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Anatomy: Groin and Inguinal
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==Femoral Triangle== *'''See [https://radiopaedia.org/cases/femoral-triangle-diagram radiopaedia figures]''' * ===Borders=== *'''<span style="color:#ff0000">Roof: fascia lata (covers femoral sheath)''' **Fascia lata is continuous with external oblique aponeurosis superiorly[https://en.wikipedia.org/wiki/Aponeurosis_of_the_abdominal_external_oblique_muscle] ***Within the femoral sheath are the femoral artery and vein and the node of cloquet *'''Floor: pectineus, ilacus, psoas major, adductor magnus muscles''' *'''<span style="color:#ff0000">Superior: inguinal ligament (runs from anterior superior iliac spine to pubic tubercle)''' **Inguinal ligament is the portion of the external oblique aponeurosis which extends between the anterior superior iliac spine and the pubic tubercle as a thick band, folded inward[https://en.wikipedia.org/wiki/Aponeurosis_of_the_abdominal_external_oblique_muscle] *'''<span style="color:#ff0000">Lateral: medial border of sartorius muscle''' *'''<span style="color:#ff0000">Medial: lateral border of adductor longus muscle''' *Apex: formed by the intersection of the medial border of the sartorius muscle and the lateral boarder of the adductor longus muscle ===Contents=== '''<span style="color:#ff0000">Lateral to medial: </span><span style="color:#0000ff">NAVEL</span>''' *'''<span style="color:#0000ff">N</span><span style="color:#ff0000">erve</span>''' *'''<span style="color:#0000ff">A</span><span style="color:#ff0000">rtery</span>''' *'''<span style="color:#0000ff">V</span><span style="color:#ff0000">ein</span>''' *'''<span style="color:#0000ff">E</span><span style="color:#ff0000">mpty space</span>''' **'''Allows the veins and lymph vessels to distend to accommodate different levels of flow''' *'''<span style="color:#0000ff">L</span><span style="color:#ff0000">ymph nodes</span> <span style="color:#0000ff">(deep inguinal lymph nodes)</span>''' ** [[File:Femoral triangle.png|thumb|Left femoral triangle; source: [[wikipedia:Femoral_triangle#/media/File:Gray549.png|Wikipedia]]|link=https://test.urologyschool.com/index.php/File:Femoral_triangle.png]] ===Nerves=== *'''<span style="color:#ff0000">Femoral nerve</span>''' **'''Contains fibers originating from the L2βL4 spinal nerve roots''' **'''Lies deep to the iliacus fascia''' **'''<span style="color:#ff0000">Lateral to common femoral artery</span>''' ***May at times be found between the artery and the vein **'''Functions''' ***'''Motor: innervates the flexors of the hip and the extensors of the knee''' ****'''Pectineus, quadriceps femoris, and sartorius muscles''' ***'''Sensory: anterior thigh, anteromedial knee, medial leg, and medial foot''' **'''Should be preserved during inguinal dissection'''. ***Some of the sensory branches, however, are commonly sacrificed in the regional node dissection. === Vasculature === *'''<span style="color:#ff0000">Posterior to fascia lata</span>''' *'''<span style="color:#ff0000">Common femoral artery</span>''' **Continuation of external iliac artery ***External iliac artery above inguinal ligament, common femoral artery below inguinal ligament **Gives off a branch called deep (profunda) femoral artery and continues as superficial femoral artery[https://www.physio-pedia.com/images/8/89/Femoral_Artery.png] **'''Blood supply to the skin of the inguinal region is from branches of the common femoral artery.''' ***'''Complete inguinal dissection necessitates ligation of these branches.''' ****'''Viability of the skin flaps raised during the dissection depends on anastomotic vessels in the superficial fatty layer of the Camper fascia''' ****'''A transverse skin incision least compromises blood supply to the skin.''' **'''<span style="color:#ff0000">Medial to femoral nerve</span>''' **'''Just medial to the midpoint of the inguinal ligament in the inguinal crease region[https://www.physio-pedia.com/Femoral_Artery]''' *'''<span style="color:#ff0000">Common femoral vein</span>''' **'''Deep femoral vein and Great saphenous vein (also known as long saphenous vein) empty into the common femoral vein''' ***'''Great saphenous vein approaches common femoral vein medially''' ***Deep femoral vein approaches common femoral vein laterally **'''<span style="color:#ff0000">Medial to common femoral artery</span>''' === Femoral Sheath === * A distal prolongation of extraperitoneal fascia that encloses the vascular compartment * * Femoral vessels and lymphatics are enclosed by the femoral sheath[https://www.kenhub.com/en/library/anatomy/femoral-artery]. * Femoral nerve is located outside the femoral sheath
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