Arteries of the Pelvis Iliolumbar Common iliac

Superior Internal iliac

and Lower Limbs- Anterior View gluteal External iliac
Inguinal
ligament Internal pudendal
Obturator
• The Abdominal Aorta branches to form:
Deep femoral Medial femoral
• The Right and Left common iliac arteries that branch Lateral femoral
circumflex
to form: circumflex

• Internal iliac artery (supplies the urinary

Femoral
bladder, walls of the pelvis, external genitalia,
and the medial side of the thigh)
• The External iliac artery (supplies blood to the
legs)
• External iliac arteries exit through the Popliteal Descending
Genicular (to knee joint
abdominal wall to form the Femoral Artery; anastomoses)
• The initial branch of the Femoral Artery, the
Deep femoral artery, branches to form the
medial and lateral circumflex arteries Posterior tibial

• The Femoral artery becomes the Popliteal

artery posterior to the knee
Anterior tibial
• The Popliteal bifurcates to form Anterior
tibial and Posterior tibial arteries
• The Posterior tibial artery gives rise to the Fibular
Fibular artery
• The Anterior tibial artery forms the Dorsal
Artery of the foot
Dorsal Artery of
• The Posterior tibial artery forms the Medial Foot
and Lateral plantar arteries Lateral plantar Medial plantar
Dorsal arch
Plantar arch

© 2018 Pearson Education, Inc. Figure 22.16a Major Arteries of the Lower Limb, Part I a Anterior view of the arteries supplying the right lower limb
Arteries of the Pelvis Superior gluteal

Right external iliac

(see Fig. 22.15)

and Lower Limbs- Posterior View Femoral

(see Fig. 22.16)

Thigh

Deep femoral
(see Fig. 22.16)

Anterior View of Left Head of Left Hip joint, femoral head,

deep muscles of the thigh
Femur, showing the Lateral and Medial
Circumflex Arteries Lateral
femoral
circumflex
Medial femoral
circumflex
Quadriceps,
hip and
Adductor and knee joints
obturator,
hip joint

Descending genicular

Skin of leg; knee joint

Popliteal

Leg and foot

Posterior Anterior
tibial tibial

Connected by anastomoses
https://www.sciencedirect.com/topics/medicine-and-dentistry/lateral-circumflex- of dorsal artery of foot, dorsal
femoral-artery arch, and plantar arch,
which supply distal portions
of the foot and the toes
Fibular

Figure 22.17
© 2018 Major Arteries
Pearson of the Lower
Education, Inc. Limb, Part II
Posterior view of the arteries supplying the right lower limb
 Arteries Leg- Anterior View
Popliteal Descending
Genicular (to knee joint)

Posterior tibial

The Anterior tibial artery passes

Anterior tibial through the interosseous
membrane from behind and runs
along the anterior surface of the
interosseous membrane
Fibular
The Posterior tibial and Fibular
arteries run along the posterior
surface of the Tibia and Fibula
Dorsal Artery respectively
Of Foot

Lateral plantar Medial plantar

Dorsal arch
Plantar arch
Figure 22.16a
Major Arteries of
the Lower Limb,
Part I (2 of 2)
© 2018 Pearson Education, Inc. a Anterior view of the arteries supplying the right lower limb
 Arteries Leg- Posterior View
Descending genicular

Skin of leg; knee joint

Popliteal

Leg and foot

Posterior Anterior
tibial tibial

Connected by anastomoses
of dorsal artery of foot, dorsal
arch, and plantar arch,
which supply distal portions
Fibular of the foot and the toes

Note: The interosseous membrane that is

traversed by the Anterior tibial artery from
behind has been removed in this image, so
that you can see the descending Anterior
tibial artery that runs down the anterior
Figure 22.17
Major Arteries of
surface of the interosseous membrane
the Lower Limb,
Part II (2 of 2)
© 2018 Pearson Education, Inc.
 Systemic Veins of Lower Limb
• Blood from the Lower Limb returns to the Inferior Vena Cava
• Veins Draining the Lower Limb
• Blood returns to the heart from the feet in the following sequence:
• Blood from the sole and digits drains to plantar veins and to the plantar
arches
• Drain into the anterior tibial, posterior tibial, and fibular veins
• Popliteal vein
• Femoral vein
• External iliac vein
• Common iliac vein
• Inferior vena cava

• Blood also leaves the foot and returns to the heart via the following
veins:
• Dorsal venous arch
• Great saphenous vein and Small saphenous vein that drain into…
• Femoral vein
• Also receives blood from deep femoral vein

© 2018 Pearson Education, Inc.

