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arteries of lower limb femoral popliteal tibial anatomy diagram

This diagnostic image contains a CT Angiogram (CTA) with Maximum Intensity Projection (MIP) reconstructions and axial cross-sections of the lower extremities. The primary panel displays a coronal MIP view of the abdominal aorta bifurcating into the common iliac arteries, extending down to the feet. Significant arterial pathology is evident: the left leg shows contrast opacification of the distal superficial femoral artery with an abrupt cutoff at the origin of the popliteal artery, suggesting acute thrombosis or occlusion. Distal to this occlusion, there is faint contrast reformation in the anterior and posterior tibial arteries via collateral circulation. In the contralateral limb, the right superficial femoral artery continues into the popliteal artery but shows a failure to visualize the tibioperoneal trunk just below the knee level. The axial inset demonstrates cross-sectional anatomy of the thighs, highlighting vascular patency and surrounding soft tissue. This imaging illustrates Grade III Acute Limb Ischemia (ALI), providing essential visualization for surgical planning such as amputation or revascularization in cases of extensive arterial thrombosis.

This diagnostic image contains a CT Angiogram (CTA) with Maximum Intensity Projection (MIP) reconstructions and axial cross-sections of the lower extremities. The primary panel displays a coronal MIP view of the abdominal aorta bifurcating into the common iliac arteries, extending down to the feet. Significant arterial pathology is evident: the left leg shows contrast opacification of the distal superficial femoral artery with an abrupt cutoff at the origin of the popliteal artery, suggesting acute thrombosis or occlusion. Distal to this occlusion, there is faint contrast reformation in the anterior and posterior tibial arteries via collateral circulation. In the contralateral limb, the right superficial femoral artery continues into the popliteal artery but shows a failure to visualize the tibioperoneal trunk just below the knee level. The axial inset demonstrates cross-sectional anatomy of the thighs, highlighting vascular patency and surrounding soft tissue. This imaging illustrates Grade III Acute Limb Ischemia (ALI), providing essential visualization for surgical planning such as amputation or revascularization in cases of extensive arterial thrombosis.

This diagnostic image is a 3D reconstructed CT arteriogram of the lower limbs, illustrating extensive arterial thrombosis and vascular occlusions. Key anatomical landmarks include the common femoral, superficial femoral, profunda femoris, popliteal, and anterior tibial arteries. Bilateral filling defects are visible in the common femoral arteries (indicated by thin white arrows). On the right side, a significant filling defect is present in the distal half of the superficial femoral artery (thin black arrow), with total non-opacification of the popliteal artery (thick black arrow), suggesting complete occlusion. The left side demonstrates proximal non-opacification of the profunda femoris and superficial femoral arteries, though distal patency is maintained via collateral flow. Distally, the left anterior tibial artery appears attenuated (thick white arrow), and there is a notable absence of the dorsalis pedis artery. This image serves as a clinical teaching tool for Peripheral Artery Disease (PAD) and acute-on-chronic limb ischemia, demonstrating the visual hallmarks of thrombus formation and the resulting impact on distal perfusion in a vasculitis or hypercoagulable context.

This diagnostic image is a 3D reconstructed CT arteriogram of the lower limbs, illustrating extensive arterial thrombosis and vascular occlusions. Key anatomical landmarks include the common femoral, superficial femoral, profunda femoris, popliteal, and anterior tibial arteries. Bilateral filling defects are visible in the common femoral arteries (indicated by thin white arrows). On the right side, a significant filling defect is present in the distal half of the superficial femoral artery (thin black arrow), with total non-opacification of the popliteal artery (thick black arrow), suggesting complete occlusion. The left side demonstrates proximal non-opacification of the profunda femoris and superficial femoral arteries, though distal patency is maintained via collateral flow. Distally, the left anterior tibial artery appears attenuated (thick white arrow), and there is a notable absence of the dorsalis pedis artery. This image serves as a clinical teaching tool for Peripheral Artery Disease (PAD) and acute-on-chronic limb ischemia, demonstrating the visual hallmarks of thrombus formation and the resulting impact on distal perfusion in a vasculitis or hypercoagulable context.

