Lower Limb Anatomical Areas

Question 1

What is the femoral triangle?

Answer 1

A hollow in the anterior thigh region, through which many large neurovascular structures pass.

Question 2

What are the borders of the femoral triangle?

Answer 2

Superior border - inguinal ligament.
Lateral border - medial border of the sartorius muscle.
Medial border - medial border of the adductor longus muscle.
Roof - fascia lata.
Base - pectineus, iliopsoas, and adductor longus muscles.

Question 3

What are the contents of the femoral triangle lateral to medial?

Answer 3

Femoral nerve, femoral artery, femoral vein, and femoral canal.
The femoral artery, vein and canal are contained in the femoral sheath.
Remember: NAVEL = nerve, artery, vein, empty space, and lymph canal.

Question 4

Where can the femoral pulse be taken?

Answer 4

Palpated inferior to where the femoral artery crosses the inguinal ligament.

Question 5

Why is the femoral artery suitable for coronary angiography?

Answer 5

Because it is superficially located so easy to access. The catheter can be navigated up into the coronary vessels by passing through the external iliac artery, and aorta.

Question 6

What is a hernia?

Answer 6

A condition in which part of an organ is displaced and protrudes through the wall of the cavity containing it.

Question 7

What happens in a femoral hernia?

Answer 7

Part of the bowel pushes into the femoral canal, underneath the inguinal ligament.

Question 8

How are femoral hernia treated?

Answer 8

Surgical intervention.

Question 9

How long is the femoral canal?

Answer 9

1.3cm.

Question 10

Where is the femoral canal?

Answer 10

In the anterior thigh, within the femoral triangle.

Question 11

What are the borders of the femoral canal?

Answer 11

Medial border - lacunar ligament.
Lateral border - femoral vein.
Anterior border - inguinal ligament.
Posterior border - pectineal ligament, superior rami of the pubi, and the pectineus muscle.

Question 12

What is the femoral ring?

Answer 12

The opening to the femoral canal at its superior border.

Question 13

What is the femoral septum?

Answer 13

The connective tissue layer that closes the femoral ring.

Question 14

What are the contents of the femoral canal?

Answer 14

Lymphatic vessels, deep lymph nodes, empty space, and loose connective tissue.

Question 15

Why is the empty space in the femoral canal needed?

Answer 15

To allow distension of the adjacent femoral vein to cope with increased venous return, or increased intra-abdominal pressure.

Question 16

What is a common site for bowel herniation?

Answer 16

The femoral canal.

Question 17

How does a bowel herniation in the femoral canal present?

Answer 17

A lump inferolaterally to the pubic tubercle.

Question 18

What is a strangulated hernia?

Answer 18

When the hernia is compressed and so the blood supply is interfered with.

Question 19

What is the adductor canal?

Answer 19

Narrow conical tunnel in the thigh, 15cm long from the apex of the femoral triangle to the adductor hiatus of the adductor magnus. It is a passageway for structures moving between the anterior thigh and posterior leg.

Question 20

What are the borders of the adductor canal?

Answer 20

Anterior - sartorius.
Lateral - vastus medialis.
Posterior - adductor longus and adductor magnus.

Question 21

What is the adductor hiatus?

Answer 21

A gap between the adductor and hamstring attachments of the adductor magnus that marks the apex of the adductor canal.

Question 22

What are the contents of the adductor canal?

Answer 22

Femoral artery, femoral vein, nerve to the vastus medialis, and the saphenous nerve.

Question 23

When do the femoral artery and vein become the popliteal artery and vein?

Answer 23

When they exit the adductor canal.

Question 24

What is adductor canal block?

Answer 24

Local anaesthetic is administered in the adductor canal to block the saphenous nerve in isolation or with the nerve to the vastus medialis.

Question 25

What are adductor canal blocks used for?

Answer 25

To provide sensory anaesthesia for procedures involving the distal thigh and femur, knee and lower leg on the medial side.

Question 26

How can the saphenous nerve be located for adductor canal block?

Answer 26

The sartorius and femoral artery are used as anatomical landmarks.

Question 27

What is adductor canal compression syndrome?

Answer 27

Entrapment of the neurovascular bundle within the adductor canal.

Question 28

What causes adductor canal compression syndrome?

Answer 28

Hypertrophy of muscles adjacent to the adductor canal, like the vastus medialis.

Question 29

What is the popliteal fossa?

Answer 29

A diamond shaped area on the posterior side of the knee.

Question 30

What are the borders of the popliteal fossa?

Answer 30

Superiomedial - semimembranosus.
Superiolateral - biceps femoris.
Inferiomedial - medial head of the gastrocnemius.
Inferiolateral - lateral head of the gastrocnemius.
Floor - posterior surface of the knee joint capsule and the posterior surface of the femur.
Roof - popliteal fascia and skin.

Question 31

What are the contents of the popliteal fossa?

Answer 31

Popliteal artery (deepest), popliteal vein, tibial nerve (superficial), and common fibular nerve (superficial).

Question 32

Which vein pierces the popliteal fossa to empty into the popliteal vein?

Answer 32

Small saphenous vein.

Question 33

What is Baker’s cyst?

Answer 33

The swelling of the semimembranosus bursa, often with arthritis of the knee.

Question 34

Why do popliteal aneurysms cause a problem?

Answer 34

The popliteal fossa is tough and non extensible so an aneurysm of the popliteal artery compresses the other structures, especially the tibial nerve.

Question 35

What are some complications of popliteal aneurysms?

Answer 35

Tibial nerve compression - leg anesthesia, or loss of leg motor function.

Question 36

How are popliteal aneurysms detected?

Answer 36

Obvious palpable pulsation in the popliteal fossa, with abnormal arterial sounds.

Question 37

What can cause popliteal masses?

Answer 37

Baker’s cyst, popliteal aneursym, deep vein thrombosis, adventitial cyst of the popliteal artery, or various neoplasms.