Lumbar Spinal Nerves Flashcards
How many pairs of lumbar nerves are there?
5
Each lumbar nerve root five dies into an _____ and ______ _____ _____
Anterior and posterior primary ramus
The posterior primary rami of lumbar nerves divide into ____ and _____ branches
Medial and lateral
The medial branch of the posterior primary ramus of a lumbar nerve supplies what?
Multifidi
What supply the multifidi in lumbar nerves?
The posterior medial branch of the lumbar nerve
What do the lateral branches of the posterior primary ramus of a lumbar nerve supply?
Erector spinae group
What supply the erector spinae group?
The lateral branches of the posterior primary ramus of lumbar nerves
The anterior primary rami of lumbar nerves contribute to ____ and ___ ______
Lumbar and sacral plexuses
The lumbar spinal nerves have communications with the sympathetic ganglia via what 3 mechanisms?
- 4 lumbar sympathetic ganglia
- White rami communicans with L1, L2, L3 (sometimes)
- Gray rami communicans (all lumbar nerves)
What forms the lumbar plexus?
Anterior primary rami of L1-L3, L4 (sometimes)
The lumbar plexus receives contribution from _____ besides the rami of L1-L4, by way of a communication from the ___ nerve
T12
Via L1 nerve
Muscular branches from the anterior rami of the lumbar plexus supply what muscles?
- Quadratus lumborum
- Paola’s major
- Posts minor
What supply the quadratus lumborum, Psoas major/minor
The muscular branches of the lumbar plexus
L1 supplies?
Quadratus lumborum, psoas minor
L2 supplies?
QL, psoas major/minor
L3 and L4 suppply?
QL, psoas major
What makes up the iliohypogastric nerves?
T12, L1
The iliohypogastric nerve travels ___ and ____ between the ____ and ______.
Anterior and inferior
QL and kidney
After the iliohypogastric nerves travels between the QL and kidney its travels through the ____ _____ and between the ____ ____ _____.
Transverse abdominus, internal abdominal oblique
The iliohypogastric nerve gives off what branch and then continues as what branch?
Lateral cutaneous
Anterior cutaneous branch
What does the anterior cutaneous branch of the iliohypogastric nerve supply?
Skin of pubic region
What supplies the skin of the public region?
Anterior cutaneous branch of the iliohypogastric nerve
The iliohypogastric nerve gives off a lateral cutaneous nerve branch that supplies what?
Posterolateral gluteal region
What supplies the posterolateral gluteal region?
Lateral cutaneous branch of the iliohypogastric nerve
What muscles does the iliohypogastric nerve supply?
Internal abdominal oblique
Transverse abdominal
What supply the internal abdominal oblique and the transverse abdominal muscles
Iliohypogastric nerve
What make up the ilioinguinal nerve?
T12 and L1
The ilioinguinal nerve enter the _____ ____. It leaves this via the superficial ring and travels with the ____ _____.
Inguinal canal Spermatic cord (round ligament in females)
What is the sensory ilioinguinal nerve supply in males and females?
Upper medial thigh
Male: base of penis and anterior scrotum
Female: mons pubis, labium majus
What supplies the upper medial thigh and base of the penis and anterior scrotum in males and mons pubis and labium majus in females?
Ilioinguinal nerve
What muscles does the ilioinguinal nerve supply?
Internal abdominal oblique
Transverse abdominal
** note iliohypogastric also supplies these
What makes up the genitofemoral nerve?
L1 and L2
The genitofemoral nerve passes _____ through the _____ ____ and then divides into a _____ and ____ branch
Anterior
Psoas major
Genital and femoral branch
The genital branch of the genitofemoral nerve (L1/L2) Enters and travels through the ____ _____, then leaves and has motor supply to _______ and sensory supply to what?
Inguinal canal
Cremaster muscles
Sensory: superior anterior scrotum, and mons pubis and labium majus
What supplies the cremaster muscle and superior anterior scrotum, mons pubis, and labium majus?
Genital branch of the genitofemoral nerve
The femoral branch of the genitofemoral nerve passes into the thigh _____ to the ____ _____ and supplies what skin?
Posterior
Inguinal ligament
Skin of upper anterior thigh
What supplies the skin of the upper anterior thigh?
Femoral branch of the genitofemoral nerve (L1 L2)
What makes up the lateral cutaneous nerve of the thigh?
L2 and L3
What does the lateral cutaneous nerve of the thigh (L2 L3) supply?
Sensory only to skin of lateral thigh, SUPERIOR to the knee
What supplies the skin of the thigh superior to the knee?
Lateral cutaneous nerve of the thigh (L2 L3)
The lateral cutaneous nerve of the thigh leaves the abdominal cavity by passing under the ____ _____ and travels anterior to the ______ through the ____ _____ to reach the skin
Inguinal ligament
Sartorius
Fascia Lata
What is the largest branch of the lumbar plexus?
Femoral nerve
What makes up the femoral nerve?
