Structures That Perforate The Diaphragm and structures of the femoral triangle

Question 1

What are the structures that perforate the diaphragm?

Answer 1

1. T6 - inferior vena cava
2. T10 - Oesophagus, vagal trunk
3. T12 - Aorta, thoracic duct, azygous vein

Question 2

What is the mnemonic to remember it?

Answer 2

I 8(ate) 10 EGGS AT 12 IVC - T8 EsophaGus & vaGuS - T10 Aorta/Azygous & Thoracic duct - T12

Question 3

What are the Aorta branches/landmarks?

Answer 3

1. T12 - Coeliac trunk
2. L1 - Left renal artery
3. L2 - Testicular/ovarian arteries
4. L3 - Inferior mesenteric artery
5. L4 - Bifurcation of the abdominal aorta

Question 4

The femoral triangle?

Answer 4

Is a hollow area in the anterior thigh. Many large neurovascular structures pass through this area, and can be accessed relatively easily. Thus, it is an area of both anatomical and clinical importance.

Question 5

Borders?

Answer 5

As this area is a triangle, it has three borders:

• Superior border – Formed by the inguinal ligament, a ligament that runs from the anterior superior iliac spine to the pubis tubercle.
• Lateral border – Formed by the medial border of the sartorius muscle.
• Medial border – Formed by the medial border of the adductor longus muscle. The rest of this muscle forms part of the floor of the triangle.

Question 6

It also has a floor and a roof:

Answer 6

• Anteriorly, the roof of the femoral triangle is formed by the fascia lata.
• Posteriorly, the base of the femoral triangle is formed by the pectineus, iliopsoas and adductor longus muscles.
• The inguinal ligament acts as a flexor retinaculum, supporting the contents of the femoral triangle during flexion at the hip.

Question 7

Femoral triangle?

Answer 7

Question 8

Answer 8

The femoral triangle contains some of the major neurovascular structures of the lower limb. Its contents (lateral to medial) are:

• Femoral nerve – Innervates the anterior compartment of the thigh, and provides sensory branches for the leg and foot.
• Femoral artery – Responsible for the majority of the arterial supply to the lower limb.
• Femoral vein – The great saphenous vein drains into the femoral vein within the triangle.
• Femoral canal – A structure which contains deep lymph nodes and vessels.

The femoral artery, vein and canal are contained within a fascial compartment – known as the femoral sheath.

Question 9

Femoral Hernia?

Answer 9

• A hernia is defined as “a condition in which part of an organ is displaced and protrudes through the wall of the cavity containing it“.
• In the case of femoral hernia, part of the bowel pushes into the femoral canal, underneath the inguinal ligament.
• This manifests clinically as a lump or bulge in the area of the femoral triangle. It usually requires surgical intervention to treat.