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Thank you Dr Elsayed Aly Metwally

3/25/12

Arteries of the gluteal region

Superior gluteal artery

branch from internal iliac artery. It enters the gluteal region through the upper part of greater sciatic foramen.

Inferior gluteal artery

branch from internal iliac artery

Blood vessels of the lower limb

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Femoral artery

Termination: at adductor hiatus and continues as popliteal artery Course: lies in femoral sheath with femoral vein medial to it and femoral nerve lateral to it and outside the sheath

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Origin: continuation of external iliac artery at mid inguinal artery

Branches of the femoral artery

1. Superficial inguinal arteries

Superficial Epigastric. Superficial Circumflex Iliac. Superficial External Pudendal

2. Deep External Pudendal. 3.Profunda Femoris. 4. Descending genicular

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Branches of profuda femoris

Lateral circumflex femoral
ascendi ng transver se descending 3/25/12

Medial circumflex femoral

ascendi ng transver se acetabul ar

Perforating arteries

4 perforating and ends as the 4 th one

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Branches of profuda femoris

transver se descendi ng 3/25/12

Lateral circumflex femoralascendi ng

Medial circumflex femoral

ascendi ng transver se acetabul ar

Perforating arteries

4 perforating and ends as the 4 th perforating

Popliteal artery
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Origin: Is the continuation of the femoral at Adductor hiatus Termination: at the lower border of the Popliteus, where it divides intoanterior

Branches of popliteal artery

1.

anterior tibial artery posterior tibial artery Superior medial genicular artery Superior lateral genicular artery middle genicular artery Inferior lateral genicular artery Inferior medial genicular artery
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2.

3.

4.

5.

6.

7.

Anterior tibial artery

Origin: at the lower border of the Popliteus as one of the two terminal branches of popliteal artery. Termination: on the front of the ankle-joint, and becomes thedorsalis pedis. Course: passes forward through the aperture above the upper border of the interosseous membrane and descends on the anterior surface of the interosseous membrane.
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Branches of anterior tibial artery

Anterior tibial recurrent. Anterior medial malleolar . Anterior lateral malleolar. muscular and nutrient
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1.

Posterior tibial recurrent.

2.

3.

4.

5.

Branches of dorsalis pedis

1.

Lateral tarsal artery Medial tarsal artery Arcuate artery (gives 2nd, 3rd, and 4th dorsal metatarsal arteries) 1St dorsal metatarsal 1st planter metatarsal
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2.

3.

4.

5.

Posterior tibial artery

Origin: as one of the two terminal branches of popliteal artery at lower border of popliteus Termination: as medial and lateral plantar arteries deep to flexor retinaculum.
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Branches of Posterior tibial artery

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1. Circumflex fibular artery runs around neck of the fibula 2. Nutrient to tibia 3. Muscular branches 4. Malleolar branches, on medial malleolus 5. Calcaneal branches to the heel 6. Peroneal artery 7. Terminal branches: medial and lateral planter arteries

Peroneal artery
Branches:

Muscular branches Nutrient artery to fibula Perforating artery pierces the interosseus membrane and may be enlarged to replace dorsalis pedis. Communicating (with the posterior tibial artery).

Medial and lateral plantar arteries

Origin: as two terminal branches of posterior tibial artery. Course: has relation with medial and lateral plantar nerves
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Anastomosis of lower limb

Trochanteric anastomosis Cruciate anastomosis Around knee Around ankle
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1.

Around anterior superior iliac spine

2. 3. 4. 5.

ANASTOMOSIS AROUND THE ANTERIOR SUPERIOR ILIAC SPINE: Ascending branch of lateral circumflex artery of profunda femoris artery. Iliac branch of iliolumbar of internal iliac artery Superior branch of superior gluteal artery. Deep circumflex iliac artery (external iliac artery)

1.

2.

3.

4.

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Trochanteric anastomosis

Formed by descending branch of superior gluteal artery. The inferior gluteal artery ascending branches of both lateral and medial circumflex femoral arteries. importance
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1.

1.

2.

Provides the main supply of the head of the femur.

Cruciate anastomosis

inferior gluteal artery lateral circumfl ex

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Anastomosis around knee

Formed by: Descending genicular of FA. Descending br of lateral CF. Superomed, superolat, inferomed, inferolat and middle genic of pop A. Ant and post tibial rec of ant tibial Circumflex fibular of post tibial.
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1.

2.

3.

4.

5.

Anastomosis around ankle

1.

Anterior lateral maleolar of AT Anterior medial maleolar of AT Maleolar br of post tibial Maleolar and perforating br of peroneal A
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2.

3.

4.

Superficial veins
I- The great saphenous vein it pass upwards in front of medial malleolus. it curves forward around the medial side of the thigh. it passes through lower part of saphenous opening. it joins the femoral vein about one and half inches below and lateral to pubic tubercle.

Superficial veins

perforating veins connect the great saphenous vein with deep veins . it receives: superficial circumflex iliac vein . superficial epigastric vein . superficial external pudendal vein .

1.

2.

3.

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II-The small saphenous vein

It begins at the lateral end of the dorsal venous arch. It ascends behind lateral maleolus. It passes at the posterior aspect of leg It terminates in popliteal vein in popliteal fossa.

Deep veins

They start as vena comittants of anterior and posterior tibial arteries which unite to form popliteal vein at lower border of popliteus. It terminates at adductor opening as femoral vein. It recieves small saphenous vein at pop fossa.

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Femoral vein

It terminates deep to inguinal ligament as external iliac vein. It receives great saphenous, profunda femoris, medial and lateral circ femoral and deep external pudendal

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It begins at adductor opening as a continuation of popliteal fossa.

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Thank you Dr Elsayed Aly Metwally

3/25/12