OTA 106 Knee/Ankle Study Guide
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On the Position and Course of the Deep Plantar Arteries, with Special Reference to the So-Called Plantar Metatarsal Arteries
Okajimas Fol. anat. jap., 48: 295-322, 1971 On the Position and Course of the Deep Plantar Arteries, with Special Reference to the So-Called Plantar Metatarsal Arteries By Takuro Murakami Department of Anatomy, Okayama University Medical School, Okayama, Japan -Received for publication, June 7, 1971- Recently, we have confirmed that, as in the hand and foot of the monkey (Koch, 1939 ; Nishi, 1943), the arterial supply of the human deep metacarpus is composed of two layers ; the superficial layer on the palmar surfaces of the interosseous muscles and the deep layer within the muscles (Murakami, 1969). In that study, we pointed out that both layers can be classified into two kinds of arteries, one descending along the boundary of the interosseous muscles over the metacarpal bone (superficial and deep palmar metacarpal arteries), and the other de- scending along the boundary of the muscles in the intermetacarpal space (superficial and deep intermetacarpal arteries). In the human foot, on the other hand, the so-called plantar meta- tarsal arteries are occasionally found deep to the plantar surfaces of the interosseous muscles in addition to their usual positions on the plantar surfaces of the muscles (Pernkopf, 1943). And they are some- times described as lying in the intermetatarsal spaces (Baum, 1904), or sometimes descending along the metatarsal bones (Edwards, 1960). These circumstances suggest the existence in the human of deep planta of the two arterial layers and of the two kinds of descending arteries. There are, however, but few studies on the courses and positions of the deep plantar arteries, especially of the so-called plantar metatarsal arteries. -
Residency Essentials Full Curriculum Syllabus
RESIDENCY ESSENTIALS FULL CURRICULUM SYLLABUS Please review your topic area to ensure all required sections are included in your module. You can also use this document to review the surrounding topics/sections to ensure fluidity. Click on the topic below to jump to that page. Clinical Topics • Gastrointestinal • Genitourinary • Men’s Health • Neurological • Oncology • Pain Management • Pediatrics • Vascular Arterial • Vascular Venous • Women’s Health Requisite Knowledge • Systems • Business and Law • Physician Wellness and Development • Research and Statistics Fundamental • Clinical Medicine • Intensive Care Medicine • Image-guided Interventions • Imaging and Anatomy Last revised: November 4, 2019 Gastrointestinal 1. Portal hypertension a) Pathophysiology (1) definition and normal pressures and gradients, MELD score (2) Prehepatic (a) Portal, SMV or Splenic (i) thrombosis (ii) stenosis (b) Isolated mesenteric venous hypertension (c) Arterioportal fistula (3) Sinusoidal (intrahepatic) (a) Cirrhosis (i) ETOH (ii) Non-alcoholic fatty liver disease (iii) Autoimmune (iv) Viral Hepatitis (v) Hemochromatosis (vi) Wilson's disease (b) Primary sclerosing cholangitis (c) Primary biliary cirrhosis (d) Schistosomiasis (e) Infiltrative liver disease (f) Drug/Toxin/Chemotherapy induced chronic liver disease (4) Post hepatic (a) Budd Chiari (Primary secondary) (b) IVC or cardiac etiology (5) Ectopic perianastomotic and stomal varices (6) Splenorenal shunt (7) Congenital portosystemic shunt (Abernethy malformation) b) Measuring portal pressure (1) Direct -
Clinical Anatomy of the Lower Extremity
Государственное бюджетное образовательное учреждение высшего профессионального образования «Иркутский государственный медицинский университет» Министерства здравоохранения Российской Федерации Department of Operative Surgery and Topographic Anatomy Clinical anatomy of the lower extremity Teaching aid Иркутск ИГМУ 2016 УДК [617.58 + 611.728](075.8) ББК 54.578.4я73. К 49 Recommended by faculty methodological council of medical department of SBEI HE ISMU The Ministry of Health of The Russian Federation as a training manual for independent work of foreign students from medical faculty, faculty of pediatrics, faculty of dentistry, protocol № 