Limbs Lower Leg Pathways Notes

1. Pathways of the Lower Leg 
1. Blood Supply 
1. Aorta  Descending aorta  common iliac  external iliac  femoral sheath  femoral  popliteal
1. Superior and inferior geniculate branches 
2. Anterior tibial  anterior muscles 
3. Posterior tibial  posterior muscles and skin 
2. Blood Drainage 
1. Anterior tibial  popliteal  femoral 
2. Great saphenous  femoral 
3. Posterior vein  popliteal  femoral 
4. Lesser saphenous  popliteal  femoral 
5. Femoral  femoral sheath  external iliac  common iliac  IVC  RA
3. Nerve Supply 
1. Afferent 
1. Somatic 
1. Medial skin  saphenous nerve  around medial epicondyle of femur  under sartorius muscle  femoral nerve  behind inguinal ligament lateral to psoas major an medial to lateral cutaneous nerve  lumbar plexus  L2,3,4  dorsal roots  spinal cord 
2. Lateral skin and muscles of anterior and posterior  sciatic nerve  lumbar/sacral plexus  L4-S3  dorsal roots  spinal cord
2. Autonomic 
1. N/A 
2. Efferent 
1. Somatic 
1. Spinal cord  ventral roots  lumbar/sacral plexus  L4-S3  
1. Anterior division  tibial nerve  posterior muscles of the leg 
2. Posterior division  common peroneal nerve  superficial and deep peroneal nerves  muscles of anterior leg 
2. Autonomic 
1. Sympathetic
1. IML  ventral root  ventral rami of LS plexus  white rami  LS plexus of sympathetic ganglion  Ach synapse to postganglionic fiber  gray rami  LS plexus  
1. Femoral nerve  saphenous  skin of medial leg 
2. Sciatic nerve  
1. Anterior division  tibial nerve  posterior skin of leg 
2. Posterior division  common peroneal  superficial peroneal and lateral sural  anterior muscles and lateral skin