ANTERIOR COMPAR

TMENT OF THIGH
FEMORAL TRIANGLE
DEFINATION-

SITUATION-

PURPOSE-
 BOUNDARIES

BASE
APEX
MEDIAL BORDER
LATERAL BORDER
FLOOR
ROOF
 Ant.sup.iliac spine

Inguinal ligament

Pubic tubercle

Iliacus
Pectineus

Psoas major
tendon Adductor longus

Sartorius
BASE APEX &
FLOOR
 ROOF OF FEMORAL TRIANGLE

Skin
Superficial fascia
Fascia lata

Cribriform fascia

Femoral sheath
Iliacus Adductor longus

Tendon of Psoas major Pectineus

 Ant.sup.iliac.spine
CONTENTS
Inguinal canal Genitofemoral nerve
Pubic tubercle

Femoral sheath

Adductor longus
Lat.cut.n.of thigh
Femoral canal
i
Femoral nerve Femoral vein
Femoral artery

Sartorius
 Anterior superior iliac spine
Inguinal ligament
Femoral sheath

Pubic tubercle

Femoral vein
Sartorius

Femoral artery

Adductor longus
FEMORAL VESSELS
Inguinal ligament
Femoral sheath
Skin
Superficial fascia

Psoas tendon
Fascia lata Iiacus
Genitofemoral nerve
Hip joint

Femoral artery LCFA

Adductor
magnus

Adductor
Femoral vein
brevis

Adductor longus
Pectineus
MCFV

RELATIONS OF FEMORAL ARTERY

 Ant.sup.iliac.spine
Superficial epigastric

Superficial ext pudendal

Sup.cir.iliac
Pubic tubercle

Deep ext pudendal

Lateral circumflex
Medial circumflex
Femoral artery

Femur Profounda femoris

Descending genicular Hiatus magnus

BRANCHES OF FEMORAL ARTERY

Ant.sup.iliac.spine

Inguinal ligament
Femoral canal
Pubic tubercle

Femoral sheath
Femoral vein

Femoral artery

FEMORAL SHEATH
 Peritoneum

Genitofemoral nerve

Femoral artery

Fascia iliaca

Fascia transversalis

Inguinal ligament

FORMATION OF FEMORAL SHEATH

 Peritoneum

Genitofemoral nerve
Inguinal
Femoral artery
ligament
Fascia
transversalis Fascia iliaca

Femoral sheath

FORMATION OF FEMORAL SHEATH

 Femoral sheath

Gland of cloquet

Femoral canal

Genitofemoral nerve Femoral vein

Femoral artery

T.S OF FEMORAL SHEATH SHOWING THE CONTENTS

 Femoral fossa
Peritoneum
Genitofemoral Femoral septum
nerve

Femoral canal
Femoral
artery Femoral vein

Falciform margin
Femoral
sheath Cribriform fascia

Saphaneous opening

FEMORAL CANAL AND FEMORAL RING

 SEXUAL DIFFERENCE FOR FEMORAL CANAL

It is wider in females due to-

-wider pelvis
-smaller diameter of femoral blood
vessels
 LUMBAR PLEXUS Iliohypogastric nerve

L1 Ilioinguinal nerve

Lat.cut.nerve.of.thigh L2 Genitofemoral nerve

Femoral nerve L3 Obturator nerve

L4 Accessory obturator nerve

Branch to Lumbosacral trunk

ANTERIOR PRIMARY RAMI

DORSAL DIVISIONS VENTRAL DIVISIONS

FEMORAL NERVE -COURSE
L2
Iliacus
L3
Psoas major
Inguinal ligament FN L4

Hip joint

Pectineus
Sartorius
QF

LCFA

Medial cutaneous Knee joint

nerve

Intermediate Saphaneous nerve

cutaneous nerve
 APPLIED ANATOMY:-
• PALPATION OF
FEMORAL ARTERY
• The palpation of femoral
artery is done at mid-inguinal
point (midpoint of the
anterior superior iliac spine
and pubic symphysis).
• The artery is easily palpated
here as it can be compressed
against the pectineus and
superior ramus of pubis.
 
• OCCLUSION OF FEMORAL ARTERY:-

• Sudden occlusion of femoral artery by ligature or

embolism is followed by the gangrene.

