À≈Õ¥‡≈ Õ¥·¥ß profunda femoris ÕÕ°®“°¥ â“π„π¢ÕßÀ≈Õ¥‡≈...

Profunda femoris artery arise from the medial aspect of femoral artery: A case report

370 »√’π§√‘π∑√å‡«™ “√ 2549; 21(4) • Srinagarind Med J 2006; 21(4)

•À≈Õ¥‡≈◊Õ¥·¥ß profunda femoris ÕÕ°®“°¥â“π„π¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß femoral: √“¬ß“π 1 √“¬

√“¬ß“πºŸâªÉ«¬ • Case Report

À≈Õ¥‡≈◊Õ¥·¥ß profunda femoris ÕÕ°®“°¥â“π„π¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß femoral:

√“¬ß“π 1 √“¬

π«æ√ ‡µ™“∑«’«√√≥, ¬√√¬ß ∑ÿ¡· π, °‘µµ‘»—°¥‘Ï »√’æ“π‘™°ÿ≈™—¬

¿“§«‘™“°“¬«‘¿“§»“ µ√å §≥–·æ∑¬»“ µ√å ¡À“«‘∑¬“≈—¬¢Õπ·°àπ 40002

Profunda femoris Artery arise from the Medial aspect ofFemoral Artery: A Case ReportNawaporn Techataweewan, Yanyong Toomsan, Kittisak SripanidkulchaiDepartment of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002

À≈—°°“√·≈–‡Àµÿº≈: À≈Õ¥‡≈◊Õ¥·¥ß profunda femoris ‡ªìπÀ≈Õ¥‡≈◊Õ¥∑’Ë‡°’Ë¬«¢âÕß‚¥¬µ√ß°—∫°“√ºà“µ—¥´àÕ¡·´¡‚§√ß √â“ß∫√‘‡«≥ à«πµâπ¢Õß¢“Õ¬Ÿà‡ ¡Õ

®“°°“√™”·À≈–√–À«à“ß°“√‡√’¬πªØ‘∫—µ‘°“√¢Õßπ—°»÷°…“·æ∑¬å„πÀâÕßªÆ‘∫—µ‘°“√¡À°“¬«‘¿“§»“ µ√å æ∫À≈Õ¥‡≈◊Õ¥·¥ß profunda femoris ÕÕ°®“°∑“ß¥â“π„π¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ßfemoral ¢Õß¢“¢â“ß¢«“„π»æ‡æ»À≠‘ß Õ“¬ÿ 56 ªï §«“¡º—π·ª√π’Èæ∫‰¥âπâÕ¬¡“° §≥–ºŸâ«‘®—¬®÷ß π„®∑’Ë»÷°…“√Ÿª·∫∫·≈–∑“ß‡¥‘π¢ÕßÀ≈Õ¥‡≈◊Õ¥π’È·≈–®—¥∑”‡ªìπ√“¬ß“π°“√æ∫‡æ◊ËÕ‡ªìπÀ≈—°∞“π∑“ß°“¬«‘¿“§»“ µ√å∑’Ë„™âÕâ“ßÕ‘ß‰¥âµàÕ‰ª«—µ∂ÿª√– ß§å:

1. »÷°…“®ÿ¥°”‡π‘¥ ∑“ß‡¥‘π·≈–·¢πß¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß profunda femoris ∑’ËÕÕ°∑“ß¥â“π„π¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ßfemoral

