10 arterial supply of lower limb

What is the main arterial pathway of the lower limb?

Abdominal aorta divides into
→ Common iliac arteries
→ External iliac artery continues
→ Femoral artery after passing deep to inguinal ligament
→ Continues as Popliteal artery after passing through adductor hiatus

What is the origin and significance of the femoral artery?

Origin: Continuation of external iliac artery
Supplies/significance: Anterior thigh; major artery of lower limb

What is the origin and significance of the profunda femoris artery?

Origin: Branch of femoral artery
Supplies/significance: Medial and posterior thigh; gives perforating branches

What is the origin and significance of the medial circumflex femoral artery?

Origin: Branch of profunda femoris
Supplies/significance: Major blood supply to femoral head and neck

What is the origin and significance of the lateral circumflex femoral artery ?

Origin: Branch of profunda femoris
Supplies/significance: Lateral/anterior thigh; contributes to anastomoses

What is the origin and significance of the obturator artery?

Origin: Anterior division of internal iliac artery
Supplies/significance: Medial thigh compartment

When does the femoral artery begin?

Begins after external iliac passes under inguinal ligament

What is the significance of the femoral artery in the femoral triangle?

Located in femoral triangle

What path does the femoral artery take through the thigh?

Descends through femoral triangle and adductor canal

Why is the femoral artery clinically important in the adductor canal?

Can be catheterized

What happens when the femoral artery passes through the adductor hiatus?

Becomes popliteal artery

What is another name for the profunda femoris artery?

Deep femoral artery or deep artery of the thigh

What is the origin of the profunda femoris artery?

Femoral artery, just distal to inguinal ligament

What is the course of the profunda femoris artery?

Descends between pectineus and adductor longus

What are the branches of the profunda femoris artery?

Perforating arteries, medial and lateral circumflex femoral arteries

What does the profunda femoris artery supply?

Medial and posterior thigh; some lateral anterior thigh

What is the NBME clue involving femoral shaft fracture?

Femoral shaft fracture can injure the profunda femoris artery.

What is the origin of the medial circumflex femoral artery?

Profunda femoris artery

What is the course of the medial circumflex femoral artery?

Passes medially and posteriorly around femoral neck

What are the key branches of the medial circumflex femoral artery?

Posterior retinacular arteries

What does the medial circumflex femoral artery supply?

Most blood to femoral head and neck

What is the NBME clue involving femoral neck fracture or posterior hip dislocation?

Femoral neck fracture or posterior hip dislocation can injure the medial circumflex femoral artery, causing avascular necrosis of the femoral head.

What is the origin of the obturator artery?

Internal iliac artery, anterior division

What is the course of the obturator artery?

Passes through obturator foramen

What branches does the obturator artery give off?

Anterior and posterior branches around adductor brevis

What does the obturator artery supply?

Medial thigh

What is the primary blood supply to the femoral head and neck?

Medial circumflex femoral artery via posterior retinacular arteries

What is the contribution of the lateral circumflex femoral artery to the femoral head and neck?

Secondary contribution

What is the role of the obturator artery in blood supply to the femoral head

Supplies artery of ligament of head of femur; minor in adults

What is the most important vessel in avascular necrosis of the femoral head?

Medial circumflex femoral artery

What are common causes of avascular necrosis of the femoral head?

• Femoral neck fracture
• Hip dislocation, especially posterior dislocation
• Disruption of retinacular arteries

What is the classic NBME vignette for avascular necrosis?

Elderly patient falls, hip pain, shortened externally rotated limb, femoral neck fracture → medial circumflex femoral artery injury → avascular necrosis.

What vessel is at risk in a pelvic fracture near the obturator foramen?

Obturator artery

Describe the course of the obturator artery related to the obturator foramen.

The obturator artery usually arises from the anterior division of the internal iliac artery and passes through the obturator foramen into the medial thigh. It then divides into anterior and posterior branches that travel with the obturator nerve around adductor brevis.