Editing Lower limb (section)

== '''Arterial supply:''' ==

* '''Common     femoral artery'''
** Path:
*** EIA becomes CFA at the       inguinal ligament
*** Enters the thigh just       medial to the mid-point of the inguinal ligament
*** Initially lying on psoas       major tendon
*** Descends on pectineus       towards the apex of the femoral triangle
** Surface markings:
*** Two-thirds of the way along       a line between mid-inguinal point towards the adductor tubercle
** Branches:
*** Superficial
**** External pudendal
**** Circumflex iliac (commonly        used to run a groin flap)
**** Epigastric
*** Deep external pudendal
*** '''Profunda       femoris''':       arises from lateral side of CFA about 3-4cm distal to IL, then       spiralling down deep to it, passing between pectineus and adductor       longus (whose upper border separates SFA and DFA), towards medial aspect       of femur. Continues down on adductor brevis and magnus and ends as the       fourth perforating artery. Supplies the majority of blood to thigh       muscles. Distal perforators anastomose with popliteal branches.
**** Branches
***** Four perforating arteries         - pass backwards through adductor magnus.
***** Lateral circumflex         femoral (within femoral triangle)
****** Arises          from lateral side of PFA. Divides into three branches: ascending,          transverse and descending. Supplies proximal quadriceps muscle.
***** Medial circumflex femoral
****** Arises          from medial side of profunda. Supplies proximal adductor compartment.
**** Parts:
***** Within femoral triangle -         approach anteriorly
***** Behind adductor longus -         medial approach, which bluntly dissects the plane between sartorius         and adductor muscles
***** Behind linea aspera -         same medial approach
** Approach:
*** Can be approached in the       adductor canal with an incision on the medial aspect of the lower thigh,       then retracting sartorius medially and dividing the fascial roof




*
* '''Superficial     femoral artery'''
** Path
*** Becomes superficial femoral       artery at the point where the deep femoral artery branch comes off.
*** Enters adductor canal       (Hunter's canal) deep to sartorius
** Branches
*** Highest geniculate just       proximal to adductor canal (important in adductor hiatus occlusions)
* '''Popliteal     artery'''
** Path:
*** Begins where it exits the       adductor canal at the apex of the popliteal fossa
*** Extends to the lower border       of popliteus muscle
*** Divides into ATA and TPT in       the distal popliteal fossa
**** True trifurcation about 3%
**** Generally forms ATA and        TPT, with the other two vessels coming off TPT 2-3cm distally
** Branches
*** Five genicular arteries -       superior and inferior medial, superior and inferior lateral, and middle
* '''Tibioperoneal     trunk'''
** Short trunk that bifurcates      into two terminal branches - peroneal and posterior tibial

*

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* '''Peroneal     artery (lateral)'''
** Initially descends on      tibialis posterior in deep posterior compartment
** Distal third runs within and      behind the belly of FHL
** Terminates in a variable      branch perforating through the distal interosseous membrane and calcaneal      branches
**
* '''Posterior     tibial artery'''     (medial)
** Descends on tibialis      posterior in deep posterior compartment
** Passes down along with      tibial nerve between FDL and FHL
* '''Anterior     tibial artery'''
** Passes into anterior      compartment at the upper end of the interosseous membrane
** Lies lateral to tibialis      anterior and the medial to the other muscles in the anterior compartment      (see above)
** Emerges at the ankle with      the deep peroneal nerve
** Continues distally as DP