WELCOME
ANATOMY OF
FEMORAL TRIANGLE
BY:
Dr. Manjula Vastrad
Asst Prof
Dept of Rachana Shareera
SMVVS RKM AMC
VIJAYAPURA
INTRODUCTION
Is a triangular depression
on the front of upper one
third of the thigh immediately
below the inguinal ligament
BOUNDARIES
Laterally - medial border of
sartorius
Medially - medial border of
adductor longus
Base - inguinal ligament
Apex - directed downwards,
is formed by the point
where medial & lateral
ROOF
Skin
Superficial fascia containing
superficial inguinal lymph
nodes
Femoral branch of
genitofemoral nerve
Branches of ilioinguinal nerve
Superficial branches of
femoral vessels
Upper part of great
saphenous vein
Deep fascia with saphenous
FLOOR
Medially-adductor longus &
pectineus
Laterally-psoas major &
iliacus
CONTENTS
1. Femoral artery & its branches
2. Femoral vein & its tributaries.
3. Nerves
Femoral nerve
Nerve to pectineus
Femoral branch of the gentiofemoral nerve
Lateral cutaneous nerve of thigh
4. Femoral sheath
5. Femoral canal
6. Deep inguinal lymph nodes
CONTENTS
FEMORAL ARTERY
ORIGIN
Is the continuation of external iliac artery
It traverses the triangle from its base at the mid inguinal
point to the apex
EXTENT AND COURSE
Passes downwards and medially, first in femoral
triangle and then in adductor canal
Then passes through an opening in adductor Magnus
to become continuous with popliteal artery
RELATIONS IN FEMORAL TRIANGLE
Anterior - skin,superficial fascia, deep fascia and
anterior wall of femoral sheath
Posterior - rests on psoas major, pectineus and
adductor longus
Medially - Femoral vein
Laterally - Femoral nerve and its branches, nerve to
pectineus, femoral branch of genito femoral nerve,
lateral cutaneous nerve of thigh.
RELATIONS
BRANCHES
Gives 3 superficial and 3 deep branches in femoral
triangle
SUPERFICIAL BRANCHES
Superficial external pudendal - supplies skin and
external genital organs
Superficial epigastric for skin and fasciae of lower part of
anterior abdominal wall
Superficial circumflex iliac for skin along iliac crest
BRANCHES
DEEP BRANCHES
Profunda femoris - largest branch
Arises from lateral side of femoral artery 4cm
below inguinal ligament, supplies all 3
compartments of thigh
Branches
Medial circumflex femoral artery Supplies adductor
muscles and head of femur
Lateral circumflex femoral artery Supplies
Four perforating arteries arise in
front of thigh. Second perforating
artery gives rise to nutrient artery
to femur
1st at upper border of adductor
brevis
2nd in front of adductor brevis
3rd immediately below adductor
brevis
4th is the termination of profunda
femoris artery
Deep external pudendal artery
Pass deep to spermatic cord / round ligament of uterus
supplies scrotum or labium major
Muscular branches
Arise from femoral and profunda femoris artery or its
branches to supply muscles of thigh
FEMORAL VEIN
ORIGIN
Begins as an upward continuation of the popleteal vein
at the lower end of adductor canal.
TERMINATION
Ends by becoming continuous with the external iliac
vein behind the inguinal ligament
COURSE
Accompanies the femoral artery, the vein is medial to
artery in the base of the triangle ends at lower end of
TRIBUTARIES
It receives great sephenous vein
Veins accompanying three deep branches of femoral artery in
femoral triangle, deep external pudendal and muscular.
Lateral and medial circumflex femoral veins
The descending genicular and muscular veins in adductor canal.
NERVES
Femoral nerve
Lies lateral to femoral artery, outside the femoral sheath, in
the groove between ilicus and psoas major muscles.
Branches-
Muscular- ant supplies- sartorius & post supplies all the vasti
and rectus femoris
Cutaneous- ant div gives 2 cut i.e intermediate & medial cut
nerve of thigh and post div gives 1 i.e saphenous nerve
Articular branches- hip jt & knee jt
Vascular branches to femoral artery & its branches
Nerve to pectineus
Arises from femoral nerve just above the inguinal ligament.
Passes behind femoral sheath to reach the surface of pectineus.
Femoral branch of genito femoral nerve.
Occupies the lateral compartment of femoral sheath along
with femoral artery. It supplies most of skin over femoral triangle.
