Femoral triangle

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Femoral triangle
Drawing of the left femoral triangle - shows superior portion of the femoral vein.
Right femoral sheath laid open to show its three compartments
Latin trigonum femorale
Gray's subject #157 626

The femoral triangle (of Scarpa) is an anatomical region of the upper inner human thigh. It is a subfascial space which in living people appears as a triangular depression inferior to the inguinal ligament when the thigh is flexed, abducted and laterally rotated.[1]

Boundaries

The femoral triangle is bounded:

Its floor is formed by the pectineus and adductor longus muscles medially and iliopsoas muscle laterally. Its roof is formed by the fascia lata, except at the saphenous opening where it is formed by the cribriform fascia.

The femoral triangle is shaped like the sail of a sailing ship and hence its boundaries can be remembered using the mnemonic, "SAIL" for Sartorius, Adductor longus and Inguinal Ligament.[3]

Contents

The femoral triangle is important as a number of vital structures pass through it, right under the skin. The following structures are contained within the femoral triangle (from lateral to medial):

  • Femoral nerve and its (terminal) branches.
  • Femoral sheath and its contents:
  • Femoral artery and several of its branches.
  • Femoral vein and its proximal tributaries (e.g., the great saphenous and deep femoral veins).
  • Deep inguinal lymph nodes and associated lymphatic vessels.

Clinical significance

Since the femoral triangle provides easy access to a major artery, coronary angioplasty and peripheral angioplasty is often performed by entering the femoral artery at the femoral triangle. Heavy bleeding in the leg can be stopped by applying pressure to points in the femoral triangle. Another clinical significance of the femoral triangle is that the femoral artery is positioned at the midinguinal point (midpoint between the pubic symphysis and the anterior superior iliac spine); medial to it lies the femoral vein. Thus the femoral vein, once located, allows for femoral venopuncture[citation needed]. Femoral venopuncture is useful when there are no superficial veins that can be aspirated in a patient, in the case of collapsed veins in other parts of body (e.g. arms)[citation needed]. The positive pulsation of the femoral artery signifies that the heart is beating and also blood is flowing to the lower extremity[citation needed].

It is also necessary to appreciate clinically that this is a case where the nerve is more lateral than the vein. In most other cases the nerve (relative to its associated artery and vein) would be the deepest or more medial followed by the artery and then the vein. But in this case it is the opposite. This must be remembered when venous or arterial samples are required from the femoral vessels[citation needed]. This can be remembered with the mnemonic "venous neares(t) the penis." The femoral triangle is also important in the embalming of bodies, as the femoral artery is often exposed and used to pump embalming fluids into the body. The order of this neurovascular bundle can be remembered using the mnemonic, "NAVY" for Nerve, Artery, Vein, Y -fronts (the British term of a style of men's underwear with a "Y" shaped front that acts as a fly). The "Y" is midline (corresponding with the penis) and the mnemonic always reads from lateral to medial (in other words, the Femoral Nerve is always lateral). An alternate to this mnemonic is "NAVEL" for Nerve, Artery, Vein, Empty Space and Lymph, to include the deep inguinal lymph nodes located medial to the Femoral vein.

Additional images

References

  1. ↑ Moore, Keith L. Clinically oriented anatomy (7th ed. ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health. ISBN 978-1451119459. 
  2. ↑ http://archive.student.bmj.com/search/pdf/03/09/sbmj318.pdf
  3. ↑ "Medical mnemonics". LifeHugger. Retrieved 2009-12-19. 

External links

Superficial anatomy and general regions of limbs (TA A01.2.07–08, GA 12.1325)
Upper limb
Lower limb
General anatomy: systems and organs, regional anatomy, planes and lines, superficial axial anatomy, superficial anatomy of limbs
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