Femoral Triangle Flashcards
Femoral triangle: roof and floor
roof = tensor fascia lata Floor = pectineus and iliopsoas muscles
Femoral triangle: boarders
medially = adductor longus laterally = sartorius superiorly = inguinal ligament
Femoral triangle: contents
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
NAVEL
femoral Nerve femoral Artery femoral Vein Empty space Lymph nodes
Femoral sheath description
“funnel shaped” fascial tube
inferior prolongation of transversalis fascia
Femoral Sheath divisions
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
Femoral canal
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
from triangle to ring
Femoral triangle –> femoral sheath (not n.) –> femoral a., v., and femoral canal –> femoral ring, I cm wide
femoral ring
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
why is the femoral ring/canal important clinically?
femoral ring is a weak area in the anterior abdominal wall where a loop of small intestine protrude into femoral canal
femoral hernia
femoral hernia
a protrusion of small intestines through the femoral ring and out the saphenous opening
more common in women
Hasselback’s triangle
in men, this is the location of an indirect inguinal hernia
Inguinal Lymph Nodes drain from —>
lower limb, including gluteal region
perineum and parts of anal canal
anterior abdominal wall (up to umbilicus)
two groups of inguinal lymph nodes —>
superficial (with proximal and horizontal)
deep
Proximal group of LNs
superficial inguinal LNs
I cm inferior to inguinal ligament
passes deep to inguinal ligament, travels beside saphenous vein
drains into external iliac lymph nodes
Distal vertical group
Along each side of great saphenous vein
pass deep to inguinal ligament
runs along side saphenous vein
dumps into external iliac lymph node
Deep Inguinal Lymph Nodes
1-3 nodes along medial side of femoral vein
inside femoral canal of femoral sheath
drains into external iliac lymph nodes
Femoral Nerve
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
Femoral nerve: who do I innervate and what are my cutaneous branches?
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
Anterior hip dislocation may affect
femoral nerve and lateral cutaneous nerve
Meralgia paresthetica
compression of lateral femoral cutaneous nerve as it passes under the inguinal ligament causes pain along lateral thigh
Saphenous Nerve
Cutaneous branch that accompanies femoral vessels
becomes superficial between sartorius and gracilis
supplies skin of anterior and medial knee and leg, plus medial foot
where do the saphenous nerve and branch of descending genicular artery exit?
through medial side of the adductor canal
adductor canal
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
Adductor canal’s start and end site, and destination
begins at the apex of the adductor triangle and ends at the adductor hiatus
supplies femoral vessels to the popliteal fossa
“hunters canal”
another name for the adductor canal, or subsartorial canal)
adductor hiatus
opening in tendon of adductor and magnus
femoral vessels reach popliteal fossa (posterior knee and leg) via this arch way
Femoral artery
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
cannulation of femoral vessels
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
chief artery to the thigh
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
medial and lateral circumflex arteries are given off by the
profunda femoris a.
main supply of blood to femoral head and neck
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
lateral circumflex artery branches
ascending, transverse, and descending
anastamosis with medial circumflex in trochanteric fossa
what do the perforating arteries supply blood to
adductor magnus and, other adductors, and hamstring muscles
