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Arteries of lower extremity

Major arteries of the hip, thigh, lower leg and foot.

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Transcript

Hey everyone! It's Megan from Kenhub, and in today's tutorial, we will be discussing the arteries of the lower leg. The divisions of the common iliac arteries are responsible for delivering oxygenated blood to the lower extremities. The common iliac artery bifurcates to form the external and internal iliac arteries about halfway between the first and second anterior sacral foramina. Just lateral to the level of the second anterior sacral foramina, the internal iliac artery – which is highlighted in green in this image – gives off the iliolumbar artery and the superior gluteal artery.

The iliolumbar artery travels superiorly before bifurcating into its lumbar and iliac branches at the level of the iliosacral joint. The iliac artery then courses along the inner margin of the iliac crest after which it exits the false pelvis superior to the lateral portion of the inguinal ligament.

The neck of the femur is vascularized by anastomosing branches from the profunda femoris artery which is also known as the deep femoral artery. The profunda femoris artery is a branch of the femoral artery and is highlighted in green in this image. It gives off several branches including the lateral circumflex femoral artery seen here on the left and the medial circumflex femoral artery seen on the right.

The lateral circumflex femoral artery trifurcates giving rise to the ascending, descending and transverse branches. The ascending branch travels superiorly along the anterior aspect of the femoral neck just medial to the greater trochanter. The ascending branch of the medial circumflex femoral artery also travels superiorly that's along the trochanteric line in the posterior aspect of the neck of the femur. These arteries both meet with the inferior division of the deep superior gluteal artery in the trochanteric fossa.

The medial circumflex femoral artery also forms a communication with the posterior branch of the obturator artery as it courses along the inner margin of the ramus of the ischium and the obturator foramen. The obturator artery also gives off anterior and acetabular branches as it enters the obturator foramen posterior to the superior pubic ramus. The anterior branch of the obturator artery follows the inner margin of the inferior pubic ramus to anastomose with the posterior branch.

In the anterior compartment of the thigh, the transverse branch of the lateral circumflex femoral artery travels laterally and courses around the greater trochanter. In the posterior aspect of the thigh, the transverse branch of the medial circumflex artery also travels laterally to meet with the corresponding branch of the lateral circumflex femoral artery. So, in this image, we can see an anterior view of the thigh with the transverse branch of the lateral circumflex femoral artery highlighted in green.

The femoral artery travels through the anteromedial compartment of the thigh before changing its course to the posterior compartment when it passes through the hiatus of adductor magnus. Prior to diverging, the femoral artery gives off the descending genicular artery which divides to give an articular branch and a saphenous branch. After passing through the adductor hiatus, the femoral artery is now referred to as the popliteal artery. So, in this image, we can see a posterior view of the lower extremity with the popliteal artery highlighted in green. At the level of the distal part of the medial supracondylar line, the popliteal artery gives off the superior medial genicular artery and the superior lateral genicular artery before continuing its descent in the popliteal fossa.

The superior lateral genicular artery bifurcates at the distal part of the lateral supracondylar line. Its ascending branch meets with the descending branch of the lateral circumflex femoral artery in the substance of vastus lateralis, which is a muscle seen here highlighted in green. The superior medial genicular artery bifurcates at the adductor tubercle giving one branch that courses laterally and another that travels inferomedially to communicate with the inferior medial genicular artery in the popliteal fossa. The inferior lateral genicular artery courses superomedially around the lateral condyle.

In the distal popliteal fossa, the popliteal artery bifurcates into the anterior and posterior tibial arteries. The anterior tibial artery gives off a posterior tibial recurrent artery that joins the inferior lateral genicular artery. In the interosseus foramen, the anterior tibial artery also gives off a circumflex fibular branch and an anterior tibial recurrent artery. The former travels superiorly to join the inferior lateral genicular artery while the latter travels superiorly to complete the patellar anastomosis.

The posterior tibial artery communicates with its anterior counterpart as well as with the fibular or peroneal artery. This communication could be observed in the posterior aspect of the leg deep to the Achilles tendon. A communicating branch of the peroneal artery travels medially towards the posterior tibial artery and a perforating branch passes through the interosseus membrane then inferolaterally to join the anterior tibial artery.

The anterior tibial artery continues down the dorsum of the foot and trifurcates just distal to the transverse tarsal joint to give the medial tarsal arteries, the dorsalis pedis artery, and the lateral tarsal artery. The dorsalis pedis artery bifurcates above the medial and intermediate cuneiform bones to give the arcuate and deep plantar arteries. The arcuate artery courses laterally along the tarsometatarsal joint known as the TMJ, where it is joined by the lateral tarsal artery at the fifth TMJ.

The posterior tibial artery divides to form a medial plantar artery and a lateral plantar artery as it emerges from the lower border of the flexor retinaculum which we can see in this image highlighted in green. The lateral plantar artery then courses to the fifth TMJ, travels vertically to the middle of the fifth metatarsal then takes an abrupt medial turn to form the deep plantar arch. It terminates by anastomosing with the deep plantar artery in the first intertarsal space. The arch gives off posterior perforating branches in the intertarsal spaces that anastomose with the arcuate artery.

Now that you just completed this video tutorial, then it’s time for you to continue your learning experience by testing and also applying your knowledge. There are three ways you can do so here at Kenhub. The first one is by clicking on our “start training” button, the second one is by browsing through our related articles library, and the third one is by checking out our atlas.

Now, good luck everyone, and I will see you next time.

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