Femoral sheath Anatomy Animation : USMLE Step 1 Review

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Femoral sheath Anatomy Animation : USMLE Step 1 Review

The femoral sheath is an extension of the abdominal fascia, specifically the transversalis and iliopsoas fasciae, that encloses the upper part of the femoral vessels. It forms a fascial compartment that extends about 3-4 cm below the inguinal ligament.

Here's a detailed look at its anatomy:

1. Composition: The femoral sheath is divided into three compartments by two vertical septa:

Lateral compartment: Contains the femoral artery, a continuation of the external iliac artery, which supplies blood to the lower limb.
Intermediate compartment: Contains the femoral vein, which carries deoxygenated blood from the lower limb back to the heart. The femoral vein lies medial to the femoral artery.
Medial compartment (Femoral Canal): This is the smallest compartment of the sheath and contains lymph vessels and fat. It allows for expansion of the femoral vein when needed.

2. Femoral Canal: The femoral canal is conical and extends from the femoral ring (its base) to the saphenofemoral opening (its apex), about 1.25 cm. Its primary function is to allow for expansion of the femoral vein during increased venous return from the lower limb. The femoral canal also contains a deep inguinal lymph node, also known as Cloquet's node or Rosenmuller's node.

3. Femoral Ring: The femoral ring is the base of the femoral canal and is bordered by several anatomical structures including the inguinal ligament anteriorly, the lacunar ligament laterally, and the pectineal ligament posteriorly. The femoral ring is the site where femoral hernias can occur.

4. Clinical Significance: The femoral sheath is important in several clinical procedures including cardiac catheterization, where catheters are often inserted into the femoral artery and sometimes the femoral vein. Understanding the anatomy of the femoral sheath is crucial in avoiding iatrogenic injuries during such procedures.

It's important to note that the femoral nerve, which is a part of the lumbar plexus, lies lateral to the femoral sheath and is not enclosed within it. It provides motor innervation to the anterior compartment of the thigh and sensory innervation to the anterior and medial aspects of the thigh, medial leg, and foot.

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