Femoral Triangle

Question 1

Femoral triangle: roof and floor

Answer 1

roof = tensor fascia lata 
Floor = pectineus and iliopsoas muscles

Question 2

Femoral triangle: boarders

Answer 2

medially = adductor longus 
laterally = sartorius 
superiorly = inguinal ligament

Question 3

Femoral triangle: contents

Answer 3

Femoral nerve and branches

Femoral sheath and its contents:

Femoral artery and branches
Femoral vein and tributaries
Femoral canal (empty space) with deep inguinal lymph bodes

Question 4

NAVEL

Answer 4

femoral Nerve 
femoral Artery 
femoral Vein
Empty space 
Lymph nodes

Question 5

Femoral sheath description

Answer 5

“funnel shaped” fascial tube

inferior prolongation of transversalis fascia

Question 6

Femoral Sheath divisions

Answer 6

vertical septa divide sheath into three compartments (femoral artery)

Laterally: Artery
Intermediate: vein
Medially: femoral canal (empty space with deep inguinal lymph nodes)

big thing is that the nerve is NOT contained in the femoral sheath

Question 7

Femoral canal

Answer 7

inside the femoral sheath

allows femoral vein to expand

contains some lymph vessels, loose connective tissue and fat

extends distally to saphenous opening
has opening around 1 cm wide
“femoral ring” is the opening to the femoral canal, and it is covered by parietal peritoneum

Question 8

from triangle to ring

Answer 8

Femoral triangle –> femoral sheath (not n.) –> femoral a., v., and femoral canal –> femoral ring, I cm wide

Question 9

femoral ring

Answer 9

base of the femoral canal, small opening to a short canal containing loose connective tissues and lymphatics

proximal opening of femoral ring = femoral canal

contains rosenmuller’s ln

Question 10

why is the femoral ring/canal important clinically?

Answer 10

femoral ring is a weak area in the anterior abdominal wall where a loop of small intestine protrude into femoral canal

femoral hernia

Question 11

femoral hernia

Answer 11

a protrusion of small intestines through the femoral ring and out the saphenous opening

more common in women

Question 12

Hasselback’s triangle

Answer 12

in men, this is the location of an indirect inguinal hernia

Question 13

Inguinal Lymph Nodes drain from —>

Answer 13

lower limb, including gluteal region
perineum and parts of anal canal
anterior abdominal wall (up to umbilicus)

Question 14

two groups of inguinal lymph nodes —>

Answer 14

superficial (with proximal and horizontal)

deep

Question 15

Proximal group of LNs

Answer 15

superficial inguinal LNs

I cm inferior to inguinal ligament

passes deep to inguinal ligament, travels beside saphenous vein

drains into external iliac lymph nodes

Question 16

Distal vertical group

Answer 16

Along each side of great saphenous vein
pass deep to inguinal ligament
runs along side saphenous vein
dumps into external iliac lymph node

Question 17

Deep Inguinal Lymph Nodes

Answer 17

1-3 nodes along medial side of femoral vein
inside femoral canal of femoral sheath
drains into external iliac lymph nodes

Question 18

Femoral Nerve

Answer 18

L2-L4

largest branch of lumbar plexus

forms in abdomen with psoas major

lateral to femoral vessels

supplies anterior thigh, hip, and knee joints

terminal cutaneous branch is saphenous nerve

Question 19

Femoral nerve: who do I innervate and what are my cutaneous branches?

Answer 19

NERVE OF ANTERIOR THIGH

L2-L4: innervates iliacus, sartorius, quadriceps femoris, pectineus

cutaneous innervation includes:

Anterior: medial+intermediate cutaneous branches of femoral nerve (#5 on nerve map of lower extremity)

Saphenous nerve (#7 on nerve map of lower extremity) on far right

lateral femoral cutaneous nerve on lateral aspect of thigh

so basically the whole thigh, and the majority of the medial aspect of the leg

Question 20

Anterior hip dislocation may affect

Answer 20

femoral nerve and lateral cutaneous nerve

Question 21

Meralgia paresthetica

Answer 21

compression of lateral femoral cutaneous nerve as it passes under the inguinal ligament causes pain along lateral thigh

Question 22

Saphenous Nerve

Answer 22

Cutaneous branch that accompanies femoral vessels
becomes superficial between sartorius and gracilis
supplies skin of anterior and medial knee and leg, plus medial foot

Question 23

where do the saphenous nerve and branch of descending genicular artery exit?

Answer 23

through medial side of the adductor canal

Question 24

adductor canal

Answer 24

intermuscular passage or fascial tunnel

femoral vessels reach the popliteal fossa through this route

begins at the apex of the femoral triangle, ends at adductor hiatus

Question 25

Adductor canal’s start and end site, and destination

Answer 25

begins at the apex of the adductor triangle and ends at the adductor hiatus

supplies femoral vessels to the popliteal fossa

Question 26

“hunters canal”

Answer 26

another name for the adductor canal, or subsartorial canal)

Question 27

adductor hiatus

Answer 27

opening in tendon of adductor and magnus

femoral vessels reach popliteal fossa (posterior knee and leg) via this arch way

Question 28

Femoral artery

Answer 28

chief arterial supply to lower limb
entry into femoral triangle, lateral to femoral vein

descends on iliopsoas, sartorius, adductor longus muscles

inferiorly: gives rise to articular branch and saphenous branch

Question 29

cannulation of femoral vessels

Answer 29

femoral artery must be palpated 2-3 cm inferior to midpoint of inguinal ligament midway between ASIS and pubic tubercle

used for radiographic visualization of left heart and coronary vessels

compression of femoral artery: femur head lies posterior to femoral artery

Question 30

chief artery to the thigh

Answer 30

Profunda Femoris artery

usually descends behind adductor longus in femoral triangle, it gives rise to medial and lateral circumflex femoral arteries

gives rise to perforating arteries

Question 31

medial and lateral circumflex arteries are given off by the

Answer 31

profunda femoris a.

Question 32

main supply of blood to femoral head and neck

Answer 32

medial/lateral circumflex arteries, branches of femoral artery

medial: passes between iliopsoas and pectineus to reach posterior thigh
lateral: passes laterally, deep to sartorius and rectus femoris

supplies lateral thigh muscles and femur head

has three named branches

Question 33

lateral circumflex artery branches

Answer 33

ascending, transverse, and descending

anastamosis with medial circumflex in trochanteric fossa

Question 34

what do the perforating arteries supply blood to

Answer 34

adductor magnus and, other adductors, and hamstring muscles