L6 - Femoral Triangle Flashcards
What is the base of the femoral triangle?
Inguinal ligament
What is the lateral border of the femoral triangle?
Sartorius muscle
What is the medial border of the femoral triangle?
Adductor longus muscle
What is the medial floor of the femoral triangle?
Pectineus muscle
What is the lateral floor of the femoral triangle?
Iliopsoas muscle
What are the contents of the femoral triangle (with femoral sheath removed)?
Femoral nerve, artery, vein and canal deep with LNs
From lateral to medial (NAVEL)
There are two vertical septa that divide the femoral sheath into three compartments known as what?
Lateral (femoral artery), intermediate (femoral vein) and medial or femoral canal
What is not contained withinthe femoral sheath?
Femoral nerve
What is the femoral ring?
Proximal opening of the femoral canal = femoral ring
A small opening covered by parietal peritoneum
What does the femoral nerve supply?
Anterior thigh muscles including iliacus, sartorius, quadriceps femoris and pectineus
What is the nerve root for the femoral nerve?
L2-4
Describe the cutaneous innervation of the anterior thigh
Anterior (intermediate and medial) cutaneous branches of femoral nerve, saphenous nerve and lateral femoral cutaneous nerve
Describe the saphenous nerve
Cutaneous branch that accompanies femoral vessels
Becomes superficial between sartorius and gracilis
Passes antero-inferiorly with great saphenous vein
Supplies skin of anterior and medial knee, leg and medial foot
Describe the adductor canal
Intermuscular passage or fascial tunnel (anteromedial)
Femoral vessels reach popliteal fossa
Begins at femoral triangle apex
Ends at adductor hiatus
What is the adductor hiatus?
Opening in tendon of adductor magnus
Femoral vessels reach popliteal fossa (posterior knee and leg) via this arch way
The saphenous nerve and saphenous branch of descending genicular artery exit through what?
The medial side of the femoral canal
What is the chief arterial supply to the lower limb?
Femoral artery
Describe the femoral artery’s entry into the femoral triangle
Deep to midpoint of inguinal ligament
Lateral to femoral vein
Describe the course of the femoral artery after it enters the femoral triangle
Descends on iliopsoas, pectineus and adductor longus muscles
Bisects apex deep to sartorius
Inferiorly in thigh, gives rise to descending genicular artery (articular and saphenous branch)
What is cannulation of femoral vessels?
Placing an IV for access to blood supply
Femoral artery must first be palpated
2-3cm 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
Describe the profunda femoris (deep femoral) artery
Largest branch of femoral artery
Typically ascends behind adductor longus
In femoral triangle it gives rise to medial and lateral circumflex femoral arteries
Describe the medial circumflex femoral artery
Passes between iliopsoas and pectineus to reach posterior thigh
Why is the medial circumflex femoral artery clincally important?
Main supply to femoral head and neck
Describe the lateral circumflex femoral artery
Passes laterally, deep to sartorius and rectus femoris
Supplies lateral thigh muscles and femur head
Has three named branches: ascending, transverse and descending
What is a femoral hernia?
Weak area in the anterior abdominal wall where a loop of SI can protrude into the femoral canal
More common in women
Describe direct and indirect hernias
Direct hernias occur in Hasselbach’s triangle
Indirect hernias follow the spermatic cord
More common in males
Describe superficial inguinal LNs
Lie in superficial fascia
Proximal/horizontal group 1cm inferior to inguinal ligament
Distal/vertical group: along each side of the great saphenous vein
Both groups pass deep to inguinal ligament and drain into external iliac LNs
Describe deep inguinal LNs
1-3 nodes along medial side of femoral vein
Inside femoral canal of femoral sheath
Drain into external iliac LNs
What is meralgia paresthetica?
Compression of lateral femoral cutaneous nerve as it passes under inguinal ligament causes pain along lateral thigh
Describe the clinical importance of the great saphenous vein
Can be used to administer blood, electrolytes, drugs, etc or for coronary bypass surgery
For access to the venous system an incision may be made anterior to medial malleolus (saphenous cutdown)
A pt may complain of pain along medial border of foot as a result of saphenous cutdown (saphenous nerve)
