Anatomy Atlas

Femoral artery

Arteria femoralis
ArteryHigh-yielddraftCardio

Continuation of the external iliac artery below the inguinal ligament and the main artery of the lower limb. Its groin pulse is a key exam site and the usual access for catheterization; the superficial femoral segment is the classic site of claudication-causing atherosclerosis.

Core anatomy

Location

Femoral triangle, then the adductor canal of the thigh.

Origin

Continuation of the external iliac artery as it passes under the inguinal ligament, at the mid-inguinal point (midway between the ASIS and the pubic symphysis).

Course

Descends through the femoral triangle (in the femoral sheath, lateral to the femoral vein), enters the adductor canal under sartorius, and passes through the adductor hiatus in adductor magnus to become the popliteal artery.

Branches
  • Superficial branches: superficial epigastric, superficial circumflex iliac, superficial and deep external pudendal
  • Deep femoral artery (profunda femoris): about 4 cm below the ligament; gives the medial and lateral circumflex femoral arteries (hip and femoral head) and perforating arteries to the posterior thigh
  • Descending genicular artery (to the knee anastomosis)
Supplies

The lower abdominal wall skin, external genitalia, and the entire lower limb (with the deep femoral supplying most of the thigh).

Anastomoses

Cruciate and trochanteric anastomoses around the hip (with the gluteal arteries); the genicular anastomosis at the knee — collaterals that open up in chronic occlusion.

Termination

Becomes the popliteal artery at the adductor hiatus.

Notes

Clinicians call the segment after the profunda origin the "superficial femoral artery" (SFA) — it is an artery, not a superficial vessel; the "superficial femoral vein" is likewise a deep vein.

Branches

Structures supplied

Found in

Mentioned in

Generated automatically from links in other entries.

Femoral triangle (right, anterior view)The femoral triangle of the right thigh, with lateral on the left. Its base is the inguinal ligament, from the anterior superior iliac spine to the pubic tubercle; its lateral border is sartorius and its medial border adductor longus, which meet at the apex, where the adductor canal begins. The floor is iliopsoas laterally and pectineus medially. From lateral to medial lie the femoral nerve outside the femoral sheath, then inside the sheath the femoral artery, the femoral vein and the femoral canal, with the deep inguinal lymph nodes most medially (NAVEL). The great saphenous vein joins the femoral vein through the saphenous opening, below and lateral to the pubic tubercle. The deep femoral artery leaves the femoral artery a few centimetres below the ligament and runs posteriorly.ASISInguinal ligamentFemoral nerveDeep femoral arteryIliopsoas (floor)SartoriusApex → adductor canalPubic tubercleFemoral arteryFemoral veinFemoral canal (ring)Deep inguinal nodesSaphenofemoral junctionPectineus (floor)Adductor longusGreat saphenous veinLateral ←→ MedialNAVEL, lateral → medialDashed outline = femoral sheath

Swipe sideways to see the whole diagram →

Femoral triangle (right, anterior view). Lateral on your left. The base is the inguinal ligament, the borders are sartorius (lateral) and adductor longus (medial), and the floor is iliopsoas and pectineus. Lateral to medial: Nerve (outside the femoral sheath), Artery, Vein, Empty space (femoral canal), Lymphatics. The pulse is felt just below the mid-inguinal point, with the vein just medial to it; a femoral hernia comes through the femoral canal.
Original schematic, created for this atlas.
Diagram of the femoral artery with the deep femoral (profunda) artery, circumflex femoral and perforating branches
Femoral artery and its branches (diagram).
Henry Vandyke Carter, Gray's Anatomy of the Human Body, 20th ed. (1918), Fig. 548. Source · Public domain (Public domain in the US: published before January 1, 1931 (per Wikimedia Commons))
Anteromedial view of the thigh showing the femoral artery descending to the adductor canal with the saphenous nerve and genicular branches
The femoral artery descending through the thigh toward the adductor canal.
Henry Vandyke Carter, Gray's Anatomy of the Human Body, 20th ed. (1918), Fig. 550. Source · Public domain (Public domain in the US: published before January 1, 1931 (per Wikimedia Commons))

Clinical correlations

Peripheral artery disease and claudication PANCE

Mechanism / lesion

Atherosclerosis, most commonly of the superficial femoral artery in the adductor canal; risk factors — smoking, diabetes, hypertension, hyperlipidemia.

