The document describes the lower limb nerves, including the femoral nerve, sciatic nerve, tibial nerve, common fibular nerve, and their branches. It provides details on the origin, course, branches and function of each nerve. The femoral nerve originates from lumbar plexus and supplies the anterior thigh. The sciatic nerve forms from sacral plexus and divides into the tibial and common fibular nerves in the popliteal fossa. The tibial nerve innervates muscles and skin of the posterior leg and foot.

1. Lower limb nerves

2. FEMORAL NERVE
LARGEST BRANCH OF THE LUMBAR PLEXUS.
IT IS DERIVED FROM THE ANTERIOR RAMI OF NERVE ROOTS L2, L3 AND L4.
AFTER ARISING FROM THE LUMBAR PLEXUS, THE FEMORAL NERVE TRAVELS INFERIORLY
THROUGH THE PSOAS MAJOR MUSCLE OF THE POSTERIOR ABDOMINAL WALL.
IT SUPPLIES BRANCHES TO THE ILIACUS AND PECTINEUS MUSCLES PRIOR TO ENTERING THE
THIGH.
THE FEMORAL NERVE THEN PASSES UNDERNEATH THE INGUINAL LIGAMENT TO ENTER THE
FEMORAL TRIANGLE.
WITHIN THIS TRIANGLE, THE NERVE IS LOCATED LATERAL TO THE FEMORAL VESSELS
APPROXIMATELY 4CM BELOW THE INGUINAL LIGAMENT, THE FEMORAL NERVE DIVIDES
INTO ANTERIOR AND POSTERIOR DIVISIONS:

4. ANTERIOR DIVISION OF THE FEMORAL NERVE
-ANTERIOR CUTANEOUS BRANCHES
-BRANCH TO SARTORIUS
-BRANCH TO PECTINEUS
POSTERIOR DIVISION OF THE FEMORAL NERVE
-SAPHENOUS NERVE
-BRANCHES TO QUADRICEPS FEMORIS
-THE TERMINAL CUTANEOUS BRANCH OF THE FEMORAL NERVE IS THE SAPHENOUS NERVE.
IT TRAVELS THROUGH THE ADDUCTOR CANAL (ACCOMPANIED BY THE FEMORAL ARTERY AND VEIN) AND
EXITS PRIOR TO THE ADDUCTOR HIATUS.
IT EMERGES ON THE MEDIAL SIDE OF THE KNEE TO SUPPLY SENSATION TO THE SKIN OVER THE REGION OF
THE GSV

5. SAPHENOUS NERVE (L3, L4)
IT ARISES IN THE PROXIMAL ASPECT OF THE ANTERIOR THIGH FROM THE POSTERIOR
DIVISION OF THE FEMORAL NERVE.
IT THEN DESCENDS THROUGH THE FEMORAL TRIANGLE, RUNNING LATERALLY TO THE
FEMORAL ARTERY.
THE SAPHENOUS NERVE THEN ENTERS THE ADDUCTOR CANAL, ALSO CALLED
HUNTER’S CANAL, WHERE IT CROSSES THE FEMORAL ARTERY ANTERIORLY TO LIE
MEDIAL TO IT.
UPON EXITING THE ADDUCTOR CANAL, THE NERVE THEN DESCENDS BEHIND THE
SARTORIUS MUSCLE AND PIERCES THE FASCIALATA BETWEEN THE TENDONS OF THE
SARTORIUS AND GRACILIS MUSCLES AND BECOMES SUBCUTANEOUS, TO SUPPLY THE
SKIN OVER THE ANTERIOR SURFACE OF THE PATELLA.

6. THE SAPHENOUS NERVE CONTINUES TO DESCEND DOWN THE
MEDIAL (TIBIAL) ASPECT OF THE LEG, RUNNING ALONGSIDE THE
GREATER SAPHENOUS VEIN.
THE NERVE COMMUNICATES WITH THE MEDIAL BRANCH OF THE
SUPERFICIAL BRANCH OF THE COMMON FIBULAR NERVE.
BOTH OF THESE NERVES THEN SUPPLY SENSATION TO THE
ANTERIOR SURFACE OF THE LEG.