Diagnostic Image: This CT angiogram (maximum intensity projection) provides a comprehensive view of the abdominal aorta and the arterial system of both lower limbs. Key anatomical structures visible include the distal abdominal aorta, iliac arteries, and the femoral-popliteal distribution. The image demonstrates significant vascular pathology, specifically multifocal arterial thrombosis. Notable findings include partial luminal occlusion within the bilateral profunda femoris arteries. In the left lower extremity, there is a complete occlusive thrombus in the popliteal artery and the tibioperoneal trunk, with proximal extension into the left anterior tibial artery. Distally, the image shows collateral vessel reformation in the left posterior tibial and peroneal arteries, indicating a compensatory response to chronic or subacute ischemia. This imaging is clinically significant for evaluating peripheral arterial disease (PAD) and acute-on-chronic limb ischemia, highlighting the extent of thrombotic burden and the viability of distal runoff via collateral pathways. It serves as a critical educational tool for vascular anatomy and the radiological presentation of lower limb arterial occlusion.

Diagnostic Image: This CT angiogram (maximum intensity projection) provides a comprehensive view of the abdominal aorta and the arterial system of both lower limbs. Key anatomical structures visible include the distal abdominal aorta, iliac arteries, and the femoral-popliteal distribution. The image demonstrates significant vascular pathology, specifically multifocal arterial thrombosis. Notable findings include partial luminal occlusion within the bilateral profunda femoris arteries. In the left lower extremity, there is a complete occlusive thrombus in the popliteal artery and the tibioperoneal trunk, with proximal extension into the left anterior tibial artery. Distally, the image shows collateral vessel reformation in the left posterior tibial and peroneal arteries, indicating a compensatory response to chronic or subacute ischemia. This imaging is clinically significant for evaluating peripheral arterial disease (PAD) and acute-on-chronic limb ischemia, highlighting the extent of thrombotic burden and the viability of distal runoff via collateral pathways. It serves as a critical educational tool for vascular anatomy and the radiological presentation of lower limb arterial occlusion.

This diagnostic image is a post-procedural digital subtraction angiogram (DSA) of the lower limb, specifically focusing on the femoropopliteal segment. The image demonstrates successful endovascular recanalization of the superficial femoral artery (SFA) and the popliteal artery. Multiple self-expanding stents are visible throughout the SFA and extending into the popliteal artery, evidenced by the uniform luminal diameter and subtle metallic mesh appearance in the opacified segments. The contrast flow indicates good patency in the treated arterial regions. Distally, the trifurcation area is visualized where the popliteal artery transitions into the infra-genicular vessels. The fibular (peroneal) artery shows adequate contrast opacification and flow, while the anterior and posterior tibial arteries appear significantly less opacified, suggesting distal occlusive disease or reduced flow. This image illustrates the outcomes of a complex hybrid revascularization procedure for Peripheral Artery Disease (PAD), showing the restoration of flow in previously occluded major vessels using stent-assisted angioplasty.

This diagnostic image is a post-procedural digital subtraction angiogram (DSA) of the lower limb, specifically focusing on the femoropopliteal segment. The image demonstrates successful endovascular recanalization of the superficial femoral artery (SFA) and the popliteal artery. Multiple self-expanding stents are visible throughout the SFA and extending into the popliteal artery, evidenced by the uniform luminal diameter and subtle metallic mesh appearance in the opacified segments. The contrast flow indicates good patency in the treated arterial regions. Distally, the trifurcation area is visualized where the popliteal artery transitions into the infra-genicular vessels. The fibular (peroneal) artery shows adequate contrast opacification and flow, while the anterior and posterior tibial arteries appear significantly less opacified, suggesting distal occlusive disease or reduced flow. This image illustrates the outcomes of a complex hybrid revascularization procedure for Peripheral Artery Disease (PAD), showing the restoration of flow in previously occluded major vessels using stent-assisted angioplasty.

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I now have all the content needed to compile comprehensive notes. Note: The "Sapiens" textbook is not available in the library - the closest authoritative anatomy references are the THIEME Atlas of Anatomy (General Anatomy and Musculoskeletal System) and Gray's Anatomy for Students. I'll compile full notes now.

