Lower Limb Anatomy For The MRCS Part A(Matary+miscellaneous) Flashcards
Define the femoral triangle
It is a subfascial space
What is the shape of the femoral triangle?
Is a triangular depression
What is the location of the femoral triangle?
(1) Situated in the front of the upper 1/3rd of the medial aspect of the the thigh
(2) Just below the inguinal ligament
Discuss the boundaries of the femoral triangle
What is the superior(base) boundary of the femoral triangle?
Inguinal ligament
What is the lateral boundary of the femoral triangle?
Medial border of sartorius
What is the medial boundary of the femoral triangle?
Medial border of adductor longus(so the muscle also shares in the floor)
What is the apex of the femoral triangle?
Meeting of the medial border of sartorius laterally and the medial border of adductor longus medially(the beginning of the adductor canal or hunter’s canal)
What is the significance of the apex of the femoral triangle?
The beginning of the adductor canal(hunter’s canal)
What is the shape of the floor of the femoral triangle?
Gutter shape
What is the the floor of the femoral triangle?
From lateral to medial(mnemonic;IPA):
(1) Iliopsoas(iliacus and psoas major muscle)-Iliacus lies posterior to the femoral nerve in the femoral triangle
(2) Pectineus
(3) Adductor longus
Discuss the roof of the femoral triangle
What is the location of the superficial fascia of the thigh in femoral triangle?
Just a finger breadth below the inguinal ligament
What are the constituents of the superficial fascia of the roof of the femoral triangle?
(1) Superficial fatty layer
(2) Deep membranous layer
What are the structures between the skin and the superficial fascia of the roof of the femoral triangle of the thigh?
Mnemonic;FEET GI
(1) superficial branch of (F)emoral artery
(2) superficial (E)pigastric vessels
(3) superficial (E)xternal pudendal artery
(4) (T)-shaped superficial inguinal lymph nodes(palpable below the inguinal ligament)
(5) (G)reat(long)saphenous vein
(6) (I)lioinguinal nerve
Where is the superficial inguinal lymph nodes can be palpable?
Palpable below the inguinal ligament
What is the other name of the deep fascia of the thigh?
Fascia lata
What does the deep fascia of the the thigh(fascia lata)contain ?
The saphenous opening which is a defect or a gap in the deep fascia of the thigh covered by cripriform fascia
What is covering the saphenous opening?
Cripriform fascia
Discuss the contents of the femoral triangle
What is the arrangement of the contents of the femoral triangle?
1st/At the apex-structures are arranged from anterior to posterior:-
(1) Femoral artery
(2) Femoral vein
(3) Profunda femoris vein
(4) Profunda femoris artery
2nd/In order from lateral to medial(other structures):-
(1) Great(Long) saphenous vein-lies lateral to the femoral vein
(2) Structures lie more laterally are
1)Deep and superficial inguinal lymph nodes
2)Lateral cutaneous nerve of the thigh
3)Femoral branch of the genitofemoral nerve
What is the other name of the femoral sheath?
Crural sheathe
Define the femoral sheath
Is a downward protrusion of the fascial lining of the abdominal wall into the thigh(i.e.,it is a subfascial tunnel or space)
What is the location of the femoral sheath?
Below the middle part of inguinal ligament
What is the shape of the femoral sheath?
A funnel shape sleeve or conical
What is the size of the femoral sheath?
(1)1 inch(2.5 cm) -1.56 inch(4 cm)-i.e.,it has a variable length and terminates by blending in with the adventitia
of the femoral blood vessels.4 cm long laterally and 1 cm long medially
(2)The femoral sheath surrounds the femoral vessels and lymphatics for about 1 inch(2cm) to 1.57 inch(4 cm).
4 cm below the inguinal ligament.
Discuss the formation of the femoral sheath
It is formed within the abdomen from:-
(1) Transversalis fascia
(2) Psoas fascia
What is the extension of the femoral sheath?
Extends from the abdomen,inferior to the inguinal ligament,into femoral triangle.
What is the function of the femoral sheath?
(1)Encloses the upper 4 cm of the femoral vessels
(2)It allows easy and smooth gliding of the femoral vessels during flexion and extension of the hip at the hip
joint.
Discuss the walls of the femoral sheath
There are 3 walls for this anatomical structure
1st/Anterior wall-1) continuous above with the fascia transversalis
2)It is pierced by the femoral branch of the genitofemoral nerve
2nd/Posterior wall-continuous with psoas fascia or fascia iliacus
3rd/Medial wall-lacunar ligament
Discuss the compartments of the femoral sheath
Two anteroposterior thin fibrous septa divide the femoral sheath into 3 compartments:
1st/Lateral compartment-contents
(1) common femoral artery-the femoral artery as it enters the thigh beneath the inguinal ligament occupies the lateral compartment of the femoral sheath,i.e.,lies laterally in the femoral sheath
(2) femoral branch of the genitofemoral nerve-pierces the anterior wall of the femoral sheath,running
on the anterior surface of the external iliac artery
2nd/Intermediate(middle)compartment-contents:
common femoral vein-the femoral vein as it leaves the thigh lies medial to the common femoral artery and occupies the intermediate compartment
3rd/Medial compartment-Femoral canal
What divides the femoral sheath into compartments?
