Arterial Supply of Lower Limb

THE ADDUCTOR CANAL (Subsartorial/Hunter’s canal) is an aponeurotic tunnel in the middle third of the thigh, extending from the apex of the femoral triangle to the opening in the Adductor magnus, the Adductor hiatus.

Most of the blood supply to the head and neck of femur is supplied by the medial circumflex femoral artery, its retinacular and epiphyseal branches included.

Medium circumflex femoral artery is an artery that branches from the deep femoral artery and it supplies the medial part of the thigh and hip joint muscles.

Ref: Merriam Websters medical dictionary, by Merrium Webster, Page 400; Campbell’s Operative Orthopaedics 10th/2908.

Superficial external pudendal artery is a branch of femoral artery. It runs medially to supply skin of the scrotum (or labium majus).

Femoral artery and vein, saphenous nerve and, in the upper part, the nerve to vastus medialis.

Adductor canal or subsartorial or Hunter‘s canal is a gutter-shaped tunnel in the middle third of the thigh. It extends from the apex of the femoral triangle to the adductor hiatus in the tendon of adductor magnus. 

Boundaries are given below:

• Anterior and lateral wall: vastus medialis
• Posterior wall – superior: adductor longus; inferior: adductor magnus
• Medial wall: Sartorius, which overlies the groove between the above muscles, forming the roof of the canal.

Superficial circumflex iliac artery is a branch of femoral artery. It is the smallest branch of the femoral artery. It pierces the deep fascia of the thigh lateral to the saphenous opening and courses laterally towards anterior superior iliac spine to supply superficial fascia and skin.

• Superficial epigastric artery
• Superficial circumflex iliac artery
• Superficial external pudendal artery
• Deep external pudendal artery
• Profunda femoris artery
• Descending genicular artery

• Inferior epigastric artery
• Deep circumflex iliac artery

A i.e. Femoral artery

A . i.e. Dorsalis pedis artery

A. i.e. Femoral artery 

• Femoral artery traverses the femoral triangle from its base (which is formed by inguinal ligament – attached between ASIS and Pubic tubercle) at midinguinal point

Deep inguinal ring lies ¹/2 inch above midinguinal pointQ; Superficial inguinal ring lies ^I/2 inch bellow midinguinal point; and Saphenous opening lies 4 cm below & lateral to the pubic tubercle.

C i.e. Femoral artery

A. i.e. Posterior tibial artery

B i.e. Medial circumflex femoral Artery

Ans is a i.e. It is not superficial 

“The pulse of the popliteal artery is the most difficult of the peripheral pulses to feel because the artery lies deep in the popliteal fossa. It is best examined with the subject lying supine or prone, with the knee flexed, in order to relax the tense popliteal fascia that roofs the popliteal fossa. The popliteal pulse is then felt by deep pressure over the midline of the fossa against the popliteal surface of the femur.” Gray’s Anatomy 40/e p1344

“Because the popliteal artery is deep in the popliteal fossa, it may be difficult to feel the popliteal pulse.” – Essential

clinical anatomy By Keith L Moore, A. M. R. Agur 3/e p356

Option b and c are not true as the popliteal artery crosses the femur and tibia bones.

Ans. is ‘d’ i.e., Femoral artery

Branches of femoral artery

1)     Superficial :- Superficial external pudendal, superficial epigastric, superficial circumflex iliac.

2)     Deep branches :- Profunda femoris, deep external pudendal, muscular branches, descending genicular branch (last branch in the adductor canal).

• Note: Superior epigastric artery is a branch of internal thoracic artery.

• Common peroneal nerve is related to neck of fibula (not tibia).
• Nutrient artery of tibia is a branch of posterior tibial artery.
• Nutrient artery of fibula is a branch of peroneal artery.
• Tibia is the commonest site of osteomyelitis.

 Femoral nerve

Femoral sheath

Femoral sheath is a funnel shaped fascial prolongation around proximal part of femoral vessels, situated in the femoral triangle, below the inguinal ligament. It is 3-4 cm long. It is formed by fascia iliaca.

Femoral sheath is divided into 3 separate fascial compartements by septa :‑

i) Lateral compartment :- It contains femoral artery and femoral branch of genitofemoral nerve.

ii) Intermediate compartment :- Femoral vein.

iii) Medial compartment (femoral canal) :- It is conical in shape, wider above adn narrow below. The wider upper opening is known as femoral ring, which is potentially a weak point in lower abdomen and is the site for femoral hernia. Femoral ring is bounded : Anteriorly by inguinal ligament, medially by lacunar ligament, posteriorly by pectineus with its covering fascia, and laterally by septum separating it from femoral vein. Femoral canal contains lymph node of cloquet or Rosenmuller and lymphatics.