Gross Anatomy- Neurovascular Landmarks in Anteromedial Thigh

Question 1

Describe the Femoral Triangle

Answer 1

• Subfascial formation
• Helpful in understanding relationships in groin
• Located inferior to inguinal l.

Question 2

What are the structures that make up the boundaries to the Femoral Triangle?

Answer 2

• Boundaries –
o Base – inguinal l.
o Medial border – lateral border of adductor longus m.
o Lateral border – sartorius m.; apex is formed where sartorius m. crosses adductor longus m.
o Floor – pectineus and iliopsoas mm.
o Roof – fascia lata, cribriform fascia, subcutaneous tissue, skin

Question 3

What are the contents of the Femoral Triangle?

Answer 3

• Contents (from lateral to medial)
o Femoral n. and terminal branches
o Femoral a. and several branches
o Femoral v. and proximal tributaries
o Deep inguinal lymph nodes and vessels

Question 4

Describe the Retro-inguinal space.

Answer 4

• Retro-inguinal space is deep to inguinal l.
o Divided into two compartments by iliopectineal arch
 Thickening of iliopsoas fascia
 From inguinal l. to iliopubic eminence
 Lateral compartment is lacuna musculorum
• Not enclosed in femoral sheath
• Lateral to femoral a.
• Contains iliopsoas m. and femoral n.

   **Medial** compartment is **lacuna vasculorum**

        • Enclosed in femoral sheath
         • Contains femoral a. and several branches
         • Femoral v. and tributaries
         • Deep inguinal lymph nodes and lymph vessels
                 o Weak area and site of femoral hernia

Question 5

Describe the Femoral Sheath

Answer 5

• Funnel-shaped fascial tube
• Lines lacuna vasculorum
• Formed by transversalis fascia and iliopsoas fascia in abdomen
• Terminates inferiorly by blending with adventitia of femoral vessels
• Encloses proximal parts of femoral vessels and creates femoral canal medial to them
o Allows femoral a. and v. to glide deep to inguinal l.

Question 6

What are the 3 compartments of the Femoral Sheath?

Answer 6

• Subdivided internally into 3 compartments by vertical septa

• *o Lateral compartment** – for femoral a.
• *o Intermediate compartment** – for femoral v.
• *o Medial compartment** – constitutes femoral canal

Question 7

Describe the Femoral Canal

Answer 7

o Between medial edge of femoral sheath and femoral v.
o Extends to level of saphenous opening
o Allows femoral v. to expand
 Temporary stasis
 Increased venous return from lower limb
o Contains loose connective tissue and lymphatics
o Base of canal is femoral ring
 Small opening at proximal (abdominal) end of femoral canal
 Closed by extraperitoneal fat and parietal peritoneum
• Pierced by lymphatics between inguinal and external iliac nodes

Question 8

Describe the Adductor Canal

Answer 8

• Also known as subsartorial canal or Hunter’s canal
• Narrow passageway in middle of thigh
• Extends from apex of femoral triangle to adductor hiatus
• Intermuscular passage for:
o Femoral a. and v.
o Saphenous n.
o N. to vastus medialis

Question 9

What structures make up the boundaries of the Adductor Canal?

Answer 9

• Boundaries –
o Anteriorly and laterally – vastus medialis m.
o Posteriorly – adductors longus and magnus mm.
o Medially – sartorius m.
 Forms roof over canal

Question 10

Describe the **Anteromedial intermuscular septum **

Answer 10

Its between adductor longus and vastus medialis mm.
o Adductor hiatus is located inferior to this structure

Question 11

Describe Femoral Hernias

Answer 11

• More common in females
o Due to wider pelves
• Protrusion of abdominal viscera through femoral ring
o Passes through femoral canal
o Appears as a mass, often tender, in femoral triangle
o Is located inferolateral to pubic tubercle
• Bounded by:
o Femoral v. – laterally
o Lacunar l. - medially
o Inguinal l. - superiorly
• Compresses contents of femoral canal
• Can enlarge by passing through saphenous opening into thigh
• Hernia is at risk for strangulation
o Interferes with blood supply
o Causes necrosis