Femoral nerve

Question 1

Femoral nerve anatomy

Answer 1

• It originates from nerve roots L2–L4
• It passes infero-laterally through the psoas muscle and emerges from its lateral border
• It exits the pelvis beneath the inguinal ligament, lateral to the femoral vessels to enter the thigh

Question 2

Femoral nerve injury facts

Answer 2

• Gynaecological surgery is the most common contributor

- Incidence of at least 11%

Question 3

Femoral nerve injury causes

Answer 3

• It occurs as a result of compression of the nerve against the pelvic sidewall as it emerges from the lateral border of the psoas muscle
• Excessively deep retractor blades are used or during the lateral placement of retractors
• Inappropriate patient positioning in lithotomy

Question 4

Femoral neuropathy symptoms

Answer 4

• Weakness of hip flexion and adduction and knee extension
• There is loss of the knee jerk reflex and paraesthesia over the anterior and medial thigh, as well as the medial aspect of the calf
• Inability to climb the stairs