Lower limb: femoral triangle: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Lower limb: femoral triangle

Sample item

An anaesthetist palpates the femoral pulse below the mid-inguinal point to place a central venous catheter in the femoral vein. Where should the needle be directed relative to the artery?

AMedial to the pulsation and 3 cm above the inguinal ligamentBDirectly over the pulsation, below the inguinal ligamentCJust lateral to the arterial pulsation, below the inguinal ligamentDJust medial to the arterial pulsation, below the inguinal ligament

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Just medial to the arterial pulsation, below the inguinal ligament

The contents of the femoral sheath and triangle from lateral to medial are femoral nerve (outside the sheath), artery, vein, empty space of the femoral canal and lymphatics. The vein therefore lies medial to the artery below the inguinal ligament. Puncture above the ligament risks retroperitoneal bleeding.

Option by option

A. Medial to the pulsation and 3 cm above the inguinal ligament
Above the inguinal ligament the vessels are the external iliac vessels, and puncture risks retroperitoneal haemorrhage.
B. Directly over the pulsation, below the inguinal ligament
Puncturing directly over the pulsation enters the artery rather than the vein.
C. Just lateral to the arterial pulsation, below the inguinal ligament
Lateral to the artery lies the femoral nerve, which may be injured.
D. Just medial to the arterial pulsation, below the inguinal ligament (correct)
Correct. The femoral vein lies immediately medial to the femoral artery.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is D, Just medial to the arterial pulsation, below the inguinal ligament. The contents of the femoral sheath and triangle from lateral to medial are femoral nerve (outside the sheath), artery, vein, empty space of the femoral canal and lymphatics.

Why is "Medial to the pulsation and 3 cm above the inguinal ligament" not the answer?

Above the inguinal ligament the vessels are the external iliac vessels, and puncture risks retroperitoneal haemorrhage.

Why is "Directly over the pulsation, below the inguinal ligament" not the answer?

Puncturing directly over the pulsation enters the artery rather than the vein.

Why is "Just lateral to the arterial pulsation, below the inguinal ligament" not the answer?

Lateral to the artery lies the femoral nerve, which may be injured.

What concept does this question test?

It tests Lower limb: femoral triangle in Anatomy. The vein therefore lies medial to the artery below the inguinal ligament. Puncture above the ligament risks retroperitoneal bleeding.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Lower limb: femoral triangle?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.