8. SCIATIC NERVE
A TERMINAL BRANCH OF THE SACRAL PLEXUS
IT IS FORMED FROM BOTH ANTERIOR AND
POSTERIOR DIVISIONS OF THE ANTERIOR
(VENTRAL) RAMI OF SPINAL NERVES L4 THROUGH
S3
THE SCIATIC NERVE THEN DESCENDS
POSTERIORLY AND LEAVES THE PELVIS THROUGH
THE GREATER SCIATIC FORAMEN.
THE SCIATIC NERVE CONTINUES ITS COURSE
THROUGH THE POSTERIOR THIGH & RUNS
BETWEEN THE LONG HEAD OF THE BICEPS
FEMORIS MUSCLE AND THE ADDUCTOR MAGNUS
MUSCLE AND LATERALLY TO THE SEMITENDINOUS
AND SEMIMEMBRANEOUS MUSCLES.

9. AT THE APEX OF THE POPLITEAL FOSSA, THE SCIATIC NERVE TERMINATES BY DIVIDING
INTO TWO TERMINAL BRANCHES:
• THE TIBIAL NERVE
• THE COMMON FIBULAR (PERONEAL) NERVE
THE TIBIAL NERVE CONTINUES THE COURSE OF THE SCIATIC NERVE AND DESCENDS
DOWN THROUGH THE POSTERIOR ASPECT OF THE LEG AS FAR AS THE HEEL OF THE
FOOT.
THE TIBIAL NERVE PASSES THROUGH THE CENTER OF THE POPLITEAL FOSSA AND
RUNS BELOW THE TENDINOUS ARCH OF THE SOLEUS MUSCLE.
IT CONTINUES ITS COURSE IN A NEUROVASCULAR BUNDLE THROUGH THE POSTERIOR
LEG COMPARTMENT AND PASSES THROUGH THE TARSAL TUNNEL.
WHEN IT REACHES THE FOOT, THE TIBIAL NERVE DIVIDES INTO TWO TERMINAL
BRANCHES: MEDIAL AND LATERAL PLANTAR NERVES THAT INNERVATE THE MAJORITY
OF THE FOOT MUSCLES.

10. • TIBIAL NERVE
The tibial nerve is the larger terminal
branch of the sciatic nerve
Root values of L4, L5, S1, S2, and S3.
It lies superficial (or posterior) to the
popliteal vessels, extending from the
superior angle to the inferior angle of the
popliteal fossa, crossing the popliteal
vessels from lateral to medial side.

11. AT THE INFERIOR ANGLE OF THE POPLITEAL FOSSA, TIBIAL NERVE
PASSES DEEP TO THE TENDINOUS ARCH OF SOLEUS TO ENTER THE
BACK OF THE LEG.
IN THE LEG, IT RUNS DOWNWARDS AND MEDIALLY TO REACH THE
POSTEROMEDIAL SIDE OF THE ANKLE, MIDWAY BETWEEN THE
MEDIAL MALLEOLUS AND MEDIAL TUBERCLE OF THE CALCANEUM.
IT TERMINATES DEEP TO THE FLEXOR RETINACULUM AT THE ORIGIN
OF THE ABDUCTOR HALLUCIS BY DIVIDING INTO MEDIAL AND
LATERAL PLANTAR NERVES TO SUPPLY THE FOOT.

12. The tibial nerve gives off several branches to supply the back of the leg:[1]
• Muscular branches - Supplies tibialis posterior, flexor digitorum longus,
flexor hallucis longus, and deep part of soleus.
• Cutaneus branches - The medial calcaneal nerve pierces the flexor
retinaculum to supply the skin of the back and lower surface of the heel
• Articular branches - Supplies the ankle joint[1]

