Lower limb: femoral artery puncture: 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.

Try it

Anatomy · Lower limb: femoral artery puncture

Sample item

An interventional cardiologist plans a femoral artery puncture for angiography and wants the artery to be compressible after the procedure while avoiding a retroperitoneal bleed. Which puncture site is best?

AOver the femoral head, just below the inguinal ligamentBAt the apex of the femoral triangle near the adductor canalCMedial to the pubic tubercle over the pectineusDAbove the inguinal ligament over the external iliac artery

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

The answer and the reasoning

A. Over the femoral head, just below the inguinal ligament

The common femoral artery is best entered over the femoral head, below the inguinal ligament, because it can be compressed against bone. A puncture above the ligament enters the external iliac artery, whose bleeding goes into the retroperitoneum unnoticed, and a puncture too low risks puncturing the profunda or superficial femoral artery and causing pseudoaneurysm or arteriovenous fistula.

Option by option

A. Over the femoral head, just below the inguinal ligament (correct)
Puncture over the femoral head allows manual compression of the artery against the head.
B. At the apex of the femoral triangle near the adductor canal
Puncture near the apex of the femoral triangle is in the superficial femoral artery, past its bifurcation, with a high risk of pseudoaneurysm.
C. Medial to the pubic tubercle over the pectineus
The area medial to the pubic tubercle lies over the pectineus and adductor longus origin and does not overlie the artery.
D. Above the inguinal ligament over the external iliac artery
Puncture above the inguinal ligament risks concealed retroperitoneal haemorrhage.

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 A, Over the femoral head, just below the inguinal ligament. The common femoral artery is best entered over the femoral head, below the inguinal ligament, because it can be compressed against bone.

Why is "At the apex of the femoral triangle near the adductor canal" not the answer?

Puncture near the apex of the femoral triangle is in the superficial femoral artery, past its bifurcation, with a high risk of pseudoaneurysm.

Why is "Medial to the pubic tubercle over the pectineus" not the answer?

The area medial to the pubic tubercle lies over the pectineus and adductor longus origin and does not overlie the artery.

Why is "Above the inguinal ligament over the external iliac artery" not the answer?

Puncture above the inguinal ligament risks concealed retroperitoneal haemorrhage.

What concept does this question test?

It tests Lower limb: femoral artery puncture in Anatomy. A puncture above the ligament enters the external iliac artery, whose bleeding goes into the retroperitoneum unnoticed, and a puncture too low risks puncturing the profunda or superficial femoral artery and causing pseudoaneurysm or arteriovenous fistula.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 artery puncture?

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.