Arteries of the Lower Limb

Reference note: The "Sapiens" anatomy textbook is not available in the library. These notes are compiled from the closest equivalent authoritative sources available: THIEME Atlas of Anatomy - General Anatomy and Musculoskeletal System and Gray's Anatomy for Students, supplemented by Imaging Anatomy: Bones, Joints, Vessels and Nerves (Vol. 3) and Color Atlas of Human Anatomy Vol. 2.

Overview

The arterial supply of the lower limb is derived from the external iliac artery, which is a terminal branch of the common iliac artery. The vessel continues distally under the inguinal ligament and is renamed at each major transition point:
External iliac artery → Femoral artery → Popliteal artery → Anterior tibial artery + Posterior tibial artery
Additional vessels - the superior gluteal, inferior gluteal, and obturator arteries (branches of the internal iliac artery) - contribute to the gluteal region and upper thigh, forming anastomotic networks around the hip joint.
(THIEME Atlas of Anatomy - General Anatomy and Musculoskeletal System, p. 549)

1. External Iliac Artery

  • Arises along with the internal iliac artery from the common iliac artery
  • Descends along the medial border of the psoas major through the lacuna vasorum
  • Becomes the femoral artery at the level of the inguinal ligament
Branches:
BranchDistribution
Inferior epigastric arteryAnterior abdominal wall
Cremasteric arteryCremaster muscle (male)
Artery of round ligament of uterusRound ligament (female)
Pubic branchPubic region
Deep circumflex iliac arteryIliac fossa, anterior abdominal wall
(THIEME Atlas, p. 549)

2. Femoral Artery

Femoral Artery - Gray's Anatomy for Students
(Fig. 6.65 Femoral Artery - Gray's Anatomy for Students)

Origin and Course

  • The femoral artery is the direct continuation of the external iliac artery, beginning as the vessel passes under the inguinal ligament to enter the femoral triangle
  • It is palpable in the femoral triangle just inferior to the inguinal ligament, midway between the anterior superior iliac spine (ASIS) and the pubic symphysis - an important clinical landmark
  • It runs vertically through the femoral triangle, then continues down the thigh in the adductor canal (Hunter's canal)
  • It exits the canal through the adductor hiatus in the adductor magnus muscle and becomes the popliteal artery behind the knee

Femoral Triangle Relations

  • Lateral: Femoral nerve
  • Middle: Femoral artery
  • Medial: Femoral vein
  • (The femoral nerve lies outside the femoral sheath; the artery and vein are within it)
(Gray's Anatomy for Students, p. 703)

Branches of the Femoral Artery

BranchNotes
Superficial epigastric arterySupplies lower abdominal wall skin
Superficial circumflex iliac arterySupplies skin over iliac region
Superficial external pudendal arterySupplies skin of perineum and scrotum/labia
Deep external pudendal arterySupplies deeper perineal skin
Deep artery of thigh (profunda femoris)Largest branch; major supply to thigh
Descending genicular arteryContributes to anastomosis around knee
(THIEME Atlas, p. 549; Gray's Anatomy for Students, p. 703)

2a. Deep Artery of the Thigh (Profunda Femoris)

  • The largest branch of the femoral artery; the principal blood supply to the thigh muscles
  • Originates from the lateral side of the femoral artery in the femoral triangle
  • Passes posteriorly between pectineus and adductor longus, then between adductor longus and adductor brevis, and finally through adductor magnus to connect with the popliteal artery branches
Branches of the profunda femoris:
i. Lateral circumflex femoral artery
  • Originates from the lateral side of the profunda (may arise directly from femoral artery)
  • Passes deep to sartorius and rectus femoris; divides into three branches:
    • Ascending branch - ascends under tensor fasciae latae; circles the femoral neck (with medial circumflex) to supply the femoral head and neck
    • Descending branch - descends under rectus femoris to supply the anterior thigh; contributes to the anastomosis around the knee
    • Transverse branch - passes laterally through vastus lateralis to the greater trochanter
ii. Medial circumflex femoral artery
  • Originates from the medial or posterior side of the profunda
  • Passes posteriorly between the pectineus and iliopsoas and around the femoral neck
  • Critical blood supply to the femoral head (damage during femoral neck fractures causes avascular necrosis)
  • Gives an ascending branch that circles the neck of the femur and supplies the neck and head
iii. Perforating branches (3-4)
  • Pierce the adductor magnus to supply the posterior compartment muscles of the thigh
(Gray's Anatomy for Students, p. 703)

