Venous drainage of lower limb

Lateral marginal vein

The femoral ring is not bounded by Femoral artery.

The great saphenous vein is one of the two major superficial veins of the lower limb. It is found in the superficial fascia, where it is accessible for procedures such as saphenous cutdown and saphenous venous graft. As the vein ascends along the lower limb, it passes anterior to the medial malleolus at the ankle and posterior to the medial side of the knee. The vein then passes through the saphenous hiatus of the fascia lata to empty into the femoral vein slightly below the inguinal ligament.

• No major vein is found anterior to the lateral malleolus.
• Veins on the dorsum of the foot are small tributaries of the great and small saphenous veins.
• The small saphenous vein passes posterior to the lateral malleolus.

Three small cutaneous arteries (superficial external pudendal, superficial epigastric and superficial circumflex iliac arteries) arising from the femoral artery can be seen a little below the inguinal ligaments.

Femoral branch of the genitofemoral nerve pierces the femoral sheath and overlying deep fascia 2 cm below the mid inguinal point.

The great saphenous vein pierces the saphenous opening in the deep fascia (fascia lata) of the thigh and joins the femoral vein 4 cm below and lateral to the pubic tubercle.

So from the above discussion it is clear that femoral branch of the genitofemoral nerve, superficial epigastric artery and saphenous vein passes below (not behind) the inguinal ligament.

Psoas major insertion: The muscle passes behind the inguinal ligament and in front of the hip joint to enter the thigh.
Femoral vein leaves the thigh by passing behind the inguinal ligament.

• The great saphenous vein originates from the medial side of the dorsal venous arch in the foot and drains in the femoral vein.
• The small saphenous vein originates from the lateral side of the dorsal venous arch in the foot and drains in the popliteal vein.

A i.e. Starts as continuation- of medial marginal vein

Ans. is `d’ i.e., Long saphenous and femoral vein

Veins which do not have valves are:

• IVC
• SVC
• Hepatic, ovarian, uterine, renal, emissary, cerebral, pulmonary, and umbilical veins
• Portal venous system is a valveless system

Ans. is ‘b’ i.e., Runs on lateral side of leg

Short saphanous vein runs in the back (posteriorly) of leg (not laterally).

Short saphanous vein

• It is formed by union of the lateral end of the dorsal venous arch with the lateral marginal vein.
• It enters the back of leg by passing behind the lateral malleolus and is accompanied by sural nerve. 
• In leg it ascends lateral to tendocalcaneous (tendoachillis). Thus tendoachillis is medial to vein.
• It usually has 7-13 valves. It terminates into the popliteal vein.
• It is connected with peroneal vein through the lateral ankle perforators.

 Femoral nerve

Femoral sheath

Femoral sheath is a funnel shaped fascial prolongation around proximal part of femoral vessels, situated in the femoral triangle, below the inguinal ligament. It is 3-4 cm long. It is formed by fascia iliaca.

Femoral sheath is divided into 3 separate fascial compartements by septa :‑

i) Lateral compartment :- It contains femoral artery and femoral branch of genitofemoral nerve.

ii) Intermediate compartment :- Femoral vein.

iii) Medial compartment (femoral canal) :- It is conical in shape, wider above adn narrow below. The wider upper opening is known as femoral ring, which is potentially a weak point in lower abdomen and is the site for femoral hernia. Femoral ring is bounded : Anteriorly by inguinal ligament, medially by lacunar ligament, posteriorly by pectineus with its covering fascia, and laterally by septum separating it from femoral vein. Femoral canal contains lymph node of cloquet or Rosenmuller and lymphatics.

Ans. is ‘c’ i.e., Femoral nerve

Contents of adductor canal are femoral artery, femoral vein, Saphenous nerve, nerve to vastus medialis, descending genicular artery, deep lymph vessels, and two terminal divisions of obturator nerve.

Ans;A).Starts as a continuation of medial marginal vein

Vein is Great Saphenous vein

•  Starts as continuation- of medial marginal vein
• The great saphenous vein (GSV, alternately “long saphenous vein“) is a large, subcutaneous, superficial vein of the leg.
• It is the longest vein in the body, running along the length of the lower limb.