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Anatomy of the lower extremity arteries and bones: angiographic 3D view

Antoine Micheau, MD, Denis Hoa, MD

Published on Monday 25 August 2008

SECTION: Musculoskeletal anatomy (upper and lower extremities)

Images and anatomical references

Anatomy of the arteries and bones of the lower limb based on 3D pictures and angiogram (angiography).

 

This part of the interactive anatomic atlas of the human body is devoted to the arterial vasculature of the pelvic girdle, pelvis, thigh, knee, leg and foot and to the study of bones and joints. It includes a 3D reconstruction of bones and arteries from angioCT with injection of a contrast agent (iodine), an angiographic view correlated with the 3D view and digital radiography of the skeleton of the lower limb.

 

Bone and artery of the pelvic girdle : anatomy based on medical imaging (3D images and angiogram adapted from computed tomography)

 

Procedure details of this interactive atlas of the lower limb anatomy:

We have selected a normal angioCT (Computed Tomography) exam of lower limbs: acquisition was made with helical multidetector CT (MDCT) after injection of iodized contrast. The axial images were post-processed using software post-treatment on a workstation for a multimodal reconstruction and a three-dimensional visualization of bone and blood vessels, then a similar angiographic view was created.

 

Angiography (angiogram) adapted from angioCT showing all pelvic arteries labeled : internal and external artery, pudendal artery, gluteal artery, femoral artery...

 

The DICOM images were exported and then integrated into the software Adobe CS3 Professional Flash to create this anatomic module. The anatomical structures were labelled on the 3D view.

 
 Radiography of the skeleton : all anatomical structures (bones and joints) of the pelvic girdle  labeled on a radiographic image (X-Rays)

 

We also selected non pathologic digital X-rays: pelvis, hip, knee, ankle and foot, labelling the skeletal structures and joints.

 

Normal arteriography of the leg : image adapted from MDCT (MIP) showing  popliteal ,fibular, anterior tibial artery and posterior tibial artery

 
All anatomical structures of the Terminologia Anatomica are translated in French, English, Spanish, Portuguese, Russian, Czech, Japanese and Chinese. This module may be used as a medical dictionary.

 

Radiography of the hip joint : anatomy of the whole human body based on medical imagin : femur, coxal bone, acetabulum, femoral head, iliac crest...

 

Peripheral vascular imaging of the lower limb:  

 

Anteroposterior radiology (X-ray) of the knee : anatomy of the femur, patella, tibia, fibula, lateral and medial condyle, intercondylar tubercle...

 

We preferred to use an angioCT of the lower limb rather than a digital arteriography because it allowed the user to make a correlation between angiographic views of arteries with three-dimensional structures.

The 3D/angiographies tab can be used to select these two kinds of view.

 

radiological atlas of the lower limb : radiograph of the knee (lateral view) showing joints (femoropatellar joint, femororibial joint, tibiofibular joint) and bones

 

The fields of view are the ones routinely used for angiography: a global vision of the entire arterial vasculature (from the aorta to the foot) and then 3 specific fields of view: iliac, femoral and tripod arteries

We have segmented the legends of the arteries into different groups: aorta and its branches, internal iliac artery and its branches, external iliac artery and its branches. This decreases the number of labels shown on each image and provides a better educational approach.

Only the arteries visible on the 3D view were labelled, this explains why on the angiographic view some arteries are visible only under particular rotation angles.

 

This module is designed for teachers in anatomy, including vascular disease, medical students and paramedical students (nurses, radiology technicians), but also practitioners in vascular medicine, ultrasound and Doppler examination, vascular surgery, interventional radiology, cardiology, angiology and endocrinology. It facilitates the study of arterial diseases of the lower limbs (atheroma, atherosclerosis), embolizations in emergencies, balloon angioplasties or stents, vascular bypass, gynaecologic embolizations (uterine fibroids, Primary Post-Partum Haemorrhages (note: the patient is male so there are some differences with the female pelvis vasculature).

 

Skeletal imaging of the lower limb

Joints and bones of the skeleton pelvis, thigh, hip, knee, leg, ankle and foot were also labelled. At the end this module please note that anatomical conventional radiology could be useful for usual practice, which is why you may find some labelled digital radiographies at the end of this module.

