Where is the saphenous opening located and what is its structure?
The saphenous opening is located on the anteromedial surface of the thigh, 1–2 cm inferior to the medial third of the inguinal ligament (lig. inguinale). It represents an aperture in the superficial lamina of the fascia lata (fascia lata).
Boundaries and structures of the opening:
- Falxiform margin (margo falciformis) — a thickened outer margin bounding the opening laterally.
- Superior horn (cornu superius) — the upper part of the falciform margin.
- Inferior horn (cornu inferius) — the lower part of the falciform margin. It is easily identified anatomically as the great saphenous vein loops over it.
- Cribriform fascia (fascia cribrosa) — the loosened medial part of the superficial lamina of the fascia lata that covers the saphenous opening itself.
What passes through the saphenous opening?
Through the apertures in the cribriform fascia filling the hiatus saphenus, the subcutaneous adipose tissue communicates with deeper layers. Vessels and lymphatic pathways pass here:
- Great saphenous vein (v. saphena magna) — passes deeply through the saphenous opening, looping over the inferior horn to drain into the femoral vein (v. femoralis).
- Superficial epigastric artery (a. epigastrica superficialis) — a superficial branch of the femoral artery.
- Superficial circumflex iliac artery (a. circumflexa ilium superficialis) — a branch of the femoral artery.
- External pudendal arteries (aa. pudendae externae superficialis et profundus) — branches of the femoral artery.
- Lymphatic vessels — lymph drainage directs to the deep nodes. The inferior superficial inguinal lymph nodes (nodi inguinales inferiores) are located in the region of the saphenous opening.
Clinical significance: femoral hernias
Normally, the femoral canal (canalis femoralis) does not exist; this slit-like space is formed only when abdominal organs protrude beneath the inguinal ligament.
The saphenous opening (hiatus saphenus) serves as the superficial (subcutaneous) opening of this canal. The hernial sac, after passing through the femoral ring (anulus femoralis) and the vascular lacuna, emerges directly at the saphenous opening beneath the fascia lata. Femoral hernias are more common in women.
During surgical treatment of femoral hernias (e.g., Bassini repair), the saphenous opening is closed by suturing the lateral falciform margin (margo falciformis) with several stitches to the fascia of the pectineus muscle.
Class and exam questions
Where does the femoral canal open?
The femoral canal opens into the saphenous opening (hiatus saphenus), which is located beneath the superficial layer of the fascia lata.
Which fascia covers the saphenous opening of the thigh?
The opening is covered by the cribriform fascia (fascia cribrosa), which is a loosened part of the superficial lamina of the fascia lata.
What bounds the saphenous opening laterally?
Laterally, the opening is bounded by the thickened lateral falciform margin (margo falciformis), which features superior and inferior horns.
What else to study on this topic
- Femoral canal and femoral ring
- Fascia lata of the thigh (fascia lata)
- Femoral triangle
- Great saphenous vein (v. saphena magna)
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