3. Popliteal Artery

  • The popliteal artery is the continuation of the femoral artery after it passes through the adductor hiatus
  • It runs through the popliteal fossa behind the knee
  • Passes between the gastrocnemius and popliteus muscles
  • Passes under the tendinous arch of the soleus muscle and enters the deep posterior compartment
  • Divides at the inferior border of the popliteus into its two terminal branches: anterior tibial artery and posterior tibial artery

Branches of the Popliteal Artery

BranchNotes
Posterior tibial recurrent arteryContributes to knee anastomosis
Medial superior genicular arteryPart of arterial plexus around the knee
Lateral superior genicular arteryPart of arterial plexus around the knee
Sural arteries (×2)Supply gastrocnemius, soleus, plantaris
Middle genicular arterySupplies ligaments and capsule of knee joint
Medial inferior genicular arteryPart of arterial plexus around the knee
Lateral inferior genicular arteryPart of arterial plexus around the knee
Note: The paired superior and inferior genicular arteries (medial + lateral) form the arterial anastomotic network around the knee joint, which is important for collateral circulation when the popliteal artery is occluded.
(THIEME Atlas, p. 549; Gray's Anatomy for Students, p. 731)

4. Anterior Tibial Artery

  • Passes forward through the aperture (opening) in the upper part of the interosseous membrane to enter the anterior compartment of the leg
  • Descends between the tibialis anterior and extensor hallucis longus muscles
  • Continues as the dorsal pedal (dorsalis pedis) artery distal to the extensor retinaculum on the dorsum of the foot

Branches

BranchNotes
Anterior tibial recurrent arteryContributes to knee anastomosis
Anterior lateral malleolar arteryAnastomoses around lateral malleolus
Anterior medial malleolar arteryAnastomoses around medial malleolus
Dorsal pedal (dorsalis pedis) arteryContinuation onto dorsum of foot
(THIEME Atlas, p. 549)

5. Dorsal Pedal (Dorsalis Pedis) Artery

Anterior tibial and dorsal pedal arteries
(THIEME Atlas - Arteries at the ankle and dorsum of foot, anterior view)
  • Direct continuation of the anterior tibial artery distal to the extensor retinaculum
  • Runs on the dorsum of the foot
Branches:
BranchNotes
Anterior lateral malleolar arteryAnkle anastomosis
Anterior medial malleolar arteryAnkle anastomosis
Lateral tarsal arteryLateral tarsal bones
Arcuate arteryArches across dorsal metatarsals
Dorsal metatarsal arteriesFrom arcuate artery; supply dorsum of toes
Deep plantar arteryPasses between 1st and 2nd metatarsals into sole; joins deep plantar arch
(THIEME Atlas, p. 549)

6. Posterior Tibial Artery

  • The direct continuation of the popliteal artery (the larger terminal branch)
  • Enters the flexor (posterior) compartment of the leg
  • Descends through the deep region of the posterior compartment on the surfaces of tibialis posterior and flexor digitorum longus
  • Passes through the tarsal tunnel behind the medial malleolus
  • Divides at the medial malleolus into its two terminal branches: medial plantar artery and lateral plantar artery

Branches

BranchNotes
Circumflex fibular arteryPasses laterally through soleus around the neck of fibula; connects with knee anastomosis
Fibular (peroneal) arteryMajor branch; descends along posterior fibula
Medial plantar arteryTerminal branch; enters sole of foot (medial side)
Lateral plantar arteryTerminal branch; enters sole of foot (lateral side); forms deep plantar arch
(Gray's Anatomy for Students, p. 731; THIEME Atlas, p. 549)

6a. Fibular (Peroneal) Artery

  • Largest branch of the posterior tibial artery
  • Descends along the lateral side of the posterior compartment, adjacent to the medial crest of the posterior fibula (between tibialis posterior and flexor hallucis longus)
  • Supplies posterior compartment muscles and bone
  • Also gives branches through the intermuscular septum to supply the fibularis (peroneal) muscles in the lateral compartment
  • A perforating branch passes anteriorly through the inferior aperture in the interosseous membrane to anastomose with a branch of the anterior tibial artery
(Gray's Anatomy for Students, p. 731)