 Veins of the Pelvis Lumbar

and Lower Limbs- Left and right

common iliac
Anterior View
External iliac
• Veins Draining the Pelvis Internal iliac
• The following veins drain into the Deep
internal iliac vein and then into the
common iliac vein and then into the
femoral
inferior vena cava Femoral
• Gluteal veins
• Internal pudendal veins
Great saphenous
• Obturator veins

Popliteal

Small saphenous Posterior tibial

Anterior tibial
Fibular

KEY
Superficial veins
Dorsal venous arch Deep veins
Figure 22.18 An
Overview of the
Systemic Venous
System (2 of 2)
Plantar venous arch
© 2018 Pearson Education, Inc.
 Veins of Pelvis and Lower Limb
Right common
iliac
Internal iliac
Superior gluteal Inferior gluteal External Iliac
Internal pudendal Superior gluteal
Right external iliac
Internal pudendal Inferior gluteal
Obturator
Obturator

Femoral
Femoral circumflex
Femoral
circumflex
Deep femoral Deep femoral
Femoral Collects blood
from the thigh
Femoral

Great saphenous

Small saphenous Great saphenous

Collects blood from Collects blood from

superficial veins of the superficial veins
the leg and foot of the lower limb

Popliteal
Small
saphenous

Anterior tibial

Small saphenous

Posterior tibial

Anterior tibial Fibular

Fibular

The dorsal and plantar venous

arches collect blood from the KEY
foot and toes Superficial veins
Deep veins
Figure 22.21 Dorsal venous arch
The Venous
Drainage of the Plantar venous arch
Lower Limb
Digital
© 2018 Pearson
Education, Inc.
a Anterior view showing the veins of the right lower limb b Posterior view showing the veins of the right lower limb
 The lumbar plexus and sacral plexus originate from the lumbar and
sacral segments of the spinal cord, respectively. The nerves
originating from these plexuses innervate the pelvic girdle and lower
limbs. Because the ventral rami of both plexuses are distributed to
the lower limbs and spinal nerves L4 and L5 are involved, these two
plexuses are collectively referred to as the lumbosacral plexus.

The Lumbar Plexus

Nerve Roots of
Lumbar Plexus
The lumbar plexus
is formed by the

The lumbar plexus originates from the ventral

T12 subcostal nerve
T12 ventral rami of
T12–L4.
rami of T12–L4. The major nerves of the plexus
are the lateral femoral cutaneous nerve, the
genitofemoral nerve, and the femoral nerve. T12
L1
Iliohypogastric Nerve L1

The iliohypogastric nerve originates from the ventral

rami of T12 and L1. It innervates the external and internal
oblique and transverse abdominis. It receives sensory
information from the skin over the inferior abdomen and
the buttocks.
L2
L2

Ilio-inguinal Nerve
The ilio-inguinal nerve originates from the ventral ramus
of L1. It innervates the external and internal oblique and
transverse abdominis. It receives sensory information L3
from the skin over the superior and medial thigh and
L3
portions of the external genitalia.

Lateral Femoral Cutaneous Nerve

The lateral femoral cutaneous nerve originates from the L4
ventral rami of L2 and L3. It receives sensory information L4
from the skin over the anterior, lateral, and posterior thigh.

Genitofemoral Nerve
The genitofemoral nerve originates from the ventral
rami of L1 and L2. It receives sensory information from
the skin over the anteromedial surface of the thigh and L5
portions of the external genitalia.