2. »÷°…“À≈Õ¥‡≈◊Õ¥·¥ß femoral ¢â“ß¢«“·≈–·¢πßµà“ßÊ „π»æ√“¬π’Èº≈°“√«‘®—¬: æ∫«à“À≈Õ¥‡≈◊Õ¥·¥ß profunda femoris ‡ªìπ·¢πß≈”¥—∫∑’Ë “¡ ¡’µâπ°”‡π‘¥®“°∑“ß¥â“π„π¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß femoral ¢â“ß¢«“ ·≈– Àà“ß≈ß¡“®“°®ÿ¥°÷Ëß°≈“ß¢Õßinguinal ligament ¢â“ß¢«“ 20.47 ¡‘≈≈‘‡¡µ√ √–À«à“ß∑’ËÕ¬Ÿà„πfemoral triangle ∑Õ¥‡©’¬ß‡¢â“¥â“π„π·≈–≈ß≈à“ßÕ¬ŸàÀπâ“µàÕÀ≈Õ¥‡≈◊Õ¥¥” femoral ∫πµàÕ saphenous opening ®“°π—Èπ®–«°ÕâÕ¡≈ß‰ª¥â“πÀ≈—ß‚Õ∫À≈Õ¥‡≈◊Õ¥¥” femoral ¢â“ß¢«“·≈â«®÷ß∑Õ¥‡©’¬ßÕÕ°¡“¥â“ππÕ°·≈–≈ß≈à“ß‡¢â“‰ª„π adductorcanal √–À«à“ß∑’ËÕ¬Ÿà¥â“πÀ≈—ßµàÕÀ≈Õ¥‡≈◊Õ¥¥” femoral ·≈–

Background: The profunda femoris artery is frequently

involved in vascular reconstructive procedures in the thigh.

During usually dissection in Gross Anatomy laboratory

of medical students, it was founded that the profunda femoris

arose from the medial side of the right femoral artery in

the embalmed female cadaver with age 56 year old. This

variation is a very rare case, thus we are interest to study

pattern and course of this artery and report for the referable

in anatomical evidence.

Objectives:

1. To study the course and branches of the profunda

femoris atery that arise from medial side of the right femoral

artery

2. To study the right femoral artery and its branches

in this cadaver

Result: The profunda femoris artery in this cadaver is the

the third branch and arise from the medial side of the right

femoral artery and far from mid-inguinal ligament for 20.47

millimeter. Within femoral triangle this artery run inferior

medially, anterior to femoral vein and superior to saphen-

ous opening, then downward and turn back to the lateral

with enclosed the right femoral vein and descend to the

adductor canal. As running behind to the femoral vein and

before piercing the adductor canal this profunda femoris

gives off its branches, the deep external pudendal, medial

circumflex femoral, first perforating branch and first perfo-

rating branch from superior to inferior respectively. The

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371»√’π§√‘π∑√å‡«™ “√ 2549; 21(4) • Srinagarind Med J 2006; 21(4)

π«æ√ ‡µ™“∑«’«√√≥ ·≈–§≥– •

°àÕπ‡¢â“ adductor canal „Àâ·¢πßÀ≈Õ¥‡≈◊Õ¥·¥ß deep externalpudendal, medial circumflex femoral, first perforating ·≈–second perforating ‡√’¬ß®“°∫π≈ß≈à“ßµ“¡≈”¥—∫ ‡¡◊ËÕ™”·À≈–µ‘¥µ“¡„π adductor canal æ∫«à“À≈Õ¥‡≈◊Õ¥·¥ß profundafemoris π’È„Àâ·¢πß third perforating ·≈– fourth √ÿª: À≈Õ¥‡≈◊Õ¥·¥ß profunda femoris ‡ªìπÀ≈Õ¥‡≈◊Õ¥·¥ßÀ≈—°∑’Ëπ”‡≈◊Õ¥¡“‡≈’È¬ß°≈â“¡‡π◊ÈÕ∑“ß¥â“πÀ≈—ß¢Õßµâπ¢“°“√∑’ËÀ≈Õ¥‡≈◊Õ¥·¥ß profunda femoris ¡’µâπ°”‡π‘¥®“°À≈Õ¥·¥ß femoral ∑“ß¥â“π„π‡ªìπ§«“¡º—π·ª√∑’Ëæ∫‰¥â ·≈–‡ªìπ°√≥’∑’Ë¡’§«“¡ ”§—≠µàÕ·æ∑¬å∑’Ëæ÷ß —ß«√‡Õ“‰«â‡æ◊ËÕªÑÕß°—π§«“¡º‘¥æ≈“¥∑’ËÕ“®‡°‘¥®“°°“√∑”À—µ∂°“√∑ÿ°™π‘¥∑’Ë∫√‘‡«≥µâπ¢“

dissection go on adductor canal and reveal the third and

the fourth perforating branches.

