
inguinal lymph nodes.
58.
59. The deep lymphatic vessels from the leg accompany
deep veins and enter the popliteal lymph nodes.
Most lymph from these nodes ascends through deep
lymphatic vessels to the deep inguinal lymph nodes
Lymph from the deep nodes passes to the external and
common iliac lymph nodes and is then received by the
lumbar lymphatic trunks