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The femoral artery is a large
artery An artery (plural arteries) () is a blood vessel The blood vessels are the components of the circulatory system The circulatory system, also called the cardiovascular system or the vascular system, is an organ system that permits bloo ...

artery
in the
thigh In human anatomy The human body is the structure of a human being. It is composed of many different types of cells that together create tissues and subsequently organ systems. They ensure homeostasis In biology Biology is the natu ...

thigh
and the main arterial supply to the thigh and leg. The femoral artery gives off the deep femoral artery or
profunda femoris artery The deep artery of the thigh, (profunda femoris artery or deep femoral artery) is a large branch of the femoral artery. It travels more deeply (posteriorly) than the rest of the femoral artery. Structure The deep artery of the thigh branches off ...
and descends along the anteromedial part of the thigh in the
femoral triangle The femoral triangle (or Scarpa's triangle) is an anatomical region of the upper third of the thigh. It is a subfascial space which appears as a triangular depression below the inguinal ligament In human anatomy, the inguinal region refers to eith ...
. It enters and passes through the
adductor canal The adductor canal, also known as the subsartorial canal or Hunter’s canal, is an Aponeurosis, aponeurotic tunnel in the middle third of the thigh. It extends from the apex of the femoral triangle to the adductor hiatus. Structure The adductor c ...

adductor canal
, and becomes the
popliteal artery The popliteal artery is a deeply placed continuation of the femoral artery The femoral artery is a large in the and the main arterial supply to the thigh and leg. The femoral artery gives off the deep femoral artery or and descends along th ...

popliteal artery
as it passes through the
adductor hiatus In human anatomy, the adductor hiatus also known as hiatus magnus is a hiatus (gap) between the adductor magnus muscle and the femur The femur (, pl. ''femurs'' or ''femora'' ), or thigh bone, is the proximal Standard anatomical terms of locati ...
in the
adductor magnus The adductor magnus is a large triangular muscle, situated on the medial Medial may refer to: Mathematics * Medial magma, a mathematical identity in algebra Geometry * Medial axis, in geometry the set of all points having more than one close ...
near the junction of the middle and distal thirds of the thigh.


Structure

The femoral artery enters the thigh from behind the
inguinal ligament In human anatomy, the inguinal region refers to either the groin or the lower lateral regions of the abdomen. It may also refer to: * Conjoint tendon, previously known as the inguinal aponeurotic falx, a structure formed from the transversus abdom ...
as the continuation of the
external iliac artery The external iliac arteries are two major arteries which bifurcate off the common iliac arteries anterior to the sacroiliac joint The sacroiliac joint or SI joint (SIJ) is the joint between the sacrum and the ilium bones of the pelvis, whi ...
. Here, it lies midway between the
anterior superior iliac spine The anterior superior iliac spine (abbreviated An abbreviation (from Latin ''brevis'', meaning ''short'') is a shortened form of a word or phrase, by any method. It may consist of a group of letters, or words taken from the full version of the ...
and the
symphysis pubis The pubic symphysis is a secondary cartilaginous joint between the left and right superior rami of the pubis of the hip bones. It is located in front of and below the urinary bladder The urinary bladder, or simply bladder, is a hollow muscul ...
. Its first three or four centimetres are enclosed, with the
femoral vein In the human body The human body is the structure of a Human, human being. It is composed of many different types of Cell (biology), cells that together create Tissue (biology), tissues and subsequently organ systems. They ensure homeostasi ...
, in the
femoral sheath The femoral sheath, also called the crural sheath, is a continuation of the abdominal fascia Abdominal fascia refers to the various types of fascia found in the abdominal region. Fascia is a sheet of connective tissue that is found beneath the ski ...
. In 65% of the cases, common femoral artery lies anterior to the femoral vein in the middle portion of the thigh.


Relations

The ''relations'' of the femoral artery are as follows: * ''Anteriorly:'' In the upper part of its course, it is superficial and is covered by skin and fascia. In the lower part of its course, it passes behind the
sartorius muscle The sartorius muscle () is the longest muscle in the human body. It is a long, thin, superficial muscle Skeletal muscles (commonly referred to as muscles) are organs An organ is a group of tissues with similar functions. Plant life and an ...

sartorius muscle
. * ''Posteriorly:'' The artery lies on the psoas, which separates it from the
hip joint In vertebrate Vertebrates () comprise all species of animal Animals (also called Metazoa) are multicellular eukaryotic organisms that form the Kingdom (biology), biological kingdom Animalia. With few exceptions, animals Heterotroph, ...

hip joint
, the
pectineus The pectineus muscle (, from the Latin word ''pecten'', meaning comb) is a flat, quadrangular muscle, situated at the anterior (front) part of the upper and medial (anatomy), medial (inner) aspect of the thigh. The pectineus muscle is the most ante ...

pectineus
, and the
adductor longus In the human body, the adductor longus is a skeletal muscle located in the thigh. One of the adductor muscles of the hip, its main function is to Adduction, adduct the thigh and it is innervated by the obturator nerve. It forms the medial wall o ...

adductor longus
. The femoral vein intervenes between the artery and the adductor longus. * ''Medially:'' It is related to the femoral vein in the upper part of its course. * ''Laterally:'' The
femoral nerve The femoral nerve is a nerve in the thigh that supplies skin on the upper thigh and inner leg, and the muscles that extend the knee. Structure Femoral nerve is the major nerve supplying the anterior compartment of the thigh. It is the largest bran ...
and its branches.


