Download MBBS (Bachelor of Medicine, Bachelor of Surgery) Human Anatomy ppt lectures Topic 87 Femoral Triangle Notes. - anatomy ppt free download human anatomy ppt lectures, medicine notes ppt, anatomy handwritten notes pdf, mbbs 1st year anatomy notes pdf download, best anatomy notes pdf, human anatomy notes pdf, anatomy easy notes pdf, anatomy notes online, anatomy short notes, Anatomy ppt, Powerpoint Presentations and lecture notes.
OBJECTIVES
Describe the anatomy of femoral triangle &
adductor canal regarding:
site, boundaries and contents.
Femoral sheath
Femoral canal
Femoral hernia -applied
SARTORIUS
ORIGIN
Anterior superior iliac
spine
INSERTION
S
Upper part of medial
S
surface of tibia
ACTION
(TAILOR'S POSITION)
Flexion, abduction &
lateral rotation of hip joint
Flexion of knee joint
PECTINEUS
ORIGIN:
Superior pubic
ramus
INSERTION:
P
P
Back of femur
(below lesser
trochanter)
ACTION:
Flexion &
adduction of hip
joint
ILIOPSOAS: ILIACUS & PSOAS MAJOR
I P
M
I P
M
INSERTION:
ACTION:
Lesser trochanter of femur
Flexion of hip joint
Femoral triangle
Contents
? Femoral n.
? Femoral sheath
? Femoral a. and its branches
? Femoral vein and its tributaries.
? Femoral canal
? Deep inguinal lymph nodes
? Fatty tissue
Femoral triangle
Femoral sheath
? A funnel- shaped sheath
? Derived from transversalis
fascia anteriorly and iliac fascia
posteriorly
? It surrounds the femoral vessels
and lymphatic about 2.5cm
below the inguinal ligament.
Femoral sheath
Femoral sheath
Divided into three
compartments by two
fibrous septa
? Lateral compartment:
femoral a.
? Middle compartment:
femoral v.
? Medial compartment:
femoral canal
The femoral canal
? About 1.3cm long , and its upper
opening is called the femoral ring
? Content: a little loose fatty tissue, a
small lymph node of CLOQUET and
some lymph vessels.
? The boundaries of the femoral ring
? Anteriorly: the inguinal ligament
? Medially: the lacunar ligament
? Posteriorly: the pecten of pubis
? Laterally: the femoral vein
? Superior: covered by femoral
septum
Femoral hernia
? If a loop of intestine is forced into the
femoral ring, it expands to form a
swelling in the upper part of the thigh.
Such a condition is known as a femoral
hernia .
? A femoral hernia is more common in
women than in men (possibly because
their wider pelvis and femoral canal ).
Femoral Triangle
Arrangement of Nerve, Artery,
Vein
From medial to lateral
Femoral Vein
V
Femoral Ar
A tery
Femoral Ner
N ve
VAN
Profunda femoris
? Arises from the posterolateral surface of
the femoral artery about 5 cm below the
inguinal ligament.
? Branches:
? Lateral circumflex artery.
? Medial circumflex artery.
? Perforating arteries
Profunda femoris A
Medial circumflex a.
Lateral circumflex a.
perforating arteries
Femoral vein
? Begins at the adductor
tendinous opening
? Continues as external iliac
vein deep to inguinal ligament
? Contains several valves
Femoral nerve
? Arises from the lumbar plexus in the
abdomen, and enters the thigh posterior to
the inguinal ligament and lateral to the
femoral artery.
? It ends by dividing into a number of
branches 2 cm below the inguinal ligament.
? Muscular branches to: pectineus, sartorius,
quadriceps femoris
Femoral nerve
? Cutaneous branches:
? Anterior cutaneous nerves of
the thigh
? Saphenous nerve is the
longest branch of the femoral
nerve. It accompanies the
femoral vessels in the adductor
canal, then accompanies the
great saphenous vein to the
medial side of the leg and food.
Femoral n.
Femoral a.
Femoral v.
Saphenous nerve
The deep inguinal lymph nodes
? Lie medial to the femoral v.
