L6 - Femoral Triangle

Question 1

What is the base of the femoral triangle?

Answer 1

Inguinal ligament

Question 2

What is the lateral border of the femoral triangle?

Answer 2

Sartorius muscle

Question 3

What is the medial border of the femoral triangle?

Answer 3

Adductor longus muscle

Question 4

What is the medial floor of the femoral triangle?

Answer 4

Pectineus muscle

Question 5

What is the lateral floor of the femoral triangle?

Answer 5

Iliopsoas muscle

Question 6

What are the contents of the femoral triangle (with femoral sheath removed)?

Answer 6

Femoral nerve, artery, vein and canal deep with LNs

From lateral to medial (NAVEL)

Question 7

There are two vertical septa that divide the femoral sheath into three compartments known as what?

Answer 7

Lateral (femoral artery), intermediate (femoral vein) and medial or femoral canal

Question 8

What is not contained withinthe femoral sheath?

Answer 8

Femoral nerve

Question 9

What is the femoral ring?

Answer 9

Proximal opening of the femoral canal = femoral ring

A small opening covered by parietal peritoneum

Question 10

What does the femoral nerve supply?

Answer 10

Anterior thigh muscles including iliacus, sartorius, quadriceps femoris and pectineus

Question 11

What is the nerve root for the femoral nerve?

Answer 11

L2-4

Question 12

Describe the cutaneous innervation of the anterior thigh

Answer 12

Anterior (intermediate and medial) cutaneous branches of femoral nerve, saphenous nerve and lateral femoral cutaneous nerve

Question 13

Describe the saphenous nerve

Answer 13

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

Question 14

Describe the adductor canal

Answer 14

Intermuscular passage or fascial tunnel (anteromedial)
Femoral vessels reach popliteal fossa
Begins at femoral triangle apex
Ends at adductor hiatus

Question 15

What is the adductor hiatus?

Answer 15

Opening in tendon of adductor magnus

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

Question 16

The saphenous nerve and saphenous branch of descending genicular artery exit through what?

Answer 16

The medial side of the femoral canal

Question 17

What is the chief arterial supply to the lower limb?

Answer 17

Femoral artery

Question 18

Describe the femoral artery’s entry into the femoral triangle

Answer 18

Deep to midpoint of inguinal ligament

Lateral to femoral vein

Question 19

Describe the course of the femoral artery after it enters the femoral triangle

Answer 19

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)

Question 20

What is cannulation of femoral vessels?

Answer 20

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

Question 21

Describe the profunda femoris (deep femoral) artery

Answer 21

Largest branch of femoral artery
Typically ascends behind adductor longus
In femoral triangle it gives rise to medial and lateral circumflex femoral arteries

Question 22

Describe the medial circumflex femoral artery

Answer 22

Passes between iliopsoas and pectineus to reach posterior thigh

Question 23

Why is the medial circumflex femoral artery clincally important?

Answer 23

Main supply to femoral head and neck

Question 24

Describe the lateral circumflex femoral artery

Answer 24

Passes laterally, deep to sartorius and rectus femoris
Supplies lateral thigh muscles and femur head
Has three named branches: ascending, transverse and descending

Question 25

What is a femoral hernia?

Answer 25

Weak area in the anterior abdominal wall where a loop of SI can protrude into the femoral canal
More common in women

Question 26

Describe direct and indirect hernias

Answer 26

Direct hernias occur in Hasselbach’s triangle
Indirect hernias follow the spermatic cord
More common in males

Question 27

Describe superficial inguinal LNs

Answer 27

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

Question 28

Describe deep inguinal LNs

Answer 28

1-3 nodes along medial side of femoral vein
Inside femoral canal of femoral sheath
Drain into external iliac LNs

Question 29

What is meralgia paresthetica?

Answer 29

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

Question 30

Describe the clinical importance of the great saphenous vein

Answer 30

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)