Femoral Triangle, Adductor Canal, Vessels and Nerves of the Anterior and Medial Thigh Flashcards
boundaries of the femoral triangle?
superior - inguinal ligament medial - lateral border of adductor longus lateral - medial border of sartorius roof - fascia lata (deep fascia) floor - pectineus, iliopsoas
contents of femoral triangle?
femoral nerve as it divides into cutaneous and motor branches
femoral artery with its branches
femoral vein
lymphatics
lateral to medial in femoral triangle?
NAVL
nerve, artery, vein, lymphatics
femoral sheath
prolongation of the transversalis fascia (of abdomen)
-contains femoral artery and vein
nerve NOT in the sheath
femoral canal
medial to femoral vein
-deep inguinal lymph node can usually be found here
fat or intestines my protrude - site of femoral hernia
at the femoral ring
where does femoral nerve course?
groove formed where iliacus and psoas major muscles join
adductor canal
connects the femoral triangle with the popliteal fossa
begins at apex of femoral triangle and passes inferiorly until it reaches an opening in the adductor magnus tendon (adductor hiatus) which communicates with the popliteal fossa
boundaries of the adductor canal?
anteromedial - sartorius and vastoadductor membrane
anterolateral - vastus medialis
posterior - adductor longus superiorly, adductor magnus inferiorly
contents of adductor canal?
femoral artery
femoral vein
motor nerves of vastus medialis (from femoral)
saphenous nerve (from femoral nerve)
as femoral artery and vein enter adductor canal?
artery comes anterior to vein
nerves in adductor canal?
DO NOT exit adductor hiatus
nerve to vastus medialis?
pierces muscle while in canal
saphenous nerve
pierces wall (vasoadductor membrane) of adductor canal to become cutaneous
descending genicular artery?
branches from femoral artery while in the canal and accompanies saphenous nerve
beginning of the femoral artery?
continuation of external iliac artery
until INGUINAL LIGAMENT
course of femoral artery
femoral triangle to adductor canal
end of the femoral artery?
after exits adductor hiatus, becomes the popliteal artery
branches of the femoral artery?
superficial circumflex iliac artery
superficial epigastric artery
superficial external pudendal artery
deep external pudendal artery
these branches are superior and considered in the units of abdomen and perineum***
deep femoral artery
arises posterolaterally from femoral artery
branches of deep femoral artery?
lateral femoral circumflex
medial femoral circumflex
perforating arteries
lateral femoral circumflex artery
arises from deep femoral artery laterally on surface of ilicus muscle and provides three branches
three branches of lateral femoral circumflex artery
ascending
transverse
descending
ascending branch of lateral femoral circumflex artery
ascends deep to tensor fascia lata muscle
transverse branch of lateral femoral circumflex artery
winds around femur within the substance of the vastus laterails to anastomose with medial femoral circumflex artery, inferior gluteal artery, and first perforating artery
**cruciate anastomosis
descending branch of lateral femoral circumflex artery
descends on surface of vastus lateralis and ultimately participates with other arteries in genicular anastomosis
medial femoral circumflex artery
arises medially from deep femoral and dives between psoas and pectineus muscles
supplies adductor muscles medially and gives a branch to the acetabulum and head of femur
posteriorly it supplies the deep lateral rotators of the thigh (deep gluteal area) and ends by participating in cruciate anastomosis
perforating arteries?
1-4
arise from lateral surface of deep femoral artery, pierce adductor magnus muscle and pass posterior to the femur to end within the substance of the vastus lateralis muscle
muscular branches may arise from any of the perforating arteries to supply posterior femoral compartment musculature
descending genicular artery
arises from femoral artery just before it passes through the adductor hiatus and divides
division of the descending genicular artery
articular branch
saphenous branch
articular branch of descending genicular artery
penetrates the substance of vastus medialis muscle and participates in genicular anastomosis
saphenous branch of descending genicular artery
pierces vasoadductor membrane with saphenous nerve
distributes to subQ areas of upper medial portion of leg
femoral vein
continuation of popliteal vein superior to adductor hiatus
receives tributaries which are vena comitantes of branches of femoral artery and greater saphenous vein of femoral triangle
obturator artery
branch of internal iliac artery
passes from pelvic cavity to thigh via obturator canal
remains deep to obturator externus muscles
branches of obturator artery
anterior
posterior
acetabular
acetabular branch of obturator artery?
provides branches to acetabulum and an artery to the head of femur via ligamentum teres femoris
ligamentum teres femoris
provides acetabular branch artery to head of femur
anterior and posterior branches of obturator artery?
anastomose and provide branches to medial femoral muscles
obturator vein
parallels course of obturator artery
receives as tributaries the vena comitantes of obturator artery
is a tributary of the internal iliac vein
femoral nerve
ventral rami of L2,3,4
-from lumbar plexus
course of femoral nerve
exits pelvis deep to inguinal ligament in groove between iliacus and psoas major muscles
passes through femoral triangle lateral to femoral vessels
while in femoral triangle, provides intermediate and medial femoral cutaneous branches and motor branches to pectinus, sartorius, rectus femoris, vastus muscles, and articularis genu
what two branches of femoral nerve enter adductor canal?
motor branch to vastus medialis and saphenous nerve L4
does something cool?? page 249
obturator nerve
ventral rami of L 2,3,4
-from lumbar plexus
course of obturator nerve?
exits the pelvis by passing through the obturator canal, opening in obturator membrane
divides into two branches as it meets adductor brevis
anterior division of obturator nerve?
goes anterior to adductor brevis and deep to adductor longus
innervates adductor longus and brevis, gracilis, and sometimes the pectineus
also sends branch to hip joint an a cutaneous nerve to medial surface of thigh
posterior division of obturator nerve?
deep to adductor brevis on the surface of the adductor magnus
innervates obturator externus muscle and a portion of the adductor magnus
sends an articular branch to knee joint
