The sapheno-femoral junction (SFJ) is located at the saphenous opening within the groin and formed by the meeting of the great saphenous vein (GSV), common femoral vein and the superficial inguinal veins (confluens venosus subinguinalis). [1] [2] It is one of the distinctive points where a superficial vein meets a deep vein and at which incompetent valves may occur. [3]
The SFJ can be located in the groin crease, [4] or in a 3 × 3 cm region situated up to 4 cm to the side and up to 3cm below to the pubic tubercle. It is nearer to the pubic tubercle in younger and thinner subjects. [5]
The GSV has two valves near the SFJ. One is a terminal valve about 1-2mm from the opening into the femoral vein and the other is about 2cm away. [4]
Veins are blood vessels in the circulatory system of humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are those of the pulmonary and fetal circulations which carry oxygenated blood to the heart. In the systemic circulation, arteries carry oxygenated blood away from the heart, and veins return deoxygenated blood to the heart, in the deep veins.
In anatomy, the thigh is the area between the hip (pelvis) and the knee. Anatomically, it is part of the lower limb.
The femoral triangle is an anatomical region of the upper third of the thigh. It is a subfascial space which appears as a triangular depression below the inguinal ligament when the thigh is flexed, abducted and laterally rotated.
The great saphenous vein(GSV), or long saphenous vein; ) is a large, subcutaneous, superficial vein of the leg. It is the longest vein in the body, running along the length of the lower limb, returning blood from the foot, leg and thigh to the deep femoral vein at the femoral triangle.
The inguinal canal is a passage in the anterior abdominal wall on each side of the body which in males convey the spermatic cords and in females the round ligament of the uterus. The inguinal canals are larger and more prominent in males.
The genitofemoral nerve is a mixed branch of the lumbar plexus derived from anterior rami of L1-L2. It splits a genital branch and a femoral branch. It provides sensory innervation to the upper anterior thigh, as well as the skin of the anterior scrotum in males and mons pubis in females. It also provides motor innervation to the cremaster muscle.
The popliteal vein is a vein of the lower limb. It is formed from the anterior tibial vein and the posterior tibial vein. It travels medial to the popliteal artery, and becomes the femoral vein. It drains blood from the leg. It can be assessed using medical ultrasound. It can be affected by popliteal vein entrapment.
In the human body, the femoral vein is the vein that accompanies the femoral artery in the femoral sheath. It is a deep vein that begins at the adductor hiatus as the continuation of the popliteal vein. The great saphenous vein, and the deep femoral vein drain into the femoral vein in the femoral triangle when it becomes known as the common femoral vein. It ends at the inferior margin of the inguinal ligament where it becomes the external iliac vein. Its major tributaries are the deep femoral vein, and the great saphenous vein. The femoral vein contains valves.
The small saphenous vein is a relatively large superficial vein of the posterior leg.
The external iliac veins are large veins that connect the femoral veins to the common iliac veins. Their origin is at the inferior margin of the inguinal ligaments and they terminate when they join the internal iliac veins.
The adductor canal is an aponeurotic tunnel in the middle third of the thigh giving passage to parts of the femoral artery, vein, and nerve. It extends from the apex of the femoral triangle to the adductor hiatus.
The pubic tubercle is a prominent tubercle on the superior ramus of the pubis bone of the pelvis.
The superficial iliac circumflex artery, the smallest of the cutaneous branches of the femoral artery, arises close to the superficial epigastric artery, and, piercing the fascia lata, runs lateralward, parallel with the inguinal ligament, as far as the crest of the ilium.
The patellar plexus is a nerve plexus within the subcutaneous tissue overlying and surrounding the patella and ligamentum patellae. It is a fine network of communicating nerve fibres.
The saphenous nerve is the largest cutaneous branch of the femoral nerve. It is derived from the lumbar plexus (L3-L4). It is a strictly sensory nerve, and has no motor function. It commences in the proximal (upper) thigh and travels along the adductor canal. Upon exiting the adductor canal, the saphenous nerve terminates by splitting into two terminal branches: the sartorial nerve, and the infrapatellar nerve. The saphenous nerve is responsible for providing sensory innervation to the skin of the anteromedial leg.
The popliteal lymph nodes, small in size and some six or seven in number, are embedded in the fat contained in the popliteal fossa, sometimes referred to as the 'knee pit'. One lies immediately beneath the popliteal fascia, near the terminal part of the small saphenous vein, and drains the region from which this vein derives its tributaries, such as superficial regions of the posterolateral aspect of the leg and the plantar aspect of the foot.
In anatomy, the saphenous opening is an oval opening in the upper mid part of the fascia lata of the thigh. It lies 3–4 cm below and lateral to the pubic tubercle and is about 3 cm long and 1.5 cm wide.
The cutaneous branch of the obturator nerve is an occasional continuation of the communicating branch to the femoral medial cutaneous branches and saphenous branches of the femoral to the thigh and leg. When present it emerges from beneath the distal/inferior border of the adductor longus muscle and descends along the posterior margin of the sartorius muscle to the medial side of the knee where it pierces the deep fascia and communicates with the saphenous nerve. When present, it provides sensory innervation to the skin of proximal/superior half of the medial side of the leg.
The anterior accessory saphenous vein is a special anterior tributary of the great saphenous vein (GSV), draining the antero-lateral face of the thigh.
Ultrasonography of suspected or previously confirmed chronic venous insufficiency of leg veins is a risk-free, non-invasive procedure. It gives information about the anatomy, physiology and pathology of mainly superficial veins. As with heart ultrasound (echocardiography) studies, venous ultrasonography requires an understanding of hemodynamics in order to give useful examination reports. In chronic venous insufficiency, sonographic examination is of most benefit; in confirming varicose disease, making an assessment of the hemodynamics, and charting the progression of the disease and its response to treatment. It has become the reference standard for examining the condition and hemodynamics of the lower limb veins. Particular veins of the deep venous system (DVS), and the superficial venous system (SVS) are looked at. The great saphenous vein (GSV), and the small saphenous vein (SSV) are superficial veins which drain into respectively, the common femoral vein and the popliteal vein. These veins are deep veins. Perforator veins drain superficial veins into the deep veins. Three anatomic compartments are described, (N1) containing the deep veins, (N2) containing the perforator veins, and (N3) containing the superficial veins, known as the saphenous compartment. This compartmentalisation makes it easier for the examiner to systematize and map. The GSV can be located in the saphenous compartment where together with the Giacomini vein and the accessory saphenous vein (ASV) an image resembling an eye, known as the 'eye sign' can be seen. The ASV which is often responsible for varicose veins, can be located at the 'alignment sign', where it is seen to align with the femoral vessels.