Xii: Anatomy of the Femoral Artery

Origin

  • Continuation of external iliac artery at level of inguinal ligament
  • Enters femoral triangle at midpoint of anterior superior iliac spine and symphysis pubis (medial to midpoint of inguinal ligament)

Termination

  • Terminates at bifurcation into superficial femoral artery and deep femoral artery (profunda femoris)
  • Exits at adductor hiatus in adductor magnus → continues as popliteal artery

Course

  • Runs down front and medial side of thigh
  • Variable in length 2-8cm & diameter 6-10mm (dependent on body habitus/volume status)
  • First 4cm of vessel enclosed within femoral sheath together with femoral vein in the femoral triangle
  • Gives off profunda femoris branch on the lateral side, 3-4cm distal to inguinal ligament
  • Continues posterior to sartorius muscle and anterior to femoral vein in the adductor canal exiting at adductor hiatus
  • Continues as popliteal artery

Borders

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

Relationships

Anterior

  • Saphenous nerve
  • Fibrous roof of adductor canal
  • Vastus medialis
  • Sartorius

Posterior

  • Femoral vein (at apex of femoral triangle)
  • Psoas major
  • Pectineus
  • Adductor longus
  • Profunda vessels
  • Adductor magnus

Lateral

  • Femoral nerve
  • Femoral vein (at distal end of artery/base of femoral triangle)
  • Vastus medialis
  • Body of femur

Medial

  • Femoral vein (at proximal end of artery)

Branches

In femoral triangle

  • 3 superficial branches
    • Superficial epigastric artery
    • Superficial circumflex iliac artery
    • Superficial external pudendal artery
  • 3 deep branches
    • Deep external pudendal artery
    • Profunda femoris deep to adductor longus (terminal branch)
    • Muscular branches

In adductor canal

  • Muscular branches
  • Descending genicular branch

Supplies

  • Lower limb
  • Superficial pelvis
  • Anterior abdominal wall

Landmarks

  • Anterior superior iliac spine (ASIS)
  • Pubic ramus
  • Inguinal ligament
  • Femoral sheath
  • Inferior epigastric artery is the last branch of external iliac artery before it passes beneath inguinal ligament (retroperitoneal haemorrhage occurs almost exclusively when arteriotomy occurs proximate to origin of this branch)

Laterally → Medially (NAVEL)

Surface Anatomy

  • Inguinal crease unreliable as landmark – sags and well inferior to ligament
  • Bony landmark: 2-3cm below midpoint of anterior superior iliac spine and symphysis pubis
  • Common femoral artery overlies medial portion of femoral head in the middle of its course (2-3cm distal from inguinal ligament) → often site of maximal femoral pulse
    • Can be compressed against femoral head at mid inguinal point to control bleeding
  • Femoral artery more superficial than vein

Anatomical Variation

  • Femoral artery overlapping femoral vein
  • High femoral arterial bifurcation

Author: Novia Tan