The descending genicular artery (highest genicular artery; a. genu suprema; anastomotica magna artery) arises from the femoral just before it passes through the opening in the tendon of the Adductor magnus, and immediately divides into a saphenous and a musculo-articular branch.
The saphenous branch pierces the aponeurotic covering of the adductor canal, and accompanies the saphenous nerve to the medial side of the knee. It passes between the Sartorius and Gracilis, and, piercing the fascia lata, is distributed to the integument of the upper and medial part of the leg, anastomosing with the medial inferior genicular artery.
The musculo-articular branch descends in the substance of the Vastus medialis, and in front of the tendon of the Adductor magnus, to the medial side of the knee, where it anastomoses with the medial superior genicular artery and anterior recurrent tibial artery. A branch from this vessel crosses above the patellar surface of the femur, forming an anastomotic arch with the lateral superior genicular artery, and supplying branches to the knee-joint.