Srinagarind Med J 2006; 21(4): 370-3•

∫∑π”

‚¥¬∑—Ë«‰ªÀ≈Õ¥‡≈◊Õ¥·¥ß profunda femoris ‡ªìπ·¢πßÀ≈Õ¥‡≈◊Õ¥·¥ß∑’Ë¡’¢π“¥„À≠à∑’Ë ÿ¥„π∫√√¥“À≈Õ¥‡≈◊Õ¥·¢πß®“°À≈Õ¥‡≈◊Õ¥·¥ß femoral À≈Õ¥‡≈◊Õ¥π’È®–·¬°ÕÕ°∑“ß¥â“π¢â“ß¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß femoral Àà“ß®“° inguinal ligamentª√–¡“≥ 5 ‡´πµ‘‡¡µ√1 ‡¡◊ËÕ·¬°ÕÕ°¡“·≈â«®–∑Õ¥µ—«Õ¬Ÿà∑“ß¥â“πÀ≈—ß¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß femoral „π adductor canal ·≈–æ“¥Õ¬ŸàÀπâ“‡ÕÁπ¢Õß°≈â“¡‡π◊ÈÕ adductor longus ·≈–‡¡◊ËÕ≈ß¡“„π√–¥—∫1/

3 à«π≈à“ß¢Õßµâπ¢“®– ‘Èπ ÿ¥‚¥¬‡ª≈’Ë¬π‡ªìπ·¢πß

fourth perforating ́ ÷Ëß®–∑–≈ÿ°≈â“¡‡π◊ÈÕ adductor magnus ·≈â«°√–®“¬ÕÕ°‰ª‡≈’È¬ß°≈ÿà¡°≈â“¡‡π◊ÈÕ hamstring ´÷ËßÕ¬Ÿà∑“ß¥â“πÀ≈—ß¢Õßµâπ¢“ „π√–À«à“ß∑’ËÕ¬Ÿà„π femoral triangle æ∫«à“À≈Õ¥‡≈◊Õ¥·¥ß profunda femoris „Àâ·¢πß medial circumflexfemoral, lateral circumflex femoral ·≈–·¢πß‰ª‡≈’È¬ß°≈â“¡‡π◊ÈÕ(muscular branches) ·≈–√–À«à“ß∑’ËÕ¬Ÿà„π adductor canal „Àâ·¢πß perforating Õ’° 3 ·¢πß °“√‡°‘¥§«“¡º—π·ª√¢ÕßÀ≈Õ¥‡≈◊Õ¥∫√‘‡«≥π’È¡—°‡ªìπ§«“¡º—π·ª√¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ßmedial ·≈– lateral circumflex femoral ∑—Èßπ’Èæ∫«à“À≈Õ¥‡≈◊Õ¥·¥ß∑—Èß Õß∑’ËÕÕ°®“° À≈Õ¥‡≈◊Õ¥·¥ß profunda ∑—Èß§Ÿà‡æ’¬ß√âÕ¬≈– 56 ‡∑à“π—Èπ1

√“¬ß“π°“√æ∫

®“°°“√™”·À≈–∫√‘‡«≥¥â“πÀπâ“µâπ¢“¢«“¢Õß»æ¥ÕßøÕ√å¡“≈‘π ‡æ»À≠‘ß Õ“¬ÿ 56 ªï ≥ ÀâÕßªØ‘∫—µ‘°“√¡À°“¬-«‘¿“§»“ µ√å ¿“§«‘™“°“¬«‘¿“§»“ µ√å §≥–·æ∑¬»“ µ√å¡À“«‘∑¬“≈—¬¢Õπ·°àπ æ∫À≈Õ¥‡≈◊Õ¥·¥ß profunda femoris·¬°ÕÕ°®“°¥â“π„π¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß femoral ‚¥¬Õ¬ŸàÀà“ß

