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    Blood Supply To Femoral Head

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    Reinita Arlin Pringgoredjo
    - The blood supply to the femoral head and neck comes from multiple sources, including the medial and lateral femoral circumflex arteries. - The medial femoral circumflex artery supplies the majority of blood to the femoral head through its branches that enter the hip capsule. - Femoral neck fractures disrupt the intraosseous vessels in the neck, and malpositioning during repair can further compromise the blood supply.

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    Blood Supply To Femoral Head

    Uploaded by

    Reinita Arlin Pringgoredjo
    541 views3 pages
    - The blood supply to the femoral head and neck comes from multiple sources, including the medial and lateral femoral circumflex arteries. - The medial femoral circumflex artery supplies the majority of blood to the femoral head through its branches that enter the hip capsule. - Femoral neck fractures disrupt the intraosseous vessels in the neck, and malpositioning during repair can further compromise the blood supply.

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    Anatomical Blood Supply to Femoral Head

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    Blood Supply to Femoral Head

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    - The blood supply to the femoral head and neck comes from multiple sources, including the medial and lateral femoral circumflex arteries. - The medial femoral circumflex artery supplies the majority of blood to the femoral head through its branches that enter the hip capsule. - Femoral neck fractures disrupt the intraosseous vessels in the neck, and malpositioning during repair can further compromise the blood supply.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    541 views3 pages

    Blood Supply To Femoral Head

    Uploaded by

    Reinita Arlin Pringgoredjo
    - The blood supply to the femoral head and neck comes from multiple sources, including the medial and lateral femoral circumflex arteries. - The medial femoral circumflex artery supplies the majority of blood to the femoral head through its branches that enter the hip capsule. - Femoral neck fractures disrupt the intraosseous vessels in the neck, and malpositioning during repair can further compromise the blood supply.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
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    The main arteries that supply blood to the femoral head are the medial femoral circumflex artery and branches from the lateral femoral circumflex artery. The ligamentum teres also provides a small blood supply via the medial epiphyseal vessels. A fracture can disrupt this blood supply, putting the femoral head at risk of avascular necrosis.

    The medial femoral circumflex artery and its branches are the primary suppliers of blood to the femoral head. It sends branches through the capsule near the distal insertion that course proximally along the femoral neck. The lateral femoral circumflex artery also contributes via anastomoses in the area.

    Even after closure of the epiphyseal plate, there is minimal anastomosis between the epiphyseal and metaphyseal circulations. In adults, the greatest portion of blood supply comes from vessels on the posterior superior surface of the femoral neck.

    Blood Supply to Femoral Head & Neck

    - Anatomy: - extracapsular arterieal ring at the base of the femoral neck; - formed posteriorly by large branch of MFCA - formed anteriorly by smaller branches of LFCA; - superior & inferior gluteal artery have minor contributions; - ascending cervical branches - these give rise to retinacular arteries; - gives rise to subsynovial intra articular ring - artery o ligamentum teres! - derived from obturator or MFCA; - inadequate to supply femoral head ith displaced fractures; - forms the medial epiphyseal vessels; - only small & variable amount of the femoral head is nourished by artery of ligamentum teres; - ref! "he ligamentum teres of the adult hip - epiphyseal blood supply: - arises primarily from lateral epiphyseal vessels that enter head posterosuperiorly; - vessels from medial epiphyseal artery entering thru ligamentum teres; - epiphyseal arterial branches! - arise as arteries of subsynovial intraarticular ring; - t o groups of epiphyseal arteries! lateral & inferior vessels; - metaphyseal blood supply: - arises from e#tracapsular arterial ring; - arise from branches of ascending cervical arteries$ & subsynovial intra articular ring; - "hanges #$ Age: - even after closure of epiphyseal plate$ there is minimal astomosis bet een epiphyseal