7. Arteries of the Sole of the Foot

The posterior tibial artery terminates behind the medial malleolus into:

Medial Plantar Artery

  • Smaller terminal branch
  • Runs along the medial side of the sole
  • Supplies the medial aspect of the sole and great toe

Lateral Plantar Artery

  • Larger terminal branch
  • Crosses the sole obliquely to reach the base of the 5th metatarsal
  • Then turns medially, forming the deep plantar arch (with the deep plantar artery from dorsalis pedis)
  • The deep plantar arch gives off plantar metatarsal arteries, which divide into common and proper plantar digital arteries to supply the toes
(THIEME Atlas, p. 549)

8. Anastomoses - Summary

RegionVessels Involved
Hip and upper thighFemoral, inferior gluteal, superior gluteal, obturator, internal pudendal branches
Around the kneeSuperior and inferior genicular arteries (medial and lateral), middle genicular, popliteal, descending branch of lateral circumflex femoral, descending genicular
Ankle regionAnterior and posterior malleolar branches (anterior tibial, posterior tibial, fibular)
Sole of the footDeep plantar arch (lateral plantar + deep plantar branch of dorsalis pedis)
(Gray's Anatomy for Students, p. 636, 669)

9. Summary Table - Arterial Segments

ArteryOriginTerminationKey Feature
External iliac arteryCommon iliac a.Femoral a. (at inguinal ligament)Gives deep circumflex iliac a. and inferior epigastric a.
Femoral arteryExternal iliac a.Popliteal a. (at adductor hiatus)Palpable midway ASIS-pubic symphysis
Profunda femorisFemoral a.Perforating branches to posterior thighMain supply to thigh muscles
Popliteal arteryFemoral a. (adductor hiatus)Anterior + posterior tibial a.Divides at lower border of popliteus
Anterior tibial arteryPopliteal a.Dorsalis pedis a.Crosses interosseous membrane anteriorly
Posterior tibial arteryPopliteal a.Medial + lateral plantar a.Passes behind medial malleolus
Fibular arteryPosterior tibial a.Perforating branches at ankleMain supply to lateral leg compartment
Dorsalis pedisAnterior tibial a.Deep plantar archPalpable on dorsum of foot
Lateral plantar arteryPosterior tibial a.Deep plantar archLarger of the two plantar arteries
Medial plantar arteryPosterior tibial a.Digital branches (medial sole)Smaller of the two plantar arteries

Clinical Notes

  • Femoral pulse is palpable at the mid-inguinal point (midway between ASIS and pubic symphysis), just below the inguinal ligament. This is used for IV access and cardiac catheterization.
  • Avascular necrosis (AVN) of the femoral head follows disruption of the medial circumflex femoral artery, which is the dominant supply to the femoral head; it is commonly seen after displaced femoral neck fractures.
  • Popliteal artery aneurysm is the most common peripheral artery aneurysm; it is associated with atheromatous disease and may cause acute limb ischemia.
  • Peripheral arterial disease (PAD) most commonly affects the superficial femoral artery at the adductor canal, and the popliteal artery; it presents with intermittent claudication.
  • Dorsalis pedis pulse is palpable on the dorsum of the foot lateral to the extensor hallucis longus tendon; the posterior tibial pulse is felt behind the medial malleolus. Both are routinely assessed in peripheral vascular disease.
  • Collateral circulation around the knee and hip protects against ischemia when individual vessels are occluded.
Sources:
  • General Anatomy and Musculoskeletal System - THIEME Atlas of Anatomy (ISBN 9781626237186), pp. 549-550
  • Gray's Anatomy for Students (ISBN 9780323934237), pp. 669-670, 703-706, 731
  • Imaging Anatomy: Bones, Joints, Vessels and Nerves, Vol. 3 (ISBN 9781626239845), p. 359-360
  • Color Atlas of Human Anatomy, Vol. 2 (ISBN 9783132424487)
Note on "Sapiens" textbook: The Sapiens anatomy textbook is not present in the available library. These notes draw from the four THIEME/Elsevier anatomy textbooks listed above, which cover the same content at an equivalent or greater depth. If you have a specific edition of Sapiens in mind, please share it and the notes can be updated accordingly.
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