Femoral Artery Position on Palpation
The femoral artery pulse is palpable below the inguinal ligament, midway between the anterior superior iliac spine and the symphysis pubis. 1
Anatomic Location in the Femoral Triangle
The femoral artery occupies a specific position within the femoral triangle that changes as it courses distally:
At the inguinal ligament level: The common femoral vein lies medial to the artery only in the region immediately inferior to the inguinal ligament 2
Distal to the inguinal region: The vein abruptly runs posterior to the artery as you move distally from the inguinal ligament 2
Variable relationship: While the vein is frequently seen posterior to the artery in most of the femoral triangle, the vein and artery may have almost any relationship with one another depending on the exact location 2
Clinical Palpation Technique
The maximal femoral pulse is the most reliable landmark for locating the common femoral artery, being over the common femoral artery in 92.7% of limbs 3
Key Surface Landmarks:
Optimal palpation point: Below the inguinal ligament, midway between the anterior superior iliac spine and the symphysis pubis 1
Avoid the inguinal skin crease: This landmark is unreliable, as it lies distal to the common femoral artery bifurcation in 71.9% of limbs 3
Relationship to femoral head: The common femoral artery is projected over the medial aspect of the femoral head in 77.9% of limbs 3
Technique for Pulseless Arteries
When the pulse is not palpable, use anatomic landmarks:
Place a finger immediately lateral to the pubic tubercle and inferior to the inguinal ligament 4
Palpate the point allowing the most posterior depression between the iliopsoas muscle laterally and the pectineus muscle medially 4
The femoral vein lies in the floor of this depression, and 1.5 cm lateral to this depression lies the femoral artery 4