STUDY OF ANATOMICAL PATTERN OF LUMBAR PLEXUS IN HUMAN (CADAVERIC STUDY)

Ahmed Elbana

doi:10.21608/ajps.2018.6633

Abstract

The lumbar plexus is situated within the substance of the posterior part of psoas major muscle. It is formed by the ventral rami of the frist three nerves and greater part of the fourth lumbar nerve with or without a contribution from the ventral ramus of last thoracic nerve. The pattern of formation of lumbar plexus is altered if the plexus is prefixed (if the third lumbar is the lowest nerve which enters the lumbar plexus) or postfixed (if there is contribution from the 5th lumbar nerve). The branches of the lumbar plexus may be injured during lumbar plexus block and certain surgical procedures, particularly in the lower abdominal region (appendectomy, inguinal hernia repair, iliac crest bone graft harvesting and gynecologic procedures through transverse incisions). Thus, a better knowledge of the regional anatomy and its variations is essential for preventing the lesions of the branches of the lumbar plexus.

Highlights

The lumbar plexus formed by the ventral rami of the upper three nerves and most of the fourth lumbar nerve with or without a contribution from the ventral ramous of last thoracic nerve
Branches of the lumbar plexus include, iliohypogastric nerve which arises from the (L1), ilioinguinal nerve (L1), lateral femoral cutaneous nerve (LFCN) which arise from the (L2,3) and femoral nerve which arise from dorsal division of ventral rami of (L2,3,4) appear in that order from above downward, at the lateral border of the psoas major muscle while the genitofemoral nerve (GFN) which arises from (L1,2) appears on the anterior surface and the obturator nerve which arises from ventral division of ventral rami of (L2,3,4) emerges along the medial border of the psoas major muscle
The main six nerves originated from the lumbar plexus were observed; iliohypogastric nerve, ilioinguinal nerve, genitofemoral nerve, lateral femoral cutaneous nerve, obturator nerve and femoral nerve arranged from above downwards

Summary

Introduction

The lumbar plexus formed by the ventral rami of the upper three nerves and most of the fourth lumbar nerve with or without a contribution from the ventral ramous of last thoracic nerve. Branches of the lumbar plexus include, iliohypogastric nerve which arises from the (L1), ilioinguinal nerve (L1), lateral femoral cutaneous nerve (LFCN) which arise from the (L2,3) and femoral nerve which arise from dorsal division of ventral rami of (L2,3,4) appear in that order from above downward, at the lateral border of the psoas major muscle while the genitofemoral nerve (GFN) which arises from (L1,2) appears on the anterior surface and the obturator nerve which arises from ventral division of ventral rami of (L2,3,4) emerges along the medial border of the psoas major muscle. The same is the position of accessory obturator nerve(L3,4) as it is present in about 29% of cases (Anloague et al, 2010)

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