Femoral Canal Flashcards
Where would you palpate the femoral pulse?
At the mid-inguinal point, ½ way between the ASIS and PS
What is the femoral canal?
The femoral canal is a potential space and medial compartment of the femoral sheath the encases the femoral artery and vein in the lateral and intermediate compartment respectively. The femoral canal contains LN and lymphatic vessels within the canal.
It allows for expansion of the femoral vein and transport of lymphatics
The canal opens superiorly into the abdomen via the femoral ring.
What are the boundaries of the femoral canal / ring?
Anteriorly: inguinal ligament
Posteriorly: pectineal ligament
Laterally: femoral vein
Medially: lacunar ligament
What are the contents of the femoral canal?
LN – Cloquet’s node, lymphatic vessels, fat
Clinically how could you differentiate between a femoral and indirect inguinal hernia?
Femoral – neck below and lateral to PT. Through the cribiform fascia of the sheath before turning
IIH –above and medial to PT, emerging from superficial inguinal ring
What is the anatomical reason for the femoral hernias being more likely to strangulate and be irreducible than inguinal hernias?
Femoral ring is narrow and lacunar ligament forms sharp medial border increasing the risk of strangulation and making it irreducible
What structure is at particular risk of damage during a femoral hernia operation?
Femoral vein
It lies immediately lateral and must be occluded during the procedure to prevent recurrence, but the vein must be allowed room to expand with increased blood flow druing LL activity
Suturing may directly damage the vein or compress it, leading to obstructed venous return and venous thrombosis
Accessory obturator artery – present in 50% people, usually passes on lateral aspect of ring to obturator foramen, but can pass medially. Division or digital stretch of the lacunar ligament, to open up the ring to allow delivery of the sac in difficult cases, risks damaging the vessel
What is the femoral triangle ?
The femoral triangle is bordered by the inguinal ligament (sup), sartorius (lat) and adductor longus (medially).
It contains the femoral vessels / sheath and is the area in which femoral hernia are seen
Anatomical region in the upper thigh
Subfascial space, appears a triangular depression inferior to the inguinal ligament when the thigh is flexed, abducted and laterally rotated.
What are the boundaries of the femoral triangle?
Sup – inguinal ligament
Med – adductor longus (lateral border)
Lat – Sartorius (medial border)
Floor – pectineus and adductor longus medially, iliopsoas laterally
Roof: fascia lata
What are the contents of the femoral triangle?
Femoral Nerve, artery, vein, canal, cloquets node, lymphatic vessels, Great saphenous vein draining into the femoral vein
What is hunters canal?
Hunter’s canal aka the adductor canal, is an aponeurotic tunnel in the middle third of the thigh, extending from the apex of the femoral triangle to the opening in the adductor magnus = the adductor hiatus
What are the boundaries of the adductor canal?
Adductor longus + magnus = medially
Vastus medialis = laterally
Sartorius = anteriorly
Courses from ANT -> Medial compartment of the thigh
What are the contents of Hunters canal?
Femoral artery
Femoral vein
Saphenous nerve
Nerve to vastus medialis
(BOTH are branches of the femoral nerve)
They enter via superior foramen, and exit via hiatus (inf foramen)
What are the branches of the femoral artery?
Inferior epigastric artery (before passing beneath inguinal ligament)
Superficial and deep external pudendal
Superficial circumflex iliac
Superficial epigastric arteries
Profunda femoris -> Lateral circumflex artery and medial circumflex
Continues as superficial femoral artery
Where would you palpate the femoral artery?
At the mid-inguinal point – ½ way between the ASIS and PS
Along the grease