01.02.2016. Authors: G.I. Songolov - associate professor, Head of Department of Operative Surgery and Topographic Anatomy, PhD, MD SBEI HE ISMU The Ministry of Health of The Russian Federation. O. P.Galeeva - associate professor of Department of Operative Surgery and Topographic Anatomy, MD, PhD SBEI HE ISMU The Ministry of Health of The Russian Federation. A.A. Yudin - assistant of department of Operative Surgery and Topographic Anatomy SBEI HE ISMU The Ministry of Health of The Russian Federation. S. N. Redkov – assistant of department of Operative Surgery and Topographic Anatomy SBEI HE ISMU THE Ministry of Health of The Russian Federation. Reviewers: E.V. Gvildis - head of department of foreign languages with the course of the Latin and Russian as foreign languages of SBEI HE ISMU The Ministry of Health of The Russian Federation, PhD, L.V. Sorokina - associate Professor of Department of Anesthesiology and Reanimation at ISMU, PhD, MD Songolov G.I K49 Clinical anatomy of lower extremity: teaching aid / Songolov G.I, Galeeva O.P, Redkov S.N, Yudin, A.A.; State budget educational institution of higher education of the Ministry of Health and Social Development of the Russian Federation; "Irkutsk State Medical University" of the Ministry of Health and Social Development of the Russian Federation Irkutsk ISMU, 2016, 45 p. -
A STUDY of PLANTAR ARTERIAL ARCH with ITS SURGICAL PERSPECTIVE Anupama K *1, Saraswathi G 2, Shailaja Shetty 3
International Journal of Anatomy and Research, Int J Anat Res 2016, Vol 4(2):2392-96. ISSN 2321-4287 Original Research Article DOI: http://dx.doi.org/10.16965/ijar.2016.228 A STUDY OF PLANTAR ARTERIAL ARCH WITH ITS SURGICAL PERSPECTIVE Anupama K *1, Saraswathi G 2, Shailaja Shetty 3. *1 Assistant professor, Department of Anatomy, M S Ramaiah Medical College. Bangalore, Karnataka, India. 2 Retired Professor, Department of Anatomy, J S S Medical College, JSS University, Mysore, Karnataka, India. 3 Professor and Head, Department of Anatomy, M S Ramaiah Medical College. Bangalore, Karnataka, India. ABSTRACT Introduction: In the present day scenario the advances in the field of plastic, reconstructive and microvascular surgeries of the foot has necessitated a thorough knowledge of variations in the formation and branching pattern of plantar arterial arch. The blood supply of the sole is rich and is derived from the branches of the plantar arterial arch formed by variable contributions of dorsalis pedis artery, lateral plantar artery and medial plantar artery. Materials and Methods: 50 feet of the formalin fixed adult human cadavers were dissected and studied, in the Department of anatomy, JSS Medical College, Mysore. Results: The formation of plantar arterial arch and the origin of plantar metatarsal arteries were noted. The plantar arterial arch was classified into six types based on the origin of plantar metatarsal arteries. Type A-10%, Type B- 4%, Type C- 26%, Type D- 36%, Type E- 20%, Type F- 4%. It was also classified into 3 types based on the contribution of the formative arteries. Type I – 40%, Type II – 36% and Type III – 24%. -
The Anatomy of the Plantar Arterial Arch
Int. J. Morphol., 33(1):36-42, 2015. The Anatomy of the Plantar Arterial Arch Anatomía del Arco Plantar Arterial A. Kalicharan*; P. Pillay*; C. Rennie* & M. R. Haffajee* KALICHARAN, A.; PILLAY, P.; RENNIE, C. & HAFFAJEE, M. R. The anatomy of the plantar arterial arch. Int. J. Morphol., 33(1):36-42, 2015. SUMMARY: The plantar arterial arch provides the dominant vascular supply to the digits of the foot, with variability in length, shape, and dominant blood supply from the contributing arteries. According to the standard definition, the plantar arterial arch is formed from the continuation of the lateral plantar artery and the anastomoses between the deep branch of dorsalis pedis artery. In this study, 40 adult feet were dissected and the plantar arch with variations in shape and arterial supply was observed. The standard description of the plantar arch was observed in 55% of the specimens with variations present in 45%. Variations in terms of shape were classified into three types: Type A (10%): plantar arterial arch formed a