Anatomy of the femoral fascia sheath and its adjacent structures

XU Zhao-yang REN Yan-hong TU Li-li XU Sheng-chun* LIANG Liang ZHANG Ming

Acta Anatomica Sinica ›› 2013, Vol. 44 ›› Issue (3) : 364-367.

Welcome to visit Acta Anatomica Sinica! Today is Chinese
Acta Anatomica Sinica ›› 2013, Vol. 44 ›› Issue (3) : 364-367. DOI: 10.3969/j.issn.0529-1356.2013.03.015

Anatomy of the femoral fascia sheath and its adjacent structures

  • XU Zhao-yang1  REN Yan-hongTU Li-li1  XU  Sheng-chun 1*  LIANG Liang2  ZHANG Ming 2,3
Author information +
History +

Abstract

Objective  To determine if a femoral nerve “sheath” exists and provide anatomic basis for the lower limb nerve
block. Methods Ten sides of lumbar and thigh regions from 5 formalin-fixed cadavers were used in this study. Eight out of 10
specimens were injected with latex using a step-by-step injection method from the distal to the proximal and dissected for
topographic anatomy examination. The other two sides from the same body were deep frozen at -35℃ for a week, cut with a bandsaw
and used for sectional anatomy examination. Results An intact femoral nerve “fascial sheath” was not observed in the specimens
examined in this study. The nerve was surrounded by various fascia-like structures. From the proximal to the distal, those
fascia-like structures were the fascia of lumbar plexus, fascial septum of the psoas, the iliac fascia and loose connective
tissue covering the femoral nerve. Conclusion At the gross anatomy level, an intact femoral nerve “fascial sheath” may not exist.

Key words

Femoral nerve / Fascia / “3-in-1”block / Iliac fascia block / Anatomy / Human

Cite this article

Download Citations
XU Zhao-yang REN Yan-hong TU Li-li XU Sheng-chun* LIANG Liang ZHANG Ming. Anatomy of the femoral fascia sheath and its adjacent structures[J]. Acta Anatomica Sinica. 2013, 44(3): 364-367 https://doi.org/10.3969/j.issn.0529-1356.2013.03.015

References

[1]Murray JM, Derbyshire S, Shields MO. Lower limb blocks[J]. Anaesthesia, 2010, 65 (Suppl 1):57-66.
[2]McMeniman TJ, McMeniman PJ, Myers PT, et al. Femoral nerve block vs fascia iliaca block for total knee arthroplasty postoperative pain control: a prospective, randomized controlled trial[J]. J Jarthroplasty, 2010,25(8):1246-1249. 
[3]Wang XL, Zhang DZh, Wang G. The observation of fascia iliaca block combined with general anesthesia for the surgey of pediatric hip dislocation[J]. The Journal of Clinical Anesthesiology, 2010, 26(8):711-712.(in Chinese)
王晓林,张大志,王庚.髂筋膜阻滞复合全身麻醉用于小儿髋脱位手术的观察[J].临床麻醉学杂志,2010, 26(8):711-712. 
[4]Winnie AP, Ramamurthy S, Durrani Z. The inguinal paravascular technic of lumbar plexus anesthesia: the “3-in-1 block”[J]. Anesth Analg, 1973, 52(6):989-996.
[5]Dalens B, Vanneuville G, Tanguy A. Comparison of the fascia iliaca compartment block with the 3-in-1 block in children[J]. Anesth Analg, 1989, 69(6):705-713.
[6]Farid IS, Heiner EJ, Fleissner PR. Comparison of femoral nerve block and fascia iliaca block for analgesia following reconstructive knee surgery in adolescents[J]. J Clin Anesth, 2010, 22(4):256-259.
[7]Sharrock NE. Inadvertent “3-in-1” block following injection of the lateral cutaneous nerve of thigh[J]. Anesth Analg, 1980, 59(11):887-888.
[8]Lonsdale M. 3-in-1 block: confirmation of winnie’s anatomical hypothesis[J]. Anesth Analg, 1988, 67(6):601-602.
[9]Ritter JW. Femoral nerve “sheath” for inguinal paravascular lumbar plexus block is not found in human cadavers[J]. J Clin Anesth, 1995, 7(6):470-473.
[10]Nash L, Nicholson HD, Zhang M. Does the investing layer of the deep cervical fascia exist [J]? Anesthesiology, 2005, 103(5):962-968.
[11]Honma M, Murakami G, Sato TJ, et al. Spread of injectate during C6 stellate ganglion block and fascial arrangement in the prevertebral region: an experimental study using donated cadavers[J]. Reg Anesth Pain Med, 2000, 25(6):573-583.
[12][ZK(]Fang XW. Clinical study on the effect of fascia iliaca compartment block for post-hip arthroplasty[D].Soochow University,2011:14-15. (in Chinese)
房小文.髋关节置换术后髂筋膜室阻滞镇痛效果观察[D].苏州大学,2011:14-15.
 

Accesses

Citation

Detail

Sections
Recommended

/