Overview

In the groin. The femoral artery begins behind the inguinal ligament at the mid-inguinal point, halfway between the anterior superior iliac spine and the pubic symphysis. In the femoral triangle it lies inside the femoral sheath with the femoral vein on its medial side. The femoral nerve lies lateral to it, outside the sheath. From lateral to medial the order is nerve, artery, vein and then the empty femoral canal, which contains lymphatics (NAVY).

Deep femoral branch. About 3–5 cm below the inguinal ligament the femoral artery gives off its largest branch, the deep femoral artery (profunda femoris). Clinicians call the segment above this point the "common femoral artery" and the segment below it the "superficial femoral artery". Despite its name, the superficial femoral artery is not superficial.

Adductor canal. The artery then enters the adductor (subsartorial) canal under sartorius, together with the femoral vein and the saphenous nerve. It leaves through the adductor hiatus in adductor magnus and becomes the popliteal artery.

Anatomy

Branches: The superficial epigastric, superficial circumflex iliac and superficial and deep external pudendal arteries, the deep femoral artery and the descending genicular artery.

Function

Carries the main blood supply to the thigh, leg and foot.

Clinical significance

Femoral pulse and arterial access

The femoral pulse is felt at the mid-inguinal point. The artery is a common access site for angiography and endovascular procedures. It is punctured over the femoral head, below the inguinal ligament, so it can be compressed afterwards. A puncture too high risks bleeding into the retroperitoneum. A puncture too low risks a false aneurysm (pseudoaneurysm) or an arteriovenous fistula.

Peripheral arterial disease

The superficial femoral artery in the adductor canal is the commonest site of atherosclerotic blockage in the leg. It causes calf pain on walking (intermittent claudication). An ankle–brachial pressure index below 0.9 confirms arterial disease.

Mnemonics

Femoral triangle contents

NAVY, from lateral to medial: Nerve, Artery, Vein, Y-fronts (the empty femoral canal, containing lymph vessels and Cloquet's node).

Test yourself

In the femoral triangle, which structure lies immediately medial to the femoral artery?

Femoral nerve
Femoral vein
Great saphenous vein
Inguinal ligament

Answer: Femoral vein

From lateral to medial the order is NAVY: Nerve, Artery, Vein, Y-fronts (the femoral canal). This is why femoral venous access is about 1 cm medial to the femoral pulse.