Anatomy
Femoral Triangle & Thigh Compartments
Femoral & Adductor Triangle
What are the boundaries of the femoral triangle?
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Boundaries
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Superiorly: Inguinal Ligament
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Medially: Adductor longus
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Laterally: Sartorius
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Floor: Pectineus (medially) + Iliopsoas (laterally)
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What are the contents of the femoral triangle?
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Contents (lateral to medial)
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Femoral Nerve
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Femoral Artery
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Femoral Vein
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Empty Femoral Canal
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Lymphatics
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What landmark would you use to perform a fascio-iliac block?
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A facio-iliac block is performed for analgesia in neck of femur fractures (NOF#)
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Landmark
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Line between anterior superior iliac spine (ASIS) and pubic tubercle
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Identify the junction between lateral 1/3 and medial 2/3
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Entry point 1cm below this point
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How would you perform a fascio-iliaca block?
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Procedure
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Consent patient + gather equipment (including USS)
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Identify landmark
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Prepare local anaesthetic
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30-40mls of 0.25% bupivacaine
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Depending on weight of patient
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Identify vessels on US
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Ensure avoid femoral artery / vein
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Advance needle and syringe
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Should feel “two pops”
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Aspirate to ensure no blood and inject local anaesthetic
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Withdraw needle and apply pressure
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What is the adductor canal?
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The adductor canal lies deep to the sartorius muscle and connects the distal femoral triangle to the popliteal fossa. Also known as subsartorial canal / Hunter’s canal.
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What are its boundaries?
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Boundaries
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Anteromedially: Sartorius
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Anterolaterally: Vastus Medialis
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Posterior: Adductor longus + magnus
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What are the contents of the adductor canal?
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Superficial femoral artery
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Superficial femoral vein
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Saphenous nerve
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Nerve to vastus medialis
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What is the adductor hiatus? What is its surface marking?
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The adductor hiatus is a gap between the abductor muscle and the femur. It allows passage of the superficial femoral artery + vein from the distal aspect of the adductor canal to the popliteal fossa. Surface marking - 2/3 of way along from the ASIS to the adductor tubercle (of the femur)
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Compartments of the Thigh
What are the origins, insertion, actions and innervations of the muscles of the anterior compartment of the thigh?
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What are the origins, insertion, actions and innervations of the muscles of the medial compartment of the thigh?
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What are the origins, insertion, actions and innervations of the muscles of the posterior compartment of the thigh?
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