 Good day everybody. This is Dr. Sanjay Sanyal, Professor, Department Chair. So this is going to be a demonstration of the femoral triangle of the rectal canal. This is a supine cadaver. This is the right side. I'm standing on the right side. So let's take a look at the boundaries of the rectal canal and the femoral triangle. Lateral boundary is formed by this muscle here, the medial border of this muscle. This is the sartorius muscle. Then we have the medial boundary is formed by the medial boundary of this muscle, which I have lifted up. This is the rectal longus. This is the medial boundary. Before I proceed any further, do not get confused by this color. This has been due to extravacation of blood when they were doing embalming of this cadaver and you can see the opening of the embalming. That's why the extravacation has produced this discoloration and it has macerated a few of the tissues here. Coming to the supine boundary of the femoral triangle, the supine boundary is where my finger is facing right now. This is the inguinal ligament, which extends from the anterior supine to the pubic tubercle. So therefore, this is the boundary of the femoral triangle. Let's take a look at the floor of the femoral triangle. Going from lateral to medial, first we have this muscle. This whole muscle that we see here, this is the iliosuas muscle. The lateral component is the iliacus. The medial component is the suas major and the fibres they go down and get inserted onto the lesser trochanter. My finger can feel it. Of course, you cannot see it in this dissection. Then going further medially, we have this muscle here. This is the pectinus muscle and we can see the boundary between the iliosuas and the pectinus. This is the pectinus muscle. The pectinus muscle takes origin from the iliopubic eminence and it goes down and laterally and gets inserted onto the pectinus line. This was covered by the pectinial fascia, which has been removed. And further medially, we have this muscle here, which I have lifted up. This is the rector brevis, which takes origin from the pubic bone and the fibres they go down and they get inserted into the upper part of the linea aspera. Some books say that the rector longus is also part of the floor because the rector longus is sloping down like this. So therefore, the lateral boundary of the rector longus also forms part of the floor, but then some books don't agree with that. So that is about the floor. Now let's take a look at the contents and then we shall mention a few clinical correlations. Going from lateral to medial, we have this structure here. This is the femoral nerve. Then we have this structure here. This is the femoral artery and the profundum femoris artery. We can see it here. I've clearly lifted it up here. And this opening is the one which I told you is the opening through which they had done them moment. And further medial to that, we have this structure here. This is the femoral vein. These two were enclosed in a tight sheet, which is called the femoral sheet, which is derived from the abdomen. And we can see this vein opening into the femoral vein. This is the long subvenous vein, which went through the subvenous opening and it entered into the femoral vein. So these are the essential contents. The whole thing was filled with fat and lymph nodes, which we have removed and discovered by the facial letter and there was opening for the subvenous vein. Having mentioned the boundaries and the contents of the femoral triangle, let's mention a few special points and clinical correlations pertaining to each of these. Starting with the sartorius. The sartorius is known as the tailor's muscle. That's the meaning of the word sartorius and it is arguably one of the longest muscles, if not the longest muscle in the human body. It takes origin from the anterior suvial spine and the fibers, they go down and medially and it crosses the knee joint and it gets inserted right down here. At the pesans arenas. The sartorius is exactly as the tailor used to do when they used to sit cross-linked on the floor to do the stitching. So therefore it is responsible for abduction of the hip, lateral rotation of the hip, flexion of the hip and flexion of the knee. So that's about the sartorius. Coming to the iliosovus. If you see, my finger goes right in. The iliosovus muscle comes right from the abdomen. The iliacus muscle comes from the iliacfossa and the suvass major comes from the lumbar vertebrae. That's why my finger can go in. It comes through the muscular compartment of the retrowing guanyal space and it gets inserted, as I said, into the lesser trochanter. If there is a rupture of the insertion of the muscle on the lesser trochanter, then it will produce severe pain and the person will not be able to flex his hip. That is called Ludlov sign. That's about the iliosovus. There is a bursa between the iliosovus tendon and the hip joint, which is called the iliosovus bursa, which reduces friction and that can get inflamed to produce iliosovus bursitis. Coming to the pectinus muscle. The pectinus muscle, as I mentioned, is this one here. The pectinus is a dual muscle. In other words, it has got dual function and it has got dual enough supply. The pectinus, though it's the muscle of the anterior compartment, it receives nerve, a branch from the femoral nerve, and it also receives a branch from the obtrator nerve, which I shall show you just a little later. And because it's got a dual function, it can flex the hip and it can also adduct the hip because of its unique insertion. Coming to the adductor brevis. It takes origin from the pubic bone and this is the muscle of the medial compartment. Therefore, it is supplied by the obtrator nerve. Coming to the adductor longus. It takes origin by a narrow tendon, which we cannot see. It is where my finger has gone in. People who ride horses, ride from childhood for many years, they can get heterotopic bone formation here. And that is known as rider's bone, which can be felt as a bony projection in front of the pubic bone. That is called the rider's bone. Now what I will do is, I will reflect the adductor longus and under that we can see this muscle here. This big muscle, this is the adductor magnus. And we can see running between the adductor brevis and the adductor magnus and then running between the adductor longus and the adductor magnus is this nerve