®“°®ÿ¥°÷Ëß°≈“ß¢Õß inguinal ligamentfemoral 20.47 ¡‘≈≈‘‡¡µ√À≈Õ¥‡≈◊Õ¥·¥ß profunda femoris π’È ‡ªìπ·¢πß∑’Ë “¡¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß femoral ¢Õß¢“¢â“ß¢«“ (¥Ÿ√Ÿª∑’Ë 1)

πÕ°‡Àπ◊Õ®“°À≈Õ¥‡≈◊Õ¥·¥ß profunda femoris ·≈â«¬—ßæ∫«à“„π femoral triangle À≈Õ¥‡≈◊Õ¥·¥ß femoral „Àâ·¢πßÀ≈Õ¥‡≈◊Õ¥·¥ßÕ’°®”π«π 4 ·¢πß ‰¥â·°à À≈Õ¥‡≈◊Õ¥·¥ßsuperficial epigastric, superficial circumflex iliac ‡√’¬ß°—πµ“¡≈”¥—∫ ‚¥¬À≈Õ¥‡≈◊Õ¥·¥ß∑—Èß Õßπ’ÈÕ¬Ÿà‡Àπ◊ÕµàÕÀ≈Õ¥‡≈◊Õ¥·¥ß profunda femoris à«πÀ≈Õ¥‡≈◊Õ¥·¥ß∑’ËÕÕ°®“°À≈Õ¥‡≈◊Õ¥·¥ß femoral „π√–¥—∫∑’ËµË”°«à“ profunda femoris §◊ÕÀ≈Õ¥‡≈◊Õ¥·¥ß lateral circumflex femoral ·≈– superficialexternal pudendal À≈Õ¥‡≈◊Õ¥·¥ß∑’ËÕÕ°®“° femoral artery∑—ÈßÀ¡¥¥—ß°≈à“«‰¥â‡√’¬ß°—π®“°∫π≈ß¡“≈à“ß ‡¡◊ËÕ«—¥√–¬–Àà“ß®“°®ÿ¥°÷Ëß°≈“ß¢Õß inguinal ligament ≈ß¡“∂÷ßµ”·Àπàßµ—Èßµâπ¢Õß·µà≈–À≈Õ¥‡≈◊Õ¥¡’√–¬–∑“ß·µ°µà“ß°—πµ“¡≈”¥—∫¥—ßµ“√“ß∑’Ë 1

‡¡◊ËÕ™”·À≈–µ‘¥µ“¡À≈Õ¥‡≈◊Õ¥·¥ß profunda femorisæ∫«à“À≈Õ¥‡≈◊Õ¥·¥ßπ’È∑Õ¥ÕÕ°‰ª¥â“π„π·≈–‡©’¬ß≈ß≈à“ß‚¥¬∑”¡ÿ¡ª√–¡“≥ 25 Õß»“°—∫À≈Õ¥‡≈◊Õ¥·¥ß femoral æ“¥Õ¬ŸàÀπâ“µàÕÀ≈Õ¥‡≈◊Õ¥¥” femoral ‡Àπ◊ÕµàÕµ”·Àπàß saphenousopening æÕ¥’ ®“°π—Èπ®÷ß«°≈ß‰ª¥â“πÀ≈—ß‚Õ∫À≈Õ¥‡≈◊Õ¥¥”femoral ·≈â«®÷ß∑Õ¥‡©’¬ßÕÕ°¡“∑“ß¥â“ππÕ°≈ß‰ª„π adductorcanal (¥Ÿ√Ÿª∑’Ë 1)

·¢πßÀ≈Õ¥‡≈◊Õ¥∑’ËÕÕ°®“°À≈Õ¥‡≈◊Õ¥·¥ß profundafemoris „π femoral triangle ®–æ∫‡©æ“–√–À«à“ß∑’Ë∑Õ¥Õ¬Ÿà¥â“πÀ≈—ßÀ≈Õ¥‡≈◊Õ¥¥” femoral ·≈–√–À«à“ß∑Õ¥≈ß¡“°àÕπ‡¢â“‰ª„π adductor canal ´÷Ëß·¢πßµà“ßÊ ‡√’¬ßµ“¡≈”¥—∫‰¥â·°à

