Deep femoral artery

The deep femoral artery, also known as the profunda femoris artery, is a major branch of the femoral artery that supplies blood to the deep structures of the thigh. It is one of the primary arteries responsible for providing oxygenated blood to the muscles and tissues in the posterior and medial compartments of the thigh.

Location

The deep femoral artery originates from the femoral artery, usually about 2-5 centimeters below the inguinal ligament. It branches off on the lateral side of the femoral artery in the upper thigh region. The deep femoral artery runs deeper into the thigh compared to the superficial femoral artery and descends along the medial and posterior thigh, between the adductor and extensor muscle groups. It gives off several perforating branches that pass through the adductor magnus muscle, supplying the deep structures of the thigh.

Structure and Anatomy

Origin

The deep femoral artery, or profunda femoris artery, originates from the femoral artery in the upper thigh. Typically, this occurs around 2-5 centimeters distal to the inguinal ligament, within the femoral triangle. The deep femoral artery is the largest and most significant branch of the femoral artery, responsible for supplying the deep structures of the thigh.

Course

After its origin, the deep femoral artery runs posteriorly and laterally, descending deep within the thigh. It passes behind the adductor longus muscle, traveling toward the posterior and medial compartments of the thigh. The artery runs between the adductor magnus muscle (medially) and the vastus medialis (anteriorly), staying deep in the thigh.

As it courses downward, it continues to give off several important branches that supply the muscles, skin, and bones of the thigh. It travels parallel to the femoral artery but stays deeper within the muscle compartments. The deep femoral artery typically terminates in the distal third of the thigh, after giving off its perforating branches, where it contributes to the supply of the posterior thigh.

Branches

The deep femoral artery gives off multiple branches that provide blood to the thigh’s muscles, bones, and connective tissues. These branches include:

• Lateral Circumflex Femoral Artery: This artery branches from the deep femoral artery and supplies the lateral part of the thigh. It runs anteriorly and laterally around the femur and provides blood to the quadriceps muscles and surrounding soft tissues. The lateral circumflex femoral artery has three primary branches: the ascending, transverse, and descending branches, which supply different regions of the thigh.
• Medial Circumflex Femoral Artery: This branch is usually located near the origin of the deep femoral artery. It courses medially and posteriorly around the femur, supplying the adductor muscles and hip joint. The medial circumflex femoral artery plays a key role in providing blood to the femoral head and neck through its branches, including the posterior retinacular arteries.
• Perforating Branches: The deep femoral artery gives off several perforating branches, typically three or four, that pierce the adductor magnus muscle and supply blood to the posterior compartment of the thigh. These perforating branches provide blood to the hamstring muscles and the deep structures of the thigh. The first perforating branch also supplies part of the gluteus maximus muscle.
• Muscular Branches: Smaller branches arise from the deep femoral artery and supply the muscles of the thigh, particularly the adductors, vastus medialis, and parts of the hamstrings.

Termination

The deep femoral artery terminates in the distal third of the thigh, after giving off its perforating branches. These branches pierce the adductor magnus muscle and continue posteriorly to supply the deep muscles and tissues of the thigh. The deep femoral artery typically does not extend beyond the lower thigh, as its role in blood supply is largely focused on the thigh itself.

Anatomical Relations

• Femoral Artery: The deep femoral artery branches from the femoral artery, which continues down the thigh more superficially. The femoral artery primarily supplies the superficial structures of the thigh, while the deep femoral artery supplies the deeper, more posterior regions.
• Adductor Longus and Adductor Magnus: The deep femoral artery runs posterior to the adductor longus muscle and anterior to the adductor magnus muscle. These large muscles form part of the medial compartment of the thigh and are supplied by branches of the deep femoral artery.
• Vastus Medialis: As the deep femoral artery descends, it lies anterior to the vastus medialis muscle, one of the quadriceps muscles. This positioning helps protect the artery within the thigh.

Perforating Arteries

The perforating branches of the deep femoral artery are crucial for supplying the posterior compartment of the thigh, which contains the hamstrings. These branches penetrate the adductor magnus muscle and travel toward the posterior thigh. The perforating arteries also contribute to the anastomotic networks around the hip and knee joints, ensuring collateral circulation.

Lateral and Medial Circumflex Femoral Arteries

The lateral circumflex femoral artery supplies the lateral and anterior regions of the thigh, including the quadriceps, and plays a role in vascularizing the hip and knee joints. Its descending branch contributes to the anastomosis around the knee.

The medial circumflex femoral artery is vital for supplying the hip joint and the head and neck of the femur. It courses medially around the femur and anastomoses with other arteries around the hip, providing crucial blood flow to this region.

Anastomoses

The deep femoral artery, through its circumflex and perforating branches, participates in several important anastomotic networks around the hip and knee joints. These anastomoses ensure that blood can still reach the lower limb in case of arterial blockage or narrowing. The medial circumflex femoral artery is particularly important for the vascular supply to the head of the femur, while the lateral circumflex femoral artery contributes to the vascularization of the knee and surrounding muscles.

Function

Blood Supply to the Posterior and Medial Compartments of the Thigh

The deep femoral artery is the primary artery responsible for supplying oxygenated blood to the posterior and medial compartments of the thigh. These compartments house major muscle groups responsible for leg movement, including the hamstring muscles (posterior compartment) and the adductor muscles (medial compartment). The deep femoral artery’s perforating branches pass through the adductor magnus to reach the posterior thigh, ensuring that the muscles involved in hip extension, knee flexion, and thigh adduction receive adequate blood flow. These muscles are essential for various physical activities such as walking, running, and stabilizing the pelvis.

