Xi: Anatomy of the femoral vein


  • Drains from popliteal vein
  • Lies in intermediate compartment of femoral sheath
  • Drains to external iliac vein (at inguinal ligament)→ common iliac vein → IVC


  • Common femoral vein → proximal to confluence with deep femoral vein


Femoral triangle

  • Superior: Inguinal ligament
  • Lateral: Medial border of sartorius muscle
  • Medial: Lateral border of adductor longus muscle
  • Superficial: Skin, subcutaneous fat, superficial fascia, fascia lata
  • Deep: Muscular fascia of pectineus, psoas & iliacus muscles


  • Anterior superior iliac spine (ASIS)
  • Pubic ramus
  • Inguinal ligament
  • Femoral sheath

Laterally → Medially (NAVEL)


  • Distally: vein lies posterolateral to superficial femoral artery
  • Proximally (apex of femoral triangle): vein lies posterior to artery
  • Base of femoral triangle (within femoral sheath): vein lies medial to artery
  • Femoral artery (midpoint between anterior superior iliac spine and pubic symphysis)
    • Femoral vein MEDIAL to pulsation 0.5-1cm


  • Greater saphenous vein
  • Deep femoral vein
  • Lateral circumflex femoral veins
  • Medial circumflex femoral veins

Structures Needle Passes Through (Superficial → Deep)

  • Skin
  • Subcutaneous tissue
  • Fascia (encloses femoral vessels)
  • Femoral vein
    • Medial: medial compartment of femoral sheath (femoral canal: lymph vessels, nodes, fatty tissue)
    • Lateral: fibrous septum separating intermediate compartment & lateral compartment (containing femoral artery) and further lateral (femoral nerve)
    • Posterior: posterior fascia & pectineus


  • Slight external rotation of hip, palpate pulse, medial to arterial pulsation
  • Folded towel under ipsilateral buttock to slightly extend hip
  • Proceduralist on ipsilateral side of patient

Femoral Artery Course

  • Continuation of external iliac artery at level of inguinal ligament
  • Enters femoral triangle deep to midpoint of inguinal ligament, lateral to femoral vein
  • Passes through triangle, exits at apex, enters adductor canal (Hunter’s canal)
  • Exits adductor canal by passing through adductor hiatus in adductor magnus (at level of junction between middle and lower third of thigh) → becomes popliteal artery
  • Several branches
    • Profunda femoris: chief artery to thigh, arises from lateral aspect of femoral artery, 2-5cm below inguinal ligament
      • Perforating arteries: perforate adductor magnus → contributes to supply of muscles in medial & posterior thigh
      • Lateral femoral circumflex artery: supply lateral thigh muscles
      • Medial femoral circumflex artery: supply neck and head
    • Superficial epigastric
    • Superficial iliac circumflex
    • Superficial & deep external pudendal arteries

Author: Novia Tan