For medical, nursing and physiotherapy undergraduates, and postgraduates

1. LOWER LIMB :
FEMORAL TRIANGLE
DR. SUNDIP CHARMODE
ASSOCIATE PROFESSOR
DEPARTMENT OF ANATOMY
AIIMS RAJKOT

2. BONY LANDMARKS

3. SUPERFICIAL FASCIA

4. CUTANEOUS NERVES

6. PATELLAR PLEXUS

7. PATELLAR PLEXUS
• It is a plexus of fine nerves situated in front of
the patella, ligamentum patellae and upper end
of tibia.
• Formed by :
1. Ant. Div of lateral cut. Nerve
2. Intermediate cutaneous nerve
3. Anterior division of medial cutaneous nerve
4. Infra-patellar branch of saphenous nerve

8. CUTANEOUS ARTERIES

9. GREAT SAPHENOUS VEIN

12. SUPERFICIAL INGUINAL LYMPH
NODES

13. SUPERFICIAL INGUINAL LYMPH
NODES
• They are arranged in T shape
• Lower vertical group – drains lymph from the
lower limb
• Upper lateral group – drains lymph from
umbilical part of anterior abdominal wall of
gluteal region
• Upper medial group – drains lymph from
external genital organs.

14. SUBCUTANEOUS BURSA

15. SUBCUTANEOUS BURSA
1. Pre-patellar bursa
2. Subcutaneous Infra-patellar bursa
3. Supra patellar bursa
4. Deep infra patellar bursa

16. DEEP FASCIA (FASCIA LATA)

17. DEEP FASCIA (FASCIA LATA)
• It is a tough fibrous sheath that envelops the
whole of thigh like a sleeve.
• Superiorly :
• Ant : Inguinal ligament, iliac crest,
• Posteriorly : gluteal fascia sacrum, coccyx, sacro-
tuberous ligament
• Medially : Pubis, pubic arch and ischial
tuberosity
• Inferiorly : front and sides of knee, capsule of
knee joint.

18. ILIO-TIBIAL TRACT

19. ILIO-TIBIAL TRACT
• It is a thickened part of Fascia lata laterally 5 cm
wide called Ilio-tibial tract.
 Superiorly : It is split into 2 layers :
• Superficial lamina – tubercle of crest
• Deep lamina – capsule of hip joint
• Inferiorly : It is attached to smooth area on
anterior surface of the lateral condyle of tibia.

20. ILIO-TIBIAL TRACT
1. Two muscles are inserted into upper part
between superficial and deep lamina
Tensor fascia lata and Gluteus maximus
2 Stabilizes knee both in extension and partial
flexion.

21. SAPHENOUS OPENING
• It is an oval opening in fascia lata.
• The centre lies 4 cm lateral and 4 cm below the
pubic tubercle.
• 2.5 cm long and 2 cm broad with long axis
directed laterally and downwards
• The opening has a sharp crescentic lateral
margin or falciform margin which lies in front of
femoral sheath.
• Medial margin – lies at a lower level and formed
by fascia covering Pectineus.

22. SAPHENOUS OPENING
• The saphenous opening is closed by the
cribriform fascia which covers the opening.

23. SAPHENOUS OPENING

24. FEMORAL TRIANGLE
• It is a triangular depression in front of the upper
one third of the thigh immediately below the
inguinal ligament.

25. FEMORAL TRIANGLE

30. FEMORAL SHEATH
• It is a funnel shaped sleeve of fascia enclosing
the upper 3-4 cm of the femoral vessels.
• Anterior wall – Fascia Transversalis which in
anterior abdominal wall lies deep to Transversus
abdominis muscle.
• Posterior wall – Fascia Iliaca
• Inferiorly : The sheath merges with connective
tissue around femoral vessels.

31. FEMORAL SHEATH
• It is asymmetrical.
• Its lateral wall is vertical
• Medial wall is oblique being directed downwards
and laterally.

36. FEMORAL CANAL
• This is the medial compartment of femoral
sheath.
• Conical in shape
• Wide above or at base and narrow below.
• Base – 1.5 cm long and 1.5 cm wide
• Base or upper end of Femoral canal is called as
Femoral ring.
• Boundaries :

38. FEMORAL CANAL
• Inferior Epigastric vessels are closely to junction
of lateral and anterior walls of Femoral Ring.
• The Femoral ring is closed by condensation of
extra peritoneal connective tissue called as
Femoral septum.
• The Parietal peritoneum covering septum from
above shows a depression called Femoral Fossa.

41. RELATIONS

46. FEMORAL NERVE

47. APPLIED ANATOMY
1. Femoral hernia
2. Compression of Femoral artery at mid-inguinal
point.
3. Stab wounds at apex of femoral triangle
4. Femoral artery used for cannulation etc.
5. Pre-patellar bursitis – Housemaids knee
6. Subcutaneous infra-patellar bursitis –
Clergyman’s knee

48. ADDUCTOR CANAL
• Hunter’s canal or sub-sartorial canal
• It is Musculo-aponeurotic tunnel, triangular in
cross-section, extending from the apex of FT to
fifth osseo-aponeurotic opening in the adductor
magnus.
• Occupies middle 1/3rd of medial side of thigh

50. BOUNDARIES
• Antero-laterally- vastus medialis
• Posteriorly- Adductor longus above and adductor
magnus below
• Roof: strong fascia, sub-sartorial plexus of nerves
and sartorius muscle
• Apex- formed by linea aspera where vastus
medialis and adductor muscles meet.

54. SUB-SARTORIAL PLEXUS
1. Branch from saphenous nerve
2. Posterior div. of med cut nerve of thigh
3. Anterior div. of obturator nerve

55. CONTENTS
1. Femoral artery and femoral vein
2. Saphenous nerve
3. Nerve to vastus medialis
4. Occasionally, posterior division of obturator
nerve
5. Terminal part of profunda Femoris vessels

56. FEMORAL HERNIA
• The hernia covered with by a pouch of
peritoneum bulges down through femoral ring
into the femoral canal.
• Then pushes forward through saphenous
opening and finally turns upward around the
upper falciform margin of saphenous opening
towards the inguinal ligament.

57. FEMORAL HERNIA
• The change of
direction is to be
followed in reverse
order during
reduction, with thigh
passively flexed.

58. COVERINGS OF COMPLETE
FEMORAL HERNIA
• From within outwards:
1. Peritoneum of hernial sac
2. Femoral septum
3. Anterior wall of femoral sheath
4. Cribriform fascia
5. Superficial fascia and skin

59. COLLATERAL CIRCULATION
• If femoral artery is ligated proximal to the origin of
PFA, the collateral circulation established in the
following situations:
1. At crucial anastomosis: inferior gluteal branch of
internal iliac artery with medial and lateral
circumflex Femoral br. and first perforating br. of
PFA.
2. At trochanteric anastomosis: superior and
inferior gluteal branch of internal iliac artery with
medial and lateral circum. Femoral branches of
PFA.

60. COLLATERAL CIRCULATION
3. At spinous anastomosis: superior gluteal branch
of internal iliac artery and deep circumflex iliac
branch of external iliac artery with superficial
circumflex iliac branch of femoral and lateral
circumflex femoral br. of PFA.
4. Around the origin of obturator externus:
obturator branch of internal iliac and medial
circumflex Femoral branches of Profunda
arteries.
5. In perineum: internal pudendal branch of
internal iliac and deep external pudendal branch
of external iliac.