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Lumbosacral Plexus
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Lumbosacral Plexus | |
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Nerve Type | Plexus |
Origin | Lumbar Plexus: T12-L4 Sacral Plexus: L4-S4 |
Major Branches | Lumbar Plexus: Femoral Nerve, Genitofemoral Nerve, Iliohypogastric Nerve, Ilioinguinal Nerve, Lateral Femoral Cutaneous Nerve, Lumbosacral Trunk, Obturator Nerve, Tibial Nerve and Common Peroneal Nerve (through sciatic trunk) Sacral Plexus: Inferior Gluteal Nerve, Nerve to Obturator Internus and Superior Gemellus, Nerve to Quadratus Femoris and Inferior Gemellus, Nerve to Piriformis, Posterior Femoral Cutaneous Nerve, Pudendal Nerve, Sciatic Nerve, Superior Gluteal Nerve, Perforating Cutaneous Nerve |
The lumbosacral plexus can be divided into two anatomical parts: the upper lumbar plexus and the lower lumbosacral plexus.
Lumbar Plexus
The lumbar plexus is located within the psoas muscle. It contains the canterior rami of the T12 to L4 nerve roots. Only the femoral nerve can be reliably tested by EMG. The lateral femoral cutaneous nerve can be tested but it is unreliable.
Nerve | Origin | Sensory Innervation | Motor Innervation |
---|---|---|---|
Femoral Nerve | L2, L3, L4 anterior rami, posterior divisions | Skin of medial lower leg through Saphenous Nerve | Quadriceps Femoris, Sartorius, Pectineus, Iliacus, |
Genitofemoral Nerve | L1, L2 | Skin of femoral triangle, lower scrotum/labia | Cremasteric muscle in men |
Iliohypogastric Nerve | T12, L1 | Skin of lower abdomen | Transversus Abdominis, Internal Obliques |
Ilioinguinal Nerve | L1 | Skin to inguinal region, small area of medial thigh, upper scrotum/labia. | Transversus Abdominis, Internal Oblique |
Lateral Femoral Cutaneous Nerve | Posterior divisions of L2 and L3 spinal nerves | Anterolateral thigh | |
Lumbosacral Trunk | L4, L5 (mainly L5) | Skin of L5 | Ankle dorsiflexors, ankle everters, ankle inverters |
Obturator Nerve | L2, L3, L4 anterior rami | Skin of medial thigh | Adductor Magnus (anterior half), Adductor Longus, Adductor Brevis, Gracilis, Obturator Externus |
Sacral Plexus
The sacral plexus is derived from the anterior rami of spinal nerves L4-S4.
Nerve | Origin | Sensory Innervation | Motor Innervation |
---|---|---|---|
Inferior Gluteal Nerve | L5, S1, S2 | Gluteus Maximus | |
Nerve to Obturator Internus and Superior Gemellus | L5, S1, S2 | Obturator Internus, Superior Gemellus | |
Nerve to Piriformis | Posterior division of the ventral rami of S1 and S2 | Piriformis | |
Nerve to Quadratus Femoris and Inferior Gemellus | L4, L5, S1 | Sensory branch to hip joint | Quadratus Femoris, Inferior Gemellus |
Perforating Cutaneous Nerve | S2, S3 | Lower medial aspect of the buttock | |
Posterior Femoral Cutaneous Nerve | S1, S2, S3 | Posterior surface of the thigh, leg, and perineum (perineal branches and inferior cluneal nerves) | |
Pudendal Nerve | S2, S3, S4 | Skin of penis, clitoris, most of the perineum | Muscles of the perineum |
Sciatic Nerve | L4, L5, S1, S2, S3 | No direct sensory function, but has indirect sensory supply to the foot (tibial nerve, common peroneal nerve) and leg (except medial portion which is saphenous nerve) | Extensive motor innervation to thigh, leg, ankle, foot. |
Superior Gluteal Nerve | L4, L5, S1 | Skin of buttock | Gluteus Medius, Gluteus Minimus, Tensor Fascia Lata |
Other Branches
Nerve | Segment | Motor Supply | Action | Sensory Supply |
---|---|---|---|---|
Tibial | L4-S3 | Hamstrings (except short head of biceps femoris, posterior part of adductor magnus), triceps surae, tibialis posterior, popliteus, flexor digitorum longus, flexor hallucis longus, intrinsic muscles of foot | Knee flexion(primary), foot plantar flexion, toe flexion | skin of posterior leg and sole of foot |
Common fibular | L4-S2 | short head of biceps femoris, fibularis longus and brevis, tibialis anterior, extensor hallucis | knee flexion (short head of biceps femoris), foot dorsiflexion and eversion, toe extension | skin of anterior and lateral leg and dorsum of foot |
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