»√’π§√‘π∑√å‡«™ “√ 2549; 21(4): 370-3

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Profunda femoris artery arise from the medial aspect of femoral artery: A case report

372 »√’π§√‘π∑√å‡«™ “√ 2549; 21(4) • Srinagarind Med J 2006; 21(4)

•À≈Õ¥‡≈◊Õ¥·¥ß profunda femoris ÕÕ°®“°¥â“π„π¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß femoral: √“¬ß“π 1 √“¬

√Ÿª∑’Ë1 ¿“æ∂à“¬· ¥ßÀ≈Õ¥‡≈◊Õ¥ profunda femoris ÕÕ°®“°¥â“π„π¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß femoral

µ“√“ß∑’Ë 1 · ¥ß≈”¥—∫¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß∑’ËÕÕ°®“°À≈Õ¥‡≈◊Õ¥·¥ß femoral ¢â“ß¢«“∑’Ëæ∫À≈Õ¥‡≈◊Õ¥·¥ß profunda femorisÕÕ°∑“ß¥â“π„π¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß femoral ·≈–√–¬–Àà“ß®“°°÷Ëß°≈“ß inguinal ligament

1 Superficial epigastric 13.502 Superficial circumflex iliac 18.153 Profunda femoris 20.474 Lateral circumflex femoral 35.725 Superficial external pudendal 45.52

≈”¥—∫∑’Ë À≈Õ¥‡≈◊Õ¥·¥ß √–¬–Àà“ß (¡‘≈≈‘‡¡µ√)

µ“√“ß∑’Ë 2 · ¥ß≈”¥—∫¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß∑’ËÕÕ°®“°À≈Õ¥‡≈◊Õ¥·¥ß profunda femoris ∑’ËÕÕ°∑“ß¥â“π„π¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ßfemoral ¢â“ß¢«“·≈–√–¬–Àà“ß®“° inguinal ligament

≈”¥—∫∑’Ë À≈Õ¥‡≈◊Õ¥·¥ß √–¬–Àà“ß (¡‘≈≈‘‡¡µ√)1 Deep external pudendal 32.962 Medial circumflex femoral 41.873 First perforating branch 58.764 Second perforating branch 93.98

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373»√’π§√‘π∑√å‡«™ “√ 2549; 21(4) • Srinagarind Med J 2006; 21(4)

π«æ√ ‡µ™“∑«’«√√≥ ·≈–§≥– •

À≈Õ¥‡≈◊Õ¥·¥ßdeep external pudendal, medial circumflexfemoral, first perforating ·≈– second perforating (¥Ÿ√Ÿª∑’Ë 3)‡¡◊ËÕ«—¥√–¬–®“°®ÿ¥°÷Ëß°≈“ß¢Õß inguinal ligament ®π∂÷ßµ”·Àπàßµ—Èßµâπ¢Õß·µà≈–À≈Õ¥‡≈◊Õ¥®–‡ªìπ√–¬–∑“ß¥—ßµ“√“ß∑’Ë 2

Õ¿‘ª√“¬º≈°“√»÷°…“

·¡â«à“‚¥¬∑—Ë«‰ª®–°≈à“«∂÷ßÀ≈Õ¥‡≈◊Õ¥·¥ß profundafemoris ÕÕ°®“°∑“ß¥â“π¢â“ß¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß femoral1