Lateral cutaneous nerve of thigh
Crosses lateral angle of triangle . Runs on lateral side of thigh
dividing into anterior and posterior branches. Supplies
anterolateral aspect of thigh and lateral aspect of gluteal region
respectively
FEMORAL SHEATH
Is a funnel shaped sleeve of fascia enclosing upper 3-4cm of
femoral vessels
Sheath is formed by downward extension of 2 layers of fascia
of abdomen
Anterior wall of sheath is formed by fascia transversalis which
lies in anterior abdominal wall deep to transversalis abdominis.
Posterior wall is formed by fascia iliaca, which covers the iliacus
muscle.
Inferiorly sheath merges with connective tissue around femoral
vessels
Femoral sheath is asymmetrical
Lateral wall is vertical
Medial wall is oblique being
directed downwards and laterally
Sheath is divided into following 3
compartments by septa
Lateral or arterial - contains
femoral artery and femoral branch
of genito femoral nerve
Intermediate or venous -
contains femoral vein
Medial or lymphatic - is smallest
of all and is known as femoral
FEMORAL CANAL
This is medial compartment
of femoral sheath, conical in
shape
Being wide above or at base
and narrow below
Is 1.5cm long and 1.5cm wide
at its base.
Base or upper end of femoral
canal is called femoral ring
FEMORAL RING
Boundaries of ring
Anteriorly inguinal ligament
Posteriorly pectineus and its covering fascia
Medially concave margin of lacunar ligament
Laterally a septum separating it from femoral vein
Femoral canal contains lymph node of colquet or of Rosen
Muller, lymphatics and small amount of areolar tissue, lymph
node drains glans penis in males and clitoris in females.
DEEP INGUINAL LYMPH NODES
Lie deep to deep fascia
Lie medial to upper part
of femoral vein and
receives lymph from
superficial inguinal lymph
nodes from glans penis or
clitoris and deep
lymphatics of lower limb
APPLIED
ANATOMY
FEMORAL HERNIA
Femoral canal is an area of
potential weakness in the abdominal
wall through which abdominal contents
may bulge out forming a femoral
hernia.
Is more common in females
because the femoral canal is wider in
them than in males.
This is associated with wider pelvis,
and the small size of femoral vessels in
the females.
In cases of strangulation of the
femoral hernia, the surgeon has to
ABNORMAL OBTURATOR ARTERY
Normal obturator artery is the branch of internal iliac,
occasionally this appears to be branch of inferior epigastric .
Usually the abnormal artery passes laterally to the femoral
canal in contact with the femoral vein and is safe in an operation
to enlarge femoral ring i.e along with the free margin of lacunar
ligament.
Such an artery is likely to cut if an attempt is made to enlarge
the femoral ring cutting lacunar ligament.
NERVE INJURIES
Injury to femoral nerve by
wounds in the groin, though
rare, causes paralysis of the
quadriceps femoris and sensory
deficit on the anterior and
medial sides of thigh thigh and
medial side of leg.
Lateral cutaneous nerve of
thigh May get enlarged in the
inguinal ligament. This leads to
pain in on lateral side of thigh. It
is called Meralgia parasthetica.
COMPRESSION OF FEMORAL ARTERY
At the mid inguinal point
against the head of femur or
against the superior ramus of
the pubis to control bleeding
from the distal part of the limb in
the thigh or leg.
The femoral artery is
exposed in the adductor canal
for various surgical procedures.
PULSATION OF FEMORAL ARTERY
Can be felt at mid inguinal
point, against the head of
femur and the tendon of psoas
major.
A bilateral absence or
feebleness of the femoral
pulse may result from
narrowing of aorta or
thrombosis, i.e the clotting of
blood within the aorta.
LIGATION OR CATHETERISATION
Since the femoral artery
is quite superficial in
femoral triangle, it can be
easily exposed for ligation
i.e tying or for passing a
cannula or a thick needle.
Catheters are passed
upwards till the heart for
certain minor operations.
STAB WOUNDS
At the apex of femoral triangle may cut all the large
vessels of lower limb because the femoral artery and
vein, and the profunda femoris artery and vein are
arranged in one line from before backwards at this site.
Injury to femoral vessels results in fatal haemorrhage.
INTRAVENOUS INFUSIONS
Femoral vein is commonly used for intravenous
infusions in infants and in patients with peripheral
circulatory failure.
THANK
YOU
