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Lumbosacral plexus & Gluteal region. IN 25 QUESTIONS. Kaan Yücel M.D., Ph.D. 22.February.2012 Wednesday. What do you think you will see about the lumbosacral plexus?. Which muscles? Which functions?. What is glutea? Gluteal region contents?.
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Lumbosacral plexus • & • Gluteal region • IN 25 QUESTIONS • Kaan Yücel M.D., Ph.D. • 22.February.2012 Wednesday
What do you think you will see about the lumbosacral plexus? Which muscles? Which functions? What is glutea? Gluteal region contents? Gun’sRoses- Godfathertheme- Live in Copenhagen-1991
LUMBOSACRAL PLEXUS IN 17 QUESTIONS
1. What is lumbosacral plexus? Sensory and motor innervation of the whole lower limb arisesfrom the spinal rootsL1-S3 Lumbal plexus Sacral plexus .
2. How is the lumbar plexus formed? Anteriorrami of upper4 lumbar spinal nerves(+L5) and from the contribution of subcostal nerve (T12) . in thelumbarregion, withinthepsoasmajormuscle.
3. Nerves of the lumbar plexus? . 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.
4. ...femoral nerve? (L2-L4) largest branch both motor and sensory. Emergesfromthelateralborder of thepsoasmajor Flexorsof thehipandextensors of theknee Skin of the anterior and lateral thigh, medial leg and foot .
5. ...saphenousnerve? largestcutaneous branch of the femoralnerve continuationof the femoral nerve Skin of medial aspects of leg andfoot .
6. ...obturator nerve? Emergesfrom the medial border of the psoasmajor Leavesthelesserpelvisthrough theobturatorcanal Skin on thesuperiormedialthigh Adductormuscles of the leg .
7. ...lumbosacral trunk? Descendingpart of the L4 nerve unites with the anterior ramus of the L5 nerve to form the lumbosacraltrunk. Participates in the formation of the sacral plexus with the anterior rami of S1-S4 nerves. .
8. ...ilioinguinal & iliohypogastric nerves? Enterthe abdomen and run obliquely across the quadratus lumborum muscle behind the kidney. Abdominalmuscles Skin of the inguinal and pubic regions. .
9. ...genitofemoral nerve?uinal & iliohypogastric nerves Piercesthe psoas major and emerges on its anteriorsurface. Skin of the middle anterior thigh; male scrotum and cremaster muscle; female labia majora.
10. ...lateralcutaneous nerve of the thigh? Runsinferolaterally on the iliacus and enters the thigh deep to the inguinal ligament/iliopubictract Skin on the anterolateral surface of thethigh .
11....lumbarplexus & thesympatheticsystem? Thelumbarplexus is alsoconnectedwiththelumbarpart of thesympatheticnervoussystemviatwoorthreelongcommunicatingbranches.
12. How is the sacral plexus formed? anteriorrami of S1 to S4, and the lumbosacral trunk (L4 and L5). formedin relation to the anterior surface of the piriformismuscle located on the posterolateral wall of the lesser pelvis. .
13... sciatic nerve? • Largestnerve in the body. • Themostlateralstructureemergingthroughthegreatersciaticforameninferiortothepiriformisandenterstheglutealregion • Posterioraspect of thethighandtheentirelegandfoot .
13... sciatic nerve? • Leavestheglutealregionbypassingdeeptothelonghead of thebicepsfemoris,atthelowermargin of thequadratusfemorismuscle • Dividesintothecommonperonealandtibialnerves, at a variable site abovethepoplitealfossa .
14... pudendal nerve ? • Main nerve of theperineumandthechiefsensorynerve of theexternalgenitalia • Enterstheglutealregionthroughthegreatersciaticforameninferiortothepiriformismuscle& medialtothesciaticnerve. • Passesthroughthelessersciaticforamentoentertheperineum. • nobranches in theglutealregion. .
15....superior & inferior gluteal nerves? Superiorglutealnerve leavesthepelviccavitythroughtheupperpart of thegreatersciaticforamensuperiortopiriformismuscle gluteusmedius, gluteusminimus, andtensorfasciaelata InferiorGlutealNerve gluteusmaximus post. thigh,leg,foot skin of thefootandlateralleg .
16....others? NervetoQuadratusFemoris NervetoObturatorInternus PosteriorCutaneousNerve of Thigh Perforatingcutaneousnerve .
17....cocygealplexus? • A minorcontributionfrom S4 and is formedmainlybytheanterior rami of S5 andCo, whichoriginateinferiorlytothepelvicfloor. • Skin in the anal triangle of theperineum .
GLUTEAL REGION IN 8 QUESTIONS
1. What is gluteal region? (G. gloutos, buttocks) transitionalregionbetweentrunk & lowerlimbs .
2. How are the muscles of the gluteal region organized? Deep Superficial .
4...superficial muscles in the gluteal region? Externalsurface of iliumbetweenanteriorandposteriorgluteallines . Iliumposteriortoposteriorglutealline; dorsalsurface of sacrumandcoccyx; sacrotuberousligament Externalsurface of iliumbetweenanteriorandinferiorgluteallines Lateralsurface of greatertrochanter of femur Anteriorsurface of greatertrochanter of femur Iliotibialtract & glutealtuberosity of femur
5...functions of the gluteal region muscles? Muscles in theglutealregionmainly abduct, extend, andlaterallyrotatethefemurrelativetothepelvic bone. .
6....innervation of the gluteal region muscles? Superiorglutealnerve Gluteusminimus& medius Tensorfascialatae Inferiorglutealnerve Gluteusmaximus . Nervetothequadratusfemoris Quadratusfemoris Gemellusinferior Nervetotheobturatorinternus Obturatorinternus Gemellussuperior Nervetothepiriformis Piriformis
8...lymphatics in the gluteal region? Lymphfromdeeptissue superior & inferiorgluteallymphnodes internal,external,commoniliaclymphnodes laterallumbar (aortic/caval) lymphnodes . Lymphfromsuperficialtissue superficialinguinallymphnodes externaliliaclymphnodes