sharp irregular curve; type B (60%): obtuse curve; type C (3%): spiral curve. Variation in the dominant contributing artery was classified into six types: type A (25%), predominance in the deep branch of dorsalis pedis artery supplying all digits; type B (5%), predominance in the lateral plantar artery supplying digits 3 and 4; and type C (20%), predominance in the deep branch of dorsalis pedis artery supplying digits 2 to 4; type D (24%), equal dominance showed; type E (10%), predominance in the lateral plantar artery supplying digits 3 to 5; and type F (21%), predominance of all digits supplied by lateral plantar artery. -
Assessment of the Pedal Arteries with Duplex Scanning
ARTIGO DE REVISÃO ISSN 1677-7301 (Online) Avaliação das artérias podais ao eco-Doppler Assessment of the pedal arteries with Duplex Scanning Luciana Akemi Takahashi1 , Graciliano José França1, Carlos Eduardo Del Valle1 , Luis Ricardo Coelho Ferreira2 Resumo A ultrassonografia vascular com Doppler é um método não invasivo útil no diagnóstico e planejamento terapêutico da doença oclusiva das artérias podais. A artéria pediosa dorsal é a continuação direta da artéria tibial anterior e tem trajeto retilíneo no dorso do pé, dirigindo-se medialmente ao primeiro espaço intermetatarsiano, onde dá origem a seus ramos terminais. A artéria tibial posterior distalmente ao maléolo medial se bifurca e dá origem às artérias plantar lateral e plantar medial. A plantar medial apresenta menor calibre e segue medialmente na planta do pé, enquanto a plantar lateral é mais calibrosa, seguindo um curso lateral na região plantar e formando o arco plantar profundo, o qual se anastomosa com a artéria pediosa dorsal através da artéria plantar profunda. A avaliação das artérias podais pode ser realizada de maneira não invasiva com exame de eco-Doppler, com adequado nível de detalhamento anatômico. Palavras-chave: ultrassonografia Doppler; artérias da tíbia; procedimentos cirúrgicos vasculares. Abstract Vascular Doppler ultrasound is a noninvasive method that can help in diagnostic and therapeutic planning in case of pedal arterial obstructive disease. The dorsalis pedis artery is the direct continuation of the anterior tibial artery and follows a straight course along the dorsum of the foot, leading medially to the first intermetatarsal space, where it gives off its terminal branches. The posterior tibial artery forks distal to the medial malleolus and gives rise to the lateral plantar and medial plantar arteries. -
Arteries of the Lower Limb
BLOOD SUPPLY OF LOWER LIMB Ali Fırat Esmer, MD Ankara University Faculty of Medicine Department of Anatomy Abdominal aorta Aortic bifurcation Right common iliac artery Left common iliac artery Right external Left external iliac artery iliac artery Rigt and left internal iliac arteries GLUTEAL REGION Structures passing through the suprapriform foramen Superior gluteal artery and vein Superior gluteal nerve Structures passing through the infrapriform foramen Inferior gluteal artery and vein Inferior gluteal nerve Sciatic nerve Posterior femoral cutaneous nerve Internal pudendal artery and vein Pudendal nerve • Femoral artery is the principal artery of the lower limb • Femoral artery is the continuation of the external iliac artery • External iliac artery becomes the femoral artery as it passes posterior to the inguinal ligament • Femoral artery, first enters the femoral triangle. Leaving the tirangle it passes through the adductor canal and then adductor hiatus and reaches to the popliteal fossa, where it becomes the popliteal artery Contents of the femoral triangle (from lateral to medial) • Femoral nerve (and its branches) • Saphenous nerve (sensory branch of the femoral nerve) • Femoral artery (and its several branches) • Deep femoral artery (deep artery of the thigh) and its branches in this region; medial and lateral circumflex femoral arteries and perforating branches • Femoral vein (and veins draining to its proximal part such as the great saphenous vein and deep femoral vein) • Deep inguinal lymph nodes MUSCULAR AND VASCULAR COMPARTMENTS -
Location of the Deep Plantar Artery a Cadaveric Study