 

Radiograph (X-ray) of the ankle : anatomy on an anterior view showing tibia, fibula, talus, lateral and medial malleolus.

 

Radioanatomy of the ankle : radiology of the ankle (lateral view) with anatomical structures labeled as calcaneus, talus, navicular, talo-crural joint.

 

The left side menu provides access to various exams.

Long bones and joints are featured so that each structure can be followed throughout its extent.
We had to use groups of anatomical structures: sacrum, coxal bone, femur, patella, tibia, fibula, bones of the feet (tarsus and metatarsus). For technical reasons, the legends of the bone structures appear on the angiographic views and some bones do not appear; please forgive us for this problem.

The joints have also been labelled, although their study is easier on such exams as CT or MR arthrography.

 

Superior radiograph of the foot with all anatomical structures labeled (bones, joints)

 

This module is less specific than slice imaging modules, so it is helpful for all who are curious about skeletal and vascular anatomy and pathology of the lower limb:

  • Medical students studying medical degrees and bachelor degrees (MBBS, MBChB, MD, DO, MDCM, BMed, etc) or United States Medical Licensing Examination.
  • Nursing assistants, orderlies, auxiliary nurses, medical assistants, registered nurses or licensed practical nurses
  • Hospital volunteers.
  • EMTs and Paramedics
  • Technicians, phlebotomy technicians, surgical technologists, and technicians trained to operate equipment such as X-ray machines.
  • Medical practitioners
  • Pharmacists
  • Medical technologists and physical therapists working with nursing staff.
  • Anatomy teachers or professors from medical universities, medical schools or faculty of medicine
  • Surgery residents or fellows, orthopaedic surgeons
  • Rheumatologists, podiatrists
  • Any Medical Doctor who wishes to explain a musculoskeletal pathology to a patient: fracture, sprain, arthritis, arthritis.

Lateral view of the foot on radiography (X-ray) : metatarsals, phalanx, cuboid, navicular, cuneiform bones...

 

References :

  • Atlas of Human Anatomy, Professional Edition by Frank H. Netter · Publisher: Saunders; 4 edition (July 13, 2006) Language: English · ISBN-10: 1416036997 · ISBN-13: 978-1416036999
  • Terminologia Anatomica: International Anatomical Terminology by FCAT · Publisher: Thieme Medical Publishers; Bilingual edition (January 1, 2000) · Language: Latin/english · ISBN-10: 0865778086 · ISBN-13: 978-0865778085
  • Diagnostic and Surgical Imaging Anatomy: Musculoskeletal (International Edition): Published by Amirsys · Publisher: Lippincott Williams & Wilkins; 1 edition (December 1, 2006) · Language: English · ISBN-10: 1931884323 · ISBN-13: 978-1931884327

