Exam 3: Lumbar Spinal Nerves Flashcards
How many nerve pairs are in the lumbars
Five
What do the medial and lateral branches of the posterior rami supply
Medial branches = multifidi, lateral branches = erector spinae group
What is special about post primary rami
It is strictly motor!
The anterior primary rami contribute to what
The lumbar (L1-L4) and sacral (L4 and L5) plexus
How many lumbar sympathetic ganglia are there
4
How do gray and white communicans communicate with sympathetic trunk
White rami communicans associated with L1,L2, L3 sometimes and gray rami communicans associated with each lumbar nerves
What forms the lumbar plexus
L1-L3 and part of L4 as well as receive some contribution from T12 by way of communication of L1 nerve
What muscular branches supply the quadratus lumborum, psoas minor, psoas major
L1-L4 supply QL, L1-L2 p. Minor, L3-L4 p.major
What fibers are contained in the iliohypogastric nerve
T12 and L1
How does the iliohypogastric nerve travel
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
What does the lateral cutaneous branch supply
The posterolateral gluteal region
What does the lateral cutaneous branch continue as
The anterior cutaneous branch
What does the anterior cutaneous branch supply
Supplies the skin of the pubic region
What fibers contribute to the ilioinguinal nerve
T12 and L1
How does the ilioinguinal nerve travel
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.
What does the ilioinguinal nerve supply sensory to where?
Snesory to skin of the upper medial thigh, base of penis, anterior scrotum in men, in females = mons pubis and labium majus
What muscles does the ilioinguinal nerve travel to
Internal abdominal oblique and transverse abdominal
What fibers are contained in the genitofemoral nerve
L1 and L2
The genitofemoral nerve travels through the ______ and divides into ______
Psoas major muscle and divides into genital branch and femoral branch
How does the genital branch travel
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
The femoral branch passes into thigh posterior to inguinal ligament and supplies the skin of where
The upper anterior thigh
What is the reflex associated with the genital branch
Cremasteric reflex
What fibers are contained in the lateral cutaneous nerve of the thigh
L2 and L3
What type of nerve is the lateral cutaneous nerve of the thigh
Purely sensory
What does the lateral cutaneous nerve of the thigh supply
Skin of lateral thigh, superior to the knee
How dos the lateral cutaneous nerve of the thigh travel
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
What branches are contained in the femoral nerve
L2, L3, L4
What is special about the femoral nerve
It is the largest branch of the lumbar plexus
How does the femoral nerve travel
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
Where does the femoral nerve give off branches
Only in abdomen and femoral triangle
What branches off the femoral nerve are given off in the abdomen
Muscular brnches to iliacus and pectineus and some to femoral artery
Once beyond the ____ the femoral nerve divides into anterior and posterior division
Inguinal ligament
What 3 nerves does the anterior division of the femoral nerve give off
Intermediate cutaneous nerve of the thigh, medial cutaneous nerve of the thigh, nerve to the sartorius
What does the intermediate cutaneous nerve of the thigh supply
The skin on anterior thigh down to knee, lateral branch communicates with femoral branch of the genitofemoral nerve
What does the medial cutaneous nerve of the thigh supply
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
What does the posterior division of femoral nerve give rise to
Muscular branches, vascular branches, saphenous nerve
What do the posterior divisions muscular branches supply
Quadriceps muscles
What do the vascular branches of the femoral nerve supply
The femoral artery and articular branches to the knee joint before continuing as saphenous nerve
Muscular branches given off in femoral triangle supply what?
Sartorius, rectus femoris, vastus lateralis, vastus medialis, vastus intermedius
What is the saphenous nerve transmitted through
The adductor canal
What does the saphenous nerve supply
Skin medial and anterior to patella, it travels with great saphenous vein and supplies the skin of the medial leg and foot
What clinical considerations are associated with the femoral nerve
Patellar reflex, sensory deficits
What fibers are contained in the obturator nerve
L2, L3, L4
What nerve is the principal contributor to the obturator nerve
L3, L2 is minimal
How does the obturator nerve travel
Medial to psoas major, posterior to common iliac vessels, descends into the pelvis, traveling on obturator internus. Leaves pelvis through obturator foramen and divides
What are the obturator nerve branches initially separated by
Obturator externus and adductor brevis
What does the anterior branch of the obturator do
Send some branches to communicate with branches of femoral nerve forming subartorial plexus
What does the subsartorial plexus do
Contributes to supply of the skin onn the medial thigh
The termination of the anterior branch of the obturator nerve supplies what
The femoral artery, sends branches to hip joint
What muscles are supplied by termination of anterior branch
Adductor longus, gracilis, pectineus, adductor brevis (TQ)
The anterior branch of obturator nerve may connect with what
Accessory obturator nerve
The anterior branch of obturator nerve may send fibers to communicate with what
medial cutaneous nerve of thigh and saphenous nerve = obturator then will contribute to skin on upper medial side of leg
The posterior branch of the obturator nerve travels through the what
Obturator externus, posterior to adductor brevis, and anterior to adductor magnus
The posterior branch of obturator nerve sends muscular branches to where
Obturator externus and adductor magnus and adductor brevis if not by anterior branch also articular fibers to knee joint
What are clinical considerations of the obturator nerve
Muscular weakness and sensory deficits
