LUMBAR PLEXUS

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LUMBAR PLEXUS:

LUMBAR PLEXUS By: Divya reddy

Slide3:

Lumbar plexus is formed within the psoas major muscles by, union of ventral ramus of L1,L2,&L3 and also the larger upper part of ventral ramus of L4 of nerve. So the larger upper part of the ventral ramus of the L4 nerve take part in formation of lumbar plexus. But the lower smaller part of L4 nerve of the ventral ramus of the L4 joins with the ventral rami or ventral ramus of L5 nerve mainly to form lumbosacral trunk, which take part in the formation of sacral plexus.

Slide4:

Various branches given by the lumbar plexus So, the ventral ramus of the L1 also receives some of the fibers mainly from the T12 The ventral ramus of the L1 is divided into larger upper part & smaller lower part The larger upper branch of L1 gives rise two important nerve 1-iliohypogastric nerve 2-ilioinguinal nerve The smaller the lower branch of L1 joins with the branch from the L2 and forms genitofemoral nerve

Nerve roots:

Nerve roots L2,L3 & L4 divides into dorsal –posterior branch- ventral - anterior branch Dorsal division of L2 as well as L3 divides further into 2 branches 1- the lateral femoral cutaneous nerve Dorsal division of L2,L3&L4 to form femoral nerve but the ventral division of L2,L3&L4 to form obturator nerve And sometimes the ventral branches of L3 & L4 divide and join to form accessory obturator nerve but is not preset in all the individual nerve

Slide6:

Easy to remember: II GOLF I-Iliohypogastric nerve-L1 I-Ilioinguinal nerve-L1 G-Genitofemoral nerve-L1&L2(ventral division) 0-obturator nerve-L2,L3,L4(ventral division) L- lateral femoral cutaneous nerve- L2, L3(dorsal division) F-femoral nerve-L2,L3,L4(dorsal division) Accessory obturator nerve-L3,L4( ventral division)

Iliohypogastric nerve:

Iliohypogastric nerve Iliohypogastric emerges beneath the lateral border of psoas major muscles passes downwards laterally infront of quadratus lumborum Of the lateral border of the quadratus lumborum it pierces upper neurotic origin of transversus abdominis just above the iliac crest and runs into the anterior abdominal wall Innervation of iliohypogastric nerve: Cutaneous innervation to the skin of gluteal region and the anterior abdominal wall in hypogastric region

ilioinguinal nerve:

ilioinguinal nerve Its goes same as the iliohypogastric nerve but, Slightly lower liver It pierces the transversus abdominis close to the anterior part of the iliac crest innervation: Motor innervation : internal oblique muscles, transversus abdominis muscles Sensory innervation : skin on the upper medial aspect of the thigh, root of penis and scrotum in males, mons pubis and labium major in female.

Genitofemoral nerve :

Genitofemoral nerve The genitofemoral nerve passes forward through the psoas major muscles piercing it and runs through on the anterior psoas, above the lingual ligament genitofemoral divides into femoral branches and genital branches Femoral branch-enters femoral sheath and pierces the anterior wall of sheath Genital branch- enter deep inguinal ring and travel through inguinal canal along the spermatic cord in males and round ligament of uterus in females Innervation: Femoral branch : cutaneous innervation to skin over femoral triangle Genital branch : supplies cremaster muscles and scrotal skin in males and skin of mons pubis and labium majus in female

Lateral femoral cutaneous:

Lateral femoral cutaneous Lateral cutaneous nerve of thigh: As it emerges beneath the lateral border of psoas major muscle above the iliac crest and it laterally, front of the lliacus muscles It emerges the thigh by passing beneath the lateral end of the inguinal ligament Innervation: Cutaneous innervation to the upper lateral aspect of thigh

Femoral nerve :

Femoral nerve Femoral nerve emerges the beneath the lateral border psoas major muscles below the iliac crest It enters the anterior compartment of the thigh by passing deep to the inguinal ligament

Obturator nerve:

Obturator nerve Obturator nerve emerges the beneath medial border of psoas major muscles and runs downward and forward along the lateral wall of true pelvis and enter the thigh but, passing through the obturator canal

Accessory obturator nerve :

Accessory obturator nerve If present, its runs along the medial border of psoas major and enters thigh Innervation: Pectineus muscles

Slide14:

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