    and metaphyseal circulations; - in the adult$ greatest portion of blood supply to head of femur is derived from vessels on posterior superior surface of femoral neck; - Femoral Neck Frx: - fr# disrupts intraosseous cervical vessels; - portion of the neck that is intracapsular has essentially no cambium layer in its fibrous covering to participate in peripheral callus formation; - hence$ healing is dependent on endosteal union alone; - femoral head nutrition is then dependent on remaining retinacular vessels$ & supply from the ligamentum teres; - position acheived at reduction is significant factor in development of avascular necrosis! - in fr# of hip$ valgus reduction may end up kinking of lateral epiphyseal vessels & tethering of medial epiphyseal vessels in ligamentum teres; - valgus and rotatory malposition may result in A%&; %edial Femoral "ircum lexa Arteri - &iscussion: - MFCA supplies ma'ority of blood supply to femoral head; - branches of MFCA enter capsule of hip 'oint near its distal insertion and couse pro#imally along femoral neck to ard femoral head; - medial femoral circumfle# artery arises from posteromedial aspect of deep femoral artery and less commonly from the common femoral artery; - its course is deep into femoral triangle$ bet een pectineus and psoas & under neck of femur to the back of thigh; - MFCA may send branches to adductor brevis & adductor magnus; - forms an important astomosis! cruciate anastomosis ; - five consistent branches of the medial femoral circumfle# artery! - deep branch! runs to ard the intertrochanteric crest bet een pectineus medially and the iliopsoas tendon laterally along inferior border of obturator e#ternus; - main division of the deep branch crosses posterior to obturator e#ternus and anterior to superior gemellus$ obturator internus$ and inferior gemellus; - runs in space bet een the quadratus femoris and the inferior gemellus - perforates the capsule superfior to the insertion of superior gemellus and distal to piriformis; - vessels course beneath synovial sheath of reflected portion of capsule of 'oint posterosuperiorly on the neck of the femur; - trochanteric branch: - branches off ne#t to the pro#imal border of quadratus femoris$ crossing over trochanteric crest to ard the lateral aspect of greater trochanter; - posterior branch: it can be identified in the space bet een the quadratus femoris and the inferior gemellus; - anterior branch:

    - anterior to quadratus femoris$ MFCA artery divides into ascending branch to the trochanteric fossa of femur & transverse branch to the hamstring muscles beyond the ischial tuberosity; - preserving the attachment of the obturator e#ternus tendon during surgery and dislocation protects the ascending branch of the MFCA from rupture and(or stretching; - transverse branch appears bet een quadratus femoris & upper border of adductor magnus; - runs ad'acent to the pro#imal border of the quadratus femoris$ crossing over the trochanteric crest to ard the lateral aspect of the greater trochanter; 'ateral Femoral "ircum lexa Artery - &iscussion: - usually arises from lateral side of deep femoral artery; - in )*+ of pts$ it arises from femoral artery above profunda; - LFCA passes laterally in front of ,soas & bet een branches of Femoral &erve; - passes deep to -artorius & rectus femoris$ and divides into anterior$ transverse$ and descending branches! - ascending branch - passes up ard beneath .ectus Femoris & "ensor Fascia Lata; - it anastomoses ( terminals of superior gluteal artery ; - transverse branch: - enters %astus Lateralis $ inds around femur belo its greater trochanter$ & anastomoses on back of thigh ( MFCA$ inferior gluteal$ & first perforating arteries /Cruciate Anastomosis 0; - descending branch! - may arise separately from femoral or profunda artery; - passes do n ard beneath the .ectus Femoris; - sends branches to %astus Lateralis & intermedius accompanied by branches of Femoral &erve$ & anastomoses ( descending genicular branch of femoral artery and lateral superior genicular branch of popliteal artery; /see genicular arterial system0 - it continues do n fascia lata & sends multiple perforators to skin overlying fascia lata and lateral aspect of the knee; - lateral circumfle# of femoral artery is principal source of blood to the trochanteric area & inferior part of femoral neck; - it anastomoses to limited degree ( branches of medial circumfle#; - nutrient artery of femur sends branches to metaphysis or neck but does not contribute significantly to head;

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