Download MBBS (Bachelor of Medicine, Bachelor of Surgery) Human Anatomy ppt lectures Topic 106 Vascular Anatomy Of Lower Limb Gk 1 Notes. - anatomy ppt free download human anatomy ppt lectures, medicine notes ppt, anatomy handwritten notes pdf, mbbs 1st year anatomy notes pdf download, best anatomy notes pdf, human anatomy notes pdf, anatomy easy notes pdf, anatomy notes online, anatomy short notes, Anatomy ppt, Powerpoint Presentations and lecture notes.
Arteries of Lower Limb
Medial and Lateral malleolar arteries
Lower Limb Venous Drainage
Superficial veins : Great Saphenous Vein
and
Short Saphenous Vein
Deep veins: Tibial, Peroneal,
Popliteal, Femoral
veins
Perforators:
Blood flow
deep veins in the sole
superficial veins in the dorsum
But
In leg and thigh from superficial to
deep veins.
Factors helping venous return
? Negative intra-thoracic pressure.
? Transmitted pulsations from adjacent arteries.
? Valves maintain uni-directional flow.
? Valves in perforating veins prevent reflux into
low pressure superficial veins.
? Calf Pump--Peripheral Heart.
? Vis-a ?tergo produced by contraction of heart.
? Suction action of diaphragm during inspiration.
Dorsal venous arch of Foot
? It lies in the subcutaneous tissue over the
heads of metatarsals with convexity directed
distally.
? It is formed by union of 4 dorsal metatarsal
veins.
Each dorsal metatarsal
vein recieves blood in
the clefts from
? dorsal digital veins.
? and proximal and distal
perforating veins
conveying blood from
plantar surface of sole.
Great saphenous Vein
Begins from the medial
side of dorsal venous
arch.
Supplemented by
medial marginal vein
Ascends 2.5 cm
anterior to medial
malleolus.
Passes posterior to
medial border of
patella.
Ascends along medial
thigh.
Penetrates deep fascia
of femoral triangle:
Pierces the Cribriform
fascia.
Saphenous opening.
Drains into femoral
vein.
superficial epigastric v.
superficial circumflex iliac v.
superficial ext. pudendal v.
posteromedial vein
anterolateral vein
GREAT SAPHENOUS VEIN
anterior leg vein
posterior arch vein
dorsal venous arch
medial marginal vein
Thoraco-epigastric vein
Deep external pudendal v.
Tributaries of Great Saphenous vein
Tributaries of Great Saphenous vein
saphenous opening
superficial epigastric
superficial circumflex iliac
superficial external
pudendal
posteromedial vein
anterolateral vein
adductor c. perforator
great saphenous vein
anterior leg vein
posterior arch vein
medial perforators
dorsal venous arch
medial marginal vein
Short/ Lesser saphenous Vein:
Drains lateral side of
dorsal venous arch.
Passes posterior to
lateral malleolus.
Accompanies sural nerve.
Ascends along midline of
calf.
Empties into popliteal
vein in popliteal fossa.
Short/ Lesser saphenous Vein:
Variable termination
a) It may join GSV in upper
third of thigh either
directly or through
accesory saphenous
vein.
b) May bifurcate : join GSV
and other in popliteal
vein.
c) May end in GSV in leg
or deep vein of leg
Deep veins
Present within the
deep fascia
surrounded by
powerful muscles.
Blood flow in greater
pressure and volume.
Accounts for 80 -90%
venous return.
Deep veins
Accompany arteries
Below the knee-
venae comitantes.
Above the knee-
single major vein
Deep veins of lower limb
FEMORAL
Femoral vein
POPLITEAL
PERONEAL
POSTERIOR
TIBIAL
ANTERIOR
TIBIAL
MEDIAL
Popliteal vein
MALLEOLUS
PERFORATORS
Communicate
superficial veins to
deep veins
Have role in varicose
veins.
All veins in lower
limb have valves
Fairly constant in position:
1 lateral ankle perforators
3 Medial ankle perforators
a)Postero inferior to medial
malleolus
b)10 cm above med.malleolus
c)15 cm above med.malleolus
3. Gastrocnemius perforators
of Boyd around knee
4. Mid thigh perforators of
Dodd
5. Hunter's perforator in thigh
Valves in Great
Saphenous Vein
?10-20 valves
?1 valve just before GSV
pierces Cribriform fascia
? valve at Sapheno-femoral
junction
?In 80% of people, a valve
is present in external iliac
vein which protects
Sapheno-femoral junction.
Varicose veins
Dilated,tortuous and elongated veins
with reversal of blood flow mainly
due to valvular incompetence
Includes
varicose veins in legs
Hemorrhoids
Varicocele
Oesophageal varices
Risk factors
? Age
? Gender
? Height
? left>right
? Heredity
? Pregnancy
? Obesity and overweight
? Elevate intra abdominal pressure
? Deep vein thrombophlebitis
? Posture
? Incompetency of valves
Saphena varix
A saphena varix is a dilatation
at the top of the Great
saphenous vein due to valvular
incompetence.
The varix is:
? soft and compressible
? disappears immediately on
lying down
? exhibits an expansile cough
impulse
Trendelenburg test
Used to assess the competence of
SFJ
Patient lies flat.
Elevate the leg and gently empty the
veins
Palpate the SFJ and ask the patient to
stand whilst maintaining pressure.
Rapid filling after thumb released SFJ is
incompetent
Filling from below upwards without releasing
thumb presence of distal incompetent
perforators
Patient in the supine position
The lower limb raised above the level of heart
Tourniquet is then applied around the saphenofemoral junction to
compress the superficial veins (but not too tight as to occlude the
deeper veins)
Then the patient asked to stand
Normally, the superficial vein will fill from below within 30-35 seconds
If the superficial veins fill more rapidly with the tourniquet in place
there is valvular incompetence below the level of the tourniquet in the
"deep veins or perforators.
If there has been no rapid filling even
after 20 seconds the tourniquet is
released.
If rapid filling from above then it indicates
that the deep and perforating veins are
competent
&
superficial veins are incompetent
The test is reported in 2 parts
a) Standing up of the patient with tourniquet on
based on rapid filling + or ?
deep veins/perforators
incompetent
b) When Tourniquet is removed
based upon rapid filling + or - superficial vein
incompetent
The test can be repeated with the tourniquet at different
levels to further pinpoint the level of valvular
incompetence
Perthes Test
Empty the vein as above, place a
tourniquet around the thigh, stand
the patient up.
Ask them to rapidly stand up and
down on their toes
filling of the veins indicated deep
venous incompetence.
This is a painful and rarely used
test.
VARICOSE ULCER
Trendelenburg's
Operation
VENOUS CUT DOWN
Cutaneous supply of skin immediately in
front of the medial malleolus is from
branches of saphenous nerve
These branches are blocked with LA
A transverse incision is made through the
skin and subcutaneous tissue across
the long axis of the vein just anterio-
superior to the medial malleolus.
Femoral Vein
Catheterization
Coronary artery bypass
This post was last modified on 05 April 2022