Iliohypogastric nerve

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Iliohypogastric nerve
Lumbar plexus.svg
Plan of lumbar plexus. (Iliohypogastric visible at upper left.)
Gray823.png
The lumbar plexus and its branches. (Iliohypogastric visible at upper left.)
Details
From lumbar plexus
InnervatesSensory: Skin over the lateral gluteal region and above the pubis [1]
Motor: internal oblique and transverse abdominal muscles
Identifiers
Latin nervus iliohypogastricus
TA98 A14.2.07.003
TA2 6496
FMA 16482
Anatomical terms of neuroanatomy

The iliohypogastric nerve is a nerve that originates from the lumbar plexus that supplies sensation to skin over the lateral gluteal and hypogastric regions and motor to the internal oblique muscles and transverse abdominal muscles.

Contents

Structure

Origin

The iliohypogastric nerve originates from the superior branch of the anterior ramus of spinal nerve L1. [2] It also receives fibers from T12 via the subcostal nerve. [2] The branch below it is the ilioinguinal nerve. [2]

Course

It emerges from the upper lateral border of the psoas major. [3] :1148 It then crosses in front of the quadratus lumborum muscle to an area superior to the iliac crest. [4] It runs behind the kidneys. Just superior to the iliac crest, it pierces the posterior part of the transversus abdominis muscle and continues anteriorly in the abdominal wall between the transversus abdominis and internal oblique muscles. [3] :1148

It divides into a lateral cutaneous branch and an anterior cutaneous branch between the transversus abdominis muscle and the internal oblique muscle.

Branches

Lateral cutaneous branch

The lateral cutaneous branch ("iliac branch") pierces the internal oblique muscles and the external oblique muscles immediately above the iliac crest. [4] It is distributed to the skin of the gluteal region, behind the lateral cutaneous branch of the subcostal nerve; the size of this branch bears an inverse proportion to that of the lateral cutaneous branch of the subcostal nerve.

When harvesting bone from the anterior iliac crest (AICBG), the lateral cutaneous branch of the Iliohypogastric nerve (L1) is most likely to be injured.

Anterior cutaneous branch

The anterior cutaneous branch ("hypogastric branch") continues onward between the abdominal internal oblique and transverse muscles.

It then pierces the internal oblique, becomes cutaneous by perforating the aponeurosis of the external oblique about 2.5 cm above the subcutaneous inguinal ring, and is distributed to the skin of the hypogastric region.

Communications

The iliohypogastric nerve communicates with the subcostal nerve and ilioinguinal nerves. [2]

Variation

The iliohypogastric nerve may be absent in up to 20% of people. [5] Its fibres are instead carried on other nerves, such as the ilioinguinal nerve. [5]

Function

The iliohypogastric nerve partially supplies the internal oblique muscles. [4] It also provides sensory innervation to the superior gluteal region and part of the suprapubic region. [4]

Clinical significance

The iliohypogastric nerve may be damaged at the points where it passes through the internal oblique muscle and the external oblique muscles. [6] It is most often damaged by medical error. [4] It may also be damaged by a nerve lesion. [4]

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<span class="mw-page-title-main">Abdominal internal oblique muscle</span> Muscle in the abdominal wall

The abdominal internal oblique muscle, also internal oblique muscle or interior oblique, is an abdominal muscle in the abdominal wall that lies below the external oblique muscle and just above the transverse abdominal muscle.

<span class="mw-page-title-main">Abdominal external oblique muscle</span> Skeletal muscle in the abdomen

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<span class="mw-page-title-main">Intercostal nerves</span>

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<span class="mw-page-title-main">Anterior superior iliac spine</span> Bony projection of the iliac bone

The anterior superior iliac spine (ASIS) is a bony projection of the iliac bone, and an important landmark of surface anatomy. It refers to the anterior extremity of the iliac crest of the pelvis. It provides attachment for the inguinal ligament, and the sartorius muscle. The tensor fasciae latae muscle attaches to the lateral aspect of the superior anterior iliac spine, and also about 5 cm away at the iliac tubercle.

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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.

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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.

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

The subcostal nerve is a mixed motor and sensory nerve contributing to the lumbar plexus. It runs along the lower border of the twelfth rib, often gives a communicating branch to the first lumbar nerve, and passes under the lateral lumbocostal arch.

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The deep circumflex iliac artery is an artery in the pelvis that travels along the iliac crest of the pelvic bone.

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<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:

References

PD-icon.svgThis article incorporates text in the public domain from page 950 of the 20th edition of Gray's Anatomy (1918)

  1. med.mun.ca
  2. 1 2 3 4 Apaydin, Nihal (2015-01-01), Tubbs, R. Shane; Rizk, Elias; Shoja, Mohammadali M.; Loukas, Marios (eds.), "Chapter 47 - Variations of the Lumbar and Sacral Plexuses and Their Branches", Nerves and Nerve Injuries, San Diego: Academic Press, pp. 627–645, ISBN   978-0-12-410390-0 , retrieved 2021-01-29
  3. 1 2 Susan Standring, ed. (2021). Gray's anatomy: the anatomical basis of clinical practice (42nd ed.). New York. ISBN   978-0-7020-7707-4. OCLC   1201341621.{{cite book}}: CS1 maint: location missing publisher (link)
  4. 1 2 3 4 5 6 H. Kim, Daniel; A. Murovic, Judith (2008-01-01), Kim, Daniel H.; Midha, Rajiv; Murovic, Judith A.; Spinner, Robert J. (eds.), "11 - Lower extremity nerve injuries", Kline and Hudson's Nerve Injuries (Second Edition), Edinburgh: W.B. Saunders, pp. 209–278, ISBN   978-0-7216-9537-2 , retrieved 2021-01-29
  5. 1 2 Aasar, YH (1947). "Anatomical Anomalies". Fouad I University Press, Cairo.
  6. Mirjalili, S. Ali (2015-01-01), Tubbs, R. Shane; Rizk, Elias; Shoja, Mohammadali M.; Loukas, Marios (eds.), "Chapter 45 - Anatomy of the Lumbar Plexus", Nerves and Nerve Injuries, San Diego: Academic Press, pp. 609–617, ISBN   978-0-12-410390-0 , retrieved 2021-01-29