Femoral nerve

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Femoral nerve
Gray823.png
The lumbar plexus and its branches. (Femoral labeled at bottom left.)
Gray545.png
Femoral sheath laid open to show its three compartments. (Femoral nerve visible in yellow.)
Details
FromL2
ToL4
Innervates Anterior compartment of thigh
Identifiers
Latin nervus femoralis
MeSH D005267
TA98 A14.2.07.020
TA2 6522
FMA 16486
Anatomical terms of neuroanatomy

The femoral nerve is a nerve in the thigh that supplies skin on the upper thigh and inner leg, and the muscles that extend the knee. It is the largest branch of the lumbar plexus.

Contents

Structure

The femoral nerve is the major nerve supplying the anterior compartment of the thigh. It is the largest branch of the lumbar plexus, and arises from the dorsal divisions of the ventral rami of the second, third, and fourth lumbar nerves (L2, L3, and L4). [1] [2]

The nerve enters Scarpa's triangle by passing beneath the inguinal ligament, just lateral to the femoral artery. In the thigh, the nerve lies in a groove between iliacus muscle and psoas major muscle, outside the femoral sheath, and lateral to the femoral artery. After a short course of about 4 cm in the thigh, the nerve is divided into anterior and posterior divisions, separated by lateral femoral circumflex artery. The branches are shown below: [1]

Muscular branches

Cutaneous branches

Articular branches

Vascular branches

Clinical significance

Signals from the femoral nerve and its branches can be blocked to interrupt the transmission of pain signals from the innervation area. Some of the nerve blocks that work by affecting the femoral nerve are the femoral nerve block, the fascia iliac block and the 3-in-1 nerve block. Femoral nerve blocks are very effective. [3]

During pelvic surgery and abdominal surgery, the femoral nerve must be identified early on to protect it from iatrogenic nerve injury. [4]

The femoral nerve stretch test can be performed to identify the compression of spinal nerve roots. [5] The test is positive if thigh pain increases. [5]

Additional images

See also

Related Research Articles

<span class="mw-page-title-main">Human leg</span> Lower extremity or limb of the human body (foot, lower leg, thigh and hip)

The leg is the entire lower limb of the human body, including the foot, thigh or sometimes even the hip or buttock region. The major bones of the leg are the femur, tibia, and adjacent fibula. The thigh is between the hip and knee, while the calf (rear) and shin (front) are between the knee and foot.

<span class="mw-page-title-main">Femoral triangle</span> Anatomical region of the thigh

The femoral triangle is an anatomical region of the upper third of the thigh. It is a subfascial space which appears as a triangular depression below the inguinal ligament when the thigh is flexed, abducted and laterally rotated.

<span class="mw-page-title-main">Genitofemoral nerve</span>

The genitofemoral nerve is a mixed branch of the lumbar plexus derived from anterior rami of L1-L2. It splits a genital branch and a femoral branch. It provides sensory innervation to the upper anterior thigh, as well as the skin of the anterior scrotum in males and mons pubis in females. It also provides motor innervation to the cremaster muscle.

<span class="mw-page-title-main">Pectineus muscle</span> Adductor of the thigh

The pectineus muscle is a flat, quadrangular muscle, situated at the anterior (front) part of the upper and medial (inner) aspect of the thigh. The pectineus muscle is the most anterior adductor of the hip. The muscle's primary action is hip flexion; it also produces adduction and internal rotation of the hip.

<span class="mw-page-title-main">Adductor longus muscle</span> Skeletal muscle located in the thigh

In the human body, the adductor longus is a skeletal muscle located in the thigh. One of the adductor muscles of the hip, its main function is to adduct the thigh and it is innervated by the obturator nerve. It forms the medial wall of the femoral triangle.

<span class="mw-page-title-main">Iliopsoas</span> Joined psoas and the iliacus muscles

The iliopsoas muscle refers to the joined psoas major and the iliacus muscles. The two muscles are separate in the abdomen, but usually merge in the thigh. They are usually given the common name iliopsoas. The iliopsoas muscle joins to the femur at the lesser trochanter. It acts as the strongest flexor of the hip.

<span class="mw-page-title-main">Internal iliac artery</span> Main artery of the pelvis

The internal iliac artery is the main artery of the pelvis.

<span class="mw-page-title-main">Popliteal fossa</span> Depression at back of knee joint

The popliteal fossa is a shallow depression located at the back of the knee joint. The bones of the popliteal fossa are the femur and the tibia. Like other flexion surfaces of large joints, it is an area where blood vessels and nerves pass relatively superficially, and with an increased number of lymph nodes.

<span class="mw-page-title-main">Posterior cutaneous nerve of thigh</span> Sensory nerve that supplies the back of the thigh, leg, buttock, and perineum

The posterior cutaneous nerve of the thigh is a sensory nerve of the thigh. It is a branch of the sacral plexus. It supplies the skin of the posterior surface of the thigh, leg, buttock, and also the perineum.

<span class="mw-page-title-main">Lumbar plexus</span> Web of nerves in the lower spine

The lumbar plexus is a web of nerves in the lumbar region of the body which forms part of the larger lumbosacral plexus. It is formed by the divisions of the first four lumbar nerves (L1-L4) and from contributions of the subcostal nerve (T12), which is the last thoracic nerve. Additionally, the ventral rami of the fourth lumbar nerve pass communicating branches, the lumbosacral trunk, to the sacral plexus. The nerves of the lumbar plexus pass in front of the hip joint and mainly support the anterior part of the thigh.

