femoral artery

The femoral artery is the principal blood supply to the lower extremity. It begins as the continuation of the external iliac artery after passing under the inguinal ligament at the midpoint between the anterior superior iliac spine (ASIS) and pubic symphysis (midinguinal point). Within the femoral triangle (boundaries: inguinal ligament superiorly, sartorius laterally, adductor longus medially), it lies medial to the femoral nerve and lateral to the femoral vein—clinically remembered by the mnemonic NAVEL (lateral to medial: Nerve, Artery, Vein, Empty space, Lymphatics).

Branches include the superficial and deep external pudendal arteries, superficial epigastric artery, superficial circumflex iliac artery, and most importantly the deep femoral artery (profunda femoris), which gives off the medial and lateral circumflex femoral arteries supplying the femoral head and neck (clinically relevant in femoral neck fractures and avascular necrosis). The femoral artery continues as the popliteal artery after passing through the adductor hiatus (adductor magnus).

Clinical significance: - Common site for arterial line placement, cardiac catheterization, and angiography due to superficial location and palpable pulse (femoral pulse) below the inguinal ligament. - Vulnerable to atherosclerosis, causing peripheral arterial disease (PAD) with symptoms like claudication. - Site of femoral pseudoaneurysm formation after catheterization (to-and-fro bruit, pulsatile mass). - Femoral hernias occur just medial to the femoral vein, within the femoral canal (a potential space medial to the femoral sheath). - Compression here can control hemorrhage from lower limb trauma. - Landmark for retroperitoneal hematoma diagnosis when arterial punctures are too high (above inguinal ligament). - Homans' sign and DVT risk relate closely to femoral vein, which lies adjacent.