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  • Print publication year: 2020
  • Online publication date: October 2019

Chapter 40 - Femoral Artery Injuries

from Section 9 - Lower Extremities

Summary

  • The common femoral artery is a continuation of the external iliac artery and is approximately 4 cm long. It begins directly behind the inguinal ligament, midway between the anterior superior iliac spine and the symphysis pubis.
  • The profunda femoris artery arises from the lateral aspect of the common femoral artery, towards the femur, approximately 3–4 cm below the inguinal ligament. The common femoral artery continues obliquely down the anteromedial aspect of the thigh as the superficial femoral artery.
  • The superficial femoral artery exits the femoral triangle to enter the subsartorial canal and ends by passing through an opening in the adductor magnus to become the popliteal artery.
  • In the upper third of the thigh, the femoral vessels are contained within the femoral triangle (Scarpa’s triangle).
    • The femoral triangle is formed laterally by the medial border of the sartorius muscle, medially by the adductor longus, and superiorly by the inguinal ligament.
    • In the femoral triangle, the femoral vein lies medial to the femoral artery. The greater saphenous vein drains into the femoral vein about 3–4 cm below the inguinal ligament; further distally, the femoral vein lies posterior to the artery and maintains this relationship in the popliteal fossa. The femoral nerve and its branches are found lateral to the common femoral artery.
  • In the middle third of the thigh, the femoral artery lies within the adductor canal (Hunter’s canal), an aponeurotic tunnel in the middle third of the thigh that extends from the apex of the femoral triangle to the opening in the adductor magnus.
    • The adductor canal is bounded by the sartorius muscle anteriorly, the vastus medialis laterally, and the adductor longus and magnus posteromedially. A fascial plane between the vastus medialis and adductor longus and magnus covers the canal.
    • The canal contains the femoral artery and vein, the saphenous nerve which crosses from lateral to medial, and branches of the femoral nerve.
    • The femoral vein courses from a medial position in the groin to a posterior and then lateral position with respect to the artery as it moves distally towards the knee.
    • The greater saphenous vein courses medially to lie on the anterior surface of the thigh, before entering the fascia lata and joining the common femoral vein at the sapheno-femoral junction near the femoral triangle.