? Receive deep lymphatics of
lower limb, perineal region,
and efferent lymphatics from
the superficial inguinal ln.
? Drain into the external iliac
ln.
Applied/Clinical Anatomy
? -stab wound at the apex of the femoral triangle may
cut all the large vessels of the lower limb , injury to
femoral vessels results in fatal hemorrhage.
? -femoral artery is quite superficial in the femoral
triangle thus can be easily exposed for ligation.
catheters are passed upwards till the heart for certain
minor operations.
? -femoral vein is commonly used fir intravenous
infusions in infants.
Clinical Relevance of the Femoral
Triangle
? Femoral Pulse
? Just inferior to where the femoral artery crosses the
inguinal ligament, it can be palpated to measure the
femoral pulse.
? The femoral artery crosses exactly midway between
the pubis symphysis and anterior superior iliac spine.
The presence of a femoral pulse means that blood is
reaching the lower extremity.
Access to the Femoral Artery
? Within the femoral triangle, the femoral artery
is located superficially, and thus easy to
access. This makes it suitable for a range of
clinical procedures.
? One such procedure is coronary angiography.
? Here, the femoral artery is catheterized with a
long, thin tube. This tube is navigated up the
external iliac artery, common iliac artery,
aorta, and into the coronary vessels.
Cardiac catheterization
? (also called heart catheterization) is a diagnostic and occasionally
therapeutic procedure that allows a comprehensive examination of
the heart and surrounding blood vessels.
? It enables the physician to take angiograms
? record blood flow,
? calculate cardiac output and vascular resistance
? perform an endomyocardial biopsy, and evaluate the heart's
electrical activity.
? Cardiac catheterization is performed by inserting one or more
catheters (thin flexible tubes) through a peripheral blood vessel in
the arm (antecubital artery or vein) or leg (femoral artery or vein)
under x-ray guidance.
Coronary artery balloon angioplasty
? A radioactive dye is then
ejected into the coronary
vessels,
and
any
wall
thickening or blockages can
be
visualized
via
x-ray
imaging.
? The femoral artery can also
be catheterised to draw
blood for arterial blood
gases.
FEMORAL VENOUS CATHETERIZATION
? Indications
? Emergency
venous
access
during cardiopulmonary resuscitation
(CPR), in that it provides a rapid and
reliable route for the administration of
drugs to the central circulation of the
patient in cardiac arrest
? In hypotensive trauma patients
? Urgent or emergency hemodialysis
access
? Hemoperfusion access in patients with
severe drug overdose
? Central venous pressure monitoring
EMBALMING
FEMORAL SHEATH
? The femoral artery, vein
and canal are contained
within a fascial
compartment ? known
as the femoral sheath.
THE FEMORAL CANAL
? The femoral canal is an anatomical
compartment, located in the anterior thigh. It
is the smallest and most medial part of
the femoral sheath.
? It is approximately 1.3cm long.
FEMORAL CANAL - BOUNDARIES
? The femoral canal is located in the anterior
thigh, within the femoral triangle. It can be
thought of as a rectangular shaped
compartment.
? It has four borders and an opening:
? 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
Borders of the femoral canal
? The opening to the femoral canal is located at its
superior border, known as the femoral ring. The
femoral ring is closed by a connective tissue layer ?
the femoral septum.
? This septum is pierced by the lymphatic vessels
exiting the canal.
CONTENTS
? The femoral canal contains:
? Lymphatic vessels ? draining the deep
inguinal lymph nodes.
? Deep lymph node ? the lacunar node.
? Empty space.
? Loose connective tissue.
? The empty space allows distension of the
adjacent femoral vein, so it can cope with
increased venous return, or increased intra-
abdominal pressure..
Clinical Relevance: Femoral Hernia
? The femoral canal is of particular clinical importance,
as it a common site of bowel herniation.
? A hernia is defined as `where an internal part of the
body pushes through a weakness in the muscle or
surrounding tissue wall`.
? In a femoral hernia, part of the small intestine
protrudes through the femoral ring.
