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Lumbar plexus roots
T12-L4 ventral rami
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anterior division of lumbar plexus innervates
flexors
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posterior division of lumbar plexus innervates
extensors
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subcostal nerve (root, sensory, motor)
- T12
- sensory: subxyphoid
- motor: none
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iliohypogastric nerve (root, sensory, motor)
- L1
- sensory: above pubis and posterolateral butt
- motor: transversus abdominis and internal oblique
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ilioinguinal nerve (root, sensory, motor)
- L1
- sensory: inguinal region and anterosuperior thigh
- motor: none
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genitofemoral nerve (root, sensory, motor)
- L1-2
- sensory: scrotum or labia majora
- motor: cremaster
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obturator nerve (root, sensory, motor)
- L2-4
- sensory: inferomedial thigh (via cutaneous branch of the obturator nerve)
- motor: external oblique and obturator externus (posterior division)
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accessory obturator nerve (root, sensory, motor)
- L2-L4
- sensory: none
- motor: psoas
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nerves of the posterior division of the lumbar plexus
- lateral femoral cutaneous
- femoral
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lateral femoral cutaneous nerve (root, sensory, motor)
- L2-3
- sensory: lateral thigh
- motor: none
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femoral nerve (root, sensory, motor)
- L2-4
- sensory: anteromedial thigh via the anterior and intermediate cutaneous nerves
- motor: psoas, pectineus, sartorius, quadriceps
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course of subcostal n
inferior to 12th rib
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course of iliohypogastric
under psoas and pierces abdominal muscles
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course of ilioinguinal
under psoas and pierces abdominal muscles
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course of genitofemoral
pierces psoas muscel and lies on the anterior surface of psoas muscle
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course of oburator
exits via oburator canal and splits into ant and post divisions
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how obturator n can be injured during surgery
by retractors placed behind the transverse acetabular ligament (TAL)
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course of lateral femoral cutanous n
runs on iliacus and crosses inferior to the ASIS
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meralgia paresthetica
compression of the lateral femoral cutaneous n as it crosses below the ASIS
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course of femoral n
lies between psoas and iliacus
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lumbosacral plexus roots
ventral rami of L4-S3
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nerve to quadratus femoris (root, sensory, motor)
- L4-S1
- sensory: none
- motor: quadratus femoris and inferior gemelli
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nerve to oburator internus (root, sensory, motor)
- L5-S2
- sensory:none
- motor: obturator internus and superior gemeli
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pudendal nerve (root, sensory, motor)
- S2-4
- sensory: perineum
- motor: bulbospongious (perineal n), ischiocavernosus (perineal), urethral spincter (perineal), urogenital diaphragm (perineal), and sphincter ani externus (inferior rectal n)
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nerve to coccygeus (root, sensory, motor)
- S3-4
- sensory: none
- motor: coccygeus and levator ani
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superior gluteal nerve (root, sensory, motor)
- L4-S1
- sensory: none
- Motor: gluteus medius, gluteus minimus, tensor fasciae latae
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inferior gluteal nerve (root, sensory, motor)
- L5-S2
- sensory: none
- motor: gluteus maximus
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nerve to piriformis (root, sensory, motor)
- S2
- sensory: none
- motor: piriformis
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posterior femoral cutaneous nerve (root, sensory, motor)
- S1-3
- sensory: inferior butt (inf cluneal nerves), posterior perineum (perineal branches), posterior thigh
- motor: none
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superior cluneal nerve (root, sensory, motor)
- L1-3
- sensory: superior 2/3 of butt
- motor: none
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medial cluneal nerve (root, sensory, motor)
- S1-S3
- sensory: sacral and medial butt
- motor: none
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course of n to quadratus femorus
exits greater sciatic foramen
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course of n to obturator internus
exits greater sciatic foramen
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course of pudendal n
exits greater sciatic foramen, then renters pelvis through lesser sciatic foramen
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course of n to coccygeus
directly innervates coccygeus
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course of superior gluteal n
exits greater sciatic foramen above the piriformis
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course of the inferior gluteal n
exits greater sciatic foramen
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course of posterior femoral cutaneous n
exits via greater sciatic foramen, under the piriformis, medial to sciatic n
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course of the sciatic n
exits greater sciatic foramen under piriformis
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during post approach to hip, how do you proctect the sciatic?
reflecting the short ext rotators
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largest nerve in the body
sciatic
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