Anatomical parts

  • 3D - 3D
  • 3D : Leg - Crus
  • 3D : Lower limb - Membrum inferius
  • 3D : Pelvis - Pelvis - Hip - Coxa
  • 3D : Thigh - Femur
  • 3D/Angiography - 3D/Angiography
  • Abdominal aorta - Aorta abdominalis
  • Acetabular fossa - Fossa acetabuli
  • Acetabular margin - Limbus acetabuli; Margo acetabuli
  • Acetabular notch - Incisura acetabuli
  • Adductor tubercle - Tuberculum adductorium
  • Ala of ilium; Wing of ilium - Ala ossis ilii
  • Ala; Wing of sacrum - Ala ossis sacri
  • Anatomical structures - Anatomical parts
  • Angiography - Angiography
  • Ankle joint - Articulatio talocruralis
  • Anterior border - Margo anterior
  • Anterior gluteal line - Linea glutea anterior
  • Anterior inferior iliac spine - Spina iliaca anterior inferior
  • Anterior intercondylar area - Area intercondylaris anterior
  • Anterior lateral malleolar artery - Arteria malleolaris anterior lateralis
  • Anterior obturator tubercle - Tuberculum obturatorium anterius
  • Anterior sacral foramina - Foramina sacralia anteriora
  • Anterior superior iliac spine - Spina iliaca anterior superior
  • Anterior surface - Facies anterior
  • Anterior tibial artery - Arteria tibialis anterior
  • Anterior tibial recurrent artery - Arteria recurrens tibialis anterior
  • Aorta and branches
  • Aortic bifurcation - Bifurcatio aortae
  • Apex - Apex ossis sacri; Apex ossis sacralis
  • Apex of head - Apex capitis fibulae
  • Apex of patella - Apex patellae
  • Arcuate line - Linea arcuata
  • Articular branches - Rami articulares
  • Articular facet - Facies articularis malleoli medialis
  • Articular surface - Facies articularis
  • Base - Basis ossis metatarsi
  • Base of patella - Basis patellae
  • Base of sacrum - Basis ossis sacri
  • Body - Corpus ossis ischii
  • Body - Corpus tali
  • Body of ilium - Corpus ossis ilii
  • Bones; Skeletal system - Ossa; Systema skeletale
  • Calcaneal tuberosity - Tuber calcanei
  • Calcaneocuboid joint - Articulatio calcaneocuboidea (Transverse tarsal joint - Articulatio tarsi transversa)
  • Calcaneus - Calcaneus
  • Coccyx; coccygeal vertebrae [I-IV] - Os coccygis; Coccyx vertebrae coccygeae [I-IV]
  • Common iliac artery - Arteria iliaca communis
  • Communicating branch - Ramus communicans (Fibular artery - Arteria fibularis)
  • Cranial base - Basis cranii (Bones - Os)
  • Cranial base - Basis cranii (Foramina - Foramina)
  • Cuboid - Os cuboideum
  • Cuneonavicular joint - Articulatio cuneonavicularis
  • Deep artery of thigh - Arteria profunda femoris
  • Deep circumflex iliac artery - Arteria circumflexa ilium profunda
  • Deep circumflex iliac artery - Arteria circumflexa ilium profunda (Ascending branch - Ramus ascendens)
  • Descending genicular artery - Arteria descendens genus
  • Diagrams - Diagrams
  • Distal phalanx - Phalanx distalis
  • Dorsal artery of foot - Arteria dorsalis pedis
  • Dorsal artery of penis male - Arteria dorsalis penis male
  • External iliac artery - Arteria iliaca externa
  • External iliac artery and branches
  • Fabella - Fabella
  • Fascia - Fasciae
  • Femoral artery - Arteria femoralis
  • Femoropatellar joint - Femoropatellar joint
  • Femorotibial joint - Femorotibial joint
  • Femur; Thigh bone - Femur; Os femoris
  • Fibula - Fibula
  • Fibular artery - Arteria fibularis
  • Fibular notch - Incisura fibularis
  • Fibular trochlea; Peroneal trochlea; Peroneal tubercle - Trochlea fibularis; Trochlea peronealis
  • Foot - Pes
  • Fovea for ligament of head - Fovea capitis femoris
  • Gluteal tuberosity - Tuberositas glutea
  • Greater sciatic notch - Incisura ischiadica major
  • Greater trochanter - Trochanter major
  • Groove for popliteus - Sulcus popliteus
  • Head - Caput femoris
  • Head - Caput fibulae
  • Head - Caput ossis metatarsi
  • Head - Caput tali
  • Hide - Hide
  • Hide all bones - Hide all bones
  • Hip bone; Coxal bone; Pelvic bone - Os coxae
  • Hip bone; Coxal bone; Pelvic bone - Os coxae (Ilium - Os ilium; Ilium - Ischium - Os ischii; Ischium - Pubis - Os pubis; Pubis)