·µà®“°°“√»÷°…“µ”·Àπàß∑’ËÕÕ°¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß profundafemoris ‚¥¬ Dixit DP, Mehta LA ·≈– Kothari ML2 æ∫«à“ à«π„À≠àÀ≈Õ¥‡≈◊Õ¥π’È∑Õ¥ÕÕ°∑“ß¥â“π¢â“ß‡¬◊ÈÕß‰ª¥â“πÀ≈—ß(posterolateral) ¡“°°«à“∑’Ë®–ÕÕ°∑“ß¥â“π¢â“ßµ√ßÊ ´÷Ëßº≈°“√»÷°…“π’È Õ¥§≈âÕß°—∫°“√»÷°…“¢Õß Brannister LH ·≈–Berry CP3 à«π√–¬–∑“ß¢Õßµ”·Àπàß∑’ËÀ≈Õ¥‡≈◊Õ¥π’ÈÕÕ°Àà“ß®“°®ÿ¥°÷Ëß°≈“ß¢Õß inguinal ligament π—Èπ æ∫«à“¡’§«“¡·µ°µà“ß°—π‚¥¬æ∫«à“¡’§à“‡©≈’Ë¬ 47.5 ¡‘≈≈‘‡¡µ√2, 35 - 40¡‘≈≈‘‡¡µ√3, 4 °“√»÷°…“§√—Èßπ’Èæ∫«à“À≈Õ¥‡≈◊Õ¥·¥ß profundafemoris ÕÕ°Àà“ß®“°®ÿ¥°÷Ëß°≈“ß¢Õß inguinal ligament ‡æ’¬ß20.47 ¡‘≈≈‘‡¡µ√´÷Ëß∂◊Õ«à“§àÕπ¢â“ß Ÿß°«à“∑—Ë«‰ª πÕ°®“°π’È¬—ßæ∫«à“À≈Õ¥‡≈◊Õ¥·¥ß lateral circumflex femoral ÕÕ°¡“®“°À≈Õ¥‡≈◊Õ¥·¥ß femoral ·≈– À≈Õ¥‡≈◊Õ¥·¥ß medial circum-flex femoral ÕÕ°¡“®“°À≈Õ¥‡≈◊Õ¥·¥ß profunda femoris ́ ÷Ëß·µ°µà“ß®“°√Ÿª·∫∫ª°µ‘ ́ ÷Ëß‚¥¬ à«π„À≠à·≈â«À≈Õ¥‡≈◊Õ¥·¥ßlateral circumflex ·≈– À≈Õ¥‡≈◊Õ¥·¥ß medial circumflex ÕÕ°®“°À≈Õ¥‡≈◊Õ¥·¥ß profunda femoris ´÷Ëß®“°°“√»÷°…“¢ÕßMassound and Fletcher 5 æ∫«à“À≈Õ¥‡≈◊Õ¥·¥ß medial ·≈–lateral circumflex femoral ‡ªìπ·¢πß®“°À≈Õ¥‡≈◊Õ¥·¥ßprofunda femoris ∂÷ß√âÕ¬≈– 81 ́ ÷Ëß Õ¥§≈âÕß°—∫°“√»÷°…“¢ÕßDixit DP, Mehta LA ·≈– Kothari ML2 ´÷Ëßæ∫«à“¡’À≈Õ¥‡≈◊Õ¥·¥ß medial circumflex femoral ‡æ’¬ß√âÕ¬≈– 20.63 ‡∑à“π—Èπ∑’Ë‡ªìπ·¢πß¡“®“°À≈Õ¥‡≈◊Õ¥·¥ß femoral

‡¡◊ËÕµ‘¥µ“¡∑“ß‡¥‘π¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß lateral circumflexfemoral æ∫«à“„Àâ·¢πß ascending, transverse ·≈– descending∑—Èß “¡·¢πß¥—ß∑’Ëæ∫„π√Ÿª·∫∫ª°µ‘ à«πÀ≈Õ¥‡≈◊Õ¥·¥ßmedial circumflex femoral °Á¡ÿ¥≈ß‰ª√–À«à“ß°≈â“¡‡π◊ÈÕ iliopsoas°—∫°≈â“¡‡π◊ÈÕ pectineus ¥—ß√Ÿª·∫∫ª°µ‘‡™àπ°—π

