Generality
The femoral triangle, also known as Scarpa's triangle, is a hollow anatomical space, located in the thigh and used to house important nerve, vascular and lymphatic structures.
With a triangular shape and placed with the apex towards the feet and the base towards the trunk, the femoral triangle has 3 edges: an upper edge, which borders the inferior margin of the inguinal ligament, a medial border, which borders the lateral margin of the adductor longus, and a lateral border, which borders on the medial margin of the sartorius muscle.
The Scarpa triangle houses the deep inguinal lymph nodes, the inguinal lymphatic vessels, a tract of the femoral artery, a tract of the femoral vein and a tract of the crural nerve (or femoral nerve).
What is the femoral triangle?
The femoral triangle, or Scarpa's triangle, is a hollow anatomical space, which resides in the upper, anterior and medial part of the thigh of the human being.
Despite its small size, the Scarpa triangle hosts nerve, vascular and lymph node structures; this makes it important not only from the anatomical point of view, but also from the clinical aspect.
ORIGIN OF THE NAME
The femoral triangle has this name, as it has a triangular shape and resides in the portion of the human body occupied by the femur (the femur is the bone of the thigh).
The second word with which it is known, namely Scarpa's triangle, is due to Antonio Scarpa . Antonio Scarpa was an Italian anatomist, who lived between the 1700s and the 1800s, who conducted numerous studies on the hernias of the inguinal and femoral region, describing the anatomical area corresponding to the femoral triangle on several occasions and in detail.
Anatomy
The femoral triangle is an inverted triangle; in other words, it is placed with the apex downwards, towards the feet, and the base upwards.
Like any triangular element, Scarpa's triangle has three edges (or sides): the upper edge, the medial edge and the lateral edge.
- The upper edge corresponds to the lower edge of the so-called inguinal ligament . The inguinal ligament is that band of fibrous connective tissue, which extends from the so-called pubic tubercle of the pubis to the so-called anterior superior iliac spine of the ilium .
- The medial border corresponds to the lateral margin of the long adductor muscle .
- The lateral border corresponds to the medial margin of the sartorius muscle .
The femoral triangle also has an area comparable to a roof, anteriorly, and an area comparable to a floor, posteriorly.
- The roof of the femoral triangle corresponds to the so - called fascia lata ;
- The floor of the femoral triangle corresponds, in the most medial region, to the pectineus and long adductor muscles and, in the most lateral region, to the ileopsoas muscle.
STRUCTURES CROSSING THE FEMORAL TRIANGLE
The crural nerve (or femoral nerve ) and the femoral artery and femoral vein pass through the femoral triangle; wrapped by the so-called femoral sheath, the aforementioned blood vessels and the crural nerve represent the most important neuro-vascular structures of the lower limbs.
Furthermore, in a structure internal to the femoral triangle, called the femoral canal, the deep inguinal lymph nodes and inguinal lymphatic vessels take place.
- Femoral artery . It is a large arterial vessel, which provides, also through its innumerable branches (or branches), the blood circulation of numerous districts of the lower limb. It is an even element, so there is one for each lower limb.
- Femoral vein . Present in each lower limb, it is a large venous vessel, which collects blood from the great saphenous vein and the deep femoral vein.
- Crural nerve . It is a peripheral nerve deriving from the lumbar plexus, with the task of innervating, also thanks to its branches, the groin, the thigh, the leg and part of the foot.
The crural nerve has both motor and sensory functions.
- Deep inguinal lymph nodes and inguinal lymphatic vessels . The deep inguinal lymph nodes collect the lymph coming from the superficial inguinal lymph nodes and, through the associated inguinal lymphatic vessels, pour it first into the external iliac lymph nodes, then into the pelvic lymph nodes and finally into the paraortic lymph nodes.
Function
The femoral triangle has protective functions against the important anatomical structures that cross it.
clinic
The reasons why the femoral triangle is important from the clinical point of view are more than one.
First of all, the femoral artery, contained in the triangle of Scarpa, represents a convenient point of entry for the catheters, used during therapeutic procedures such as coronary angioplasty and peripheral angioplasty .
Secondly, in the presence of severe bleeding from a lower limb, pressure at the femoral triangle can interrupt blood loss, preventing the victim from dying due to excessive bleeding.
Thirdly, the femoral vein, passing through the triangle of Scarpa, is a venous vessel that allows the practice of venipuncture, when this is not possible in the classical veins.
Finally, the combined pressure of the index finger and the middle finger on the femoral triangle makes it possible to measure the heart rate and understand if there is an inflow of blood to the lower extremities of the human body. The measurement of heart rate, carried out with the aforementioned modalities, is called the femoral pulse .
diseases
From a pathological point of view, the femoral triangle can be the protagonist of a medical condition known as crural hernia (or femoral hernia ).
Recalling that a hernia is the escape of a bowel from the cavity or seat in which it resides in normal conditions, the crural hernia consists in the exit of an abdominal bowel towards the so-called femoral canal. In other words, in those suffering from a femoral hernia there is a protrusion of an abdominal bowel in the structure of the femoral triangle, which encloses the deep inguinal lymph nodes and the inguinal lymphatic vessels.
