A pulse is the rhythmic expansion of an artery caused by the surge of blood ejected from the heart. The femoral pulse is one of the major peripheral pulses, representing the blood flow through the large femoral artery, which is the principal conduit for blood supply to the lower limb. Due to the significant size and relatively superficial location of this artery, the femoral pulse is often easier to detect than other pulses, particularly in situations where blood pressure is low.
Anatomical Location of the Femoral Pulse
The femoral pulse is situated in the groin region, where the external iliac artery transitions into the femoral artery as it passes into the thigh. This transition point is immediately below the inguinal ligament, a strong band of tissue that stretches between two bony prominences of the pelvis. Specifically, the ligament connects the anterior superior iliac spine (ASIS), which is the prominent bone at the front of the hip, to the pubic tubercle near the pubic bone.
The most precise point for locating the pulse is known as the mid-inguinal point, found halfway along an imaginary line drawn between the anterior superior iliac spine and the pubic symphysis. The femoral artery lies within a fascial space called the femoral triangle, a structure located in the upper, inner thigh. At the mid-inguinal point, the artery is relatively close to the skin surface, making its pulsation detectable through manual pressure.
The pulse is felt in the crease where the abdomen meets the inner thigh, just inferior to the inguinal ligament. Understanding these bony landmarks provides a reliable map for palpation, as the artery’s path is consistently related to the skeletal structure. The proximity of the artery to the underlying bone allows the pulse to be compressed and felt.
Proper Technique for Palpation
To check the femoral pulse, the individual should be positioned lying flat on their back, which helps relax the muscles in the groin area. The person performing the check should use the pads of their index and middle fingers, as these are the most sensitive for detecting subtle pulsations. These two fingers should be placed directly over the identified mid-inguinal point in the crease of the groin.
A firm, but not excessive, downward pressure is required to compress the artery against the underlying bone structure of the pelvis. A deeper press is necessary because the femoral artery is large and covered by soft tissue. You may need to shift your fingers slightly up or down along the line of the inguinal ligament until the characteristic rhythmic throbbing is felt.
Once a pulse is detected, the beats can be counted to determine the heart rate, typically over a 15-second period and then multiplied by four. It is good practice, especially in a clinical setting, to check the pulse bilaterally, comparing the strength and timing of the pulse on both the left and right sides. Any difference in pulse volume or timing between the two sides may indicate a circulatory issue, such as a blockage in one of the iliac or femoral arteries.
Practical Applications for Checking the Pulse
The femoral pulse holds significant value in medical and emergency situations, primarily due to its status as a central pulse. In cases of severe shock or very low blood pressure, the body shunts blood flow away from the extremities, making peripheral pulses like the radial pulse in the wrist difficult or impossible to find. Because the femoral artery is large and close to the body’s core, its pulse often remains detectable even when blood flow is significantly compromised.
For first responders and medical professionals, the femoral pulse serves as one of the primary sites for assessing circulation during cardiopulmonary resuscitation (CPR) or following severe trauma. The presence of a femoral pulse suggests that the patient’s systolic blood pressure is likely above a certain threshold, considered adequate for core organ perfusion. While the carotid artery in the neck is also a central pulse check site, the femoral artery is sometimes preferred if the neck is inaccessible or if there is concern about potential neck injury.
The femoral artery’s superficial location in the femoral triangle also makes it a common access point for various interventional medical procedures. For instance, in cardiac catheterization procedures, a thin wire is often inserted into the femoral artery and navigated up to the heart. Assessing the pulse in the lower extremities, including the femoral pulse, is also a standard part of evaluating circulation following trauma to the legs or in cases of suspected arterial disease.