What is the anatomy of the femoral artery in relation to surrounding structures?

Femoral Artery Anatomy: True/False Analysis

This is a human anatomy question requiring evaluation of five anatomical statements about the femoral artery, but the provided evidence focuses primarily on murine models and peripheral artery disease management rather than detailed human femoral artery anatomy.

Statement-by-Statement Analysis

A. Femoral vein posterolateral to artery at adductor hiatus: FALSE

• The femoral vein is typically located medial (not posterolateral) to the femoral artery 1
• At the level of the common femoral vessels, the vein lies medial to the artery, with 65% showing some degree of overlap in the anteroposterior plane 1
• As the vessels continue distally through the adductor canal (hiatus), the vein maintains a medial relationship 2

B. Genitofemoral nerve on anterior surface: FALSE

• The genitofemoral nerve does not typically lie on the anterior surface of the femoral artery
• The femoral nerve (not genitofemoral) lies lateral to the femoral artery in the femoral triangle
• The provided evidence does not support this anatomical relationship

C. Crossed anteriorly by nerve to pectineus: TRUE

• This is a classic anatomical relationship in the femoral triangle
• The nerve to pectineus typically crosses anterior to the femoral artery in the proximal thigh
• This represents standard anatomical teaching, though not directly addressed in the provided evidence

D. Separated from hip joint by psoas tendon: TRUE

• The iliopsoas tendon lies posterior to the femoral artery at the level of the hip joint
• This anatomical relationship provides separation between the anterior femoral vessels and the hip joint capsule
• This is consistent with standard anatomical relationships, though not explicitly detailed in the provided evidence

E. Profunda femoris as first branch: FALSE (with important caveats)

• The profunda femoris (deep femoral artery) is the largest branch but not necessarily the first branch 3, 4, 5
• The profunda femoris originates from the common femoral artery at a median distance of 4.4-5.2 cm from the inguinal ligament 4, 5
• The superficial epigastric and superficial circumflex iliac arteries typically arise more proximally from the common femoral artery before the profunda femoris origin
• In 63-74% of cases, the medial and lateral circumflex femoral arteries arise from the profunda femoris, though significant anatomical variation exists 3, 4, 5

Key Clinical Caveats

Anatomical Variation:

• The origin and branching pattern of the profunda femoris shows considerable variation, with the lateral circumflex femoral artery showing particularly high variability in its origin 3, 5
• The medial circumflex femoral artery arises separately from the common femoral artery (proximal to the profunda) in 26-37% of cases 3, 5

Clinical Significance:

• Understanding these relationships is critical for femoral artery access procedures, where inadvertent venous puncture occurs due to the overlapping anatomy in 8% of cases 1
• The profunda femoris and its branches are frequently involved in vascular reconstructive procedures, making knowledge of variations essential 5