Exam 3: Lumbar Spinal Nerves

Question 1

How many nerve pairs are in the lumbars

Answer 1

Five

Question 2

What do the medial and lateral branches of the posterior rami supply

Answer 2

Medial branches = multifidi, lateral branches = erector spinae group

Question 3

What is special about post primary rami

Answer 3

It is strictly motor!

Question 4

The anterior primary rami contribute to what

Answer 4

The lumbar (L1-L4) and sacral (L4 and L5) plexus

Question 5

How many lumbar sympathetic ganglia are there

Answer 5

4

Question 6

How do gray and white communicans communicate with sympathetic trunk

Answer 6

White rami communicans associated with L1,L2, L3 sometimes and gray rami communicans associated with each lumbar nerves

Question 7

What forms the lumbar plexus

Answer 7

L1-L3 and part of L4 as well as receive some contribution from T12 by way of communication of L1 nerve

Question 8

What muscular branches supply the quadratus lumborum, psoas minor, psoas major

Answer 8

L1-L4 supply QL, L1-L2 p. Minor, L3-L4 p.major

Question 9

What fibers are contained in the iliohypogastric nerve

Answer 9

T12 and L1

Question 10

How does the iliohypogastric nerve travel

Answer 10

Anterior and inferior between the QL and kidney. Then through the transverse abdominal muscle and travels between it and the internal abdominal oblique then give off the lateral cutaneous branch

Question 11

What does the lateral cutaneous branch supply

Answer 11

The posterolateral gluteal region

Question 12

What does the lateral cutaneous branch continue as

Answer 12

The anterior cutaneous branch

Question 13

What does the anterior cutaneous branch supply

Answer 13

Supplies the skin of the pubic region

Question 14

What fibers contribute to the ilioinguinal nerve

Answer 14

T12 and L1

Question 15

How does the ilioinguinal nerve travel

Answer 15

Follow path similar to iliohypogastric nerve enters and is transmitted through the inguinal canal. It leaves the canal through superficial inguinal ring and travels with spermatic cord.

Question 16

What does the ilioinguinal nerve supply sensory to where?

Answer 16

Snesory to skin of the upper medial thigh, base of penis, anterior scrotum in men, in females = mons pubis and labium majus

Question 17

What muscles does the ilioinguinal nerve travel to

Answer 17

Internal abdominal oblique and transverse abdominal

Question 18

What fibers are contained in the genitofemoral nerve

Answer 18

L1 and L2

Question 19

The genitofemoral nerve travels through the ______ and divides into ______

Answer 19

Psoas major muscle and divides into genital branch and femoral branch

Question 20

How does the genital branch travel

Answer 20

Enters and travels through the inguinal canal, leaves canal and provides motor supply to cremaster muscle and sensory supply to skin of anterior scrotum, and mons pubis/labium majus in females

Question 21

The femoral branch passes into thigh posterior to inguinal ligament and supplies the skin of where

Answer 21

The upper anterior thigh

Question 22

What is the reflex associated with the genital branch

Answer 22

Cremasteric reflex

Question 23

What fibers are contained in the lateral cutaneous nerve of the thigh

Answer 23

L2 and L3

Question 24

What type of nerve is the lateral cutaneous nerve of the thigh

Answer 24

Purely sensory

Question 25

What does the lateral cutaneous nerve of the thigh supply

Answer 25

Skin of lateral thigh, superior to the knee

Question 26

How dos the lateral cutaneous nerve of the thigh travel

Answer 26

The nerve leaves the abdominal cavity by passing under inguinal ligament. It travels anterior to the sartorius and through the fascia lata to reach the skin

Question 27

What branches are contained in the femoral nerve

Answer 27

L2, L3, L4

Question 28

What is special about the femoral nerve

Answer 28

It is the largest branch of the lumbar plexus

Question 29

How does the femoral nerve travel

Answer 29

Forms posterior to psoas major and emerges latral to psoas and anterior to iliacus passes inferior to inguinal ligament and enters femoral triangle just lateral to femoral artery. Runs inferior and medially through the adductor canal and into leg, medial to knee

