IV.B,'The femoral artery bisects the triangb.{S
Femoral vein & its tributaries.
Femoral sheath: surrounding the upper 4 cm of femoral vessels.
Femoral nerve: outside the sheath, but femoral branch of genito-femoral
It is the funnel shaped fascial sleeve which encloses the upper 4 cm of
Furucnoru or rne Fenaonel Sneern:
It allows easy & smooth gliding of the femoral vessels during flexion
and extension of the thigh at the hip joint.
, Sr'fe: below the middle part of Poupart's triangle.
. Size:4 cm long laterally & 1 cm medially.
. Anterior Wall: fascia transversalis.
. Posterior Wall: fascia iliaca.
sepfa divide the sheath into 3 compartmenfs:
. Lateral Compartment: contains the femoral artery & the femoral
branch of genito-femoral nerve.
. Middle Compartment: contains the femoral vein.
. Medial Compartment'the femoral canal.
- lt is the mouth of the femoral canal in the abdomen.
- lt is closed by a plug of fat called femoral septum.
. $@g!9I: Poupart's ligament (inguinal ligament).
. E!g1igl: Cooper's ligament (pectineal ligament).
Medial: Sharp crescentic margin of Gimbernat's ligamen!
N.B. lnguinal ligament, lacunar ligament & reflected part of inguinal
ligament are attached ta pubic tubercle
OUf lef (SApnENOUS OpeNtUC): covered by cribriform fascia
COruf grufS: LN of Cloquet, lymphatic vessels & areolar CT fat (fat distribution
in femoral canal is higher in the upper part).
PoTNTS oF SURGTcAL lnnpoRTANcE
Femoral ring is wider in females because they have wider pelvis,
smaller vessels & weaker ligaments ) higher incidence of femoral
Femoral hernia descends first downwards in the femoral canal, then
foruvards through the saphenous opening. Later on, if it becomes larger
it curves upwards & laterally in the direction of the A.S.l.S. (this is
because of the attachment of Scarpa's fascia to fascia lata at a finger's
breadth below the inguinal ligament.
c- Abnormal obturator artery (see vascular anatomy).
S tf e : naiool& of the thigh. tt begins at
at the opening in adductor magnus muscle.
Femoral vessels: the vein at first is behind
Descending genicular artery: from
femoral artery (anastomtica magna).
Nerve to vastus medialis: lateralto the
4. Saphenous nerye: crosses the vessels
To decrease bleeding in above knee
amputation, we ligate the femoral vessels in the
canal by dividing the sartorius & its fascia.
However, if there is arteriosclerosis, there is no
@bicepsfemoris. ' 2. Upper medial: semitendinosus &
semihembranosus muscles supplemented by
the sartorius, gracilis & adductor magnus.
3. Lower lateral: Iateral head of qastrocnemius
suppiffi"Ey the plantaris riuscle.
4. Lower medial: medial head of gastrocnemius.
-fTe roof of the fossa is formed by:
. Superficial fascia containing:
- The upper part of short saphenous vein.
- Branches of posterior cutaneous nerve of thigh.
. Popliteal fascia (deep fascia of the roof which is a downward extension
of the fascia lata. lt is pierced by saphenous vein).
1. Upper part: popliteal surface of femur.
2. Middle part: back of the capsule of the knee joint.
3. Lower paft: fascia covering the popliteus muscle. The lower limit of the
fossa is the distal border of the popliteus muscle.
1. Lateral popliteal nerve (common peroneal nerve).
2. Medial popliteal nerve (tibial nerve).
5. Termination of the posterior cutaneous nerve of the thigh.
All these structures are embedded in a variable amount of fat.
There are two retinacula: extensor and flexor. These are formed by
thickened deep fascia and their function is to maintain the position of long
Structures that pass anterior to the extensor retinaculum on the
anterior surface of the ankle: (medial to lateral)
. Saphenous nerve and great saphenous vein (anterior to medial
Structures that pass deep to the extensor retinaculum (medial to
lateral) [Tom Has Very Nice Dog & Pig]
. Extensor hallucis longus tendon.
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