Femoral Triangle.pptx

This article is about anatomy of femoral triangle.

1. Femoral Triangle

2. Femoral Triangle Triangular area Located at superomedial one third part of the thigh .

3. Large neurovascular structures pass through this area, and can be accessed relatively easily . Thus , it is an area of both anatomical and clinical importance.

4. Boundaries It is bounded by: 1. Superiorly by inguinal ligament 2. Medially by medial border of the adductor longus muscle . 3. Laterally by medial border of the sartorius muscle.

5. Boundaries The floor of the femoral triangle is not flat but gutter – shaped Its formed from medial to lateral: 1 . Adductor longus 2 . Pectineus 3 . Iliopsoas Its roof is formed by the fascia lata ( deep fascia )

6. Contents • Femoral artery and its branches • Femoral vein and its tributaries • Femoral n erve • Deep inguinal lymph nodes • Fatty tissue

7. 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.

8. Femoral sheath Divided into three compartments by two fibrous septa • Lateral compartment: femoral a. • Middle compartment: femoral v. • Medial compartment: femoral canal

9. F emoral canal The femoral canal is located in most medial part of the femoral sheath . It is approximately 1.3cm long . The femoral ring is closed by a connective tissue layer – the femoral septum . This septum is pierced by the lymphatic vessels exiting the canal. Cloquet’s node is a lymph node situated in the femoral canal.

10. Femoral canal The boundaries of the femoral ring – Anteriorly : the inguinal ligament – Medially: the lacunar ligament – Posteriorly : the pecten of pubis – Laterally: the femoral vein

11. Applied 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. Heavy bleeding in the leg can be stopped by applying pressure to points in the femoral triangle femoral vein is commonly used for intravenous infusions in infants

12. Clinical Relevance of 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 midway between the pubis symphysis and anterior superior iliac spine .

13. The femoral pulse can be palpated in the femoral triangle, 2 to 3 cm inferior to the midpoint of the inguinal ligament . The head of the femur lies posterior to the femoral artery at this site, making compression of the vessel easy .

14. Clinical Relevance of Femoral Triangle Access to the Femoral Artery The femoral artery is located superficially within the femoral triangle, and is thus easy to access. This makes it suitable for coronary angiography. In coronary angiography, the femoral artery is catheterised with a long thin tube . This tube is navigated up the external iliac artery, common iliac artery, aorta, and into the coronary vessels . A radio-opaque dye is then injected into the coronary vessels , and any wall thickening or blockages can be visualised via x-ray.

15. 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

16. • Urgent or emergency hemodialysis access • Hemoperfusion access in patients with severe drug overdose • Central venous pressure monitoring

17. Saphena varix A  saphena varix is a dilation of the   saphenous  vein at its junction with the femoral vein in the groin due to valvular incompetence.

18. The varix is: soft and compressible disappears immediately on lying down exhibits an expansile cough impulse demonstrates a fluid thrill Percussion over the saphenous vein in the thigh produces a transmitted impulse in the varix above

19. Inguinal lymphadenopathy The horizontal group receive lymph vessels from lower abdomen,urethra , external genitalia and lower half of anal canal. The vertical group receives most of the superficial lymph vessels of the lower limb.

20. Lymph node swellings are common Benign causes include sexually transmitted infections such as herpes simplex, lymphogranuloma venereum , chancroid , and syphilis, and lower extremity skin infections Lymphadenopathy associated malignancies are penile and vulvar squamous cell carcinomas and melanoma.

21. 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 )

22.  Richter’s hernia Richter’s hernia  is a variant of strangulated hernia when only part of the circumference of the bowel is entrapped and is common as a complication of femoral hernia. Part of the circumference of the bowel is entrapped