here. This is the obtrator nerve. This nerve strictly speaking is not in the femoral triangle, but because it is visible here, I'm showing it. These branches are the ones which supply the muscles of the adductor compartment. Coming to the adductor canal. Now what exactly is the adductor canal and how, where does it start? Typically, it starts exactly at the apex of the femoral triangle. And that is the location where the sartorius muscle overlaps the adductor longus. So that is the beginning of the adductor canal. But a more sure shot way of locating the adductor canal is when we retract these muscles, we will notice a unique change of relationship. In the femoral triangle, the femoral artery is lateral, the femoral vein is medial. But as it goes towards the adductor canal, they change their orientation. We see the following things. We see that the femoral artery has come anterior and the femoral vein has gone posterior. That is the beginning of the adductor canal. And that's how it runs in the adductor canal till the adductor hiatus, where it will become the popliteal artery in the popliteal vein. Additionally, in the adductor canal, we can see these two structures. We can see this nerve here. This is saphenous nerve. The saphenous nerve is the longest cutaneous branch of the femoral nerve and it runs all the way down through the adductor canal. And then it pierces the adductor canal. It runs on the medial side of the knee and goes right down to the leg and a little bit of the medial side of the foot. The next structure that we can see is this nerve here. This is the nerve to vastus medialis. This is also a content of the adductor canal to a certain extent. The adductor canal is roofed over anterior medially by statorius with the sub-statorial fascia underneath and the plexus which has been removed. Antrolaterally is this muscle. This is the vastus medialis muscle and posteriorly is the adductor longus, which I mentioned has been macerated because of the embalming process. So these are the contents of the adductor canal and the course. The adductor canal starts from the apex of the femoral triangle and it ends at the adductor hiatus, which is not visible in this dissection. So this is the femoral artery and we have lifted it up here and we can see some of the branches which are visible here. These are the two branches of the femoral artery going superiorly and medially. This is the branch is the superficial epigastric and this is the branch or the external potential. There was a branch which you can see the opening here, the muscle artery has been removed. This was the superficial circumflex iliac. Apart from these, the femoral artery gives a descending genicular branch for the lower down, which we cannot see in this dissection. Last but definitely not the least is this big branch here. This is the profundum femoris artery, which is almost as big as the femoral artery itself, the deep artery of the thigh. And we can see the profundum femoris artery in all its extent here. This is the branch which gives the lateral circumflex femoral and the medial circumflex femoral arteries, which form, participate in many anastomosis. And the main profundum femoris then continues down and here you can see it is running between the origin of the vastus medialis and insertion of the adductor magnus. And from here it will give four perforating arteries which will pierce through the adductor magnus and go to the posterior aspect of the thigh. Pulsation of the femoral artery can be palpated at the mid-inguinal point, which is the point midway between the anterior supine and the pubic symphysis. One inch below the inguinal ligament, we can palpate the pulsation of the femoral artery against the pubic bone. This is a very useful point for palpation because we can use the femoral artery punctured for angiogram, femoral-populatial angiogram. And we can put the canal in the reverse direction through the external iliac, common iliac, aorta and we can do angiogram of all the branches of the aorta including coronary vessels. Likewise, when we palpate the femoral artery, we know that the femoral vein is located just one centimeter meter to that. We can puncture the femoral vein to do cardiac catheterization or for any other procedure. Likewise, we know that the femoral nerve is located a little lateral to the femoral artery and using the same pulsation, we can do a femoral nerve block if we want to do any surgery, lower down like for example in the knee. So these are the uses of the femoral artery. Having mentioned that, now let's come to a few other points. As I mentioned, this syphilis nerve, this is the longest cutaneous branch and this is the only branch of the femoral nerve which goes beyond the knee, beyond the thigh and beyond the knee right down to the foot. This syphilis nerve, as it goes down, it accompanies the long syphilis vein and it continues down in the same fashion right down to the foot. This syphilis nerve is a very important cutaneous nerve. Let's mention a few quick words about the femoral nerve itself. I have lifted up the femoral nerve. We can see a few branches. Femoral nerve has got a very short course inside the femoral triangle. The moment it emerges under the inguinal ligament, just after a short distance it breaks up into literally hundreds of branches. All these branches supply all the muscles of the anterior compartment. Not only that, it also gives many cutaneous branches which have been removed, which pierces through the deep fascia and supplies most of the anterior aspect of the skin of the thigh. So these are the distribution of the femoral nerve. This whole thing that we see here, this is the quadriceps. This is the rectus femoris. Medially this muscle here, this is the vastus medialis, which takes origin from the medial lip of the laniaspora and comes forward. This muscle on the lateral aspect, this is the vastus lateralis, which is the largest of the quadriceps. And all these four muscles, they converge here above the knee in a tough tendon here, which is called the quadriceps tendon. So these are the structures that we can see in this anterior dissection. Thank you very much for watching. If you have any questions or comments, please put them in the comment section below. Dr. Sanjay Sanyal signing out. Kendall Kumberbatch is the camera person. Have a nice day. Please like and subscribe. Thank you.