Anatomy of The Leg and Foot
Anatomy of The Leg and Foot
Anatomy of The Leg and Foot
1. The arterial blood supply to the leg and foot is almost entirely derived from branches of
the popliteal artery. Very schematically, the major arterial branches in the leg and foot are
as follows:
See Atlas Fig. 4-11 for a diagram of the arteries of the lower limb.
2. Two sets of veins drain the leg and foot: 1) Deep veins, which are usually venae
comitantes accompanying the arteries of the leg and foot; and 2) Superficial veins, which
drain into the great saphenous or the small saphenous vein. The two sets of veins are
connected by valved perforating veins, 80 that (ideally) blood flows from superficial to
deep veins and moves toward the heart mainly in deep veins. (See Fig. 18, p. 495 in
Snell, Clinical Anatomy for Medical Students.)
3. The lymphatic drainage of the leg and foot is to popliteal nodes, the vertical group of
superficial inguinal nodes, and deep inguinal nodes. Popliteal nodes receive superficial
lymph vessels from the lateral side of the leg and foot (the area drained by the small
saphenous vein) and from deep lymph vessels accompanying the anterior and posterior
tibial arteries. The efferent vessels from the popliteal nodes drain into deep inguinal
nodes. The vertical group of superficial inguinal nodes receives superficial lymph vessels
from the territory drained by the great saphenous vein. Efferent vessels from this group of
superficial inguinal nodes drain into deep inguinal nodes. The deep inguinal nodes
receive lymph from deep vessels in the lower limb that travel alongside of arteries, from
the superficial inguinal nodes (horizontal and vertical groups), and from the popliteal
nodes. Efferent vessels from the deep inguinal nodes drain into external iliac nodes. (See
Fig. 2S, p. 513, Snell, Clinical Anatomy for Medical Students.)
4. Autonomic innervation of the leg and foot is limited to postganglionic sympathetic nerves
supplying vascular smooth muscle (vasoconstriction) and sweat glands.
5. Somatic sensory end motor innervation of the leg and foot is almost entirely by way of
branches of the sciatic nerve. Exception: The cutaneous innervation of the anteromedial
portion of the leg is by way of the saphenous nerve, a branch of the femoral nerve. The
major branches of the sciatic nerve are summarized schematically below. (See Figs. 8 and
9, pages 481 and 482, Snell, Clinical Anatomy for Medical Students for a diagram
summarizing the distribution of the major cutaneous nerves of the lower limb. Study
suggestion: Color code these figures to indicate which areas of the lower limb receive
cutaneous innervation from branches of the following nerves: obturator, femoral,
common peroneal, deep peroneal, superficial peroneal, tibial. The sources of motor
innervation to muscles of the leg and foot should be evident if you understand Principle
6, below.)
6. The leg is subdivided by the arrangement of bones, interosseous membrane, and fascial
septa into 3 fascia] compartments. Each of these has its own muscles, its own nerve
supply, its own "gateway" to the foot, and (by and large) its own blood supply. The figure
below is a highly schematic diagram (a cross-section through the leg) summarizing the
compartmental organization of the leg.