Question 30

Where does the femoral nerve give off branches

Answer 30

Only in abdomen and femoral triangle

Question 31

What branches off the femoral nerve are given off in the abdomen

Answer 31

Muscular brnches to iliacus and pectineus and some to femoral artery

Question 32

Once beyond the ____ the femoral nerve divides into anterior and posterior division

Answer 32

Inguinal ligament

Question 33

What 3 nerves does the anterior division of the femoral nerve give off

Answer 33

Intermediate cutaneous nerve of the thigh, medial cutaneous nerve of the thigh, nerve to the sartorius

Question 34

What does the intermediate cutaneous nerve of the thigh supply

Answer 34

The skin on anterior thigh down to knee, lateral branch communicates with femoral branch of the genitofemoral nerve

Question 35

What does the medial cutaneous nerve of the thigh supply

Answer 35

Skin of medial thigh, medial knee, and knee across to the laateral side of patella. Some supply skin medial leg through communications with saphenous nerve

Question 36

What does the posterior division of femoral nerve give rise to

Answer 36

Muscular branches, vascular branches, saphenous nerve

Question 37

What do the posterior divisions muscular branches supply

Answer 37

Quadriceps muscles

Question 38

What do the vascular branches of the femoral nerve supply

Answer 38

The femoral artery and articular branches to the knee joint before continuing as saphenous nerve

Question 39

Muscular branches given off in femoral triangle supply what?

Answer 39

Sartorius, rectus femoris, vastus lateralis, vastus medialis, vastus intermedius

Question 40

What is the saphenous nerve transmitted through

Answer 40

The adductor canal

Question 41

What does the saphenous nerve supply

Answer 41

Skin medial and anterior to patella, it travels with great saphenous vein and supplies the skin of the medial leg and foot

Question 42

What clinical considerations are associated with the femoral nerve

Answer 42

Patellar reflex, sensory deficits

Question 43

What fibers are contained in the obturator nerve

Answer 43

L2, L3, L4

Question 44

What nerve is the principal contributor to the obturator nerve

Answer 44

L3, L2 is minimal

Question 45

How does the obturator nerve travel

Answer 45

Medial to psoas major, posterior to common iliac vessels, descends into the pelvis, traveling on obturator internus. Leaves pelvis through obturator foramen and divides

Question 46

What are the obturator nerve branches initially separated by

Answer 46

Obturator externus and adductor brevis

Question 47

What does the anterior branch of the obturator do

Answer 47

Send some branches to communicate with branches of femoral nerve forming subartorial plexus

Question 48

What does the subsartorial plexus do

Answer 48

Contributes to supply of the skin onn the medial thigh

Question 49

The termination of the anterior branch of the obturator nerve supplies what

Answer 49

The femoral artery, sends branches to hip joint

Question 50

What muscles are supplied by termination of anterior branch

Answer 50

Adductor longus, gracilis, pectineus, adductor brevis (TQ)

Question 51

The anterior branch of obturator nerve may connect with what

Answer 51

Accessory obturator nerve

Question 52

The anterior branch of obturator nerve may send fibers to communicate with what

Answer 52

medial cutaneous nerve of thigh and saphenous nerve = obturator then will contribute to skin on upper medial side of leg

Question 53

The posterior branch of the obturator nerve travels through the what

Answer 53

Obturator externus, posterior to adductor brevis, and anterior to adductor magnus

Question 54

The posterior branch of obturator nerve sends muscular branches to where

Answer 54

Obturator externus and adductor magnus and adductor brevis if not by anterior branch also articular fibers to knee joint

Question 55

What are clinical considerations of the obturator nerve

Answer 55

Muscular weakness and sensory deficits