Page 260 - Clinical Anatomy

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The arteries 245

adductor tubercle by passing through the hiatus in adductor magnus to
become the popliteal artery (Fig. 153).
Throughout its course, the femoral artery is accompanied by its vein,
which lies first on the medial side of the artery and then passes posteriorly
to it at the apex of the femoral triangle.

Branches

In the groin, the femoral artery gives off:
1◊◊the superficial circumflex iliac artery;
2◊◊the superficial epigastric artery;
3◊◊the superficial external pudendal artery.
These three vessels are encountered in the groin incision for repair for
an inguinal hernia. Their corresponding veins drain into the great saphe-
nous vein (see Fig. 180).
The profunda femoris arises posterolaterally from the femoral artery 2in
(5cm) distal to the inguinal ligament. It is conventional to call the femoral
artery above this branch the common femoral, and below it, the superficial
femoral artery.
The profunda passes deep to adductor longus and gives off medial and
lateral circumflex branches and four perforating branches. These are important
both as the source of blood supply to the great muscles of the thigh and as
collateral channels which link the rich arterial anastomoses around the hip
and the knee.

Clinical features

1◊◊Recapitulate the surface markings of the femoral artery—the upper two-
thirds of a line connecting the mid-inguinal point with the adductor tuber-
cle, the hip being held somewhat flexed and externally rotated (Fig. 153).
The femoral artery in the upper 4in (10cm) of its course lies in the
femoral triangle where it is quite superficial and, in consequence, easily
injured. A laceration of the femoral artery at this site is an occupational
hazard of butchers and bullfighters.
2◊◊The femoral artery at the groin is readily punctured by a hypodermic
needle and is the most convenient site from which to obtain arterial blood
samples. Arteriography of the peripheral leg vessels is also easily per-
formed at this point. ASeldinger catheter can be passed proximally through
a femoral artery puncture in order to carry out aortography or selective
renal, coeliac and mesenteric angiography.
3◊◊Arteriosclerotic changes, with consequent thrombotic arterial occlu-
sion, frequently commence at the lower end of the femoral artery, perhaps
as a result of compression of the diseased vessel by the margins of the
hiatus in adductor magnus. Collateral circulation is maintained via anasto-
moses between the branches of profunda femoris and the popliteal artery. If
arteriography demonstrates a patent arterial tree distal to the block, it is
possible to bypass the occluded segment by means of a graft between the
common femoral and popliteal arteries.