TBL 14: functional anatomy of Lumbar plexus Flashcards
Femoral nerve– arises from
posterior divisions of L2 to L4 spinal segments
Blood supply to the Lumbosacral plexus is derived from:
i) Lumbar branch of Iliolumbar artery (branch of Internal iliac artery)
muscles innervated by Femoral nerve-
Femoral nerve gives rise to what cutaneous branches?
II. Anterior cutaneous nerve of thigh– sensory branch to skin at anterior surface of thigh
III. Saphenous nerve to the skin of– medial surface of knee, and anteromedial surface of
leg as far as foot
medial leg
fame gives rise to sad ant
- Injury to Femoral nerve can result in:
- weakened/difficultyflexionofthighathipjoint
- weakened/difficultyextensionofknee
- lossofsomaticskinsensations(e.g,touch,etc)onanteriorsurfaceofthigh,medialsurfaceknee, and anteromedial surface of leg as far as foot
Lateral femoral cutaneous nerve of thigh:
– arises from ________
– gives off following branches:
posterior divisions of L2, and L3 spinal segments
I. Anterior branch to skin at– anterolateral area of thigh as far as knee
II. Posterior branch to skin– over the greater trochanter of femur
Obturator nerve– arises from
what muscles does it innervate?
anterior divisions of L2 to L4 spinal segments
I. Motor (muscular) branches to– 1. Obturator externus– lateral (external) rotation of thigh at hip joint, abduction of hip, and stabilizes hip joint
- Muscles of medial compartment of thigh [Gracilis, Adductor longus, Adductor brevis, and pubofemoral (adductor) portion of Adductor magnus– adduction and medial (internal) rotation of thigh]
II. Sensory branches to the skin at– medial (inner) aspect of thigh
III. Articular branches to– Hip and Knee joints
obturator, cutaneous innervation
obturator nerve innervates:
direct branch
anterior branch
posterior branch
Injury to Obturator nerve can result in:
- weakened adduction and medial rotation of knee
- loss of somatic sensations (e.g, touch, etc) on medial aspect of thigh
Iliohypogastric nerve– arises from _______ segment – gives off following branches:
I. Motor (muscular) branches to– ________
II. Sensory branches to the skin at–
Iliohypogastric nerve– arises from L1 spinal segment – gives off following branches:
I. Motor (muscular) branches to– Internal oblique, Transversus abdominis, and Quadratus lumborum
II. Sensory branches to the skin at– inferior part of abdomen, lateral aspect of hip, supra pubic region, skin over the greater trochanter of femur
Ilioinguinal nerve– arises from_____spinal segments
– gives off following branches:
motor brach to:
sensory branch:
I. Some motor (muscular) branches to– Internal oblique, and Transversus abdominis (like illiohypogastric) (contraction of
both these muscles result in compression of abdominal cavity)
II. Sensory branches to the skin at– superomedial aspect of thigh, around pubic symphysis, root of penis, superolateral aspect of scrotum (males)/ or labia
majora (females)
tile color
anterior
posterior
Genitofemoral nerve– arises from_______ spinal segment
femoral branch
Genital branch–
Genitofemoral nerve– arises from L1, and L2 spinal segment
I. Genital branch–
– provides motor (muscular) input to Cremaster muscle (contraction of cremaster
muscle raises the scrotum)
– provides primary sensory supply to skin in– pubic region, scrotum (males)/ or labia majora (females)
II. Femoral branch– provides sensory supply to the skin at– superoanterior and medial aspect of thigh (superolateral part of femoral
triangle)
Cremasteric reflex, and its physiological and clinical significance:
Lumbar disc herniation (L4-L5) can:
a) result in occlusion of the intervertebral foramen, which can mechanically compress lumbar
spinal nerves
Nerve blocks to Iliohypogastric, Ilioinguinal or Genitofemoral nerves are clinically used for the management of:
a) Patients undergoing an elective cesarian section for delivery of the baby
b) Children requiring inguinal hernia surgery
Injury to Lumbosacral plexus and its branches symptoms
Sacral plexus:
arises at the level of ____vertebrae
L4-S4
provides motor and sensory nerves for part of the pelvis, posterior thigh, lower leg and foot
what are the major branches of the Sacral plexus:
where does the gluteus max originate and attach?
Superior gluteal nerve (________)–
innervates
actions of muscles innervated
Superior gluteal nerve (L4, L5, and S1)
provides innervation to the Gluteus medius, Gluteus minimus, and Tensor fasciae latae muscles (which abduct and medially (internally) rotate the extended thigh at the hip joint, and stabilize the femur head in the hip joint)
Clinical significance of Superior gluteal nerve:
Inferior gluteal nerve
innervations
clinical significance
sciatic nerve L4-S3
- At the level of thigh, Sciatic nerve innervates the:
common fibular vs tibial branch
I. Hamstring muscles at the posterior compartment of thigh (Semitendinosus, Semimembranosus, and long of Biceps femoris (by tibial branch), short head of bicep femoris by common fibular branch. Help in extension of thigh at hip joint, flexion of leg at the knee joint, and assist in internal [medial] rotation of flexed knee)
II. Ischiocondylar (hamstring) portion of Adductor magnus– which is an adductor of thigh, and aids in extension at hip joint—-by tibial branch
Tibial nerve of sciatica – which provide sensory innervation to skin at the________, innervates the muscles in the __________
sensory branches
which provide sensory innervation to skin at the sole of foot(sural, calcaneal, plantar branches) , innervates the muscles in the posterior compartment of the leg and sole of the foot
allows for plantar flexion
Tibial nerve of sciatica
Motor branches to muscles in posterior compartment of leg– _______________muscles____________________________— plantar flex foot, flex digits
Tibial nerve of sciatica
Motor branches to muscles in posterior compartment of leg–
gastrocnemius, soleus, plantaris, popliteus, tibialis posterior, flexor digitorum longus, and flexor hallucis longus muscles—
plantar flex foot, flex digits
Tibial nerve of sciatica
_____________ nerve which supplies the skin of the lower half of the back of the leg and lateral border of the foot until the tip of the little toe
v. Sural cutaneous nerve which supplies the skin of the lower half of the back of the leg and lateral border of the foot until the tip of the little toe
Tibial nerve of sciatica
______nerve which supply the skin of the posteroinferior back surface of heel
vi. Medial calcaneal nerve which supply the skin of the posteroinferior back surface of heel
sciatic: Common fibular (peroneal/external popliteal/lateral popliteal) nerve– which innervates
and gives off which branches
Nerve to the short head of Biceps femoris muscle of thigh– which helps in knee flexion
comes from???
common fibular nerve of sciatic nerve
what muscles are innervated by the sciatic common fibular nerve?
what action is down by this nerve
Superficial fibular (peroneal) nerve–
innervates the muscles of the lateral compartment of leg (Fibularis longus, and Fibularis brevis– helps in eversion and plantar flexion of foot), also provides sensory innervation to skin over the antero-lateral surface of the leg along with the greater part of the dorsum of foot
sciatic Deep fibular (peroneal) nerve– innervate the muscles of
what action is done
Deep fibular (peroneal) nerve– innervate the muscles of the anterior compartment of leg (Tibialis anterior, Extensor hallucis longus, Extensor digitorum longus, Fibularis tertius– helps in inversion and dorsiflexion of foot, and extension of digits)
Clinical significance of Common fibular nerve and its branches:
Piriformis Syndrome
Clinical significance of Sciatic nerve and its branches:
label
