Arterial system of the lower limb

Femoral artery

It’s the distal continuation of the External Iliac artery beyond the inguinal ligament. Along its course it traverses the femoral triangle and terminates a hand’s breadth above the Adductor tubercle, passing through the hiatus in the Adductor Magnus to become the popliteal artery.


Branches
1) Branches In the Groin
A) Superficial circumflex iliac artery
B) Superficial epigastric artery
C) Superficial external pudendal artery                        

2) Profunda Femoris
            This arises from the femoral artery posterolaterally 5cm distally from the inguinal ligament.    

Conventionally above this branch it’s called the Common iliac artery. Below it the Superficial femoral artery. Profunda femoris has 4 perforating branches, a medial circumflex and a lateral circumflex branch.


Clinical            
Arterial access is obtained into the femoral artery at the groin for Arteriography.

Popliteal Artery

Continues down from the Femoral artery at the Adductor hiatus & terminates at the lower border of the popliteal muscle. It lies deep within the popliteal fossa( It is covered superficially by the popliteal vein and crossed by the tibial nerve).

                                           Popliteal vein above the popliteal artery not compreesd

                                            Popliteal vein above the popliteal artery compressed

                                                              DVT

Branches of the popliteal artery

• Muscular branches

• Geniculate branches (to knee joint)

• Terminal branches- Anterior tibial artery

                                          Posterior tibial artery



Posterior tibial artery

Proximally it descends deep to soleus muscle, and becomes superficial in the lower 3rd of the leg and passes behind the medial malleolus, between the tendons of Flexor digitorum longus and flexor hallucis longus. It’s accompanied by corresponding vein and nerve.

Below the ankle the Posterior tibial artery divides into medial and lateral Plantar arteries which constitutes the main blood supply to the foot. In addition to the branches to muscles and skin it gives off the peroneal artery about 4cm distally from its origin.

Peroneal artery runs down the postrior aspect of the fibula. Above the ankle it gives off its perforating branch which pierces the interosseous membrane, descends over the lateral malleolus to & anastamoses with the arteries of the dorsum of the foot.

Anterior tibial artery  
                                         
After its origin from the bifurcation of the popliteal artery it passes forward between the tibia and the fibula under the lower margin of the popliteus, and descends in the anterior compartment of the leg. At first it’s deeply buried but becomes superficial just above the ankle between the tendons of extensor hallucis longus and tibials anterior.


The artery continues over the dorsum of the foot as the Dorsalis pedis. This gives off the arcuate artery which supplies the cutaneous branches to the back of the toes. Dorsalis pedis runs between the 1st & the 2nd metatarsals to join the lateral plantar artery in the formation of the plantar arch, from which branches run forward to supply the plantar aspect of the toes.