por What is the femoral artery?
The femoral artery It is the main artery of the thigh of the lower limb. In turn, it is made up of two arteries, a right and a left femoral artery. It is a large artery and is the continuation of the external iliac artery as it passes through the femoral ring below the inguinal ligament.
In this area, the artery lies midway between the pubic symphysis and the anterior superior iliac spine. The artery runs in a fairly straight line down each lower limb from the groin to the popliteal region, where it is continuous with the popliteal artery.
The external iliac artery that gives rise to it is a branch of the primitive iliac artery and, in turn, a branch of the abdominal aorta. The abdominal aorta, upon reaching the lower third of the fourth lumbar vertebra, just below the umbilicus, divides into two arteries called the right and left primitive iliac arteries.
Each common iliac artery runs on each side over the body of the fourth and fifth lumbar vertebrae, follows the medial border of the psoas major muscle, and then arcs outward, downward, and forward. Passing through the anterior aspect of the sacroiliac joint, it divides into the internal iliac artery and the external iliac artery.
The femoral artery, like other body arteries, can be subject to trauma, inflammatory and obstructive processes, infections, etc., which can affect blood flow and, therefore, the integrity of the tissues that it supplies.
Location and route
The femoral artery begins its course from the femoral ring, below the inguinal ligament, where it originates as a continuation of the external iliac artery on each side. Initially, at the groin level, it is superficial and covered by fascia and skin. From there it descends along the inner part of the thigh in a straight line, penetrating the deep areas of the lower limb.
On its downward course it occupies the canal located between the abductor and pectineus muscles, on the one hand, and the vastus medialis and the iliopsoas on the other. In its lower part it occupies the Hunter’s duct or the adductor duct of the lower limb.
Once it passes through the third adductor ring, it enters the popliteal region where it ends its course and becomes the popliteal artery.
In its upper part it is located parallel to the femoral vein, but in an external position with respect to it. Descending toward the distal portion of its course, the femoral artery lies anterior to the femoral vein. On its downward course it is covered by the sartorius muscle.
In addition to giving rise to the branches that supply the neighboring muscles and skin, the femoral artery gives rise to 6 collateral branches, which are:
abdominal subcutaneous artery or superficial epigastric artery.
Superficial circumflex iliac artery or circumflex artery ilium superficialis.
external pudendal arteries or external pudendal arteries.
inguinal branches or inguinal rami.
Greater anastomotic artery or genus descendens artery.
deep femoral artery or profunda femoris artery.
In turn, the deep femoral artery gives rise to the internal circumflex artery with its two branches: the superficial and the deep, and to the external circumflex artery with its ascending and descending branches. It also generates three perforating branches.
Femoral artery function
The femoral artery supplies the lower abdominal wall, the external genitalia and lower limb, the upper thigh, and, with its popliteal extension, supplies the knee, leg, and foot.
The arterial irrigation of the tissues brings nutrients and oxygen, which allows maintaining their metabolism and collecting, through the venous system, metabolic wastes and CO2.
branches
As indicated above, there are 6 branches of the femoral artery; the route of each one and its irrigation areas will be defined below.
Abdominal subcutaneous artery or epigastric artery superficialis
It arises below the femoral arch, passes through the edge of the fascia lata and takes an ascending course towards the umbilical region. It gives off collateral branches that supply the skin and the oblique muscle of the abdomen.
Superficial circumflex iliac artery or circumflex artery ilium superficialis
It frequently presents as a branch of the abdominal subcutaneous artery, but in other cases it is a branch of the femoral artery. It is the smallest branch of the femoral artery.
It follows a superficial course above the fascia lata toward the anterior superior iliac spine. It supplies the skin, superficial fascia, and superficial inguinal nodes.
External pudendal arteries or external pudendal arteries
There are two or three arteries. It passes in front of or behind the femoral vein and supplies the scrotum and penis in men, as well as the labia majora in women.
Inguinal branches or inguinal rami
They are branches that terminate in the lymph nodes and muscles of the triangle of Scarpa (anatomical space in the inguinal area).
Greater anastomotic artery or artery descendens genus
It arises when the femoral artery passes through the adductor canal, pierces the canal in its anterior wall, and glides down the sartorius muscle passing behind the medial tuberosity of the femur.
It accompanies the saphenous nerve along a variable route. It supplies articular branches that help form the articular network that supplies the knee and muscular branches that supply the vastus medialis.
Deep femoral artery or profunda femoris artery
It arises two to six centimeters below the femoral arch and descends behind and outside the femoral artery that gave rise to it. It extends anterior to the median adductor, pectineus, and iliopsoas muscles. The median adductor covers it in its descent.
This artery gives off five main branches:
The internal circumflex artery
The external circumflex artery
three perforating arteries
The first arises immediately below the origin of the medial femoris and passes in its descent behind the femoral arteries and veins. It gives rise to the superficial branch and the deep branch. They irrigate part of the hip joint, the skin and neighboring muscles such as the adductors or the pectineus, among others.
The second arises just in front of the previous one and passes over the iliopsoas, in turn giving off two branches: the ascending branch that supplies the tensor fascia lata and the gluteus, and the descending branch that supplies the vastus lateralis and femoris muscles. it reaches the knee and irrigates the skin.
The perforating arteries supply the adductors as well as the skin and muscles of the posterior or dorsal thigh. The second perforator gives rise to the feeding artery of the femur.
Obstruction and other alterations in the groin
Because of their superficial location within the femoral triangle in the groin, both the femoral artery and femoral vein are vulnerable to lacerations, particularly in upper anterior thigh injuries.
In these cases, since these vessels are quite thick and have a high flow rate, an injury that ruptures these vessels can be fatal. This is because the blood loss is violent and abundant, rapidly causing hypotension, loss of consciousness, and death in a few minutes.
Atherosclerosis, which is a peripheral vascular disease in which atheromatous plaques accumulate on the inner surface of the arteries, can affect the femoral artery, generating, in some cases, occlusion of the arterial lumen.
Femoral occlusion is associated with severe limb pain with no or insufficient blood supply, intermittent claudication, and cramps. The pain increases with exercise or movement and decreases with rest, but does not go away.