Branches of genitofemoral nerve:

Femoral branch

Genital branch Lumbosacral trunk

Femoral Nerve Obturator Nerve

The femoral nerve originates from the ventral rami of
L2–L4. It innervates the quadriceps femoris, sartorius,
pectineus, and iliopsoas. It receives sensory
© 2018 Pearson information from the skin of the anteromedial surface of
the thigh and the medial surface of the leg and foot.
Education, Inc.
The obturator nerve originates from the ventral
rami of L2–L4. It innervates the gracilis and
obturator externus, and the adductor magnus,
brevis, and longus. It receives sensory
information from the medial surface of the thigh.
 The Sacral Plexus L4 Nerve Roots of
Sacral Plexus
The sacral plexus is
The sacral plexus is formed by the ventral
formed by part of the
rami of L4–S4. Part of the ventral ramus of L4 ventral ramus of L4,
and the ventral ramus of L5 form the and by the ventral
Branch of L4 rami of L5–S4.
lumbosacral trunk, which joins the sacral
plexus. The five major nerves of the sacral
plexus are discussed below. L5
Lumbosacral trunk
L5

Superior Gluteal Nerve

The superior gluteal nerve originates from the
ventral rami of L4–S1. It innervates the gluteus
minimus, gluteus medius, and tensor fasciae latae.

Sacrum
Inferior Gluteal Nerve
S1
The inferior gluteal nerve originates from the
ventral rami of L5–S2. It innervates the gluteus
maximus.
S2

Sciatic Nerve
S3
The sciatic nerve is the largest nerve in the body. It
originates from the ventral rami of L4–S3 and
innervates the semimembranosus, semitendinosus,
and adductor magnus. S4

Posterior Femoral Cutaneous Nerve

The posterior femoral cutaneous nerve originates S5
from the ventral rami of S1–S3. It receives sensory
information from the perineum and the posterior
CO1
surface of the thigh and leg.

Pudendal Nerve
The pudendal nerve originates from the ventral
rami of S2–S4. It innervates muscles of the
perineum, including the urogenital diaphragm and
the external anal and urethral sphincters. It
receives sensory information from the external
genitalia and related skeletal muscles (the
bulbospongiosus and ischiocavernosus).
Branches of the Sciatic Nerve
The sciatic nerve branches into the tibial and fibular nerves as it
approaches the popliteal fossa. (See Figure 14.11)

Tibial Nerve: Innervates the flexors of the knee and plantar

flexors of the ankle; flexors of the toes; and skin
over the posterior surface of the leg and the
plantar surface of the foot.

Fibular Nerve: Innervates the short head of the biceps

femoris, the fibularis longus, fibularis brevis, and
tibialis anterior, and the extensors of the toes. It
receives sensory information from the anterior
surface of the leg and skin over the lateral portion
© 2018 Pearson of the foot (through the sural nerve).
Education, Inc.
 Nerves of the Lower Limb and Hip
Nerves Originating from Subcostal nerve
the Lumbar Plexus
Iliohypogastric nerve Nerves Originating The Deep Fibular Nerve
from the Sacral Plexus
Ilio-inguinal nerve
travels downward into the
Superior gluteal nerve
Genitofemoral nerve
Inferior gluteal nerve
dorsum of the foot to feed the
Lateral femoral
cutaneous nerve Posterior femoral intrinsic extensor muscles of
Femoral nerve cutaneous nerve
the foot (Extensor Hallucis
Obturator nerve Pudendal nerve
Brevis, Extensor Digitorum
Sciatic nerve
Brevis).

