China
Africa
Explore chapters and articles related to this topic
Analgesia and Anaesthesia
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
A line drawn from the pubic tubercle to the anterior superior iliac spine marks the position of the inguinal ligament. The femoral artery can be palpated in the centre of this line, and the femoral nerve lies about 1 cm lateral to the artery just below the ligament. The needle is directed posteriorly and distally at a 45° angle. A ‘click’ may be felt as the needle pierces the fascia lata. Paraesthesia or pain may occur if the needle has penetrated the nerve, in which case the needle should be withdrawn slightly before injection in order to prevent neuronal damage. The total depth should be no more than 2.0–3.5 cm.
Technical aspects of treating aortic aneurysms
Published in Peter A. Schneider, Endovascular Skills: Guidewire and Catheter Skills for Endovascular Surgery, 2019
On the day of the procedure, the skin of the femoral areas is extensively prepared. Ultrasound is used to identify the best place along the length of the artery to perform the percutaneous access. The inguinal ligament may be marked along its course for anatomic definition from pubic tubercle to anterior-superior iliac spine. If there is extensive common femoral disease, and the decision is to proceed with percutaneous access, it is usually best to enter the artery with the needle proximal to the common femoral artery disease. Ultrasound is used to avoid calcific areas of the artery wall. A short skin incision is made, usually just large enough to accommodate the intended sheath (Figure 28.1). A Kelly clamp can be used to dilate the tissues a little along the intended pathway of the needle. This is performed under ultrasound.
The cardiovascular system
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
The femoral pulse Difficulty in feeling pulsation in the common femoral artery may result from patient obesity or from calcification of the artery, but it often results from seeking it too low down. Remember that the inguinal ligament lies parallel to but some 3 cm above the groin crease. The femoral pulse should be sought, with the patient supine, between the groin crease and the level of the inguinal ligament, not in the groin crease or below. The artery lies medial to the rectus femoris muscle and lateral to the medial border of the adductor muscles.
Sentinel lymph node biopsy based on anatomical landmarks and locoregional mapping of inguinofemoral sentinel lymph nodes in women with vulval cancer: an operative technique
Published in Journal of Obstetrics and Gynaecology, 2023
Fong Lien Kwong, Miski Scerif, Jason KW Yap
Surgical technique: We start by identifying the anterior superior iliac spine and pubic tubercle to map the course of the inguinal ligament. We then palpate the femoral artery to identify its location and a handheld Doppler may be used in obese women. Situated on its medial side in the femoral triangle is the femoral vein and the latter is joined on its medial side by the saphenous vein at the saphenofemoral junction. We make a 3-4cm incision inferior to and parallel to the inguinal ligament. The incision extends over the femoral vein and slightly above the saphenous vein (Figure 1). Radiolocalisation of the SLN was achieved after identifying and excising the node with the highest signal count using a handheld gamma counter. The groin was re-examined and dissection continued until there was no residual radioactivity. All histological specimens were analysed using ultrastaging with immunohistochemistry. Ipsilateral unilateral inguinal SLN biopsies were conducted for lateral tumour and bilateral excisions for central tumours. The long saphenous vein was preserved in all cases.
Anatomical course of the lateral femoral cutaneous nerve with special reference to the direct anterior approach to total hip arthroplasty
Published in Modern Rheumatology, 2020
Masahiko Sugano, Junichi Nakamura, Shigeo Hagiwara, Takane Suzuki, Takayuki Nakajima, Sumihisa Orita, Tsutomu Akazawa, Yawara Eguchi, Yohei Kawasaki, Seiji Ohtori
The following dissection protocol was applied. Each cadaver was first placed on a dissection table in a supine position. Along the inguinal ligament, an incision was made from the anterior superior iliac spine (ASIS) to the pubic tubercle, followed by longitudinal dissection of the center of the anterior thigh from the center of the inguinal ligament. The LFCN and its branches were identified by their origin from the pelvis at the level of the inguinal ligament. All nerve branches of the LFCN were carefully traced distally in the subcutaneous tissue of the proximal aspect of the thigh. The following distances of Ropars et al. [12] were measured using a ruler (Figure 1). (a) The distance from the midpoint of the ASIS to the LFCN at the level of the inguinal ligament. When the nerve divided proximally to the inguinal ligament into two main femoral and gluteal branches their distance from the ASIS was measured. Whether each nerve passed through or under the inguinal ligament was recorded. (b) The distance from the midpoint of the ASIS to the points where the LFCN branches crossed the anterior margin of the TFL was recorded and the distance from the ASIS to this point was measured. (c) The distance from the lateral epicondyle of the femur to the lateral malleolus of the ankle (lower leg length) was measured.
Surgical management of obturator neuropathy with a concomitant acetabular labral tear — a case report
Published in Acta Orthopaedica, 2018
Shiho Kanezaki, Akinori Sakai, Eiichiro Nakamura, Soshi Uchida
At 4 months postoperatively, the patient began to complain of medial thigh paresthesia and at 12 months postoperatively she reported improved range of motion (ROM) but continued discomfort with the same medial groin pain as before arthroscopy. Pain was localized to the inner side of the thigh over the adductor muscle, starting 2 cm distal to the inguinal ligament (Figure 2A). An MRI scan was performed, confirming appropriate healing of the labrum without evidence of any abnormality. There was nothing changed on this MRI from the preoperative MRI in the obturator nerve or magnus area. MMT of the affected hip adductor was still fair (3/5).