Final - Regional Neuroanatomy Part 2 Flashcards
What plexus provides motor and sensory innervation for the pelvis and lower limbs?
Lumbosacral plexus!
* superior part: Lumbar plexus (L1-L4)
* inferior part: Sacral plexus (L4-S4)
What spinal nerves contribute to the lumbosacral plexus?
L1 to S4.
* lumbar plexus: L1 - L4
* sacral plexus: L4 - S4
What are the 6 nerves that make up the lumbar plexus?
- Iliohypogastric nerve (L1) - most superior in this plexus
- Ilioinguinal nerve (L1)
- Genitofemoral nerve (L1-L2)
- Lateral cutaneous nerve of the thigh (L2-L3)
- Obturator nerve (L2-L4)
- Femoral nerve (L2-L4) - largest diameter nerve in this plexus
IIGLOF :)
What is the largest diameter nerve in the lumbar plexus?
A. lateral cutaneous
B. genitofemoral
C. obturator
D. femoral
D. Femoral nerve
What are the 3 superior pelvic nerves?
hint: part of lumbar plexus
- Iliohypogastric nerve
- Ilioinguinal nerve
- Genitofemoral nerve
What muscle do the 3 superior pelvic nerves “come out of” or “run parallel to”?
A. transverse abdominis
B. quadratus lumborum
C. psoas major
D. iliacus
C. Psoas major muscle
What are the 2 branches of the iliolhypogastric nerve and to what part of the body is their sensory innervation? Select 2.
A. transverse cutaneous branch; lateral portion of pelvis
B. inguinal branch; on crease leading to reproductive system
C. lateral cutaneous branch; small part of lateral pelvis/hip
D. internal oblique branch; lateral side of hip
E. anterior cutaneous branch; anterior portion leading to reproductive system
F. superior branch; top part of the hip
C. Small part of the lateral pelvis/hip through the lateral cutaneous branch
E. Anterior portion leading to reproductive system through anterior cutaneous branch (runs parallel to inguinal ligament)
What muscles will have motor innervation through the iliohypogastric nerve? Select 2.
A. external oblique
B. transverse abdominis
C. internal abdominis
D. major rectus abdominis
B. Transverse abdominis (utilized during heavy/labored breathing)
C. Internal abdominis (not pictured)
The Ilioinguinal nerve will provide sensory innervation to what parts of the body? select 2.
A. inguinal crease
B. lateral upper quad
C. medial upper quad
D. right above reproductive organs
E. right below/on reproductive organs
F. lateral middle quad
C. Medial upper quadricep muscle (groin area)
D. Right above the reproductive organs
rmbr: this nerve comes up & out of psoas major also
What muscle will have motor innervation through the ilioinguinal nerve?
A. internal oblique
B. transverse abdominis
C. external oblique
D. major rectus abdominis
A. Internal oblique muscle
also important during labored breathing!
The genitofemoral nerve also comes through the psoas major muscle and then branches off into what two?
A. femoral branch
B. inguinal branch
C. genital branch
D. spermatic branch
E. iliacus branch
A. Femoral branch (sensory to upper middle thigh)
C. Genital branch (sensory to genitals)
The genital branch of the genitofemoral nerve supplies motor innervation in men to what muscle?
A. spermatic muscle
B. suspendis muscle
C. cremaster muscle
D. ischiocavernosus muscle
C. Cremaster muscle/reflex
contracts as a reflex to pull testicle up closer to body to increase its temperature (per google)
What 2 bony projections does schmidt call our “two sets of hips”?
A. ASIS
B. pubic tubercle
C. PSIS
D. obturator foramen
E. greater trochanter
A. Anterior Superior Iliac Spine: lateral pelvic bone
E. Greater Trochanter: top lateral portion of femur
should be palpable on patients with normal BMI
what is the area where the two pelvic bones meet in the front of the structure called?
pubic symphysis (junction)
pubic tubercle is a projection on the symphysis that the inguinal ligament attaches to!
What are the two attachment points for the inguinal ligament?
A. pubic tubercle
B. PSIS
C. ASIS
D. greater trochanter
E. ischial tuberosity
A. medial attachment point = pubic tubercle
C. lateral attachment point = Anterior Superior Iliac Spine (ASIS)
this is important since this forms the top border of femoral triangle!!
A horizontal line across the iliac crests will indicate what landmark on the spine?
border of L4 and L5 (Tuffier’s line)
What are the 4 muscles that make up the femoral triangle?