The Medial and

Lateral Plantar
nerves are the
main terminal
Branches of
the Sciatic Nerve
branches of the
Saphenous nerve Tibial nerve
Tibial nerve: They
Common fibular
feed the muscles
Common Fibular Nerve
and its Branches
nerve
on the plantar
Common fibular nerve
Medial sural
cutaneous nerve
surface of the foot
Lateral sural
and carry
Superficial fibular nerve
cutaneous nerve sensation from the
plantar surface.
Deep fibular nerve Sural nerve The digital
distribution (foot)
of the Medial and
Lateral Plantar
Medial plantar nerve
nerves is
Figure 14.11ab
Peripheral Nerves
Lateral plantar nerve
analogous to the
Originating from the
Lumbar and Sacral
Median and Ulnar
Plexuses
a The lumbar and sacral b The sacral plexus,
nerves of the hand
© 2018 Pearson Education, Inc. plexuses, anterior view. posterior view.
 Nerves of Lower Limb- Posterior View
Gluteus maximus
(cut) Gluteus medius
(cut)

Inferior gluteal nerve Gluteus

minimus
Pudendal nerve Superior
gluteal nerve
Perineal branch
Inferior anal Piriformis
branch

Posterior femoral
cutaneous nerve

Perineal branches
Sciatic nerve

Descending
cutaneous branch

Semitendinosus Biceps femoris

(cut)

Tibial nerve Common fibular

nerve
Popliteal artery and vein

Medial sural cutaneous

nerve Lateral sural
cutaneous nerve

Gastrocnemius

Small saphenous vein

Sural nerve

Calcaneal tendon
Figure 14.11c
Peripheral
Tibial nerve
Nerves (medial calcaneal branch)
Originating
from the
Lumbar and
Sacral
Plexuses c Posterior view of the right hip and
lower limb detailing the distribution of
© 2018 Pearson Education, Inc. peripheral nerves.
 Compartments and Sectional Anatomy of
the Thigh and Leg
• The linea aspera of the posterior femur is a prominent longitudinal
ridge, on the middle third of the bone. It is the insertion point for the
adductors and the lateral and medial intermuscular septa that
divides the thigh into three compartments

• Musculoskeletal compartments of the thigh and leg

• Medial and lateral intermuscular septa

• Thigh is divided into compartments:

• Anterior
• Posterior
• Medial

• Lower leg is divided into compartments:

• Anterior
• Lateral
• Superficial posterior
• Deep posterior

© 2018 Pearson Education, Inc.

 Compartments of the Lower Limb- Overview
Anterior Compartment
Medial Compartment
Rectus femoris
Vastus lateralis
Adductor longus
Sartorius
Vastus medialis Adductor magnus
Femoral artery, vein, and nerve

Posterior Compartment
Femur
Sciatic nerve
Gluteus maximus
Biceps femoris and
semitendinosis

a Horizontal section through proximal right thigh

Anterior Compartment Medial Compartment

Rectus femoris Adductor longus

Femoral artery,
vein, and Adductor magnus
nerve
Vastus lateralis Posterior Compartment

Sciatic nerve
Biceps femoris

b Horizontal section through distal right thigh

Tibia
Deep Posterior Compartment
Anterior Compartment
Tibialis posterior
Tibialis anterior
Anterior tibial Posterior tibial artery
artery and vein and vein

Superficial Posterior Compartment

Lateral Compartment
Soleus
Fibularis longus
Gastrocnemius

c Horizontal section through

proximal right leg

Anterior Compartment Deep Posterior Compartment

Tendon of tibialis Flexor hallucis longus

anterior
Posterior tibial artery
Anterior tibial artery and vein
and vein
Fibula

Figure 11.28 Lateral Compartment Superficial Posterior Compartment

Musculoskeletal Soleus
Tendon of fibularis
Compartments of longus
Calcaneal tendon
the Lower Limb d Horizontal section
through distal right leg
© 2018 Pearson Education, Inc.
 Compartments of the Proximal Thigh
• Extensor (Anterior) compartment:
• Muscles: Rectus Femoris, Vastus (Lateralis, Intermedius, Medialis), Psoas Major+Iliacus,
Sartorius (Knee flexor)
• Nerve Supply: Femoral Nerve (L2-L4) except Psoas Major (Branches of Lumbar Plexus: L1-L3)
• Blood Supply: Femoral Artery and Deep Femoral Artery

• Adductor (Medial) compartment

• Muscles: Adductor Brevis, Adductor Longus, Adductor Magnus, Gracilis, Pectineus, Obturator
Internus (Lateral Hip Rotator)
• Nerve Supply: Obturator Nerve
• Blood Supply: Branches of Obturator Artery, Femoral Artery, Deep Femoral Artery