13. IN THE FOOT, THE NERVE TERMINATES BY DIVIDING INTO MEDIAL AND LATERAL PLANTAR
BRANCHES.
MEDIAL PLANTAR NERVE
LARGEST TERMINAL BRANCH OF THE TIBIAL NERVE.
PASSES BETWEEN THE ABDUCTOR HALLUCIS AND FLEXOR DIGITORUM BREVIS TO DIVIDE FURTHER
INTO BRANCHES.
ITS DISTRIBUTION RESEMBLES TO THAT OF THE DISTRIBUTION OF MEDIAN NERVE IN THE HAND. ITS
MUSCULAR BRANCHES SUPPLY THE ABDUCTOR HALLUCIS, THE FLEXOR DIGITORUM BREVIS, THE
FLEXOR HALLUCIS BREVIS AND THE FIRST LUMBRICAL.
CUTANEOUS DISTRIBUTION OF THE MEDIAL PLANTAR NERVE SUPPLIES THE MEDIAL SOLE AND
MEDIAL THREE AND ONE HALF TOES THROUGH FOUR DIGITAL BRANCHES.
EACH DIGITAL BRANCH GIVE OFF A DORSAL BRANCH TO SUPPLY THE NAIL BEDS ON THE DORSUM.
THIS NERVE ALSO GIVES OFF ARTICULAR BRANCHES TO SUPPLY THE BONES OF THE TARSUS AND
METATARSUS

14. LATERAL PLANTAR NERVE -
SMALLEST TERMINAL BRANCH OF THE TIBIAL NERVE.
IT COURSES LATERALLY AND FORWARD UNTIL THE BASE OF FIFTH METATARSAL BONE, WHERE IT
DIVIDES INTO SUPERFICIAL AND DEEP BRANCHES.
ITS DISTRIBUTION RESEMBLES TO THE DISTRIBUTION OF ULNAR NERVE IN THE HAND.
THE MAIN TRUNK OF THE NERVE SUPPLIES TWO MUSCLES: FLEXOR DIGITORUM ACCESSORIUS
AND ABDUCTOR DIGITI MINIMI.
NERVE ALSO SUPPLIES THE SKIN OF THE SOLE.
THE SUPERFICIAL BRANCH IS DIVIDED INTO MEDIAL AND LATERAL BRANCHES.
LATERAL BRANCH SUPPLIES THREE MUSCLES: FLEXOR DIGITI MINIMI, 3RD AND 4TH INTEROSSEI,
AND THE SKIN OVER THE LATERAL SIDE OF THE TOE.
MEDIAL BRANCH COMMUNICATES WITH THE MEDIAL PLANTAR NERVE AND SUPPLIES THE SKIN
OVER THE FOURTH INTERDIGITAL CLEFT. THE DEEP BRANCH SUPPLIES THE 2ND, 3RD, AND 4TH
LUMBRICALS, FIRST AND SECOND PLANTAR INTEROSSEI AND ADDUCTOR HALLUCIS

15. MEDIAL CALCANEAL NERVE
ORIGINATED FROM THE TIBIAL
NERVE BEFORE BIFURCATION
INTO MEDIAL AND LATERAL
PLANTAR NERVES
SENSORY BRANCH OF THE TIBIAL
NERVE THAT PROVIDES
INNERVATION TO MOST OF THE
HEEL PAD AND TO THE
SUPERFICIAL TISSUES
OVERLYING THE MEDIAL ASPECT
OF THE CALCANEUS

17. COMMON FIBULAR NERVE - ROOT
VALUES OF L4, L5, S1, AND S2.

18. THE COMMON FIBULAR (PERONEAL) NERVE COURSES
LATERALLY TOWARDS THE HEAD OF THE FIBULA.
WHEN IT REACHES THE ANTERIOR COMPARTMENT OF THE
LEG,
THE NERVE DIVIDES UNDERNEATH THE FIBULARIS LONGUS
MUSCLE INTO THE SUPERFICIAL FIBULAR (PERONEAL)
NERVE AND DEEP FIBULAR (PERONEAL) NERVE.
THE SUPERFICIAL BRANCH SUPPLIES THE LATERAL
COMPARTMENT OF THE LEG,
THE DEEP BRANCH SUPPLIES THE ANTERIOR
COMPARTMENT OF THE LEG AND MEDIAL ASPECT OF THE
FOOT.
THE DEEP FIBULAR (PERONEAL) NERVE DESCENDS
BETWEEN THE FIBULA AND THE SUPERIOR PART OF
FIBULARIS (PERONEUS) LONGUS, RUNS DEEP TO
EXTENSOR DIGITORUM LONGUS AND ANTERIOR TO THE
INTEROSSEOUS MEMBRANE.