Branches

The femoral artery gives off several ''branches'' in the thigh which include; * The ''
superficial circumflex iliac artery The superficial iliac circumflex artery (or superficial circumflex iliac), the smallest of the cutaneous branches of the femoral artery, arises close to the superficial epigastric artery, and, piercing the fascia lata, runs lateralward, parallel wit ...
'' is a small branch that runs up to the region of the
anterior superior iliac spine The anterior superior iliac spine (abbreviated An abbreviation (from Latin ''brevis'', meaning ''short'') is a shortened form of a word or phrase, by any method. It may consist of a group of letters, or words taken from the full version of the ...
. * The ''
superficial epigastric artery The superficial epigastric artery (not to be confused with the superior epigastric artery) arises from the front of the femoral artery about 1 cm below the inguinal ligament, and, passing through the femoral sheath and the fascia cribrosa, t ...
'' is a small branch that crosses the inguinal ligament and runs to the region of the . * The ''
superficial external pudendal artery The superficial external pudendal artery (superficial external pudic artery) is one of the three pudendal arteries. It arises from the medial side of the femoral artery, close to the superficial epigastric artery and superficial iliac circumflex art ...
'' is a small branch that runs medially to supply the skin of the scrotum or labium majus as. * The ''
deep external pudendal artery The deep external pudendal artery (deep external pudic artery), is one of the pudendal arteries The pudendal arteries are a group of arteries which supply many of the muscles and organs of the pelvic cavity. The arteries include the internal pudenda ...
'' runs medially and supplies the skin of the scrotum or labium majus. * The ''
profunda femoris artery The deep artery of the thigh, (profunda femoris artery or deep femoral artery) is a large branch of the femoral artery. It travels more deeply (posteriorly) than the rest of the femoral artery. Structure The deep artery of the thigh branches off ...
'' is a large and important branch that arises from the lateral side of the femoral artery about 1.5 in. (4 cm) below the inguinal ligament. It passes medially behind the femoral vessels and enters the medial fascial compartment of the thigh. It ends by becoming the fourth perforating artery. At its origin, it gives off the medial and lateral femoral circumflex arteries, and during its course it gives off three perforating arteries. * The '' descending genicular artery'' is a small branch that arises from the femoral artery near its termination within the adductor canal. It assists in supplying the knee joint.


Segments

In clinical parlance, the femoral artery has the following segments: *The common femoral artery is the segment of the femoral artery between the inferior margin of the
inguinal ligament In human anatomy, the inguinal region refers to either the groin or the lower lateral regions of the abdomen. It may also refer to: * Conjoint tendon, previously known as the inguinal aponeurotic falx, a structure formed from the transversus abdom ...
and the branching point of the
deep femoral artery The deep artery of the thigh, (profunda femoris artery or deep femoral artery) is a large branch of the femoral artery. It travels more deeply (posteriorly) than the rest of the femoral artery. Structure The deep artery of the thigh branches off ...
. *The subsartorial artery or superficial femoral artery are designations for the segment between the branching point of the deep femoral artery and the
adductor hiatus In human anatomy, the adductor hiatus also known as hiatus magnus is a hiatus (gap) between the adductor magnus muscle and the femur The femur (, pl. ''femurs'' or ''femora'' ), or thigh bone, is the proximal Standard anatomical terms of locati ...
, passing through the
subsartorial canal The adductor canal, also known as the subsartorial canal or Hunter’s canal, is an aponeurotic An aponeurosis (; plural: ''aponeuroses'') is a type or a variant of the deep fascia A fascia (; plural fasciae ; adjective fascial; from Latin: "ban ...
. However, usage of the term ''superficial femoral'' is discouraged by many
physician A physician (American English), medical practitioner (English in the Commonwealth of Nations, Commonwealth English), medical doctor, or simply doctor, is a professional who practices medicine, which is concerned with promoting, maintainin ...

physician
s because it leads to confusion among general medical practitioners, at least for the
femoral vein In the human body The human body is the structure of a Human, human being. It is composed of many different types of Cell (biology), cells that together create Tissue (biology), tissues and subsequently organ systems. They ensure homeostasi ...
that courses next to the femoral artery. In particular, the adjacent femoral vein is clinically a
deep vein A deep vein is a vein Veins are blood vessels The blood vessels are the components of the circulatory system The circulatory system, also called the cardiovascular system or the vascular system, is an organ system An organ system ...
, where
deep vein thrombosis Deep vein thrombosis (DVT) is a type of venous thrombosis Venous thrombosis is blockage of a vein caused by a thrombus (blood clot). A common form of venous thrombosis is deep vein thrombosis (DVT), when a blood clot forms in the deep veins. ...
indicates
anticoagulant Anticoagulants, commonly known as blood thinners, are chemical substance A chemical substance is a form of matter In classical physics and general chemistry, matter is any substance that has mass and takes up space by having volume. All ...
or
thrombolytic therapy Thrombolysis, also called fibrinolytic therapy, is the breakdown (lysis Lysis ( ; Greek λύσις ''lýsis'', "a loosing" from λύειν ''lýein'', "to unbind") is the breaking down of the membrane of a cell, often by viral, enzymic, or ...
, but the adjective ''"superficial"'' leads many physicians to falsely believe it is a
superficial vein A superficial vein is a vein Veins are blood vessels The blood vessels are the components of the circulatory system The circulatory system, also called the cardiovascular system or the vascular system, is an organ system An organ ...

