FEMORAL TRIANGLE.ppt

femoral triangle

1. FEMORAL SHEATH
FEMORAL CANAL
FEMORAL NERVE
FEMORAL VESSELS
MUSCLES RELATED TO FEMORAL TRIANGLE
FEMORAL TRIANGLE

2. FEMORAL TRIANGLE
Triangular depression in
the upper 1/3
rd
of the
front of thigh below the
inguinal ligament with
the apex directed
below.
SCARPA’S
triangle.

4. BOUNDARIES

9. CONTENTS
oVAN

11. FEMORAL SHEATH
Funnel shaped fascial
prolongation around the
proximal part of femoral
vessels.
Blends with tunica
adventitia of vessels 3-4
cm below the inguinal
ligament.
Formation
Anterior wall -fascia
transversalis
Posterior wall -fascia
iliaca.
Femoral nerve is not
enclosed within the
sheath as it passes
entirely beneath the
fascia iliaca.

14. FEMORAL SHEATH
SUBDIVISIONS
Lateral wall -vertical
Medial wall -slopes downward and laterally
2 A-P septa divide the sheath into 3
compartments
Femoral
sheath
Lateral
compartment
Femoral
artery
Femoral br.of
GF nerve
Intermediate
compartment
Femoral vein
Medial
compartment
Femoral
canal

15. FEMORAL SHEATH -
COMPARTMENTS

18. STRUCTURES PIERCING
FEMORAL SHEATH
LATERALLY -femoral
br.of genitofemoral.N
IN FRONT -
sup.epigastric.A,
sup.Cx iliac A,
sup.Ext.Pudendal A.
(not the
corresponding veins)
MEDIALLY -great
saphenous vein and
lymphatics.

19. FUNCTION OF FEMORAL
SHEATH
Allows the femoral vessels to glide freely in & out
beneath the inguinal ligament during movements
of hip joint.

20. FEMORAL CANAL
Medial compartment of
femoral sheath.
Conical,& is 1.25cm long
Base is directed above,&
forms oval shaped ring
measuring 1.25cm in
transverse diameter -
FEMORAL RING.
Ring is closed-femoral
septum(condensation of
extra peritoneal tissue
covered by parietal
peritoneum)
Septum is pierced by
lymphaticsconnecting the
deep inguinal with external
iliac nodes.

21. FEMORAL RING
BOUNDARIES OF FEMORAL RING
anterior-inguinal ligament
posterior-pectineuswith its
covering fascia.
medial-base of lacunarligament.
lateral-femoral vein.
STRUCTURES RELATED TO
FEMORAL RING
1. spermatic cord(male) / round
ligament of the uterus (female) lie
immediately above the anterior
margin of the ring
2. inferior epigastricvessels are
close to its upper and lateral angle

23. CONTENTS OF FEMORAL
CANAL
1.Lymph node -
CLOQUET’S NODE
2.Loose areolartissue.
Canal allows the
expansion of femoral
vein during increased
venous return from the
lower limb
Femoral ring -wider in
females
( Due to greater width
of female pelvis &
narrow diameter of
femoral vessels in
females)

24. FEMORAL HERNIA
HERNIA -abnormal protrusion of a viscusthrough
the opening in the wall of the cavity containing it.
FEMORAL HERNIA -protrudes through the femoral
ring
More common in females than males due to larger
femoral ring.

27. FEMORAL HERNIA-
PATHOGENESIS
Finally turns upward around upper margin of saphenousopening
Further descent is prevented by narrow sap.opening,closeattachment of sup.fascia& sheath to lower rim of saphenous
opening,vessels
Pushes forward through the saphenousopening
Bulges downward through the femoral ring into femoral canal
Pushes out a hernialsac of peritoneum covered by femoral septum
A section of intestine bulges through the ring

29. FEMORAL HERNIA
COVERINGS
From within outwards
Peritoneum of hernialsac
Femoral septum
Anterior wall of femoral sheath
Cribriformfascia
Superficial fascia and skin

30. FEMORAL VEIN
Continuation of popliteal
vein from the fifth osseo-
aponeuroticopening in the
adductor magnus
Ends as external iliac vein
beneath inguinal ligament

31. FEMORAL VEIN
COURSE
In the adductor canal-
lies behind the artery in
upper part &
posterolateralin lower
part.
In the femoral triangle-
enters through the
apex, posterior to artery
& ascends lying
medially.
In the femoral sheath
occupies middle
compartment.

32. FEMORAL VEIN
TRIBUTARIES
Great saphenous vein.
Profunda femoris vein.

33. FEMORAL VEIN
APPLIED ANATOMY
Catheterization is most
commonly done in this
vein.

34. FEMORAL NERVE
Nerve of extensor
compartment of thigh.
Largest branch of
lumbar plexus.
ROOT VALUE
dorsal branches of
ventral ramiof
L2,L3,L4.

35. FEMORAL NERVE
COURSE
Appears in the iliac fossa
undercover of fascia iliaca
between psoasmajor &
iliacus.
Enters femoral triangle
behind inguinal ligament
lateral to femoral sheath &
is separated from fem.
artery by psoasmajor
tendon.
Trunk splits into anterior &
posterior divisions by
lateral Cxfemoral artery
about 2-3 cm below the
inguinal ligament.

36. FEMORAL NERVE -BRANCHES
Femoral
nerve
Trunk
Nerve to
iliacus,pect
ineus,vasc
ular
branches
Anterior division
Intermediat
e femoral
cutaneous
nerve
Medial
femoral
cutaneous
nerve
Nerve to
sartorius
Posterior division
Saphenous
nerve
Muscular
br.to
quadriceps
femoris

37. SAPHENOUS NERVE
Longest cutaneous
nerve of body
Arises from
post.divisionof
femoral.N
COURSE
IN THIGH-extends
downward along lateral
side of femoral artery in
triangle& upper part of
hunter’s canal
Crosses the artery from
lat to medial in the
middle of the canal &
leaves it by piercing its
roof.

38. SAPHENOUS NERVE
IN KNEE
Reaches posteromedial
surface of knee,pierces
fascia latabetween
sartorius& gracilis, then
gives off infrapatellarbr.
IN LEG
Accompanies GSV, lying
first behind then in front
Passes down on medial
side of leg along medial
border of tibia
Lower 3
rd
of leg-2
branches
One extends uptoankle
Other goes uptodorsum
of ball of great toe

39. SAPHENOUS NERVE
DISTRIBUTION
Infra patellar branch -
skin in front of patella
Medial part of upper
2/3
rd
of front of leg.
Medial part of lower
1/3
rd
of leg.
Medial part of
posterior aspect of leg.
Proximal part of
medial side of dorsum
of foot.