Lecture 2 Femoral Triangle Flashcards
What are the boundaries of the femoral triangle?
- Base: Inguinal ligament
- Lateral wall: Sartorius m.
- Medial wall: Adductor longus m.
SAIL
(Sartorius, Adductor Longus, Inguinal Ligament)
What are the contents of the femoral triangle?
N.A.V.e.L under your naval (from lateral–> medial)
- Femoral nerve
- Femoral artery
- Femoral vein
- Femoral canal (empty space) with deep inguinal lymph nodes
What makes up the floor of the femoral triangle?
- Pectineus m.
2. Iliopsoas m.
What makes up the roof of the femoral triangle?
Fascia lata
What is the femoral triangle?
A subfacial place/triangular depression that is located on the superomedial 1/3 of the thigh.
What is the femoral sheath?
The femoral sheath is a funnel shaped prolongation of the transversalis fascia that will surround the femoral vessels, allowing them to glide smoothly when the hips are moving.
Femoral sheath is a prolongation of what?
It is an inferior prolongation of the transversalis fascia.
What does the femoral sheath allow?
helps vessels glide smoothly deep when hip joints are moving.
When does the femoral sheath end?
4-10 cm below the inguinal ligament. It is continuous with the connective tissue that covers the femoral vessels.
How is the femoral sheath organized?
The femoral sheath surrounds the femoral artery, vein and lymph. Not the femoral nerve.
Two vertical walls divide it into 3 components (lateral, intermediate and medial compartments).
- Lateral portion holds the femoral artery.
- Intermediate holds the femoral vein.
- Medial portion holds the femoral canal.
What exactly is the femoral canal?
The femoral canal is the medial compartment of the femoral sheath. It contains
- [lymph vessels],
- [loose connective tissue] and
- [fat].
This opening will allow the femoral vein to increase during venous return.
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Describe the opening of the femoral canal.
The opening is about 1 cm wide and is called the femoral ring. It is covered by parietal peritoneum.
What is best: a complete or partial cut to the femoral artery?
Complete cut. Partial cuts will result in more loss of blood.
Femoral hernias
Femoral hernias are most common in women
Femoral hernias are protrusions of the small intestine through the anterior abdomen–> femoral ring–> femoral canal.
They can get bigger by leaving the canal and entering the subcuteneous tissue.
Thus, they will appear as a mass in the femoral triangle.
Where do direct inguinal hernias happen?
Hasselbach’s triangle. Borders are made up of the
- Rectus abdominas m. (medial border)
- Inguinal ligament (base)
- Inferior epigastric vessels. (lateral border)
It passes through the superficial inguinal ring.
Thus, direct hernias occur medial to the inferior epigastric rings
Where do indirect inguinal hernias occur
Passes through the deep and superficial inguinal ring.
Where do you feel to look for inguinal hernias?
Superficial inguinal ring. Both indirect and direct hernias pass through. To test for indirect, look at the deep inguinal ring and to look for direct, look at Hasselbach’s triangle.
Where do inguinal lymph nodes drain lymph from?
- Lower limbs (including the butt region)
- Perineum and parts of the anal canal.
- Anterior abdominal wall, up to the umbilicis
What are the two groups of inguinal lymph nodes?
- Superficial inguinal lymph nodes
- Proximal (horizontal) group
- Distal (vertical) group
- Deep inguinal lymph nodes
Where are the superficial inguinal lymph nodes located?
They lie in the superficial fascia.
The proximal (horizontal) group is located 1cm inferior to the inguinal ligament.
The distal (vertical) group is located on each side of the great saphenous vein.
Both the proximal and distal superficial inguinal ligaments do what?
- Pass deep to the inguinal ligament
2. Drain into external iliac lymph nodes
Where do superficial inguinal lymph nodes drain into?
External iliac lymph nodes.
Where are the deep inguinal lymph nodes located?
inside of the femoral canal/femoral sheath.
Where do the deep inguinal lymph nodes drain into?
External iliac lymph nodes.
What is the femoral nerve?
The femoral nerve comes off of L2-L4 and forms in the abdomen, within the psoas minor muscle.
It is the largest branch of the lumbar plexus!
What does the femoral nerve innervate?
Anterior thigh muscles, hip and knee joint.
- Iliacus m.
- Sartorius m.
- Quadriceps femoris
- Pectineus m.
What seperates the femoral nerve into anterior and posterior divisions?
Lateral circumflex femoral artery.