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Anatomy

Lower Limb

Question 91 of 180

A 87 year old woman presents to the ED after her carers noted she was complaining of pain in the right groin. On examination you note a tender swelling in keeping with a femoral hernia. The femoral ring is bordered posteriorly by which of the following structures:

Answer:

The femoral ring is bordered anteriorly by the inguinal ligament, posteriorly by the pectineal ligament, medially by the lacunar ligament and laterally by the femoral vein.

Femoral Canal and Femoral Ring

Femoral canal

The femoral canal lies between the femoral vein and the medial edge of the femoral sheath. The femoral canal contains loose connective tissue, lymphatic vessels, deep inguinal lymph nodes and empty space. The femoral canal allows the femoral vein to expand, for example, when venous return from the leg is increased, or when increased intra-abdominal pressure causes a temporary stasis.

By Henry Vandyke Carter [Public domain], via Wikimedia Commons

Femoral Sheath Open to Reveal Contents: Femoral Artery, Femoral Vein and Femoral Canal (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

Femoral ring

Table: Anatomical Borders of the Femoral Ring

Femoral Ring Structure
Anterior border Inguinal ligament
Posterior border Pectineal ligament
Medial border Lacunar ligament
Lateral border Femoral vein

The femoral ring is formed by the proximal abdominal opening of the femoral canal, and is important clinically, as it is a common site of hernia. It is bordered anteriorly by the inguinal ligament, posteriorly by the pectineal ligament, medially by the lacunar ligament and laterally by the femoral vein.

By Henry Vandyke Carter [Public domain], via Wikimedia Commons

Femoral Ring. (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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