19. BEFORE ITS DIVISION, THE COMMON FIBULAR NERVE GIVES OFF
SEVERAL BRANCHES IN THE POPLITEAL FOSSA
CUTANEOUS BRANCHES
• LATERAL SURAL CUTANEOUS NERVE (LATERAL CUTANEOUS
NERVE OF CALF) - SUPPLIES THE SKIN OF THE UPPER TWO-
THIRDS OF THE LATERAL SIDE OF LEG.
• SURAL COMMUNICATING NERVE - IT RUNS ON THE
POSTEROLATERAL ASPECT OF THE CALF AND JOINS THE
SURAL NERVE.

20. sural nerve (L4-S1)
cutaneous sensory nerve of the posterolateral calf
with cutaneous innervation to the distal one-third of
the lower leg.
Formation of the sural nerve is the result of either
anastomosis of the medial sural cutaneous nerve
and the sural communicating nerve, or it may be
found as a continuation of the lateral sural
cutaneous nerve traveling parallel to the medial
sural cutaneous nerve.
The sural nerve specifically innervates cutaneous
sensorium over the posterolateral leg and lower
lateral ankle via lateral calcaneal branches.

21. SURAL NERVE TRAVELS SUPERFICIALLY IN
THE POSTERIOR LEG OVER THE DISTAL
PART OF THE GASTROCNEMIUS OVER THE
BEGINNING OF THE ACHILLES TENDON
AND THEN TRAVELS PARALLEL TO THE
ACHILLES WITH THE SMALL SAPHENOUS
VEIN TO SEND OF LATERAL CALCANEAL
BRANCHES
WHILE THE REMAINING NERVE PASSES
UNDER THE LATERAL MALLEOLUS AND
FINALLY FINDING ITS TERMINAL NAME AS
THE SURAL NERVE BECOMES THE
LATERAL DORSAL CUTANEOUS NERVE.

23. MOTOR INNERVATION
• THE SCIATIC NERVE -MOTOR SUPPLY - BICEPS FEMORIS,
SEMIMEMBRANOSUS, SEMITENDINOSUS, AND THE ISCHIAL PORTION OF THE
ADDUCTOR MAGNUS
• THE TIBIAL NERVE PROVIDES MOTOR SUPPLY FOR THE MUSCLES IN THE
POSTERIOR PORTION OF THE LEG AND FOOT. THESE MUSCLES INCLUDE THE
GASTROCNEMIUS, SOLEUS, PLANTARIS, POPLITEUS, FLEXOR HALLUCIS
LONGUS, FLEXOR DIGITORUM LONGUS, AND TIBIALIS POSTERIOR.
• THE COMMON PERONEAL NERVE SUPPLIES THE MUSCLES OF THE ANTERIOR
AND LATERAL SECTIONS OF THE LEG AND FOOT. THE MUSCLES OF THE
ANTERIOR ASPECT INCLUDE: TIBIALIS ANTERIOR, EXTENSOR HALLUCIS
LONGUS, EXTENSOR DIGITORUM LONGUS, AND PERONEUS TERTIUS. THE
LATERAL LEG MUSCLES INCLUDE PERONEUS LONGUS AND PERONEUS
BREVIS.

24. THE SCIATIC NERVE GIVES OFF SENSORY BRANCHES THAT PROVIDE
SENSORY SUPPLY THROUGH ITS TERMINAL BRANCHES;
• THE TIBIAL NERVE INNERVATES THE SOLE OF THE FOOT.
• THE BRANCHES OF THE COMMON PERONEAL NERVE
INNERVATE THE LATERAL ASPECT OF THE LEG AND DORSUM
OF THE FOOT, AS WELL AS THE SKIN BETWEEN THE FIRST TWO
TOES.
• THE TIBIAL NERVE AND COMMON PERONEAL NERVE MAKE UP
THE MEDIAL AND LATERAL SURAL NERVES. THESE NERVES
PROVIDE SENSATION TO THE CALF AND A SMALL LATERAL
PORTION OF THE FOOT.