G) Arteries Of The Lower Limb

Arteries of the Gluteal Region

The gluteal muscles and skin are supplied by branches of the internal iliac artery; the superior and inferior gluteal arteries. These vessels exit the pelvis through the greater sciatic foramen, their position relative to the piriformis muscle. The inferior gluteal artery may descend for some distance into the thigh, supplying the knee flexors.

Arteries of the Thigh

Obturator Artery

The obturator artery usually arises from the anterior division of the internal iliac. It passes anteriorly along the medial surface of obturator internus to the obturator foramen, where it exits through the obturator canal. From here, it descends in the adductor compartment of the thigh, supplying the muscles therein.

Femoral Artery

The femoral artery is the continuation of the external iliac artery after it passes through the retroinguinal space. It passes through the femoral triangle on an inferior trajectory, passing behind sartorius to enter the adductor canal. This continues behind sartorius for about 15 cm before passing through the adductor hiatus, a gap in the tendon of adductor magnus. Beyond this point, the artery is known as the popliteal.

The femoral artery has several large branches in the femoral triangle but relatively few in the adductor canal.

Deep Artery of the Thigh

The deep artery of the thigh (profunda femoris, deep femoral artery) arises from the posterior surface of the femoral artery. It passes deep to adductor magnus towards the femur. It gives off several large branches (perforating arteries) that supply the quadriceps, adductors and hamstrings.

Lesser Branches

  • Lateral and medial circumflex femoral arteries form an anastamotic ring around the proximal femur, below the trochanters.
  • The superficial epigastric and superficial iliac arteries supply the skin and musculature of the anterolateral abdominal wall.
  • The external pudendal artery contributes to the vascular supply of the external genitalia and perineum.

Arteries of the Knee

Popliteal Artery

The popliteal artery is the continuation of the femoral artery, and begins at the adductor hiatus. Passing posteriorly and slightly laterally through the popliteal fossa, it divides below the knee joint into the anterior and posterior tibial arteries. Numerous genicular anastamoses form a plexus around the knee joint, and are important in the event of femoral artery occlusion.

Arteries of the Lower Leg

Anterior Tibial Artery

The anterior tibial artery is the smaller of the popliteal branches, and passes through a gap in the interosseous membrane to descend on its anterior surface. It supplies the muscles of the anterior compartment of the lower leg. It becomes the dorsalis pedis artery as it crosses the ankle joint, midway between the two malleoli.

Posterior Tibial Artery and Fibular Artery

The posterior tibial artery passes through the posterior compartment of the lower leg. It gives off a large branch, the fibular artery, which descends lateral to it, and posterior to the fibula. Both arteries are separated from the bones by the deep muscles of the posterior compartment. The fibular artery continues to the lateral malleolus beyond which its supply is less certain; the posterior tibial curves behind the medial malleolus to enter the plantar surface of the foot as medial and lateral plantar arteries.

Arteries of the foot

Dorsalis Pedis (Dorsal Surface)

The dorsalis pedis gives off the lateral tarsal artery, and together these form an arcade across the proximal, dorsal surface of the metatarsals. From this arcade arise dorsal metatarsal arteries which run along the space between each pair of metatarsals. The metatarsal arteries divide into dorsal digital arteries at the base of each toe. The dorsal arch communicates with the deep plantar arch through perforating arteries between the proximal parts of the metatarsals. The largest of these, the deep plantar artery, passes between the first and second metatarsal and forms the medial side of the deep plantar arch.

Medial and Lateral Plantar Arteries

The medial plantar artery passes along the medial sole of the foot to the great toe, occasionally anastamosing with the deep plantar arch. The lateral plantar artery is larger, and passes across the plantar surface of the foot to the 5th metatarsal. From here, it curves medially to form the deep plantar arch, which anastamoses with the deep plantar branch of the dorsalis pedis. Plantar metatarsal arteries, and their terminal plantar digital arteries, arise from the deep plantar arch.