ORIGINAL ARTICLES Location of the Deep Plantar Artery A Cadaveric Study James H. Whelan, DPM* John P. Lazoritz, DPM* Caroline Kiser, DPM† Vassilios Vardaxis, PhD‡ Downloaded from http://meridian.allenpress.com/japma/article-pdf/110/6/Article_4/2679579/i8750-7315-110-6-article_4.pdf by guest on 28 September 2021 Background: The deep plantar (D-PL) artery originates from the dorsalis pedis artery in the proximal first intermetatarsal space, an area where many procedures are performed to address deformity, traumatic injury, and infection. The potential risk of injury to the D- PL artery is concerning. The D-PL artery provides vascular contribution to the base of the first metatarsal and forms the D-PL arterial arch with the lateral plantar artery. Methods: In an effort to improve our understanding of the positional relationship of the D-PL artery to the first metatarsal, dissections were performed on 43 embalmed cadaver feet to measure the location of the D-PL artery with respect to the base of the first metatarsal. Digital images of the dissected specimens were acquired and saved for measurement using in-house software. Means, standard deviations, and 95% confi- dence intervals (CIs) were calculated for all of the measurement parameters. Results: We found that the origin of the D-PL artery was located at a mean 6 SD of 11.5 6 3.9 mm (95% CI, 4.5–24.7 mm) distal to the first metatarsal base and 18.6% 6 6.5% (95% CI, 8.1%–43.4%) of length in reference to the proximal base. The average interrater reliability across all of the measurements was 0.945. -
17-Vascular Anatomy of Lower Limb.Pdf
Color Code Important Vasculature of Lower Limb Doctors Notes Notes/Extra explanation Editing File Objectives • List the main arteries of the lower limb. • Describe their origin, course distribution & branches. • List the main arterial anastomosis . • List the sites where you feel the arterial pulse. • Differentiate the veins of LL into superficial & deep • Describe their origin, course & termination and tributaries • Some related clinical points Overview of the lecture: Arteries Veins Arteries Of Lower Limb Extra (Lower limp) Femoral Artery Femoral artery /vein At the inguinal ligament: It is the main arterial supply to the lower limb. The vein lies medial to Origin: the artery. It is the continuation of the External iliac artery. At the apex of the Beginning: femoral triangle: How does it enter the thigh? The vein lies posterior to Behind the inguinal ligament (it is btw anterior superior iliac the artery. )هنا spine & pubic tubercle), midway at the midinguinal point At the opening in the Femoral a ( between the anterior superior iliac يصبح اسمه adductor magnus: spine and the symphysis pubis. The vein lies lateral to the artery Termination by passing through the Adductor )ينتهي(The femoral artery terminates Canal (deep to sartorius) It exits the canal by passing through the Adductor Hiatus (& enters popliteal fossa) and becomes the Popliteal artery. Femoral Artery Relation Upper part: Skin & fascia.(its superficial) Lower part: Sartorius. Anteriorly Relations (in the Laterally Medially femoral triangle) Femoral nerve Femoral vein and -
Posterior Mediastinum: Mediastinal Organs 275
104750_S_265_290_Kap_4:_ 05.01.2010 10:43 Uhr Seite 275 Posterior Mediastinum: Mediastinal Organs 275 1 Internal jugular vein 2 Right vagus nerve 3 Thyroid gland 4 Right recurrent laryngeal nerve 5 Brachiocephalic trunk 6 Trachea 7 Bifurcation of trachea 8 Right phrenic nerve 9 Inferior vena cava 10 Diaphragm 11 Left subclavian artery 12 Left common carotid artery 13 Left vagus nerve 14 Aortic arch 15 Esophagus 16 Esophageal plexus 17 Thoracic aorta 18 Left phrenic nerve 19 Pericardium at the central tendon of diaphragm 20 Right pulmonary artery 21 Left pulmonary artery 22 Tracheal lymph nodes 23 Superior tracheobronchial lymph nodes 24 Bronchopulmonary lymph nodes Bronchial tree in situ (ventral aspect). Heart and pericardium have been removed; the bronchi of the bronchopulmonary segments are dissected. 1–10 = numbers of segments (cf. p. 246 and 251). 15 12 22 6 11 5 2 1 14 2 23 1 3 21 3 20 24 4 5 4 17 8 5 6 6 15 8 7 8 9 9 10 10 Relation of aorta, pulmonary trunk, and esophagus to trachea and bronchial tree (schematic drawing). 1–10 = numbers of segments (cf. p. 246 and 251). 104750_S_265_290_Kap_4:_ 05.01.2010 10:43 Uhr Seite 276 276 Posterior Mediastinum: Mediastinal Organs Mediastinal organs (ventral aspect). The heart with the pericardium has been removed, and the lungs and aortic arch have been slightly reflected to show the vagus nerves and their branches. 1 Supraclavicular nerves 12 Right pulmonary artery 24 Left vagus nerve 2 Right internal jugular vein with ansa cervicalis 13 Right pulmonary veins 25 Left common carotid artery -
