1
2
3
Sensory and motor innervation of the whole
.lower limb
arises from the spinal roots L1-S4
Lumbal plexus
Sacral plexus
4
Anterior rami of
.upper 4 lumbar
spinal nerves (+L5)
and from the
contribution of
subcostal nerve
(T12)
in the lumbar
region, within
the psoas major
muscle.
5
.L1
gives rise to the iliohypogastric and ilioinguinal nerves
L1 + L2 gives rise to the genitofemoral nerve
L2 + L3 gives rise to the lateral femoral cutaneous
L2 + L3 + L4 give rise to the femoral and obturator nerves
L4 + L5 give rise to the lumbosacral trunk which joins sacral
nerves to form the sacral plexus.
6
(L2-L4)
largest
branch
.
both motor and sensory.
Emerges from the lateral
border of the psoas major
Flexors of the hip and
extensors of the knee
Skin of the anterior and
lateral thigh, medial leg
and foot
7
largest cutaneous
branch
of the femoral
.
nerve
continuation of the
femoral nerve
Skin of medial aspects
of leg and foot
8
Emerges from the medial
border
of the psoas
.
major
Leaves the lesser
pelvis through
the obturator canal
Skin on the superior
medial thigh
Adductor muscles of the
leg
9
Descending part of
the
L4 nerve unites
.
with the anterior
ramus of the L5
nerve to form the
lumbosacral trunk.
Participates in the
formation of the
sacral plexus with
the anterior rami
of S1-S4 nerves.
10
Enter the abdomen and
run
obliquely across
.
the quadratus
lumborum muscle
behind the kidney.
Abdominal muscles
Skin of the inguinal
and pubic regions.
11
uinal & iliohypogastric nerves
Pierces the psoas major
and emerges on its
anterior surface.
Skin of the middle
anterior thigh; male
scrotum and cremaster
muscle; female labia
majora.
12
Runs
.
inferolaterally on
the iliacus and
enters the thigh
deep to the
inguinal
ligament/iliopubic
tract
Skin on the
anterolateral
surface of the
thigh
13
The lumbar
plexus is also
connected with
the lumbar part
of the
sympathetic
nervous system
via two or
three long
communicating
branches.
14
anterior rami of S1
to
S4, and the
.
lumbosacral trunk
(L4 and L5).
formed in relation to
the anterior surface
of the piriformis
muscle
located on the
posterolateral wall
of the lesser pelvis.
15
o Largest nerve in
the body.
.
o The most lateral
structure
emerging through
the greater
sciatic foramen
inferior to the
piriformis and
enters the
gluteal region
o Posterior aspect
of the thigh and
the entire leg
and foot
16
o Leaves the
. gluteal region by
passing deep to
the long head of
the biceps
femoris,at the
lower margin of
the quadratus
femoris muscle
o Divides into the
common peroneal
and tibial
nerves, at a
variable site
above the
popliteal fossa
17
o Main nerve of the
perineum
and the chief
.
sensory nerve of the
external genitalia
o Enters the gluteal
region through the greater
sciatic foramen inferior to
the piriformis muscle & medial
to the sciatic nerve.
o Passes through the
lesser sciatic foramen to
enter the perineum.
ono branches in the
gluteal region.
18
Superior gluteal nerve
leaves
the pelvic
.
cavity through the
upper part of the
greater sciatic foramen
superior to piriformis
muscle
gluteus medius, gluteus
minimus, and tensor
fasciae lata
Inferior Gluteal Nerve
gluteus maximus
post. thigh,leg,foot
skin of the foot and
lateral leg
19
Nerve to Quadratus
Femoris
.
Nerve to Obturator
Internus
Posterior
Cutaneous Nerve of
Thigh
Perforating
cutaneous nerve
20
o A minor
. contribution
from S4 and is
formed mainly
by the anterior
rami of S5 and
Co, which
originate
inferiorly to
the pelvic
floor.
o Skin in the
anal triangle
of the perineum
21
22
(G. gloutos, buttocks)
transitional
region between trunk & lower limbs
.
23
Deep
Superficial
.
24
.
25
.
External surface of ilium between
anterior and posterior gluteal lines
External
Ilium
posterior
surfacetoofposterior
gluteal
ilium
between
line; dorsal surface of
sacrum
anterior
and
coccyx;
inferior
Lateraland
surface
of
Anterior surface of
sacrotuberous
gluteal
lines
ligament
greater
trochanter
of
greater trochanter
femur
of femur
Iliotibial tract & gluteal
tuberosity of femur
26
Muscles in the gluteal region mainly
abduct,
extend, and laterally rotate the femur
.
relative to the pelvic bone.
27
Superior gluteal nerve
Inferior gluteal nerve
Gluteus
minimus & medius
.
Tensor fascia latae
Gluteus maximus
Nerve to the quadratus femoris
Quadratus femoris
Gemellus inferior
Nerve to the obturator internus
Obturator internus
Gemellus superior
Nerve to the piriformis
Piriformis
28
.
29
Lymph from deep tissue
superior
& inferior gluteal lymph nodes
.
internal,external,common iliac lymph nodes
lateral lumbar (aortic/caval) lymph nodes
Lymph from superficial tissue
superficial inguinal lymph nodes
external iliac lymph nodes
30