61 - FEMORAL TRIANGLE

BOUNDARIES OF FEMORAL CANAL : 

It is bounded by:

(superiorly) the inguinal ligament

(medially) the medial border of the adductor longus muscle

(laterally) medial border of the sartorius muscle 

Its floor is provided laterally by iliopsoas, medially by pectineus and adductor longus. Its roof is formed by the fascia lata.

The femoral triangle is shaped like the sail of a ship.

Its boundaries can be remembered using the mnemonic, "SAIL" for Sartorius, Adductor longus and Inguinal Ligament. 

CONTENTS :

It is important as a number of vital structures pass through it, right under the skin. The following structures are contained within the femoral triangle (from lateral to medial):

terminal part of the femoral nerve and its branches

femoral sheath

femoral artery and its branches

femoral veins and its tributaries

femoral canal, containing the deep inguinal lymph nodes (snell, 8th edition)

- FLOOR

iliopsoas

pectineus

adductor longus

Lacunar Ligament

- ROOF is formed by the skin and fascia lata.

CLINICAL SIGNIFICANCE: 

 Since the femoral triangle provides easy access to a major artery, coronary angioplasty and peripheral angioplasty is often performed by entering the femoral artery at the femoral triangle. Heavy bleeding in the leg can be stopped by applying pressure to points in the femoral triangle. Another clinical significance of the femoral triangle is that the femoral artery is positioned at the midinguinal point (midpoint between the pubic symphysis and the anterior superior iliac spine); medial to it lies the femoral vein. Thus the femoral vein, once located, allows for femoral venopuncture[citation needed]. Femoral venopuncture is useful when there are no superficial veins that can be aspirated in a patient, in the case of collapse. 

The positive pulsation of the femoral artery signifies that the heart is beating and also blood is flowing to the lower extremity[citation needed].It is also necessary to appreciate clinically that this is a case where the nerve is more lateral than the vein. In most other cases the a nerve (relative to its associated artery and vein)would be the deepest or more medial followed by the artery and then the vein. But in this case it is the opposite. This must be remembered when venous or arterial samples are required from the femoral vessels. The order of this neurovascular bundle can be remembered using the mnemonic, "NAVY" for Nerve, Artery, Vein, Y -fronts (the British term of a style of men's underwear with a "Y" shaped front that acts as a fly). The "Y" is midline (corresponding with the penis) and the mnemonic always reads from the outside - in, so that the Femoral Nerve is always lateral. An alternate to this mnemonic is "NAVaL" for Nerve, Artery, Vein, and Lymph, to include the deep inguinal lymph nodes located medial to the Femoral vein.