Vascularization of the Hamstring Muscles

Through its perforating branches, the deep femoral artery supplies blood to the hamstring muscles—including the biceps femoris, semitendinosus, and semimembranosus. These muscles play a crucial role in the flexion of the knee and the extension of the hip. By providing blood to the posterior compartment, the deep femoral artery supports the hamstrings’ ability to function effectively during dynamic movements such as running, jumping, and walking.

Supply to the Adductor Muscles

The deep femoral artery also plays a critical role in supplying blood to the adductor muscles in the medial compartment of the thigh. These muscles—adductor longus, adductor brevis, and adductor magnus—are responsible for adduction of the thigh, pulling the legs together. Adequate blood supply ensures that these muscles can perform their function efficiently, particularly during movements that require stabilization of the legs or when exerting force to bring the legs together.

Blood Supply to the Hip Joint and Femoral Head

One of the key functions of the deep femoral artery is to provide blood to the hip joint and the femoral head and neck through its medial circumflex femoral artery branch. This branch plays a vital role in maintaining the health of the femoral head, which is crucial for hip stability and function. It is also a primary source of blood for the femoral neck, which is vulnerable to fractures, especially in the elderly.

The medial circumflex femoral artery wraps around the posterior aspect of the femur and supplies the retinacular arteries, which are essential for nourishing the femoral head and preventing necrosis, a condition where the bone tissue dies due to inadequate blood supply.

Blood Supply to the Quadriceps Muscles

The lateral circumflex femoral artery, a branch of the deep femoral artery, supplies the quadriceps femoris muscles located in the anterior compartment of the thigh. These muscles are responsible for extending the knee and play a key role in standing, walking, and running. The lateral circumflex femoral artery also contributes to the blood supply of the hip joint and part of the knee joint through its descending branches.

By providing oxygenated blood to the quadriceps, the deep femoral artery ensures these muscles can perform their primary function of knee extension, which is essential for mobility, balance, and weight-bearing.

Participation in Collateral Circulation

The deep femoral artery plays a significant role in collateral circulation in both the hip and knee regions. Collateral circulation refers to the formation of alternative pathways for blood flow in case of blockage or narrowing of the main arteries. Through its branches—especially the medial and lateral circumflex femoral arteries—the deep femoral artery forms anastomoses with other arteries around the hip joint (such as the obturator artery and the inferior gluteal artery) and the knee joint (through the genicular arteries).

This collateral network ensures that even if the main arteries, such as the femoral artery, are compromised, blood can still reach critical regions of the hip and knee, supporting joint health and functionality.

Support for Hip Movements

By supplying blood to the muscles and ligaments involved in hip movement, the deep femoral artery supports a wide range of hip actions, including flexion, extension, abduction, and adduction. The artery’s role in delivering oxygenated blood to the gluteal muscles (via perforating branches) and the hip joint ensures that these structures can function effectively during movement. Proper blood flow to the muscles and joints allows for smooth and pain-free hip motion, critical for walking, running, squatting, and maintaining posture.

Contribution to Knee Stability and Movement

The descending branch of the lateral circumflex femoral artery descends toward the knee joint, contributing to the vascular supply of the anterior knee structures and participating in the genicular anastomosis around the knee. This ensures that the knee joint and surrounding muscles receive a continuous supply of oxygenated blood, helping support the stability and flexibility of the knee during activities like walking, squatting, and climbing stairs.

Nourishment of Femur Bone

The deep femoral artery, through its perforating branches, provides essential blood supply to the shaft of the femur. This helps maintain bone health by supplying oxygen and nutrients necessary for bone repair and remodeling. Proper blood flow is crucial for bone strength and healing in case of fractures, particularly in the femur, the largest and strongest bone in the body.

Maintenance of Muscle and Soft Tissue Health

By supplying blood to the deep muscles, soft tissues, and fascia of the thigh, the deep femoral artery helps maintain overall tissue health. This is important for the recovery of tissues after injury or physical activity. By providing oxygen and removing metabolic waste products, the deep femoral artery supports the health of the thigh’s deep muscles, enabling them to function efficiently during movement and physical exertion.

Oxygenation and Metabolic Support

As with other arteries, the deep femoral artery provides the muscles, bones, and tissues of the thigh with oxygen and nutrients essential for cellular metabolism. Adequate oxygenation allows for proper muscle contraction, energy production, and tissue repair. The artery also helps remove metabolic waste, such as carbon dioxide and lactic acid, from the muscles, preventing fatigue and maintaining endurance during prolonged physical activity.

Clinical Significance

The deep femoral artery (profunda femoris) is clinically significant due to its critical role in supplying blood to the thigh’s deep muscles, hip joint, and femoral head. Its branches, particularly the medial circumflex femoral artery, are vital for maintaining the blood supply to the femoral head and neck, which is essential for hip joint health. Compromise of this artery, such as in fractures of the femoral neck, can lead to avascular necrosis of the femoral head, a serious condition requiring surgical intervention.

In vascular disease, such as peripheral artery disease (PAD), the deep femoral artery can be involved in arterial occlusions, leading to ischemia of the thigh muscles and potential muscle weakness or pain. Its perforating branches are also important in the collateral circulation of the leg, particularly when the femoral artery becomes obstructed. The deep femoral artery’s location and branches make it a key structure during hip surgeries and procedures involving the thigh, such as reconstructive surgery or vascular grafting.