superficial vein
, which has resulted in patients with femoral thrombosis being denied proper treatment. Therefore, the terms ''subsartorial artery'' and ''subsartorial vein'' have been suggested for the femoral artery and vein, respectively, distally to the branching points of the deep femoral artery and vein.


Clinical significance


Vascular access

As the pulsation of the common femoral artery can often be through the skin; and the site of maximum pulsation is used as a point of puncture for
catheter In medicine Medicine is the science Science () is a systematic enterprise that builds and organizes knowledge Knowledge is a familiarity, awareness, or understanding of someone or something, such as facts ( descriptive knowledge) ...
access. Common femoral artery (CFA) can be assessed by retrograde puncture. Then another catheter is advanced through the common iliac artery to the contralateral external iliac artery and contralateral superficial femoral artery (SFA). The SFA can be assessed by antegrade puncture after the contralateral retrograde puncture was done. From here, 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 Blood pressure (BP) is the pressure Pressure (symbol: ''p'' or ''P'') is the force In physics, a force is an influence that can change the motion (physics), motion of an Physical object, object. A force can cause an object with mas ...

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 A peripheral or peripheral device is an auxiliary device used to put information into and get information out of a computer A computer is a machine that can be programmed to carry out sequences of arithmetic or logical operations automatica ...
. When it is blocked through
atherosclerosis Atherosclerosis is a disease in which the wall of the artery An artery (plural arteries) () is a blood vessel The blood vessels are the components of the circulatory system that transport blood throughout the human body. These vessels tr ...

atherosclerosis
,
percutaneous {{More citations needed, date=January 2021 In surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical or dental specialty that uses operative manual and ...
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
aneurysm An aneurysm is an outward bulging, likened to a bubble or balloon, caused by a localized, abnormal, weak spot on a blood vessel The blood vessels are the components of the circulatory system The circulatory system, also called the ca ...
, blood can still reach the
popliteal artery The popliteal artery is a deeply placed continuation of the femoral artery The femoral artery is a large in the and the main arterial supply to the thigh and leg. The femoral artery gives off the deep femoral artery or and descends along th ...

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.


History

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 ''Gray's Anatomy'' is a reference book of human anatomy written by Henry Gray and illustrated by Henry Vandyke Carter, published in London in 1858. It has gone through multiple revised editions and the current edition, the 42nd (October 2020), ...
in 1910. Neither the 1910 illustration nor any subsequent version, was made of an anatomical dissection but rather from the writings of John Hunter and
Astley Cooper Sir Astley Paston Cooper, 1st Baronet (23 August 176812 February 1841) was a British surgeon In modern medicine Medicine is the Art (skill), art, science, and Praxis (process) , practice of caring for a patient and managing the diagnosis ...
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 An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation In physics Physics is the natural science that studies matter, its Elementary particle, fundamental constituents, its Moti ...
or
angiography Angiography or arteriography is a medical imaging Medical imaging is the technique and process of imaging Imaging is the representation or reproduction of an object's form; especially a visual representation (i.e., the formation of an ima ...
.


See also

*
Brachial artery The brachial artery is the major blood vessel The blood vessels are the components of the circulatory system The circulatory system, also called the cardiovascular system or the vascular system, is an organ system An organ system ...
, an arm based artery with a similar function


References


Additional images

Gray546.png, Structures passing behind the
inguinal ligament In human anatomy, the inguinal region refers to either the groin or the lower lateral regions of the abdomen. It may also refer to: * Conjoint tendon, previously known as the inguinal aponeurotic falx, a structure formed from the transversus abdom ...
. (Femoral artery labeled at upper right.) File:Gray344.png, Cross-section showing structures surrounding right hip-joint. File:Gray545.png, Femoral sheath laid open to show its three compartments. File:Gray550.png, The femoral artery. File:Gray1146.png, The spermatic cord in the inguinal canal. File:Gray1245.png, Front of right thigh, showing surface markings for bones, femoral artery and femoral nerve. File:Gray548.png, Femoral artery and its major branches - right thigh, anterior view. File:Blausen 0607 LegArteries.png, Illustration depicting main leg arteries (anterior view). File:Slide2888.JPG, Femoral artery - deep dissection. File:Slide4888.JPG, Femoral artery - deep dissection.


External links

* *
Image at umich.edu - pulse



QuantaFlo vs ABI in Peripheral Arterial Disease
{{DEFAULTSORT:Femoral Artery Arteries of the lower limb