|Artery: Femoral artery|
Structures passing behind the inguinal ligament. (Femoral artery labeled at upper right.)
Schema of femoral artery (labeled as #20) and its major branches - right thigh, anterior view.
|Supplies||Anterior compartment of thigh|
|Source||External iliac artery|
|Branches||Superficial epigastric artery, superficial iliac circumflex, superficial external pudendal, deep external pudendal, deep femoral artery|
The femoral artery (Latin: arteria femoralis) is a large artery in the thigh. It is a continuation of the external iliac artery and begins at the inguinal ligament (femoral head). In this segment, it is also called the common femoral artery (arteria femoralis communis) and gives the deep femoral artery, which provides blood to the thigh. After the branching of the deep femoral artery, it is called the superficial femoral artery (arteria femoralis superficialis) in clinical parlance, because of its superficial course. It continues along the femur to provide blood to the arteries that circulate the knee and the foot and enters the adductor canal. After it emerges from the adductor canal through the adductor hiatus, it is named the popliteal artery.
The femoral arteries receive blood through the external iliac artery. This connection occurs at the femoral triangle behind the inguinal ligament, which is usually near the head of the femur bone. That proximal section of the femoral artery, known specifically as the common femoral artery (CFA), leaves the femoral triangle through an apex beneath the sartorius muscle. It then divides into a deep femoral artery, more commonly known as the Profunda, which provides blood to the thigh, and the superficial femoral artery or SFA, which connects to the popliteal artery at the opening of adductor magnus or hunter's canal towards the end of the femur.
The branches of femoral arteries are (from proximal to distal) the superficial and deep external pudendal, superficial epigastric, superficial circumflex iliac, profunda femoral and descending genicular arteries.
As the femoral artery can often be palpated through the skin, it is often used as a catheter access artery. From it, wires and catheters can be directed anywhere in the arterial system for intervention or diagnostics, including the heart, brain, kidneys, arms and legs. The direction of the needle in the femoral artery can be against blood flow (retro-grade), for intervention and diagnostic towards the heart and opposite leg, or with the flow (ante-grade or ipsi-lateral) for diagnostics and intervention on the same leg. Access in either the left or right femoral artery is possible and depends on the type of intervention or diagnostic.
The site for optimally palpating the femoral pulse is in the inner thigh, at the mid-inguinal point, halfway between the pubic symphysis and anterior superior iliac spine. Presence of a femoral pulse has been estimated to indicate a systolic blood pressure of more than 50 mmHg, as given by the 50% percentile.
The femoral artery can be used to draw arterial blood when the blood pressure is so low that the radial or brachial arteries cannot be located.
Peripheral arterial disease
The femoral artery is susceptible to peripheral arterial disease. When it is blocked through atherosclerosis, percutaneous intervention with access from the opposite femoral may be needed. Endarterectomy, a surgical cut down and removal of the plaque of the femoral artery is also common. If the femoral artery has to be ligated surgically to treat a popliteal aneurysm, blood can still reach the popliteal artery distal to the ligation via the genicular anastomosis. However if flow in the femoral artery of a normal leg is suddenly disrupted, blood flow distally is rarely sufficient. The reason for this is the fact that the genicular anastomosis is only present in a minority of individuals and is always undeveloped when disease in the femoral artery is absent.
Textbook illustrations of the genicular anastomosis, such as that shown in the sidebox, all appear to have been derived from the idealized image first produced by Gray's Anatomy in 1910. Neither the 1910 illustration, nor any subsequent version, was made of an anatomical dissection but rather from the writings of John Hunter (surgeon) and Astley Cooper which described the genicular anastomosis many years after ligation of the femoral artery for popliteal aneurysm. The genicular anastomosis has not been demonstrated even with modern imaging techniques such as X-ray computed tomography or angiography.
- Schulte, Erik; Schumacher, Udo (2006). "Arterial Supply to the Thigh". In Ross, Lawrence M.; Lamperti, Edward D. Thieme Atlas of Anatomy: General Anatomy and Musculoskeletal System. Thieme. p. 490. ISBN 978-3-13-142081-7.
- Deakin CD, Low JL (September 2000). "Accuracy of the advanced trauma life support guidelines for predicting systolic blood pressure using carotid, femoral, and radial pulses: observational study". BMJ 321 (7262): 673–4. doi:10.1136/bmj.321.7262.673. PMC 27481. PMID 10987771.
- Macpherson DS, Evans DH, Bell PR (January 1984). "Common femoral artery Doppler wave-forms: a comparison of three methods of objective analysis with direct pressure measurements". The British Journal of Surgery 71 (1): 46–9. doi:10.1002/bjs.1800710114. PMID 6689970.
- Sabalbal M, Johnson M, McAlister V (September 2013). "Absence of the genicular arterial anastomosis as generally depicted in textbooks". Annals of the Royal College of Surgeons of England 95 (6): 405–9. doi:10.1308/003588413X13629960046831. PMID 24025288.
|Wikimedia Commons has media related to Femoral artery.|
This article uses anatomical terminology; for an overview, see anatomical terminology.
||This section contains a gallery of images.|
- Anatomy photo:12:05-0101 at the SUNY Downstate Medical Center
- Cross section at UV pelvis/pelvis-e12-15
- Image at umich.edu - pulse
- Diagram at MSU