- Iliopsoas
- Sartorius
- Pectineus
- Adductor Longus
bunch of skeletal muscles that have the inguinal ligament as the superior border to form the femoral triangle and give space for fem a,v,and n
Describe the position of the femoral nerve, femoral artery, and femoral vein in the femoral triangle.
- Most lateral: Femoral Nerve
- Middle: Femoral Artery (<1cm in diameter)
- Most medial: Femoral Vein
rmbr: NAV! These structures are about 1 cm apart from each other.
What is the fibrous pouch that wraps around the femoral nerve, artery, and vein?
A. sartorius sheath
B. adductor sheath
C. femoral sheath
D. inguinal sheath
C. Femoral sheath
protective connective tissue pouch where we can plant significant amount of LA and should hopefully stay mostly confined to the area
what nerve provides motor innervation for all the muscles in the anterior top part of quadricep area?
femoral nerve
mixed motor and sensory (since saphenous is branch of femoral n.)
What nerve is a branch of femoral nerve that continues down the quad after the motor branches and is responsible for the sensory innervation of the lower leg?
A. genitofemoral nerve
B. saphenous nerve
C. lateral cutaneous femoral nerve
D. obturator nerve
B. Saphenous Nerve
almost entirely sensory!! important to know since we may only wanna block this and not the motor branches of femoral nerve!
T/F: The adductor canal is a potential space for the saphenous nerve to pass through.
True, located between anterior and medial thigh muscles
rides solo and right next to femoral artery and vein
What are the three muscles that make up/surround the adductor canal?
A. quadricep femoris
B. pectineus
C. gracialis
D. adductor longus
E. sartorius
F. vastus medialis
D. Adductor Longus
E. Sartorius
F. Vastus Medialis
probz the most important canal per schmidt!
Which nerve provides sensory information to the lateral anterior thigh?
A. anterior cutaneous nerve
B. femoral nerve
C. lateral cutaneous nerve
D. obturator nerve
B. Lateral Cutaneous Nerve of the thigh (LCA)
originates from L2-L3
The obturator nerve does not take a typical path down the leg like the other nerves of the lumbar plexus. What opening at the base of the pelvis does it pass through?
A. sacral foramen
B. sacral hiatus
C. obturator hiatus
D. obturator foramen
D. Obturator Foramen
then it descends down medial part of thigh
The obturator nerve serves primarily as a motor neuron. What are the direct branches of innervated muscles?
anterior branches?
posterior branches?
Direct: Obturator externus
Anterior: Adductor longus, Adductor brevis, Gracilis, Pectineus
Posterior: Adductor magnus
Where is the small area of sensory innervation provided by the obturator nerve?
A. medial thigh just above the knee.
B. lateral thigh just above the knee.
C. medial thigh just below the knee.
D. lateral thigh just below the knee.
A. medial thigh just above the knee.
The femoral nerve’s muscular branches will innervate what four muscles in the leg? Select 4.
A. iliopsoas
B. adductor longus
C. pectineus
D. sartorius
E. gracilis
F. quadriceps femoris
A. Iliopsoas
C. Pectineus
D. Sartorius
F. Quadriceps femoris
What are the 2 sensory branches of the femoral nerve? select 2.
A. anterior cutaneous branch
B. saphenous nerve
C. obturator nerve
D. pectineus branch
A. Anterior cutaneous branch (tiny branch for anterior medial thigh)
B. Saphenous nerve (medial and some posterior part lower leg)
saphenous > anterior cutaneous branch (shallow, less signals, less important..)
The superior gluteal nerve is primarily a motor nerve!!! What are the three muscles innervated by the superior gluteal nerve? Select 3
A. gluteus maximus
B. gluteus medius
C. gluteus minimus
D. tensor fascia latae
E. piriforimis
B. Gluteus medius
C. Gluteus minimus (not pictured but sits right next to gluteus medius)
D. Tensor fasciae latae
What muscle does the inferior gluteal nerve innervate?
A. Gluteus maximus
B. Gluteus medius
C. Gluteus minimus
D. Tensor fasciae latae
A. Gluteus Maximus
inferior glut nerve is also primarily motor!