Classic presentation

Calf claudication (reproducible pain with walking, relieved by rest), diminished distal pulses, cool hairless shiny skin. Ankle–brachial index ≤ 0.90 confirms PAD. Treat with smoking cessation, supervised exercise, antiplatelet therapy and a statin; revascularization for limiting symptoms or critical ischemia.

Acute limb ischemia PANCE

Mechanism / lesion

Embolism (atrial fibrillation) or thrombosis, often lodging at the femoral bifurcation.

Classic presentation

The 6 Ps: pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia (cold). Emergency — heparin and urgent revascularization; paralysis and sensory loss signal threatened limb.

Femoral access complications PANCE

Mechanism / lesion

Arterial puncture for angiography, PCI or lines.

Classic presentation

Groin hematoma, pseudoaneurysm (pulsatile mass with a bruit — ultrasound-guided thrombin injection), AV fistula, or retroperitoneal hemorrhage (high puncture above the inguinal ligament — back/flank pain, hypotension).

High-yield PANCE pearls

  • Calf claudication → SFA (adductor canal) disease; buttock claudication → aortoiliac.
  • ABI ≤ 0.90 = PAD; > 1.3–1.4 = noncompressible (calcified) vessels.
  • 6 Ps = acute limb ischemia → emergency.
  • Femoral pulse at the mid-inguinal point; vein is medial to the artery (NAVEL).
  • Pulsatile groin mass with bruit after catheterization → pseudoaneurysm.

Imaging anatomy

CT

CT angiography maps occlusive disease and aneurysms before intervention.

MRI

MR angiography (alternative without iodinated contrast).

Ultrasound

ABI and arterial duplex ultrasound first; duplex also diagnoses pseudoaneurysm and AV fistula.

Key views & landmarks
  • Ankle–brachial index
  • Arterial duplex of the lower extremity

Physical exam

Surface landmarks

The femoral pulse is felt just below the mid-inguinal point, halfway between the ASIS and the pubic symphysis.

Palpation

Compare femoral, popliteal, dorsalis pedis and posterior tibial pulses on both sides; auscultate for femoral bruits.

Strength / function testing

Inspect for trophic skin changes, capillary refill, Buerger test (elevation pallor, dependent rubor) in chronic ischemia.

Self-quiz

Q1.

A 64-year-old smoker has cramping pain in his right calf after walking two blocks that resolves with 5 minutes of rest. The right popliteal and pedal pulses are diminished; the femoral pulse is normal. ABI is 0.68. Where is the most likely site of stenosis?

Show answer

C

Calf claudication with a normal femoral pulse and reduced popliteal and pedal pulses points to the superficial femoral artery, typically in the adductor canal — the most common site of lower-limb PAD.

Q2.

The femoral head receives most of its blood supply from branches of which vessel?

Show answer

B

The deep femoral (profunda) artery gives the medial circumflex femoral artery, whose retinacular branches supply most of the femoral head.

Q3.

A patient with long-standing diabetes has an ankle–brachial index of 1.5. How should this be interpreted?

Show answer

D

An ABI above about 1.3–1.4 means the tibial arteries are calcified and noncompressible, common in diabetes and CKD, so the ABI can't be interpreted. An ABI ≤ 0.90 confirms PAD.

Q4.

The day after a cardiac catheterization through the right femoral artery, a patient has a pulsatile groin mass with a bruit. What is the most likely diagnosis?

Show answer

A

A pulsatile mass with a bruit after femoral access is a pseudoaneurysm, usually treated with ultrasound-guided thrombin injection. A simple hematoma isn't expansile or pulsatile; an AV fistula gives a continuous bruit.

Q5.

Hours after femoral artery access, a patient develops back and flank pain and hypotension without an obvious groin hematoma. What was the most likely problem with the puncture?

Show answer

C

A high puncture above the inguinal ligament enters the external iliac artery, where bleeding tracks into the retroperitoneum and can't be compressed, causing back or flank pain and hypotension. Puncture below the ligament allows compression against the femoral head.

Flashcards

See also