The circumflex iliac artery [Latin : circumflexa ilii], smaller than the preceding vessel, arises from the outer side of the iliac artery near Poupart's ligament, and is directed outwards behind that structure to the anterior superior spine of the ilium.
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The popliteal artery [a. poplitea], at the back of the knee-joint, extends along the lower third of the thigh and the upper part of the leg, reaching from the opening in the great adductor to the lower border of the popliteus muscle. It is continuous above with the femoral, and divides at the lower end into the anterior and posterior tibial arteries.
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The femoral artery is accessible to the surgeon for the application of a ligature without serious difficulty in its entire length ; but as the lower half is deeply placed, the difficulty of reaching this part is greatest, at the same time that the depth at which the vessel lies renders it necessary to divide and disturb the surrounding structures to a greater extent than where the vessel is nearer the surface. For these reasons the upper part of the artery is to be preferred for the performance of the operation adverted to, in all cases in which other circumstances do not control the choice of the surgeon. But the upper part of the femoral artery is not equally eligible for the application of a ligature at all points, in consequence of the position of the branches — an important consideration in the surgical anatomy of this vessel.
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The external iliac artery admits of being tied in a surgical operation at any part except near its upper and lower end ; the near neighbourhood of the upper end being excepted on account of the circulation through the internal iliac, and the lower end on account of the common position of the branches (epigastric and circumflex iliac). Occasional deductions from this statement occur in consequence of a branch or branches taking origin near or at the middle of the artery; and as the operator may see such a branch he will avoid placing a ligature very near it.
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The external circumflex artery, [circumfiexa femoris interna s. posterior,] a branch of considerable size, arises from the outer side of the profunda, and, after passing outwards for a short distance beneath the sartorius and rectus muscles, and through the divisions of the anterior crural nerve, gives branches, which may be divided into three sets, according to the directions which they take.
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The vessel which supplies the lower extremity forms a continuous trunk from the point of division of the common iliac artery down to the lower border of the popliteus muscle, where it divides into the anterior and posterior tibial arteries ; but though thus continued as a single trunk different parts of the vessel have received different names, taken from the anatomical regions through which they pass. Whilst within the pelvis, it is named iliac; in the upper two-thirds of the thigh, femoral ; and thence to its termination, popliteal. These divisions, however, are artificial, and are intended merely to facilitate reference to the vessel in different situations.
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The deep femoral artery (a. profunda femoris), is the principal nutritious vessel of the thigh; its branches being mainly distributed to that part of the lower limb, whereas the femoral artery supplies the leg and foot. It is a vessel of considerable calibre, being nearly equal in size to the continuation of the femoral after the origin of this great branch (The artery of the lower limb, after emerging from the abdominal cavity, was described bv Murray as the common femoral, and was regarded by him as dividing into two parts, which he named respectively, the superficial, and the deep femoral arteries. These terms are often conveniently used by surgical writers for easy reference to different parts of the vessel).
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The femoral artery gives off the following branches. Some, small and superficial, which are distributed to the integument and glands of the groin, or ramify on the lower part of the abdomen, viz., the external pudic (superior and inferior), the superficial epigastric, and the superficial circumflex iliac ; the great nutrient artery of the muscles of the thigh, named the deep femoral; several small muscular branches; and lastly, the anastomotic artery, which descends on the inner side of the knee-joint.
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