  • Hip joint - Articulatio coxofemoralis
  • Iliac crest - Crista iliaca
  • Iliac tuberosity - Tuberositas iliaca
  • Iliolumbar artery - Arteria iliolumbalis
  • Iliopubic eminence - Eminentia iliopubica
  • Inferior articular surface - Facies articularis inferior
  • Inferior epigastric artery - Arteria epigastrica inferior
  • Inferior gluteal artery - Arteria glutea inferior
  • Inferior gluteal line - Linea glutea inferior
  • Inferior lateral genicular artery - Arteria inferior lateralis genus
  • Inferior medial genicular artery - Arteria inferior medialis genus
  • Inferior pubic ramus - Ramus inferior ossis pubis
  • Inferior rectal artery - Arteria rectalis inferior
  • Inner lip - Labium internum
  • Intercondylar fossa - Fossa intercondylaris
  • Intercuneiform joints - Articulationes intercuneiformes
  • Intermediate cuneiform; Middle cuneiform - Os cuneiforme intermedium
  • Intermediate line - Linea intermedia
  • Intermediate sacral crest - Crista sacralis medialis
  • Intermetatarsal joints - Articulationes intermetatarsales
  • Internal iliac artery - Arteria iliaca interna
  • Internal iliac artery and branches
  • Internal pudendal artery - Arteria pudenda interna
  • Interosseous border - Margo interosseus
  • Interphalangeal joints of foot - Articulationes interphalangeae pedis
  • Intertrochanteric crest - Crista intertrochanterica
  • Intertrochanteric line - Linea intertrochanterica
  • Intervertebral foramina - Foramina intervertebralia
  • Ischial spine - Spina ischiadica
  • Ischial tuberosity - Tuber ischiadicum
  • Joint - Junctura
  • Joints of foot - Articulationes pedis
  • Knee joint - Articulatio genus
  • Lateral circumflex femoral artery - Arteria circumflexa femoris lateralis (Ascending branch - Ramus ascendens)
  • Lateral circumflex femoral artery - Arteria circumflexa femoris lateralis (Descending branch - Ramus descendens)
  • Lateral circumflex femoral artery - Arteria circumflexa femoris lateralis (Transverse branch - Ramus transversus)
  • Lateral condyle - Condylus lateralis
  • Lateral cuneiform - Os cuneiforme laterale
  • Lateral epicondyle - Epicondylus lateralis
  • Lateral intercondylar tubercle - Tuberculum intercondylare laterale
  • Lateral malleolus - Malleolus lateralis
  • Lateral plantar artery - Arteria plantaris lateralis
  • Lateral process - Processus lateralis tali
  • Lateral process - Processus lateralis tuberis calcanei
  • Lateral sacral arteries - Arteriae sacrales laterales
  • Lateral sacral crest - Crista sacralis lateralis
  • Lateral supracondylar line - Linea supracondylaris lateralis
  • Lateral surface - Facies lateralis
  • Lesser sciatic notch - Incisura ischiadica minor
  • Lesser trochanter - Trochanter minor
  • Ligaments - Ligamenta
  • Linea aspera - Linea aspera (Lateral lip - Labium laterale)
  • Linea aspera - Linea aspera (Medial lip - Labium mediale)
  • Lumbar arteries - Arteriae lumbales
  • Lumbosacral joint - Articulatio lumbosacralis
  • Malleolar fossa - Fossa malleoli lateralis
  • Malleolar groove - Sulcus malleolaris
  • Medial border - Margo medialis
  • Medial circumflex femoral artery - Arteria circumflexa femoris medialis
  • Medial condyle - Condylus medialis
  • Medial crest - Crista medialis
  • Medial cuneiform - Os cuneiforme mediale
  • Medial epicondyle - Epicondylus medialis
  • Medial intercondylar tubercle - Tuberculum intercondylare mediale
  • Medial malleolus - Malleolus medialis
  • Medial plantar artery - Arteria plantaris medialis
  • Medial process - Processus medialis tuberis calcanei
  • Medial supracondylar line - Linea supracondylaris medialis
  • Medial surface - Facies medialis
  • Median sacral artery - Arteria sacralis mediana
  • Median sacral crest - Crista sacralis mediana
  • Metatarsals [I-V] - Ossa metatarsi [I-V]
  • Metatarsophalangeal joints - Articulationes metatarsophalangeae
  • Middle genicular artery - Arteria media genus
  • Middle phalanx - Phalanx media
