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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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Kaan y cel m d ph d 2612950

  • Lumbosacral plexus

  • &

  • Gluteal region

  • IN 25 QUESTIONS

  • Kaan Yücel M.D., Ph.D.

  • 22.February.2012 Wednesday


Kaan y cel m d ph d 2612950

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


Kaan y cel m d ph d 2612950

LUMBOSACRAL

PLEXUS

IN

17 QUESTIONS


Kaan y cel m d ph d 2612950

1. What is lumbosacral plexus?

Sensory and motor innervation of the whole lower limb

arisesfrom the spinal rootsL1-S4

Lumbal plexus

Sacral plexus

.


Kaan y cel m d ph d 2612950

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.


Kaan y cel m d ph d 2612950

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.


Kaan y cel m d ph d 2612950

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

.


Kaan y cel m d ph d 2612950

5. ...saphenousnerve?

largestcutaneous branch of the femoralnerve

continuationof the femoral nerve

Skin of medial aspects of leg andfoot

.


Kaan y cel m d ph d 2612950

6. ...obturator nerve?

Emergesfrom the medial border of the psoasmajor

Leavesthelesserpelvisthrough

theobturatorcanal

Skin on thesuperiormedialthigh

Adductormuscles of the

leg

.


Kaan y cel m d ph d 2612950

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.

.


Kaan y cel m d ph d 2612950

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.

.


Kaan y cel m d ph d 2612950

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.


Kaan y cel m d ph d 2612950

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

.


Kaan y cel m d ph d 2612950

11....lumbarplexus & thesympatheticsystem?

Thelumbarplexus is alsoconnectedwiththelumbarpart of thesympatheticnervoussystemviatwoorthreelongcommunicatingbranches.


Kaan y cel m d ph d 2612950

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.

.


Kaan y cel m d ph d 2612950

13... sciatic nerve?

  • Largestnerve in the body.

  • Themostlateralstructureemergingthroughthegreatersciaticforameninferiortothepiriformisandenterstheglutealregion

  • Posterioraspect of thethighandtheentirelegandfoot

.


Kaan y cel m d ph d 2612950

13... sciatic nerve?

  • Leavestheglutealregionbypassingdeeptothelonghead of thebicepsfemoris,atthelowermargin of thequadratusfemorismuscle

  • Dividesintothecommonperonealandtibialnerves, at a variable site abovethepoplitealfossa

.


Kaan y cel m d ph d 2612950

14... pudendal nerve ?

  • Main nerve of theperineumandthechiefsensorynerve of theexternalgenitalia

  • Enterstheglutealregionthroughthegreatersciaticforameninferiortothepiriformismuscle& medialtothesciaticnerve.

  • Passesthroughthelessersciaticforamentoentertheperineum.

  • nobranches in theglutealregion.

.


Kaan y cel m d ph d 2612950

15....superior & inferior gluteal nerves?

Superiorglutealnerve

leavesthepelviccavitythroughtheupperpart of thegreatersciaticforamensuperiortopiriformismuscle

gluteusmedius, gluteusminimus, andtensorfasciaelata

InferiorGlutealNerve

gluteusmaximus

post. thigh,leg,foot

skin of thefootandlateralleg

.


Kaan y cel m d ph d 2612950

16....others?

NervetoQuadratusFemoris

NervetoObturatorInternus

PosteriorCutaneousNerve of Thigh

Perforatingcutaneousnerve

.


Kaan y cel m d ph d 2612950

17....cocygealplexus?

  • A minorcontributionfrom S4 and is formedmainlybytheanterior rami of S5 andCo, whichoriginateinferiorlytothepelvicfloor.

  • Skin in the anal triangle of theperineum

.


Kaan y cel m d ph d 2612950

GLUTEAL REGION

IN

8 QUESTIONS


Kaan y cel m d ph d 2612950

1. What is gluteal region?

(G. gloutos, buttocks)

transitionalregionbetweentrunk & lowerlimbs

.


Kaan y cel m d ph d 2612950

2. How are the muscles of the gluteal region organized?

Deep

Superficial

.


Kaan y cel m d ph d 2612950

3...deep muscles of the gluteal region?

.


Kaan y cel m d ph d 2612950

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


Kaan y cel m d ph d 2612950

5...functions of the gluteal region muscles?

Muscles in theglutealregionmainly

abduct, extend, andlaterallyrotatethefemurrelativetothepelvic bone.

.


Kaan y cel m d ph d 2612950

6....innervation of the gluteal region muscles?

Superiorglutealnerve

Gluteusminimus& medius

Tensorfascialatae

Inferiorglutealnerve

Gluteusmaximus

.

Nervetothequadratusfemoris

Quadratusfemoris

Gemellusinferior

Nervetotheobturatorinternus

Obturatorinternus

Gemellussuperior

Nervetothepiriformis

Piriformis


Kaan y cel m d ph d 2612950

7...arteries in the gluteal region?

.


Kaan y cel m d ph d 2612950

8...lymphatics in the gluteal region?

Lymphfromdeeptissue

superior & inferiorgluteallymphnodes

internal,external,commoniliaclymphnodes

laterallumbar (aortic/caval) lymphnodes

.

Lymphfromsuperficialtissue

superficialinguinallymphnodes

externaliliaclymphnodes


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