What four main nerves provide sensory innervation to the gluteal region? Select 3
A. gluteal nerve
B. superior and inferior clunial nerves
C. saphenous nerve
D. middle clunial nerve
E. lateral branch of iliohypogastric nerve
F. lateral branch of ilioinguinal nerve
B. Superior and inferior Clunial Nerve
D. Middle Clunial Nerve
E. Lateral Branch of Iliohypogastric Nerve
The superior clunial nerve is formed by:
A. anterior rami of L1 to L3
B. anterior rami of S1 to S3
C. posterior rami of L1 to L3
D. posterior rami of S1 to S3
C. Posterior Rami of L1 to L3
The middle clunial nerve is formed by:
A. anterior rami of L1 to L3
B. anterior rami of S1 to S3
C. posterior rami of L1 to L3
D. posterior rami of S1 to S3
D. Posterior Rami of S1 to S3
The inferior clunial nerve arises from:
A. anterior femoral cutaneous nerve
B. posterior femoral cutaneous nerve
C. lateral femoral cutaneous nerve
D. femoral nerve
B. Posterior femoral cutaneous
so from a branch of the sacral plexus, NOT from rami like the other 2 clunial nerves
The sciatic nerve is a combo of what two nerves?
A. tibial and pudendal
B. common fibular and peroneal
C. tibial and peroneal
D. common fibular and pudendal
C. Tibial Nerve (L4 to S3) and Common Fibular Nerve aka Peroneal nerve (L4 to S2)
note: common fibular has less origin pathways (since only goes down to S2)
Label 1
- Sciatic nerve
Label 2
- Common fibular nerve (peroneal nerve)
think: fibula = lateral … tibial = medial
Label 3
- Deep fibular nerve
Label 4
- Superficial fibular nerve
Label 5
- Superficial fibular nerve
Where does the Lateral Sural Cutaneous nerve provide sensory innervation?
A. lateral side of upper thigh
B. lateral side of big toe
C. lateral side of calf
D. lateral side of foot
C. Lateral side of the calf (gastrocnemius)
and lateral shin in front part of leg! since this nerve wraps around
Where is the sensory innervation of the Superficial Fibular Nerve?
A. between big toe and 2nd toe
B. top of foot
C. bottom of foot
D. medial ankle
B. Top of the foot
What are the two branches of the superficial fibular nerve?
A. medial dorsal cutaneous
B. medial ventral cutaneous
C. common medial cutaneous
D. intermediate dorsal cutaneous
A. Medial dorsal cutaneous nerve
D. Intermediate dorsal cutaneous nerve
Where is sensory innervation of the Deep Fibular Nerve?
A. lateral foot
B. top of foot
C. bottom of foot
D. between big toe and 2nd toe
D. Between the Big Toe and 2nd Toe
What are the 2 branches of the Deep Fibular Nerve? Select 2.
A. lateral cutaneous nerve of 2nd toe
B. lateral cutaneous nerve of big toe
C. medial cutaneous nerve of big toe
D. medial cutaneous nerve of 2nd toe
B. Lateral cutaneous nerve of the big toe
D. Medial cutaneous nerve of the 2nd toe
Label 1, 2, and 3
- 1: Sciatic Nerve
- 2: Tibial Nerve (travels medially)
- 3: Common Fibular Nerve (travels laterally)
What are the four direct cutaneous branches of the tibial nerve?
- Medial Sural Cutaneous Branch - sensory to medial back part of leg
- Medial Calcaneal Branch - middle heel/bottom foot
- Lateral Calcaneal Branch - lateral heel
- Lateral Dorsal Cutaneous Branch - lateral foot
The tibial nerve will branch off to what two nerves at the bottom of foot?
- Medial Plantar Nerve
- Lateral Plantar Nerve
What are the nerves that make up the sacral plexus?
- Superior gluteal nerve
- Inferior gluteal nerve
- Posterior cutaneous nerve of thigh
- Sciatic Nerve (Peroneal and Tibial n.)
- Pudendal Nerve
List the spinal nerve origins of the following:
-Superior gluteal nerve
-Inferior gluteal nerve
-Posterior cutaneous nerve of thigh
-Common fibular nerve
-Tibial nerve
-Pudendal nerve
The function of the pudendal nerve (which originates from S2-S4) involves sensory innervation to the pelvis as well as:
A. anterior thigh sensation
B. rectum/colon motility and bladder control
C. cremaster reflex
D. reproductive organ function especially in men
B. Rectum and colon motility (rectal branch)
D. Reproductive organ function esp. men (dorsal branch of penis and posterior scrotal branch)
Where does the posterior cutaneous nerve of the thigh provide sensory innervation? Select 2.
A. hamstring
B. lower gluteal region
C. upper gluteal region
D. quadriceps
A. Hamstring
B. Lower Gluteal Region
This nerve is also the starting point of the inferior clunial nerve