„π°“√»÷°…“§√—Èßπ’È‡√“æ∫«à“À≈Õ¥‡≈◊Õ¥·¥ß profundafemoris ÕÕ°®“°¥â“π„π¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß femoral ¢â“ß¢«“´÷Ëß‡ªìπ°√≥’°“√æ∫∑’Ëæ∫πâÕ¬¡“° µ”·Àπàß∑’ËÕÕ°Õ¬Ÿà Ÿß°«à“µ”·Àπàß∑’Ë¡’ºŸâ»÷°…“√“¬ß“π‡Õ“‰«â§◊ÕÀà“ß®“°®ÿ¥°÷Ëß°≈“ß¢Õßinguinal ligament ‡æ’¬ß 20.47 ¡‘≈≈‘‡¡µ√‡∑à“π—Èπ πÕ°‡Àπ◊Õ®“°

°“√æ∫À≈Õ¥‡≈◊Õ¥·¥ß medial circumflex femoral ·≈â«¬—ßæ∫«à“¡’À≈Õ¥‡≈◊Õ¥·¥ß deep external pudendal ‡ªìπ·¢πß·√°∑’ËÕÕ°®“°À≈Õ¥‡≈◊Õ¥·¥ß deep profunda femoris π’È ´÷Ëß‚¥¬ª°µ‘·≈â«À≈Õ¥‡≈◊Õ¥·¥ß deep external pudendal ®–‡ªìπ·¢πßÕÕ°®“°À≈Õ¥‡≈◊Õ¥·¥ß femoral ‚¥¬µ√ß

§«“¡√Ÿâ‡°’Ë¬«°—∫µ”·Àπàß®ÿ¥°”‡π‘¥¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ßprofunda femoris ®“°À≈Õ¥‡≈◊Õ¥·¥ß femoral ¡’§«“¡ ”§—≠Õ¬à“ß¬‘Ëß„π°“√™à«¬À≈’°‡≈’Ë¬ß°“√‡°‘¥ arterio-venous fistula ∑’ËÕ“®‡°‘¥®“°°“√ªØ‘∫—µ‘¢Õß·æ∑¬å√–À«à“ß∑’ËµâÕß‡®“–À≈Õ¥‡≈◊Õ¥·¥ß femoral „π∑ÿ°°√≥’ Õ¬à“ß‰√°Áµ“¡§«“¡º‘¥æ≈“¥π’È¬‘ËßÕ“®‡°‘¥¢÷Èπ‰¥âßà“¬„π°√≥’∑’Ë¡’§«“¡º—π·ª√¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß profunda femoris ∑’Ë¡’®ÿ¥°”‡π‘¥®“°∑“ß¥â“π„π¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß femoral ·≈â«æ“¥Õ¬ŸàÀπâ“µàÕÀ≈Õ¥‡≈◊Õ¥¥” femoral‡æ√“–Õ“®‡¢â“„®º‘¥«à“À≈Õ¥‡≈◊Õ¥·¥ß profunda femoris ‡ªìπÀ≈Õ¥‡≈◊Õ¥·¥ß femoral ∑”„Àâ°“√‡®“–À≈Õ¥‡≈◊Õ¥·¥ßprofunda femoris ∑–≈ÿ‰ª∂÷ßÀ≈Õ¥‡≈◊Õ¥¥” femoral ‰¥â

√“¬ß“ππ’È®÷ß‡ªìπÀ≈—°∞“π°“√æ∫§«“¡º—π·ª√¢ÕßÀ≈Õ¥‡≈◊Õ¥·¥ß profunda femoris ´÷Ëß®–‡ªìπª√–‚¬™πåµàÕ·æ∑¬åºŸâ‡°’Ë¬«¢âÕß·≈–‡ªìπ¢âÕ¡Ÿ≈¬◊π¬—πÀ≈—°∞“π°“√æ∫„π∑“ß°“¬-«‘¿“§»“ µ√åµàÕ‰ª

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3. Brannister LH, Berry CP. Grayûs anatomy. In cardiovascularsystem. 38th ed. Edinburgh: Churchill Livingstone, 1995:1586-8.

4. Snell RS. Clinical anatomy for medical students. 6th ed. Phila-delphia: Lippincott Williams & Wilkins. 2000: 532-7.

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6. Bilgic S, Sahin B. Rare arterial variation: a common trunk fromthe external iliac artery for the obturator, inferior epigastricand profunda femoris arteries. Surg Radiol Anat 1997; 19:45-7.

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