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Lumbosacral plexus
- 2. Lumbar Plexus • Anterior rami of spinal nerve L1 to L4 ( with T12 ) • Six major nerves Iliohypogastric nerve Ilioinguinal nerve Genitofemoral nerve Lateral Cutaneous nerve of thigh Obturator nerve Femoral nerve
- 5. Sacral Plexus • Posterior pelvic wall in front of piriformis muscle • Anterior/ventral rami of S1 to S4 and lumbosacral trunk (L5 joined by L4) • Anteriorly, parietal pelvic fascia separating internal iliac vessels and rectum • Posteriorly, piriformis muscle
- 6. • Branches (major) Superior gluteal Inferior gluteal Sciatic nerve Posterior femoral cutaneous nerve Pudendal nerve Pelvic splanchnic nerve
- 9. Autonomic component Parasympathetic: • Vagus nerve provide preganglionic fibers till splenic flexure • Pelvic splanchnic nerve (S2-S4) Sympathetic: preganglionic fiber sympathetic trunk splanchnic nerves Synapse with ganglions
- 11. • Superior hypogastric plexus & Inferior hypogastric plexus
Editor's Notes
- Genitofemoral nerve: emerge from the psoas Obturator : medial to psoas and Rest of the nerve lateral to Psoas Iliohypogastric and Ilioinguinal: Lateral and anterior abdominal wall, Ilioinguinal enter inguinal canal as well Lateral cut. Nerve of thigh: crosses iliac fossa infront of iliacus muscle behind the lateral end of inguinal ligament, skin on lateral surface of thigh Femoral nerve: largest branch of lumbar plexus, between psoas and iliacus muscle, lateral to femoral vessels Obturator : crosses the pelvic brim infront of sacroiliac joint behind common iliac vessels. Pass through obturator foramen into thigh
- Superior gluteal: gReater sciatic foramen and supply medius, minimus and tensor fascia lata Inferior gluteal: greater sciatic foramen and supply maximus Sciatic : greater sciatic foramen Posterior femoral cutaneous nerve: greater sciatic foramen Pudendal : greater sciatic foramen and enter perineum via smaller sciatic foramen
- Superior hypogastric plexus: infront of promontory of sacrum, continuation of aortic plexus added by sacral splanchnic. Divide into right and left hypogastric nerve Inf. Hypogastric plexus lie on each side of the rectum, base of bladder and vagina; formed by hypogastric nerve, pelvic splanchnic nerve.