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    Roma Fe Mabanag
    The lumbar plexus is formed by the anterior rami of L1-L4 and supplies the abdomen, pelvis and lower limb. It gives rise to the iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, obturator and femoral nerves. The sacral plexus is formed by L4-S4 and gives rise to the superior and inferior gluteal, sciatic and pudendal nerves. The main arteries of the lower limb include the femoral, popliteal, anterior and posterior tibial arteries.

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    The lumbar plexus is formed by the anterior rami of L1-L4 and supplies the abdomen, pelvis and lower limb. It gives rise to the iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, obturator and femoral nerves. The sacral plexus is formed by L4-S4 and gives rise to the superior and inferior gluteal, sciatic and pudendal nerves. The main arteries of the lower limb include the femoral, popliteal, anterior and posterior tibial arteries.

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    Comprehensive Reviewer for Lumbosacral Plexus

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    Lumbosacral Plexus

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    The lumbar plexus is formed by the anterior rami of L1-L4 and supplies the abdomen, pelvis and lower limb. It gives rise to the iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, obturator and femoral nerves. The sacral plexus is formed by L4-S4 and gives rise to the superior and inferior gluteal, sciatic and pudendal nerves. The main arteries of the lower limb include the femoral, popliteal, anterior and posterior tibial arteries.

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    56 views3 pages

    I 2x Get Laid On Fridays

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    Roma Fe Mabanag
    The lumbar plexus is formed by the anterior rami of L1-L4 and supplies the abdomen, pelvis and lower limb. It gives rise to the iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, obturator and femoral nerves. The sacral plexus is formed by L4-S4 and gives rise to the superior and inferior gluteal, sciatic and pudendal nerves. The main arteries of the lower limb include the femoral, popliteal, anterior and posterior tibial arteries.

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    The key takeaways are the anatomy and functions of the major nerves of the lumbosacral plexus, branches of the sacral plexus, and blood vessels of the lower limb as described in the text.

    The major nerves of the lumbosacral plexus are the iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, obturator, and femoral nerves. The text describes their motor innervations and cutaneous distributions.

    The major branches of the sacral plexus are the superior and inferior gluteal nerves, the nerves to the obturator internus and quadratus femoris muscles, the sciatic nerve, and the pudendal nerve. The text outlines their motor functions.

    LUMBOSACRAL PLEXUS 3.

    Nn to Obturator Internus (L5-S2) ant


    - Gemellus Superioris = re-enters
    Lumbar Plexus
    Formed by: Ant. Rami of L1-L4 (+T12)=> 6 nn 4. Nn to Quadratus Femoris (L4-S1) ant
    At: Ant of Piriformis, Surface of Posterior Pelvic Wall - Mm: Quadratus Fem & G. Inferior; Pure motor
    In: Psoas Major (I 2x Get Laid On Fridays)
    Ilioing, Iliohypogastric , GenitoFem (psoas maj), LFCN, Obt, Fem 5. Sciatic Nn (L4-S3)
    All arise fr: Lat. aspect of Psoas Major (exc G&O) - Largest nn in the body; lower medial of gluts
    Ant: Genitofemoral :: Medial: Obturator Injection Palsy: should be at upper lat
    *2 fr 1, 2 fr 2, 2 fr 3* Piriformis Syndrome: spasm of mm d/t impingement
    L1 rt: Ilihypogastric & Ilioinguinal Leads to sciatica; aka fatwallet/thickwallet syndrome
    L1 & L2 rt: Genitofemoral 5.1 Tibial nn (L4-S3)
    L2 & L3 rt: LFCN Mm: HS, PF, foot mm
    L2,3,4: Obturator & Femoral Branches: Sural nn lat side of leg & foot
    -Principal nn of LP; bec I largest mm groups Med. Calcaneal nn heel
    Med & Lat Plantar nn sole of foot
    Additional:
    Subcostal Nn: brach fr T12 5.2 Common Peroneal (L4-S2)
    Accessory Obturator (not always present): fr L3-4 braches nn Mm: ant & lat compartment of leg
    Muscular branches to the psoas muscle & Iliacus mm: fr femoral nn Branches: Sural Comunicating &Lat. Sural Cutaneous nn of calf
    Motors: Superficial (Lat), Deep (ant)
    1. Iliohypogastric nn (L1)
    - Mm: Ant. Abdominal wall mm: TIE (-R) 6. Pudendal nn
    - S: over lower ant abd wall & buttock - Mm: Perineum; if inj: incontinence
    - S: M: Penis & Scrotum :: F: Clitoris, Labia Maj/Min
    2. Ilioinguinal nn (L1) - MOI: entrapment of nn to bikers, cyclist
    - Mm: Ant. Abd wall mm: TIE (-R)
    - S: Groin (Upper Med of thigh), 7. Nn to Piriformis
    F: Mons Pubis & Labia Majora :: M: root of penis & scrotum - Pure motor

