96 Section 1: Basic science

Dermatomes of the lower limb

L1 Around inguinal region and anterior perineum,
L3 Front of knee,
L4 Over tibia/medial leg,
L5 Over fibula/lateral leg,
L5 Medial side of foot,
S1 Lateral side of foot.
One stands on S1, sits on S3 (around the anus) and S2 is a narrow strip up
the middle of the calf and hamstrings.

Note that there are extensive overlaps between dermatomes and therefore
various references will have slight variations of the exact mapping of the
dermatomes. These maps are a guide to ease examination and aid in diagnosis.

Femoral triangle
What are the boundaries of the femoral triangle?
See Figure 5.7.
Superiorly Inguinal ligament,
Copyright 2012. Cambridge University Press. All rights reserved.

Medially Medial border of adductor longus muscle,

Laterally Medial border of sartorius muscle,
Floor Iliacus, tendon of pectineus, psoas and adductor longus,
Roof Superficial fascia and fascia lata.

Inguinal triangle Figure 5.7

Femoral triangle.
Inguinal ligament

Femoral nerve

Femoral artery

Femoral vein

External pudendal vein

Sartorius

Adductor longus

Great saphenous vein

Kanani, Mazyar, and Khaled M. Sarraf. MRCS Revision Guide: Limbs and Spine, Cambridge
University Press, 2012. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/warw/detail.action?docID=866837.<
 Chapter 5: Anatomy 97

What are the contents of the femoral triangle?

From lateral to medial:
 Femoral nerve,
 Femoral artery,
 Femoral vein,
 Femoral canal (containing extra-peritoneal fat and Cloquets lymph
node), and
 Deep inguinal lymph nodes within the femoral triangle.

What operative procedures occur in and around the femoral triangle?

Femoral embolectomy for acute limb ischaemia, and femoral hernia repairs.

Hip and femur

See Figure 5.8.

Figure 5.8 Hip

and femur.
Ilium
Copyright 2012. Cambridge University Press. All rights reserved.

Synovial
membrane (cut)
Iliofemoral ligament
(cut to show Cotyloid ligament
underlying structures)
Head of femur
Greater
trochanter Pubofemoral
ligament

Pubis

Ischium
Pubocapsular
ligament
Obturator
membrane
Femur
Lesser trochanter

Kanani, Mazyar, and Khaled M. Sarraf. MRCS Revision Guide: Limbs and Spine, Cambridge
University Press, 2012. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/warw/detail.action?docID=866837.<