Femoral Vessels and Nerves

IMAGING ANATOMY

Femoral Vessels

• Enter thigh deep to inguinal ligament midway between anterior superior iliac spine and pubic symphysis

External iliac vessels become common femoral vessels
• Upper thigh: Vessels within femoral triangle

Vein, artery, nerve from medial to lateral
• Midthigh: Vessels within adductor canal

Adductor canal: 15-cm long, triangular-shaped canal running from femoral triangle to adductor hiatus

– Bordered by vastus medialis, adductor longus/adductor magnus, and sartorius

Artery anterior to vein

– Saphenous nerve accompanies femoral vessels in adductor canal
• Distal thigh: Exits adductor canal via adductor hiatus and enters popliteal fossa

Adductor hiatus is gap between adductor magnus muscle and femoral shaft 10 cm proximal to knee

– Saphenous nerve does not pass through adductor hiatus

Superficial femoral vessels become popliteal artery and vein
• Common femoral artery

Branches

– Superficial epigastric, superficial circumflex iliac, superficial external pudendal arise anteriorly

– Deep external pudendal arises medially

Divides into superficial and deep branches

Superficial femoral artery

– Branch: Descending genicular

Deep femoral (profunda femoris)

– Arises laterally in femoral triangle

– Dives between pectineus and adductor longus muscles

– Medial to femur, deep to adductor longus muscle

– Branches in femoral triangle: Medial circumflex femoral (supplies femoral head), lateral circumflex femoral, muscular branches

– Branches in adductor canal: 3 perforating branches, descending geniculate
• Femoral vein : Travels with artery

Tributaries: Similar to arteries and long saphenous vein

Long saphenous vein

– Longest vein in body

– Toes → anterior to medial malleolus → medial leg → posteromedial knee → proximal thigh dives deeply through cribriform fascia → saphenofemoral junction → common femoral vein

Saphenous nerve accompanies long saphenous vein in leg and superficial femoral artery in thigh

Femoral Nerve

• Nerve contributions from L2 to L5
• Travels in groove between psoas and iliacus muscles
• Exits pelvis beneath inguinal ligament, lateral to femoral vessels where it enters femoral triangle
• Multiple muscular and sensory branches in femoral triangle

Saphenous nerve is largest cutaneous branch of femoral nerve

– Enters adductor canal until 10 cm proximal to knee where it pierces fascia between gracilis and sartorius muscles to become subcutaneous and join long saphenous vein

Sciatic Nerve

• Nerve contributions from L4 to S3

2 nerves in 1 sheath

– Tibial nerve (medial) and common peroneal nerve (lateral)

– Separate in popliteal fossa
• Course

Exits pelvis inferior to piriformis muscle

– Anomalous relationship in 10%

Deep to gluteus maximus muscle, more distally deep to biceps femoris muscle

– Crosses over superior gemellus, obturator internus, inferior gemellus, quadratus femoris muscles

– Midway between ischial tuberosity and greater trochanter in transverse plane

Runs deep to long head of biceps femoris muscle after exiting gluteal region
• Tibial nerve : Larger division of sciatic nerve

Descends through popliteal fossa
• Common peroneal nerve

Runs obliquely to fibular head

Lateral Cutaneous Nerve of Thigh

• Nerve contributions from L2 and L3

Sensory innervation to anterior/lateral aspects of thigh
• Runs from medial to lateral superficial to proximal end of sartorius muscle
• Passes either under or through split in inguinal ligament close to anterior superior iliac spine to enter thigh

Runs distally lateral to sartorius before dividing into many small branches

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Apr 9, 2020 | Posted by admin in MUSCULOSKELETAL IMAGING | Comments Off

IMAGING ANATOMY

Femoral Vessels

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Femoral Vessels and Nerves

Femoral Vessels and Nerves

Femoral Nerve

Sciatic Nerve

Lateral Cutaneous Nerve of Thigh

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Radiology Key

Fastest Radiology Insight Engine

Femoral Vessels and Nerves

Femoral Vessels and Nerves

IMAGING ANATOMY

Femoral Vessels

Femoral Nerve

Sciatic Nerve

Lateral Cutaneous Nerve of Thigh

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