L2, L3, L4
The femoral nerve forms posterior to the ___ ____ and emerges _____ to the ____ and anterior to the ______
Psoas major
Lateral
Psoas major
Iliacus
After emerging lateraly front the psoas major the femoral nerves passes _____ to the ______ _____ and enters the _______ ______ lateral to the femoral artery
Posterior
Inguinal ligament
Femoral triangle
After entering the femoral triangle the femoral nerve runs inferior through the ____ _____ into the leg, ______ to the knee
Adductor canal
Medially
Where does the femoral nerve give of branches?
Abdomen and femoral triangle
What branches does the femoral nerve give off within the abdomen?
Muscular branches to the iliacus and pectineus
Also sends fibers to femoral artery
Once the femoral nerve passes posterior and beyond the inguinal ligament the nerve dives into an _____ and _____ division
Anterior and posterior
The anterior division of the femoral nerve (after passing the inguinal canal) gives rise to what 3 nerves?
- Intermediate cutaneous nerve of the thigh
- Medial cutaneous nerve of the thigh
- Nerve to the sartorius
The intermediate cutaneous nerve of the thigh further divides into branches that supply what?
Skin on anterior thigh down to knee
Other branch communicates with femoral branch of genitofemoral nerve
What nerve supplies the skin on the anterior thigh down to the knee and has a communicating branch with the femoral branch of the genitofemoral nerve?
Intermediate cutaneous nerve of the thigh
The medial cutaneous nerve of the thigh crosses anterior to the femoral artery and supplies what?
Skin to medial thigh, medial knee, knee across to the lateral patella
Some supply medial thigh through communicans with the saphenous nerve
What nerve supplies the medial thigh, medial knee, and knee to lateral patella, some of medial thigh though communications with saphenous nerve?
Medial cutaneous nerve of the thigh
The posterior division of the femoral nerve gives rise to ______ and ____ branches
Muscular and vascular
The muscular branches of the femoral nerve supply what?
(Quadriceps muscles)
- Sartorius
- Rectus femoris
- Vastus lateralis
- Vastus medialis
- Vastus intermediaries
What supply the quadriceps muscles?
The muscular branch of the posterior division of the femoral nerve
What do the vascular branches of the femoral nerve supply? (Before continuing as the saphenous nerve)
Femoral artery and branches, and articular branches to the knee joint
What supply the femoral artery and articular branches to the knee joint before continuing on as the saphenous nerve?
Vascular branches of the posterior division of the femoral nerve
The saphenous nerve is transmitted through the _____ _____ and within it crosses the femoral artery, the nerve being medial when emerging.
Adductor canal
What does the saphenous nerve supply after it exits the adductor canal medial to the femoral artery?
Skin medial and anterior to the patella
In the leg the saphenous nerve travels with the ____ _____ ____ and supplies what?
Great saphenous vein
Skin of medial leg and foot
What supplies the skin of the anterior and medial patella, and medial leg and foot?
Saphenous nerve
Clinical considerations for the femoral nerve?
Patellar reflex
Sensory deficits
What forms the obturator nerve?
L2-L4
What is the main fiber of the obturator nerve?
L3
The obturator nerve travels _____ to the psoas major, but _____ to the iliac vessels, descends to pelvis and travels on the _____ ______
Medial
Posterior
Obturator internus
The obturator internus leaves the pelvis through the ____ ___ and divides into an _____ and ______ which are separated by the obturator external and adductor brevis
Obturator canal
Anterior and posterior branch
The anterior branch of the obturator nerve passes _______ to the obturator externus and adductor brevis and ______to pectineous and adductor longus
Anterior
Posterior
The anterior branch of the obturator nerve sends some communicating branches to branches of the _______ nerve, forming the ______ _______
Femoral
Subsartorial plexus
What creates the subsartorial plexus?
Communicating branches between the obtorutor and femoral nerves
What does the subsartorial plexus supply?
Skin on the medial thigh
What supplies skin of the medial thigh?
Subsartorial plexus
The anterior branch of the obturator nerve terminates supplying what>
Femoral A.
To where does the anterior branch of the obturator nerve send articular branches?
Hip joint
The hip joint receives articular branches from what nerve?
Anterior branch of obturator
The obturator nerve sends muscular branches to what 4 muscles?
- Adductor longus
- Gracilis
- Pectineus
- Adductor brevis
What nerve supplies adductor longus and brevis, pectineus, and gracilis?
Muscular branches from the anterior branch of the obturator nerve
The anterior branch of the obturator nerve may also send branches to connect with the _____ ____ ____ if present
Accessory obturator nerve
The anterior branch of the obturator nerve may send communicating branches with the medial cutaneous nerve of the thigh (ant. Femoral branch) and the saphenous nerve (term. N. Of femoral N. )
What supply do these communications give?
Sensory to skin on upper medial side of the leg
If the obturator nerve also has a sensory supply to the upper medial side of the leg what additional communications may be present?
Medial cutaneous nerve of the thigh and the saphenous
The posterior branch of the obturator nerve travels through the ______ _____, posterior to the adductor brevis and anterior to the adductor magnus.
Obturator externus
The posterior branch of the obturator nerve sends muscular branches to where?
Obturator externus and adductor magnus/brevis
The posterior branch of the obturator N sends articular fibers to where?
The knee joint
Clinical considerations regarding the obturator nerve?
- Muscular weakness
2. Sensory deficits