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AnatomyLower limbNerves and vesselsCruciate anastomosis
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AnatomyLower limbNerves and vesselsCruciate anastomosis

Cruciate anastomosis

Author: Jana Vasković, MD • Reviewer: Roberto Grujičić, MD
Last reviewed: November 03, 2023
Reading time: 4 minutes

Recommended video: Neurovasculature of the hip and thigh [15:10]
Arteries, veins and nerves of the hip and thigh.

The cruciate anastomosis is an arterial network located on the posterior surface of the proximal femur. Some authors refer to it as the collateral circulation at the hip joint. The cruciate anastomosis is formed by the:

The function of the cruciate anastomosis is to provide an alternative route for the blood supply of the lower limb when there is a blockage of the blood flow between the external iliac and femoral arteries. The cruciate anastomosis is often confused with the trochanteric anastomosis. However, the latter is a network between the superior gluteal artery and medial/lateral circumflex femoral arteries. But essentially, its function is the same as that of the cruciate anastomosis; it provides the collateral blood flow to support the femoral head.

Key facts about the cruciate anastomosis
Origin Deep femoral, inferior gluteal, lateral circumflex femoral, medial circumflex femoral arteries
Supply and function Alternative route for the blood supply of the lower limb in case of femoral artery obstruction

This article will discuss the anatomy and function of the cruciate anastomosis.

Contents
  1. Origin and location
  2. Function
  3. Sources
+ Show all

Origin and location

Deep femoral artery
Arteria profunda femoris
1/4
Synonyms: Deep artery of thigh, Deep branch of femoral artery , show more...

The cruciate anastomosis is found at the level of the lesser trochanter, just below the femoral attachment of the quadratus femoris muscle. It resembles a cross, which is why it is called like this (lat. crux means cross).

The anastomosis is formed by the four vessels:

  • Ascending branch of the first perforating artery (of deep femoral artery), which joins the anastomosis from below
  • Descending branch of the inferior gluteal artery, which joins the anastomosis from above
  • Transverse branch of the lateral circumflex femoral artery, which joins the anastomosis from the lateral side
  • Transverse branch of the medial circumflex femoral artery, which joins the anastomosis from the medial side

A handy mnemonic for remembering the participating vessels is “FILM” (First perforating, Inferior gluteal, Lateral circumflex femoral, Medial circumflex femoral).

Function

The function of the cruciate anastomosis is to provide the collateral arterial circulation when the communication between the femoral artery and its parent vessel, the external iliac artery, is blocked. If it wasn’t for the cruciate anastomosis, the blood supply to the whole lower limb below the site of blockage would be compromised.

In these cases, the internal iliac artery becomes the main source of the arterial blood for the lower limb, which it delivers via the cruciate anastomosis in the following way;

  1. The internal iliac artery gives off the inferior gluteal artery, which contributes to forming of the cruciate anastomosis
  2. Via cruciate anastomosis, the arterial blood reaches the first perforating branch of the deep femoral artery and the lateral circumflex femoral artery
  3. The arterial blood then flows through the descending branch of the lateral femoral circumflex artery, via which it reaches the superior lateral genicular artery
  4. Lastly, from here, the blood flows into the popliteal artery; the chief parent vessel for the blood supply of the leg and foot

Explore our articles, video tutorials, quizzes and labeled diagrams to learn everything about the arteries of the lower limb.

Neurovasculature of the hip and thigh Explore study unit
Femoral artery and its branches Explore study unit

Sources

All content published on Kenhub is reviewed by medical and anatomy experts. The information we provide is grounded on academic literature and peer-reviewed research. Kenhub does not provide medical advice. You can learn more about our content creation and review standards by reading our content quality guidelines.

References:

  • Moore, K. L., Dalley, A. F., & Agur, A. M. R. (2014). Clinically Oriented Anatomy (7th ed.).
  • Netter, F. (2019). Atlas of Human Anatomy (7th ed.). Philadelphia, PA: Saunders.
  • Standring, S. (2016). Gray's Anatomy (41st ed.). Edinburgh: Elsevier Churchill Livingstone.
  • Tubbs, R. S., Shoja, M. M., Loukas, M., & Bergman, R. A. (2016). Bergman’s comprehensive encyclopedia of human anatomic variation. Hoboken: Wiley Blackwell.

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