 If you take a close look between the adductor magnus and the adductor brevis, we can see this nerve here. This is the operator nerve and we can clearly see it is giving numerous branches to the adductor compartment. It's giving branches to the adductor longus, magnus and brevis. It also gives branches to gracilis. Now we shall move to the inner aspect, pelvis. And we can see the operator nerve here in the pelvis and I'm going to lift it up. This is the operator nerve in the pelvis. It rises from the adductor division of L2-3-4 and it passes through the operator canal and it enters into the thigh. And we can see when I'm exerting traction here, this nerve is moving here. So this is the operator nerve. Now we shall switch to a totally different topic altogether. We shall talk about the femoral artery and then the pulmonary artery. This is the femoral artery and this is the femoral vein. They were all enclosed in a sheath called the femoral sheath which is derived from the iliosuas fascia and the fascia transversalis of the abdomen and we have removed the sheath. The course of the femoral artery is from the mid-enguinal point to the adductor hiatus. So let's take a look at the mid-enguinal point. It is not the same as the midpoint of the inguinal ligament. This is the inguinal ligament that we have lifted up here. We can see that the femoral artery is coming in the sub-enguinal space and this space is referred to as the vascular compartment because the blood vessels are located here and it is the continuation of external iliac artery and the external iliac vein which we have lifted up here. So the mid-enguinal point is midpoint between the anterior superior iliac spine and the pubic symphysis. The midpoint of that and one inch below that is the location of the femoral artery. The femoral artery then descends down to the thigh and it becomes a pulmonary artery here. If we were to look on the medial side, we can see a tendular structure here. This is the adductor tendon and just later to that, an opening and my finger has gone into that opening. That is called the adductor hiatus and that places the location where the femoral artery becomes a pulmonary artery. So this, where my fingers are located, this is the course of the femoral artery and this is how we draw the surface marking of the femoral artery. Now let's take a look at the branches of the femoral artery. We can see this branch here. This is the superficial circumflex iliac artery which goes around the iliac bone. There should be a branch which runs like this towards the abdomen which we have removed. That is called the superficial epigastric. Finally, one branch runs towards the genitalia that is known as the external pudendal. So these are the three small branches and after that the femoral artery gives this huge branch and we can see that. This is the profunda femoris artery, the deep artery of the thigh. And we can see in certain situations the funda femoris is almost as big or even bigger than the main femoral artery. To continue, the femoral artery in the femoral triangle is located lateral to the femoral vein and then as it descends down, it enters the canal here and that canal is referred to as the adductor canal or the sub-sartorial canal. This adductor canal is bounded by the sartorials medially, the vastus medial is laterally and posteriorly it is bounded by the adductor longus and it is pitched over by a fascia called the sub-sartorial fascia which we have split open. And in the adductor canal, the relationship is like this. Anteriorly is this nerve here, this is the subvenus nerve. Middle is the femoral artery and posterior is the femoral vein. So these are the three structures which run through the adductor canal and now my finger has gone into the adductor canal and this adductor canal then ends in the hiatus which I mentioned earlier called the adductor hiatus where the femoral artery in the vein becomes the femoral artery in the vein. So this is the full course of the femoral artery. Now let's mention a few important clinical correlations. Femoral artery is a very useful root for various angiograms. It is usually palpated here just below the ligament against the superior ramus of the pubis and this is where we feel the femoral pulse and we can cannulate it and we can go through the external iliac artery, the common iliac artery, the abdominal aorta and we can do various angiograms in pheromiscentric, superior miscentric, celiac, renal angiogram and we can go right up to the coronary circulation and we can do coronary angiogram. This is a femoral-puppetial-tibial angiogram. We can use the femoral artery to demonstrate the tendency of the distal circulation also. So this is one important use of the femoral artery. We can use the femoral artery as a guide to do any puncture of the femoral vein for cardiac catheterization because we know that the femoral vein is located just below the femoral artery. So this is another important use of the femoral artery. Finally, when we want to do a knee surgery or any surgery on the anterior aspect of the thigh, it is sometimes necessary to give a femoral nerve block. So how to locate the femoral nerve? We use the position of the femoral artery as our guide and using this we know that the femoral nerve is located about an inch lateral to the femoral artery and that's how we give a femoral nerve block in the femoral triangle before any knee surgery. So therefore these are some clinical uses of the femoral artery in the thigh. Now we should show the continuation of the femoral artery to the popliteal artery in the popliteal fossa. For that we are using a separate cadaver which is prone. The popliteal artery in the femoral vein becomes the popliteal artery. We can see a circular opening here and we can see that the popliteal artery and the popliteal vein are disappearing. That is called the adductor hiatus and I'm going to put my finger inside and my finger has disappeared in the adductor hiatus. This adductor hiatus is formed by this tendon that we can see here. This is the adductor tendon which is the hamstring component of the adductor magnus which is attached to the adductor tubercle of the femur. That is the medial boundary and the lateral boundary of the adductor hiatus is the adductor component of the adductor magnus. So there's a small opening between the two and that is known as the adductor hiatus. This adductor hiatus forms the inferior limit of the adductor canal which we can see on the medial surface of the thigh from the anterior view and it is in this location that the femoral artery and the femoral vein become known as the popliteal artery and the popliteal vein. So from here onwards it is now the popliteal vein and the popliteal artery. This is one potential side of entrapment of the popliteal artery. So here the nerve, vein and artery form a very uniform relationship from lateral to medial and from superficial to deep. We have the nerve, vein, artery and we can see that clearly here. Now let's take a look at the branches of the popliteal artery here and I have lifted up the popliteal artery and we can see five branches one, two, this is the superior lateral superior medial genicular artery then we have the next branch. You can see this branch. This is the middle genicular artery. Further lower down we can see two more branches. One going laterally and one going medially. This is inferior lateral genicular and the inferior medial genicular. This is a popliteal angiogram to show some of the genicular arteries which you mentioned just now. So these five genicular arteries, apart from supplying the knee joint they form a genicular anastomosis which is reinforced by two arteries from above and one from below. One artery from above is this one. This is the descending genicular branch of the femoral artery and we can see in this case it is coming through the adductor hiatus and then there's a descending branch from the lateral circumflex femoral artery and from below we have anterior tibial recurrent artery. One artery from below and two arteries from above and five arteries inside the popliteal fursor, all of them form a genicular anastomosis. And this genicular anastomosis forms a very important collateral circulation in femoral, popliteal occlusion. The popliteal artery position can be felt when we are testing a patient for peripheral vascular disease. When we gently flex the knee, partially flex the knee and we can feel the pulsation of the popliteal artery against the posterior tibial condyne between the two heads of the gastrocnemius. That is one of the place where we can feel for popliteal artery pulsations. It should not be confused with an aneurysm of the popliteal artery which can sometimes occur where there will be swelling and it will show a different kind of pulsation from that of a normal popliteal artery. This popliteal artery, the popliteal vein, can be endured in posterior dislocation of the knee. This popliteal artery, it can also be obstructed by the medial head of the gastrocnemius and this is the medial head of the gastrocnemius which we have cut. The medial head of the gastrocnemius is larger than the lateral head and there is a very well defined classification called the popliteal artery entrapment syndrome by Love and Valen which describes six different types of obstruction of the popliteal artery, popliteal vein and functional obstruction. So that is another site of potential obstruction of the popliteal artery. And the third site of obstruction of the popliteal artery I shall show you when I come a little lower down. In order to show the continuation of the popliteal artery, we have sliced the origin of the medial head of the gastrocnemius and the lateral head of the gastrocnemius and we have reflected this up here. And under that we can see this muscle, this is the soleus muscle.