Anatomy
Lower Limb
A patient with very poor peripheral access requires urgent intravenous fluids. The femoral vein in his groin is determined the most accessible vessel. Which of the following landmarks is the most accurate to identify the femoral vein:
Answer:
The femoral artery can be palpated in the femoral triangle as it passes over the femoral head, just inferior to the inguinal ligament, midway between the anterior superior iliac spine and the pubic symphysis (at the mid-inguinal point). The femoral vein lies immediately medial to this pulsation.Femoral Artery
Anatomy / Lower Limb / Femoral Triangle
Last Updated: 10th April 2019
The major artery supplying the lower limb is the femoral artery.
Anatomical Course
The femoral artery is the continuation of the external iliac artery, beginning as the vessel passes under the inguinal ligament to enter the femoral triangle in the anterior thigh.
The femoral artery can be palpated in the femoral triangle as it passes over the femoral head, just inferior to the inguinal ligament, midway between the anterior superior iliac spine and the pubic symphysis (at the mid-inguinal point).
The femoral vein lies immediately medial to this pulsation, which is an important landmark for central venous line insertion. Medial to the femoral vein is the femoral canal which contains lymphatics and lies immediately lateral to the pubic tubercle. The femoral nerve lies lateral to the femoral artery.
The femoral artery gives rise to the deep profunda femoris artery in the femoral triangle which is a major source of blood supply to the medial and posterior compartments of the thigh and the proximal femur.
After exiting the femoral triangle, the femoral artery continues down the anterior surface of the thigh via the adductor canal. During its descent it supplies the anterior thigh, giving rise to numerous superficial cutaneous branches.
The femoral artery becomes the popliteal artery after entering the posterior compartment of the thigh through the adductor hiatus just proximal to the knee.
![Modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons](https://mrcemsuccess.com/wp-content/uploads/2017/01/Femoral-Artery.png)
Femoral Artery. (Image modified by FRCEM Success. Original 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 |