FEMORAL HERNIA
? It presents as a lump
situated inferolaterally to
the pubic tubercle.
? more common in women
due to
? their wider bony pelvis
? Narrower blood vessels
FEMORAL HERNIA
? The borders of the femoral canal
are tough, and not particularly
extendible.
? This can compress the hernia,
interfering with its blood supply.
A hernia with a compromised
blood supply is known as
a strangulated hernia
Femoral Canal
? During open femoral hernia repair lacunar ligament may
have to be incised ? this puts an accessory obturator artery
at risk
? 50% of people have an accessory or abnormal obturator
artery
? Accessary Obturator Artery:
? Deep inferior epigastric gives a pubic branch to the
periosteum of superior pubic ramus ? this anastamoses
with the pubic braches of obturator artery
? If obturator artery absent ? then this anastamosis is
patent
Cross-section of the thigh, showing
the borders of the adductor canal.
Note: the adductor magnus is not visible in this
illustration
CONTENTS
? The adductor canal serves as a passageway from
structures moving between the anterior thigh and
posterior leg.
? It contains the femoral artery, femoral vein, nerve to
the vastus medialis and the saphenous nerve (the
largest cutaneous branch of the femoral nerve).
? As the femoral artery and vein exit the canal, they
become the popliteal artery and vein respectively.
Clinical Relevance ? Adductor Canal
Block
? In the adductor canal block, local anaesthetic is
administered in the adductor canal to block
the saphenous nerve in isolation, or together
with the nerve to the vastus medialis.
? The block can be used to provide sensory
anaesthesia for procedures involving the distal
thigh and femur, knee and lower leg on the
medial side.
? The sartorius and femoral artery are used as
anatomical landmarks to locate the saphenous
nerve.
Adductor Canal Compression
Syndrome
? Adductor
canal
compression
syndrome
describes entrapment of the neurovascular
bundle within the adductor canal.
? caused by hypertrophy of adjacent muscles such
as vastus medialis.
? It is most common in young males, who may
present with claudication symptoms due to
femoral artery occlusion (more common) or
neurological symptoms due to entrapment of the
saphenous nerve.
Adductor canal
? An intermuscular cleft situated on the medial aspect of
the middle third of the thigh beneath the sartorius.
? Extends from apex of femoral triangle to adductor
tendinous opening
? Boundies
? Anterior wall: adductor lamina and sartorius
? Lateral wall : vastus medialis
? Posteomedial wall: adductors longus and magmus
? Contents
? Saphenous n.
? Femoral a. and femoral v.
? lymphatic vessels and loose connective tissue
Femoral triangle / RELATIONS
Deep contents
?Femoral a. & v.
surrounded by
femoral sheath
?Profunda
femoris a. ?
principal artery
of thigh
?Lat and med.
femoral
circumflex aa.
?Deep external
pudendal a.
?Femoral n.
?A few deeper
lymph nodes --
Anterior view
Femoral triangle / RELATIONS
Anterior view
Blood vessels and nerve of medial side of thigh
? Obturator a.
? Arises from internal iliac artery in the
lesser pelvis
? passes through the obturator canal where
it divides into anterior and posterior
branches.
? Obturator n.
? Arises from the lumbar plexus in the
abdomen.
? Enters the thigh through the obturator
canal where it divides into anterior and
posterior branches.
? Supplies medial group of muscles of thigh,
obturator externus, and skin of medial
side of thigh
Test
Question
Answer
? What is the midinguinal
? ? way between PS and ASIS
point?
? Name the structure for
? Femoral artery
which the midinguinal point
is a landmark?
Test
Question
Answer
? What is the Midpoint of
? ? way between PT and ASIS
Inguinal Ligament?
? Name the structure for
? Deep inguinal ring
which the midinguinal point
is a landmark?
Test
Question
Answer
? What are the
? Anterior ? medial part of inguinal
borders of the
ligament
Femoral Ring?
? Lateral ? femoral vein
? Posterior ? pectineal ligament and
pectaneus
? Medial ? crescentic edge of
lacunar ligament
This post was last modified on 05 April 2022