Vascular Anatomy of the Lower Extremities
129 Vascular Anatomy of the Lower Extremities The external iliac artery becomes the common femoral popliteal artery courses through the popliteal fossa, it artery after passing under the inguinal ligament. The gives multiple branches of geniculate arteries (superior common femoral artery and vein are enveloped by the lateral and medial geniculate arteries, inferior lateral and femoral sheath. Scarpa’s triangle is defined by the adduc- medial geniculate arteries). The popliteal vein lies pos- tor longus muscle medially, the Sartorious muscle later- terolateral to the artery in the adductor hiatus, dorsal to ally, and by the inguinal ligament superiorly.The femoral the artery behind the knee, and then moves medial to the vessels and nerves are in the following orientation lateral artery inferiorly. The small saphenous vein joins the to medial: femoral nerve, femoral artery, femoral vein, popliteal vein in the popliteal fossa. and lymphatics (NAVeL). The common femoral artery Approximately 3cm below the knee, the popliteal gives off several branches that include the superficial artery bifurcates into the anterior tibial artery and the epigastric artery, the superficial circumflex artery, and tibioperoneal trunk. The anterior tibial artery exits the the superficial and deep external pudendal arteries. The deep posterior compartment through the interosseous fossa ovalis is a medial opening in the fascia lata where membrane and enters the anterior compartment medial the saphenous vein enters the femoral triangle. Approx- to the fibula. Here it is joined by the deep peroneal nerve imately 4cm below the inguinal ligament, the common and continues to travel through the anterior compart- femoral artery splits into the superficial femoral artery ment toward the dorsum of the foot. -
Vascular Anatomy of the Lower Limb
Vascular Anatomy of The Lower Limb “Spending today complaining about yesterday won’t make tomorrow any better” -Unknown Objectives At the end of the lecture, students should be able to: • List the main arteries of the lower limb • Describe their origin, course distribution & branches • List the main arterial anastomosis • List the sites where you feel the arterial pulse • Differentiate the veins of Lower Limb into superficial & deep veins • Describe the veins’ origins, courses & terminations as well as tributaries • Some related clinical points Femoral Artery Relations Femoral Artery/Vein Main arterial supply to the lower Anteriorly: At the inguinal ligament: limb. Upper part: Skin & fascia. •The vein is medial to the artery. Origin: Lower part: Sartorius. At the apex of the femoral • Continuation of the External Posteriorly: iliac artery. Psoas (separates it from the hip triangle: joint), Pectineus & Addcutor •The vein is posterior to the artery. Longus • Enters the thigh behind the Medially: At the opening in the adductor inguinal ligament, midway Femoral vein. magnus: between the anterior superior iliac spine and the symphysis Laterally : •The vein lies lateral to the pubis. Femoral nerve and its branches. artery. Branches of Femoral Artery Profunda Femoris Artery Branches •It is a large artery supplying the •Medial & Lateral circumflex 1.Superficial Epigastric. medial compartment of the thigh. femoral arteries. 2.Superficial Circumflex iliac. •Arises from the lateral side of the •Three Perforating arteries. 3.Superficial External Pudendal. femoral artery (about 4cm below •Profunda Femoris ends by 4.Deep ExternalSPudendal. the inguinal ligament). becoming the 4th perforating 5.Profunda Femoris •Passes medially behind the artery.