femoral triangle, boundaries and contents of femoral triangle. femoral shetah. compartments of femoral sheath. ddfemoral canal. contets of femoral canal. femoral hernia. definition. causes. sign and symptoms. and treatment of femoral hernia.

1. FEMORAL
TRIANGLE
D R S A N A Y A S E E N
A N A T O M Y D E P A R T M E N T

2. INTRODUCTION
• Is a triangular
depression on front
of the upper 1/3rd of
the thigh
immediately below
the inguinal
ligament.

3. BOUNDARIES
MEDIAL: medial border of adductor longus
LATERAL: medial border of sartorius
BASE : Inguinal ligament
Apex: point where medial and lateral boundaries meet.
Roof: skin
superficial fascia: (containing superficial ingunal lymphnodes, femoral
branch fo genito femoral nerve, br of ilioinguinal nerve, superficial branches of
femoral artery and vein and upper part of great sephanous vein).
Deep fascia ( with sephanous opening, cribriform fascia)
Floor: from medial to lateral
adductor longus- pectineus- iliacus and psoas major muscles

5. CONTENTS OF FEMORAL TRAINGLE
ARTERY: femoral artery and its branches (3 superficial and 3 deep branches)
SUPERFICIAL BRANCHES : superficial external pudendal, superficial
epigastric,superficial circumflex iliac artery
DEEP BRANCHES: profunda femoris , deep external pudendal and muscular
branches.
VEIN: femoral vein and its tributaries namely; great sephanous vein, circumflex
vein, corresponding veins to the branches of femoral artery.
FEMORAL SHEATH: covers upper few cm of the vessels
 NERVES: femoral nerve – nerve to pectineus- femoral branch of genitofemoral
nerve- lateral cutaneous nerve of thigh
LYMPH: deep inguinal lymphnodes

7. FEMORAL
SHEATH
• Is funnel shaped sleeve of fascia
enclosing almost upper 3-4cm of
femoral vessels.
• Formed by downward extension
of two layer of abdominal fascia.
Hence making anterior and
posterior wall.
• Anterior wall if formed by fascia
of transversus abdominis muscle
• Posterior wall if formed by fascia
iliaca.
• Inferiorly the sheath merges with
the connective tissue of the
femoral vessels
 Is asymmetrical
structure.
 Lateral wall is vertical,
and medial wall is
obligue, being
directed downward
and laterally

9. • The sheath is divided into 3 compartments:
LATERAL/ ARTERIAL COMPARTMENT: contains femoral artery and
branches and femoral branch of genitofemoral nerve
INTERMEDIATE / VENOUS COMPARTMENT: contains femoral vein
MEDIAL/ LYMPHATIC COMPARTMENT: is the smallest of all and
continue as femoral canal

11. FEMORAL
CANAL
• Is the extension of the medial compartment
of the femoral sheath.
• Conical in shape
• Long: 1.5cm
• Wide: 1.5 cm
• The upper end of the femoral canal is known
as FEMORAL RING.
• Femoral ring is enclosed by condensation of
extraperitoneal connective tissue called
FEMORAL SEPTUM.
• The parietal peritoneum covering the ring
from above shows a depression called
FEMORAL FOSSA
BOUNDARIY OF FEMORAL
RING:
Anteriorly: inguinal ligament
Posteriorly: pectineus and its
fascia
Medially: lacunar ligament
Laterally: septum separating
from femoral vein

12. CONTENTS
• Femoral canal contains:
Lymphnodes of cloquet
Lymphatics
loose areolar tissue

14. HERNIA
DEFINITION
• Is protusion of viscus or the part of viscus from
an opening (natural/ acuired) present in the
wall of its containing cavity.

16. • They are relatively uncommon (they account for 2% of all hernias and
6% of all groin hernias, the other 94% are inguinal),
• more likely to occur in women than in men (70% of femoral hernias
occur in women,
• Located below and lateral to pubic tubercle

19. The femoral canal:
is located below the
inguinal ligament on the lateral
aspect of the pubic tubercle. It
is bounded by the inguinal
ligament anteriorly, pectineal
ligament posteriorly,lacunar
ligament medially, and
the femoral vein laterally

22. A reducible femoral hernia occurs
when a femoral hernia can be
pushed back into the abdomen,
either spontaneously or with
manipulation, but most likely,
spontaneously. This is the most
common type of femoral hernia and
is usually painless.
An irreducible femoral
hernia occurs when a femoral hernia
hernia becomes stuck in the femoral
canal. This can cause pain and a
feeling of illness.

23. • An obstructed femoral
hernia occurs when a part of
the intestine becomes
intertwined with the hernia,
causing an intestinal
obstruction. The obstruction
may grow and the hernia can
become increasingly painful.
Vomiting may also result.

24. A strangulated femoral hernia occurs
when a femoral hernia blocks blood
supply to part of the bowel - the loop of
bowel loses its blood supply.
Strangulation can happen in all hernias,
but is more common in femoral and
inguinal hernias due to their narrow
"necks". Nausea, vomiting, and severe
abdominal pain may occur with a
strangulated hernia. This is a medical
emergency. A strangulated intestine can
result in necrosis (tissue death) followed
by gangrene (tissue decay). This is a life-
threatening condition requiring
immediate surgery.

25. FACTS OF FEMORAL HERNIA
• the femoral hernia is an acquired lesion, and as such, has no hernial sac. The
defect occurs within an anatomic triangle bounded by the inguinal ligament,
the lower side of the pubic bone, and femoral vein. So the hernia emerges
below the inguinal ligament, rather than at the external ring.
• Because this triangular gap is larger in females, due to the shape and angle of
the pelvis, femoral hernias are much more common in women.
• These hernias are also much more prone to incarcerate or strangulate, and in
fact, are almost always incarcerated with retroperitoneal or omental fat (and
occasionally bowel).
• Early repair, once the diagnosis is made, is strongly advised.

28. CLINICAL PRESENTATION
AND TREATMENT
• Hernioplasty
• Herniorraphy
• Hernioplasty: mesh placement

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