Anterior Compartment
Medial Compartment
Rectus femoris
Vastus lateralis
Adductor longus
Sartorius
Vastus medialis Adductor magnus
Femoral artery, vein, and nerve
Posterior Compartment
Femur
Sciatic nerve
Gluteus maximus
Biceps femoris and
semitendinosis

a Horizontal section through proximal right thigh

© 2018
Pearson
Education, Inc.
 Compartments of the Distal Thigh

• Compartments similar to Proximal Thigh, but includes the bulk of musculature in the
Posterior-Flexor compartment

• Flexor (Posterior) compartment:

• Muscles: Biceps Femoris (Short and Long Heads), Semitendinosus, Semimembranosus
• Nerve Supply: Sciatic Nerve L4-S3 (Tibial Branch innervates most), except Short Head of
Biceps Femoris (Sciatic Nerve: Fibular Branch)
• Blood Supply: Deep Femoral Artery branches

Anterior Compartment Medial Compartment

Rectus femoris Adductor longus

Femoral artery, Adductor magnus
vein, and
nerve
Vastus lateralis Posterior Compartment

Sciatic nerve
Biceps femoris
(long head)

b Horizontal section through distal right thigh

© 2018 Pearson Education, Inc.

 Compartments of the Leg- Overview
Lateral Compartment Superficial Posterior Compartment
• Gastrocnemius
• Fibularis longus
• Soleus
• Fibularis brevis
• Plantaris
• Superficial fibular nerve
• Tibial Nerve branches

Fibula

Tibia

Anterior Compartment Deep Posterior Compartment

• Tibialis anterior • Popliteus

Figure 11.27 • Extensor hallucis longus • Flexor hallucis longus
Musculoskeletal
Compartments • Extensor digitorum longus • Flexor digitorum longus
of the Leg,
Anterior View • Anterior tibial artery • Tibialis posterior
© 2018
and vein • Posterior tibial artery
Pearson
Education, • Deep fibular nerve and vein
Inc. • Tibial nerve
 Compartments of the Proximal Leg
• Extensor/Dorsiflexor (Anterior) compartment:
• Muscles: Tibialis Anterior, Extensor Hallucis Longus, Extensor Digitorum Longus
• Nerve Supply: Deep Fibular Nerve
• Blood Supply: Anterior Tibial Artery

• Plantar Flexor/Eversion (Lateral) compartment

• Muscles: Fibularis Longus and Fibularis Brevis
• Nerve Supply: Superficial Fibular Nerve
• Blood Supply: Branches of Fibular Artery

Tibia
Deep Posterior Compartment
Anterior Compartment
Tibialis posterior
Tibialis anterior
Anterior tibial Posterior tibial artery
artery and vein and vein

Superficial Posterior Compartment

Lateral Compartment

Fibularis longus Soleus

Gastrocnemius

c Horizontal section through

proximal right leg

© 2018 Pearson Education, Inc.

 Compartments of the Distal Leg
• Superficial Plantar Flexor (Superficial Posterior) compartment:
• Muscles: Gastrocnemius, Soleus, Plantaris
• Nerve Supply: Tibial Nerve
• Blood Supply: Posterior Tibial Artery

• Deep Plantar Flexor/Inversion (Deep Posterior) compartment:

• Muscles: Tibialis Posterior, Flexor Hallucis Longus, Flexor Digitorum Longus, Popliteus (Lateral
Rotation at Knee to unlock femur)
• Nerve Supply: Tibial Nerve
• Blood Supply: Posterior Tibial Artery

Anterior Compartment Deep Posterior Compartment

Tendon of tibialis Flexor hallucis longus

anterior
Posterior tibial artery
Anterior tibial artery and vein
and vein Fibula

Lateral Compartment Superficial Posterior Compartment

Tendon of fibularis Soleus

longus Calcaneal tendon

d Horizontal section
© 2018 Pearson Education, Inc. through distal right leg