  • Navicular - Os naviculare
  • Neck - Collum femoris
  • Neck - Collum fibulae
  • Neck - Collum tali
  • Nerves - Nerves
  • Obturator artery - Arteria obturatoria
  • Obturator crest - Crista obturatoria
  • Obturator foramen - Foramen - Foramen obturatum
  • Obturator groove - Sulcus obturatorius
  • Outer lip - Labium externum
  • Patella - Patella
  • Patellar surface - Facies patellaris
  • Pecten pubis; Pectineal line - Pecten ossis pubis
  • Pectineal line; Spiral line - Linea pectinea
  • Perforating arteries - Arteriae perforantes
  • Perforating branch - Ramus perforans (Fibular artery - Arteria fibularis)
  • Perineal artery - Arteria perinealis
  • Popliteal artery - Arteria poplitea
  • Popliteal surface - Facies poplitea
  • Posterior border - Margo posterior
  • Posterior gluteal line - Linea glutea posterior
  • Posterior inferior iliac spine - Spina iliaca posterior inferior
  • Posterior intercondylar area - Area intercondylaris posterior
  • Posterior obturator tubercle - Tuberculum obturatorium posterius
  • Posterior process - Processus posterior tali
  • Posterior sacral foramina - Foramina sacralia posteriora
  • Posterior superior iliac spine - Spina iliaca posterior superior
  • Posterior surface - Facies posterior
  • Posterior tibial artery - Arteria tibialis posterior
  • Promontory - Promontorium
  • Proximal phalanx - Phalanx proximalis
  • Pubic crest - Crista pubica
  • Pubic symphysis - Symphysis pubica
  • Pubic tubercle - Tuberculum pubicum
  • Radiography - Radiography
  • Ramus - Ramus ossis ischii
  • Regions / Modality - Regions / Modality
  • Sacral canal - Canalis sacralis
  • Sacral hiatus - Hiatus sacralis
  • Sacral horn - Cornu sacrale
  • Sacral tuberosity - Tuberositas ossis sacri
  • Sacrococcygeal joint - Articulatio sacrococcygea
  • Sacroiliac joint - Articulatio sacroiliaca
  • Sacrum [sacral vertebrae I - V] - Os sacrum [vertebrae sacrales I - V]
  • Saphenous branch - Ramus saphenus
  • Sesamoid bones - Ossa sesamoidea
  • Shaft of femur; Body of femur - Corpus femoris
  • Shaft; Body - Corpus ossis metatarsi
  • Show all bones - Show all bones
  • Soleal line - Linea musculi solei
  • Subtalar joint; Talocalcaneal joint - Articulatio subtalaris; Articulatio talocalcanea
  • Superficial circumflex iliac artery - Arteria circumflexa ilium superficialis
  • Superficial epigastric artery - Arteria epigastrica superficialis
  • Superior articular process - Processus articularis superior
  • Superior articular surface - Facies articularis superior
  • Superior gluteal artery - Arteria glutea superior
  • Superior gluteal artery - Arteria glutea superior (Deep branch - Ramus profundus - Inferior branch - Ramus inferior )
  • Superior gluteal artery - Arteria glutea superior (Deep branch - Ramus profundus - Superior branch - Ramus superior )
  • Superior gluteal artery - Arteria glutea superior (Superficial branch - Ramus superficialis)
  • Superior lateral genicular artery - Arteria superior lateralis genus
  • Superior pubic ramus - Ramus superior ossis pubis
  • Sural arteries - Arteriae surales
  • Sustentaculum tali; Talar shelf - Sustentaculum tali
  • Symphysial surface - Facies symphysialis
  • Talocalcaneonavicular joint - Articulatio talocalcaneonavicularis (Transverse tarsal joint - Articulatio tarsi transversa)
  • Talus - Talus
  • Tarsal bones - Ossa tarsi; Ossa tarsalia
  • Tarsal sinus - Sinus tarsi
  • Tarsometatarsal joints - Articulationes tarsometatarsales
  • Tendon - Tendo
  • Tibia - Tibia
  • Tibial tuberosity - Tuberositas tibiae
  • Tibiofibular joint; Superior tibiofibular joint - Articulatio tibiofibularis
  • Transverse ridges - Lineae transversae
  • Trochanteric fossa - Fossa trochanterica
  • Trochlea of talus - Trochlea tali
  • Tuberculum of iliac crest - Tuberculum iliacum
  • Umbilical artery - Arteria umbilicalis
  • Zygapophysial joints - Articulationes zygapophysiales

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