Femoral Vessels_RD.pptx

FEMORAL TRIANGLE , WITH VESSELS WITH ITS IMPORTANCE

1. Femoral Vessels Dr. SOMESH M.S. PROFESSOR & HOD

2. FEMORAL TRIANGLE It is the triangular hollow in the upper 1/3 of the front of thigh, and is continuous below with the adductor canal. Boundaries: The triangle has 2 borders (lateral and medial), base (above) and apex (below) in addition to floor and roof. Lateral border: formed by medial border of the sartorius . Medial border: formed by medial border of adductor longus. Base: formed by the inguinal ligament Apex: is the meeting of the lateral and medial borders .

3. ROOF OF THE FEMORAL TRIANGLE Roof: Is formed by skin superficial fascia & its contents and the deep fascia .

4. CONTENTS OF THE FEMORAL TRIANGLE 1. Femoral artery and its branches. 2 . Femoral vein and its tributaries. 3 . Femoral nerve and its branches. 4 . Deep inguinal lymph nodes. Femoral branch of the genito femoral nerve L ateral cutaneous nerve of the thigh.

5. Fascia transversalis Ant. abd. wall muscles Ext. iliac artery Fascia iliaca Iliacus Post. wall of the sheath Skin Femoral artery The femoral sheath is a funnel shaped sheath of deep fascia surrounds the upper 3 -4 cms of the femoral vessels. The anterior wall - Fascia T ransversalis of anterior abdominal wall. The posterior wall - the F ascia I liaca of the posterior abdominal wall. FEMORAL SHEATH

6. FEMORAL SHEATH The sheath is divided by two septa into three compartments: Lateral compartment: contains the F emoral artery and Femoral branch of G enito -femoral nerve . Intermediate compartment: contains the F emoral vein . Medial compartment: Called the Femoral canal , contains lymph node + some fat.

7. FEMORAL ARTERY Mid-Inguinal point as the continuation of the external iliac artery. upper 1/3 rd - femoral triangle , middle 1/3 rd adductor canal. Its uppermost part (3-4 cm) is surrounded by the femoral sheath. It ends at the opening in the adductor magnus where it enters the popliteal fossa and becomes the popliteal artery. A.S.I.S Inguinal lig. Pubic tubercle Apex Add. longus Sartorius Femoral triangle Site of sub. sartorial canal

8. Relations: Ant: Skin,Fascia , femoral Sheath; Med.Femoral . Cut. N. from Lat to Med. Post: Floor of Femoral Triangle Med: FEMORAL Vein Lat : Femoral Nerve ; Med.Femoral . Cut. N + Saphenous N

9. Femoral artery - Superficial Br. Superficial Circumflex iliac: passes laterally to the anterior superior iliac spine (A.S.I.S). Superficial Epigastric : ascends to the lower part of anterior abdominal wall. Superficial External Pudendal : passes medially to the genitalia & superficial to spermatic cord. Branches of femoral a. A.S.I.S Descending genicular a. Superficial epigastric a. Superficial circumflex iliac a. Superficial external pudendal a. Deep external pudendal a. Profunda femoris a.

10. FEMORAL ARTERY Deep branches: Deep external pudendal : passes medially deep to spermatic cord to reach the genitalia. Profunda femoris : arises from the P osterolateral side Descending genicular : arises in the adductor canal. Branches of femoral a. A.S.I.S Descending genicular a. Superficial epigastric a. Superficial circumflex iliac a. Superficial external pudendal a. Deep external pudendal a. Profunda femoris a.

11. PROFUNDA FEMORIS ARTERY Largest branch of Femoral Artery Lateral side, 3 cm below inguinal Ligament Passes deep to adductor muscles between adductor longus & magnus It pierces Adductor Magnus as – 4 th Perforating artery & anastomosis with Muscular br of Popliteal art Lateral Circumflex br - 3 branches- Medial circumflrex br – 3 branches Perforating Arteries – 4 in number Descending Genicular Art

12. BRANCHES OF PROFUNDA ARTERY Femoral a. Ascending Acetabular Transverse Med. circumflex 1 st perforating 2 nd perforating 3 rd perforating 4 th perforating Profunda a. Descending Transverse Lat. circumflex Ascending Profunda a.

13. Blood Supply of head of femur

14. Femoral artery ( surface marking ) symphysis Femoral Pulse – Mid-Inguinal Point Angiographic Studies

15. Femoral Vein From Adductor Canal – it enters femoral triangle through its Apex, lies behind the artery Then it ascends medial side of artery & continues as External Iliac Vein beneath Inguinal Ligament

16. Tributaries: 2 imp ones- Profunda femoris Vein Great saphenous vein

17. Summary Femoral triangle is situated at the upper part of the anterior aspect the thigh Main contents of the triangle are femoral artery, femoral vein, femoral nerve and its branches. Femoral artery and femoral vein are enclosed by the femoral sheath.

18. Summary contd….. Superficial branches arises from the femoral artery Superficial veins do not drain directly into the femoral vein, these drain into great saphenous vein. The femoral canal which forms the medial compartment of the femoral sheath is prone for femoral hernia.

19. MCQ: 1 . The pulsation of Femoral Artery can be best felt at: The Apex of Femoral Triangle t he Adductor canal the mid inguinal Point The popliteal Fossa

20. 2 . A serious complication of fractures of the femoral neck is avascular necrosis of the femoral head. This usually occurs from rupture of which artery? A. Deep Circumflex b. Descending br. Of Lat. Circumflex A C. Medial circumflex Femoral d. 2 nd Peforatoring br. Of Lat. circumflex