Arteries of Lower Limbs

The arteries of the lower limbs originate from the abdominal aorta, which divides into the right and left common iliac arteries. At the sacroiliac joints, each common iliac artery splits into internal and external iliac arteries. The external iliac arteries supply the anterior abdominal wall and limbs, while the internal iliac arteries primarily supply pelvic organs, the gluteal region, and perineum.

The external iliac artery becomes the femoral artery as it descends into each limb, transitioning from the body cavity into the femoral region. The femoral artery is responsible for distributing blood to the thigh's deep muscles and the skin's ventral and lateral regions through several branches, including the lateral deep femoral artery and genicular artery.

The femoral artery is clinically significant because it is commonly used for cardiac catheterization, a procedure essential in coronary angiography and bypass surgery. Its accessible location and size make it an ideal access point for these cardiovascular interventions, allowing physicians to reach the heart and coronary vessels.

The popliteal artery forms when the femoral artery passes through the adductor hiatus and navigates behind the knee near the popliteal fossa. It supplies blood to the knee joint, distal thigh muscles, tibia, and fibula. The popliteal artery then divides into the anterior and posterior tibial arteries, which supply the anterior and posterior parts of the leg, foot, and toes.

The anterior tibial artery, situated between the tibia and fibula, directs blood to the anterior tibial region's skin and muscles. As it continues distally, it transforms into the dorsalis pedis artery in the tarsal region. The dorsalis pedis artery subsequently gives rise to numerous branches that feed blood to the foot's tarsal and dorsal regions.

The posterior tibial artery serves the posterior surface of the tibial region, delivering blood to respective muscles and skin. It gives rise to the fibular or peroneal artery, which splits into the medial plantar artery and lateral plantar artery that supply the plantar surfaces. These arteries interact with the dorsalis pedis artery to form the dorsal and plantar arches, ensuring complete blood supply to the foot and toes.

Two arterial arches form in the foot: the dorsal arch (arcuate arch) and the plantar arch. These arches are created through anastomoses between branches of the dorsalis pedis artery and the plantar arteries. They ensure comprehensive blood supply to the remaining foot and toes, providing collateral circulation and redundancy for optimal tissue perfusion throughout the foot.