It is bounded by the inguinal ligament anteriorly, pectineal ligament posteriorly, lacunar ligament medially, and the femoral vein laterally. It normally contains a few lymphatics, loose areolar tissue, and occasionally a lymph node called Cloquets node. The function of this canal appears to be to allow the femoral vein to expand when necessary to accommodate increased venous return from the leg during periods of activity. Diagnosis
The diagnosis is largely a clinical one, generally done by physical examination of the groin. However, in obese patients, imaging in the form of ultrasound, CT, or MRI may aid in the diagnosis. For example, an abdominal X-ray showing small bowel obstruction in a female patient with a painful groin lump needs no further investigation. Several other conditions have a similar presentation and must be considered when forming the diagnosis: inguinal hernia, an enlarged femoral lymph node, aneurysm of the femoral artery, dilation of the saphenous vein, athletic pubalgia, and an abscess of the psoas. Classification
Several subtypes of femoral hernia have been described. Management
Femoral hernias, like most other hernias, usually need operative intervention. This should ideally be done as an elective (non-emergency) procedure. However, because of the high incidence of complications, femoral hernias often need emergency surgery. Surgery
Some surgeons choose to perform "key-hole" or laparoscopic surgery (also called minimally invasive surgery) rather than conventional "open" surgery.
Neurasthenia (from the Ancient Greek νεῦρον neuron "nerve" and ἀσθενής asthenés "weak") is a term that was first used at least as early as 1829 for a mechanical weakness of the nerves and became a major diagnosis in North America during the late nineteenth and early twentieth centuries after neurologist George Miller Beard reintroduced the concept in 1869. As a psychopathological term, the first to publish on neurasthenia was Michigan alienist E. H. Van Deusen of the Kalamazoo asylum in 1869, followed a few months later by New York neurologist George Beard, also in 1869, to denote a condition with symptoms of fatigue, anxiety, headache, heart palpitations, high blood pressure, neuralgia, and depressed mood. Van Deusen associated the condition with farm wives made sick by isolation and a lack of engaging activity, while Beard connected the condition to busy society women and overworked businessmen. Neurasthenia was a diagnosis in the World Health Organizations ICD-10, but is no more diagnosed in ICD-11, marked as deprecated. It also is no longer included as a diagnosis in the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders. The condition is, however, described in the Chinese Society of Psychiatrys Chinese Classification of Mental Disorders. Americans were said to be particularly prone to neurasthenia, which resulted in the nickname "Americanitis" (popularized by William James). Another, rarely used, term for neurasthenia is nervosism. Symptoms
The condition was explained as being a result of exhaustion of the central nervous systems energy reserves, which Beard attributed to modern civilization.