Summary Study Guide: Inguinal Region: Femoral Artery

artery or vein. The tube in this artery is connected to a mechanical pump that

dissection of a preserved specimen. identify the major veins draining into the superior and inferior

• The surgeon will make an incision in your abdomen. This is usually an up-and-down incision in the midsection of your abdomen. The incision will extend through the inside lining of your abdomen (peritoneum).

an artery in the neck. Once the catheter is in place, the needle is removed and a

Usually, accessing vascular structures is done through a needle to puncture the vessel percutaneously, followed by a wire introduced through the needle to secure the vascular access. The needle is then removed and a sheath is advanced over the wire. Vascular sheaths are hollow structures with a built in diaphragm to prevent bleeding. Catheters are then placed into and out of the sheath with a minimal loss of blood.11

Intervention Procedure: Following the diagnostic portion of the procedure, the left femoral vein was accessed under ultrasound guidance with a 21 gauge thin wall needle. A double lumen 4 -French (5 cm in length) was placed percutaneously into the left femoral vein by modified Seldinger technique with guide-wire exchange. Blood was withdrawn from all lumens and flushed with normal saline. The catheter was sutured in place and a sterile dressing was applied over the site prior to removal of drapes.

The normal path of the blood to these arteries follows this route: abdominal aorta, common iliac artery, external iliac artery, femoral artery, popliteal artery, and then branches into the genicular arteries and circumflex fibular artery. The genicular and circumflex femoral arteries anastomosis and supply the knee joint. To assess the area for normal blood flow I would palpate the popliteal artery, posterior tibial artery, and dorsalis pedis artery (Hill). To palpate the popliteal artery, I would tell the patient to lay in the supine position and I would encircle and support his knee with both my hands on either side of his knee. I would then press deeply into the popliteal fossa with my fingertips, not thumb (Hill). To palpate the posterior tibial artery, I would curl my fingers anteriorly around the patient’s ankle and press my fingertips in the space between the medial malleolus and Achilles tendon (Hill). To palpate the dorsalis pedis artery, I would have the patient be in the recumbent position and relax the ankle, then I would stand at the foot of the examining table and place my

Central lines are tubes that are placed into large veins to withdraw blood, administer medications, give fluids or monitor patients’ conditions. They are often inserted in the arm, neck, chest or groin area. Unlike

Ultimately, avascular necrosis occurs through one final common pathway, which is decreased blood flow to the bone that leads to bone ischemia and death (Seamon). The medial femoral circumflex artery provides the primary blood supply to the femoral head. The MFCA branches off from the profunda femoris artery and anastomoses, or cross connects, with branches of the lateral femoral circumflex and inferior gluteal arteries in order to form an extracapsular arterial ring at the base of the femoral neck (Glynn). Blood is supplied to the femoral head by retinacular vessels that originate at the arterial ring and travel subsynovially along the capsule of the hip joint. The femoral nutrient artery has additional intraosseous vessels that travel from the femoral nutrient artery to the femoral head. The artery of the ligamentum teres derived from the obturator artery and occasionally from the MFCA also supplies a small yet valuable portion of blood to the medial femoral head (Grose). Avascular necrosis of the femoral head occurs when any of these blood supplies are affected.

Following the diagnostic portion of the procedure, a 4-French glide catheter was used to facilitate placing a 0.035 Rosen curved guide wire in the LPA. Then, 6 mm x 2 cm Mustang balloon was tracked over the Rosen wire and balloon angioplasty was performed in the previously placed LPA stent x1 and removed out of the body. Subsequently, the previously inserted 5-Fr sheath in the right femoral vein was exchanged by a 6-Fr long sheath (check-Flo Performer Introducer). Next, a 7 mm x 2 cm Coefficient balloon was tracked over the Rosen curved wire and balloon angioplasty of the LPA was carried out x 2. Afterward, the 6-Fr long sheath was exchanged by a 7-Fr long sheath (check-Flo Performer Introducer) to facilitate angioplasty with bigger balloon. Thereafter, 10 mmx 2 cm Mustang balloon was tracked over the Rosen guide wire and placed with the mid balloon at the most narrowed area of the conduit and the distal part at the proximal LPA

To perform a cardiac catheterization the cardiologist will insert a sheath, or a short tube usually into the femoral artery. A long very thin catheter will then be fed through the sheath and guided through the arteries until it is in the heart and coronary arteries. The physician uses fluoroscopy equipment to guide the catheter into the coronary arteries. To allow for clear viewing of the coronary arteries, contrast material is injected into the catheter. As the contrast material flows through the heart chambers and coronary arteries x-rays are taken. The

The IV tubes may be in veins in your hands, arms, or feet. In some cases, a long IV line (catheter) may be placed into a vein in your groin or shoulder.

Once the artery is identified, scan proximal and distal, keeping the vessel in the middle of the screen looking for arterial braches. Also, press down with the probe and then relax pressure on the skin to identify corresponding veins. The block can be performed anywhere in the axilla provided the teres major muscle is identified deep to the artery. (Gonzales et al, 2012).

The femoral artery (Fig 4) begins immediately behind the inguinal ligament, midway between the anterior superior spine of the ileum and the symphysis pubis, and passes down the front and medial side of the thigh. It ends at the junction of the middle with the lower third of the thigh, where it passes through an opening in the Adductor Magnus to become the popliteal artery.(Henery, 2007)

Cardiac catheterization a long flexible thin tube place in blood vessel in arm, groin, or neck looks in coronary arteries. Dye can be added to see how well the heart is pumping.