• However gradual occlusion as occurs in the

atherosclerosis is less likely to be followed by
gangrene because the collateral blood vessels have
time to dilate fully.
• TRAUMATIC INJURY:-
• Injury to large femoral artery can cause rapid
exsanguinations of the patient.
• Unlike upper limb, arterial injuries of lower limb do
not have good prognosis.
• The collateral circulations around the hip and knee
joints are not adequate.
• Damage to neighbouring large vein further increases
the complication.
• The artery can be compressed against the head of
femur at the mid-inguinal point for arresting the
traumatic hemorrhage from the lower limb.
• FEMORAL ARTERY
CATHERIZATION
• Contrast medium can be
injected into the artery and a
permanent record can be
obtained by taking
radiographs.
• This method is used for
coronary angiography and
uterine vessels.
• FEMORAL VEIN
CATHERIZATION:-
• This method is used when
rapid access to large vein
is needed.
• High incidence of
thrombosis, fatal
pulmonary embolism.
• USES OF FEMORAL
VEIN:-

• Femoral vein is used for

taking the blood samples,
infusions and transfusions
in children.
• FEMORAL NERVE
INJURY:-
• The femoral nerve can be
injured in the stab or gunshot
wounds.
• Paralysis of quadriceps femoris
and knee cannot be extended.
• Loss of skin sensation over the
anterior and medial sides of the
thigh, medial side of the lower
part of the leg, and medial
border of the foot upto big toe.
• FEMORAL HERNIA:-
• Protrusion of the abdominal
contents covered by
peritoneum through the
femoral canal.
• Enters saphaneous opening
• Depending upon the
severity of the hernia
surgical mode of the
treatment is done.
 COURSE OF HERNIA-
• The hernial sac passes down the femoral canal pushing the
femoral septum.
• Then it expands to form a swelling in the upper part of the thigh.
• With further expansion the hernial sac turn upwards towards the
inguinal ligament.
• The neck of the hernial sac always lies below and lateral to the
pubic tubercle. The neck of the sac is narrow and lies at the
femoral ring.
• Because of the important
structures at the neck ,the sac
is unable to expand.
• Difficult to push it up and
return it to the abdominal
cavity (irreducible hernia).
• If the person strains or coughs
a piece of bowel may be forced
through the neck and its blood
vessels may be compressed by
the femoral ring, impairing its
blood supply (strangulated
hernia)
• COVERINGS OF
FEMORAL HERNIA-
• From within outwards-
• a) Peritoneum of the
sac.
• b) Femoral septum.
• c) Anterior wall of
femoral sheath.
• d) Cribriform fascia.
• e) Superficial fascia.
• f) Skin.
• TREATMENT-

• Femoral hernia is a dangerous condition and should be treated

surgically. Normally following three ways are used to treat any
hernia.

• They are-
• Herniotomy-In this the total hernial sac is removed along with
gangrenous bowel.
• Herniorapphy-In this the hernia is reduced manually and then
the diameter of femoral ring is reduced.
• Hernioplasty- Hernia is reduced and if to prevent recurrence, a
flap of inguinal ligament or iliotibial tract is used to strengthen
the walls of the canal.
• SURGICAL MEASURES-
• 1) Lottissen’s operation-
• In this, the size of femoral ring is increased in upward
and medial direction; by incising the lacunar ligament;
between two haemostatic clamps then the hernia is
reduced manually. But care should be taken in order to
avoid bleeding from abnormal obturator artery if
present, on lacunar ligament.
 
• 2) Mc’evedy’s operation-
• In this directly inguinal ligament is cut and the hernia
is reduced. Further suturing of ligament is done. If
required, hernioplasty is done.
 
• BLOCK DISSECTION OF
INGUINAL LYMPH
NODES:-
• In case of carcinoma of penis
block dissection of inguinal
lymph nodes is done.
• Superficial fascia, deep fascia
fatty tissue and lymph nodes are
removed along with GSV.
• By detaching inguinal ligament
external iliac nodes can also be
removed through the triangle.
• STAB WOUNDS:-

• Stab wounds at the apex of the femoral triangle may

cut all the large vessels of the lower limb because the
femoral artery, femoral vein and the profounda
femoris artery and vein are arranged in one line from
before backwards at this site.
THANK YOU