<span class="mw-page-title-main">Ilioinguinal nerve</span> Branch of the first lumbar nerve

The ilioinguinal nerve is a branch of the first lumbar nerve (L1). It separates from the first lumbar nerve along with the larger iliohypogastric nerve. It emerges from the lateral border of the psoas major just inferior to the iliohypogastric, and passes obliquely across the quadratus lumborum and iliacus. The ilioinguinal nerve then perforates the transversus abdominis near the anterior part of the iliac crest, and communicates with the iliohypogastric nerve between the transversus and the internal oblique muscle.

<span class="mw-page-title-main">Obturator nerve</span>

The obturator nerve in human anatomy arises from the ventral divisions of the second, third, and fourth lumbar nerves in the lumbar plexus; the branch from the third is the largest, while that from the second is often very small.

<span class="mw-page-title-main">Lateral cutaneous nerve of thigh</span> Nerve of the thigh

The lateral cutaneous nerve of the thigh is a cutaneous nerve of the thigh. It originates from the dorsal divisions of the second and third lumbar nerves from the lumbar plexus. It passes under the inguinal ligament to reach the thigh. It supplies sensation to the skin on the lateral part of the thigh by an anterior branch and a posterior branch.

<span class="mw-page-title-main">Lateral circumflex femoral artery</span>

The lateral circumflex femoral artery is an artery in the upper thigh. It is usually a branch of the profunda femoris artery, and produces three branches. It is mostly distributed to the muscles of the lateral thigh, supplying arterial blood to muscles of the knee extensor group.

<span class="mw-page-title-main">Pubic tubercle</span> Bone

The pubic tubercle is a prominent tubercle on the superior ramus of the pubis bone of the pelvis.

The saphenous nerve is the largest cutaneous branch of the femoral nerve. It is derived from the lumbar plexus (L3-L4). It is a strictly sensory nerve, and has no motor function. It commences in the proximal (upper) thigh and travels along the adductor canal. Upon exiting the adductor canal, the saphenous nerve terminates by splitting into two terminal branches: the sartorial nerve, and the infrapatellar nerve. The saphenous nerve is responsible for providing sensory innervation to the skin of the anteromedial leg.

<span class="mw-page-title-main">Anterior compartment of thigh</span> Muscles which extend the knee and flex the hip

The anterior compartment of thigh contains muscles which extend the knee and flex the hip.

<span class="mw-page-title-main">Anterior cutaneous branches of the femoral nerve</span>

The anterior cutaneous branches of the femoral nerve consist of the following nerves: intermediate cutaneous nerve and medial cutaneous nerve.

<span class="mw-page-title-main">Outline of human anatomy</span> Overview of and topical guide to human anatomy

The following outline is provided as an overview of and topical guide to human anatomy:

Femoral nerve dysfunction, also known as femoral neuropathy, is a rare type of peripheral nervous system disorder that arises from damage to nerves, specifically the femoral nerve. Given the location of the femoral nerve, indications of dysfunction are centered around the lack of mobility and sensation in lower parts of the legs. The causes of such neuropathy can stem from both direct and indirect injuries, pressures and diseases. Physical examinations are usually first carried out, depending on the high severity of the injury. In the cases of patients with hemorrhage, imaging techniques are used before any physical examination. Another diagnostic method, electrodiagnostic studies, are recognized as the gold standard that is used to confirm the injury of the femoral nerve. After diagnosis, different treatment methods are provided to the patients depending upon their symptoms in order to effectively target the underlying causes. Currently, femoral neuropathy is highly underdiagnosed and its precedent medical history is not well documented worldwide.

References

PD-icon.svgThis article incorporates text in the public domain from page 955 of the 20th edition of Gray's Anatomy (1918)

  1. 1 2 3 4 5 6 7 8 9 10 Krishna, Garg (2010). "Front of the thigh (Chapter 3)". BD Chaurasia's Human Anatomy (Regional and Applied Dissection and Clinical) Volume 2 - Lower limb, abdomen, and pelvis (Fifth ed.). India: CBS Publishers and Distributors Pvt Ltd. p. 55. ISBN   978-81-239-1864-8.
  2. Massey, E. Wayne; Massey, Janice M. (2020-01-01), Steegers, Eric A. P.; Cipolla, Marilyn J.; Miller, Eliza C. (eds.), "Chapter 8 - Mononeuropathies in pregnancy", Handbook of Clinical Neurology, Neurology and Pregnancy: Neuro-Obstetric Disorders, 172, Elsevier: 145–151, doi:10.1016/B978-0-444-64240-0.00008-8, ISBN   9780444642400, PMID   32768085 , retrieved 2021-01-17
  3. Candido, Kenneth D.; Benzon, Honorio T. (2005-01-01), Benzon, Honorio T.; Raja, Srinivasa N.; Molloy, Robert E.; Liu, Spencer S. (eds.), "Chapter 76 - Lumbar Plexus, Femoral, Lateral Femoral Cutaneous, Obturator, Saphenous, and Fascia Iliaca Blocks", Essentials of Pain Medicine and Regional Anesthesia (Second Edition), Philadelphia: Churchill Livingstone, pp. 645–658, ISBN   978-0-443-06651-1 , retrieved 2021-01-06
  4. Cheema, Zahid F.; Robbie, Ahmad (2003), "Femoral Nerve", Encyclopedia of the Neurological Sciences, Elsevier, pp. 366–367, doi:10.1016/B0-12-226870-9/00868-6, ISBN   978-0-12-226870-0 , retrieved 2021-01-06
  5. 1 2 Fritz, Julie (2012-01-01), Andrews, James R.; Harrelson, Gary L.; Wilk, Kevin E. (eds.), "17 - Low Back Rehabilitation", Physical Rehabilitation of the Injured Athlete (Fourth Edition), Philadelphia: W.B. Saunders, pp. 333–356, ISBN   978-1-4377-2411-0 , retrieved 2021-01-06