    3. Genitofemoral nn (L1-L2) Additional Smaller Branches (Direct)


    - Mm: Cremaster for reflex Perforating Cutaneous Nn : Skin of Inf Gluts or fold (S2-3)
    - S: over ant surface of thigh
    CUTANEOUS DISTRIBUTION
    4. Lat. Femoral Cutaneous nn (L2-L3)
    - Mm: none I. Anterior Leg
    - S: Anterolat thigh Lat. Cutaneous nn of Calf UAL or upper ant lat
    - D/O: Meralgia Paresthetica, Saphenous nn medial leg
    MOI-TOP: Tight belt & U/W, Obesity, Pregnancy Superficial Peroneal nn - LAL or lower ant lat

    5. Obturator nn (L2-L4) II. Posterior Leg


    - Mm: of medial compartment of thigh (adductors) Post. Cutaneous nn of thigh
    - S: Inner medial thigh Post. Cutaneous nn of calf
    - D/O: weak in hip ADER => x: cross leg, (-add) reflex Sural & Saphenous

    6. Femoral nn (L2-L4) III. Dorsal Foot


    - Largest nn in lumbar plexus; aka Ant. Crural nn Superficial Peroneal
    - Mm: Hip flexors, knee extensors Deep Peroneal
    - S: anteromedial side of leg & foot Sural & Saphenous
    - D/O: (-) patellar knee jerk
    - Gait: Ant. Lurching/ ant. Trunk bending IV. Sole Foot
    - Femoral (L-M): NAVL Med. Calcaneal
    - Branches: Medial FCN medial distal thigh Med. Plantar
    Saphenous FCN med leg & foot Lat. Plantar
    Intermediate FCN ant surface of thigh Med & Plantar nn

    Sacral Plexus
    Formed By: Ant. Rami of L4-S4 (SIOQSPP)
    *if lumbosacral trunk: L4-S5
    On the: Ant Piriformis (PosLat border of Pelvic Wall)
    Emerges: Ant. Sacral Foramina
    5 Major Peripheral Nn: S/I Gluteal, Sciatic, PFC, Pudendal Nerve
    Descends to:
    - Leave pelvis via Greater Sciatic Foramen
    to enter gluteal reg (most)
    - Loop around the sacral spinous ligament and re-enter via lesser sciatic
    foramen to supply lat. pelvic and peroneal structures
    - Remain inside to innervate pelvic mm organs and perineum

    1. Superior Gluteal Nerve (L4-S1) post


    - Mm: G. Med, Min & TFL; pure motor
    - Gait: Trendelenburg/G. Med Lurch- if weak, stand at affected leg

    2. Inferior Gluteal Nerve (L5-S2) post


    - Mm: G. Max; pure motor
    - Gait: Post. Lurching weak h/k extensors
    LOWER LIMB
    BLOOD SUPPLY

    Ascending >
    Brachiocephalic+Common
    Carotid + Subclavian
    In
    Arch of Aorta (T4-T5)
    At Sternal /A of Louis
    >Descending Aorta
    = Diaphragm =
    Lm: T12; Phrenic nn
    Piston Action: Vertical (Inhale:
    out & down)

    Abdominal Aorta
    R/L Common Iliac Artery
    3.B Internal Iliac Artery
    3.A External Iliac Artery
    - main BS of pelvic organs
    - larger; LM: pelvic brim
    - LM: ant. Sacrum
    - Piriformis divides it to
    Sup/Inf Gluteal Artery
    LM: GSF
    4. Femoral Artery
    - LM: Inguinal/Pouparts/Groin Lig
    - MBS of LE; Sf or Deep*, terminates as perforating A
    - LM: Adductor/Subsartorial/Hunters Canal
    Cont: Obt. Nn & Saphenous nn

    *Deep FA or Femoral Profunda


    Med. Circumflex A Lat. Circumflex A
    MBS (adult) Femoral Head Trochanteric
    (child) Obturator A Anastomosis

    5. Popliteal Artery
    - UL: Biceps Fem; LL: Lat. Head of Gastrocs + Plantaris
    - UM: Semimem/ten; LM: Med. Head of Gastrocs
    Ends at Popliteus to become

    6.A Anterior Tibial A. 6.B Posterior Tibial A.


    -direct cont of Dorsalis Pedis > Fibular/Peroneal A.
    -thru IOM 6.B.1 Med. Plantar A: big toe
    -palpation: TA, EHL, EDL 6.B.2 Lat. Plantar A: lat four toes

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