Septa:-
(1) two
(2) anteroposterior
(3) thin
(4) fibrous
(5) divide the femoral sheath into 3 compartments
What are the features of the septa that divide the femoral sheath into compartments?
(1) two
(2) anteroposterior
(3) thin
(4) fibrous
(5) divide the femoral sheath into 3 compartments
What are the contents of the lateral compartment of the femoral sheath?
(1)common femoral artery
The common femoral artery as it enters the thigh beneath the inguinal ligament,occupies the lateral compartment of the femoral sheath,i.e.,it lies laterally in the femoral sheath
(2)the femoral branch of the genitofemoral nerve
Pierces the anterior wall of the femoral sheath running on the anterior surface of the external iliac artery
What is the other name of the intermediate compartment of the femoral sheath?
Middle compartment
What are the contents of the intermediate compartment of the femoral sheath?
Common femoral vein-The femoral vein as it leaves the thigh:
(1) lies medial to the common femoral artery(i.e.,lies medially in the femoral sheath
(2) occupies the intermediate(middle)compartment
What are the contents of the medial compartment of the femoral sheath?
Femoral canal
Define the femoral canal
The small medial compartment for the lymph vessels is termed the femoral canal
What is the location of the femoral canal?
The femoral canal lies at the medial aspect of the:-
(1) Femoral sheath-the femoral canal is the most medially located in the femoral sheath
(2) Femoral vein-the femoral canal lies medial to the femoral artery
What is the size of the femoral canal?
It is about 0.5 inch to 1.5 inch
What is the shape of the femoral canal?
Funnel shape
What are the boundaries(borders) of the femoral canal?
What is the other name of the inlet of the femoral canal?
(1) Base
(2) Femoral ring
Define the femoral ring
(1) It is the upper opening of the femoral canal
(2) Represents the mouth of the femoral canal in the abdomen
What is the structure that closes the femoral ring?
Femoral septum
Define the femoral septum
Is a condensation of extra peritoneal tissue and fat
What is the function of the femoral septum for the femoral ring?
These functions occurs in the following sequence:
(1) plugs the opening of the femoral ring
(2) closes the femoral ring
What are the relations and boundaries of the femoral septum in the femoral ring?
What are the relations(boundaries)of the femoral ring?
What is the other name for outlet of the femoral canal?
(1) Apex
(2) Saphenous opening
Define the saphenous opening
Is a defect or a gap in the deep fascia of the thigh(fascia lata)and covered by cripriform fascia
What is the location of the saphenous opening?
(1) In front of the thigh
(2) Just below the inguinal ligament
(3) It is situated about 1.5 inch(4 cm) below and lateral to the pubic tubercle
What are the landmarks of the saphenous opening?
(1)Cribriform fascia-a loose connective tissue filling the saphenous opening
(2)Falciform margin
.Definition:is the lower lateral border of the saphenous opening
.Location:lies anterior to the femoral vessels
Define the cripriform fascia
a loose connective tissue filling the saphenous opening
Define the falciform margin and where it is located?
.Definition:is the lower lateral border of the saphenous opening
.Location:lies anterior to the femoral vessels
Define the falciform margin
is the lower lateral border of the saphenous opening
What is the location of the falciform margin?
lies anterior to the femoral vessels
Discuss the direction of borders of the saphenous opening
What are the contents of the femoral canal?
What is the importance of the femoral canal?
What is the physiological importance of the femoral canal?
What is the pathological importance of the femoral canal?
What is the surgical importance of the femoral canal?
Discuss the femoral hernia in relation to the femoral canal
What is the mechanism of the femoral hernia in relation to the femoral canal?
Why is femoral hernia is more common in females?
What is the direction of descend of the femoral hernia?
Discuss the boundaries of the femoral sheath
What is the other name for the adductor canal?
(1) Hunter’s canal
(2) Subsartorial canal
Define the adductor canal
Is an intermuscular cleft
What is the location of the adductor canal?
(1) situated on the medial aspect of the middle 1/3rd of the thigh
(2) immediately distal to the apex of the femoral triangle
(3) deep to the sartorius muscle-since the name subsartorial canal
What is the shape of the adductor canal?
Triangular
Discuss the boundaries of the adductor canal
Where does the adductor canal begin?
It begins above at the apex of the femoral triangle
Where does the adductor canal terminate?
It ends below at the adductor hiatus (the opening in the adductor magnus)
Where does the adductor canal terminate?
It ends below at the adductor hiatus (the opening in the adductor magnus)
Discuss the walls of the adductor canal
Discuss the structure of the walls of the adductor canal?
1st/the anteromedial wall(roof)
(1) a strong fibrous wall on which lies the sartorius muscle
(2) fascia
2nd/the posterior wall(floor)
(1) adductor longus muscle
(2) adductor magnus muscle
3rd/the lateral wall
Vastus medialis muscle