Anatomy of the lumbo sacral plexus

Stoyan Pavlov, MD Department of anatomy, histology and embryology, University of Medicine Prof. Dr. Paraskev Stoyanov, Varna

Lumbar plexus L1, L2, L3 and part of L4 (50% of subjects contribution from T12. Sacral plexus contribution of L4, L5, S1-S3, and part of S4 Coccygeal plexus the rest of S4,S5 and Co1

Nn. iliohypogastricus and ilioinguinalis (L1)

N. genitofemoralis (L1,2) N. obturatorius (L2-4)

N. cutaneus femoris lateralis (L2,3)

N. femoralis (L2-4)

N. iliohypogastricus (L1)

N. ilioinguinalis (L1)

N. genitofemoralis (L1,2)

N. cutaneus femoris lateralis (L2,3)

N. femoralis (L2-4) N. obturatorius (L2-4)

N. saphenus

Truncus lumbosacralis S1 S2 S3

Plexus sacralis
Collateral branches: -N. quadratus femoris (L4-S1) -N. piriformis (S2) -N. gluteus superior (L4-S1) -N. gluteus inferior (L5-S2) -N. cutaneus femoris posterior (S1-3)

Terminal branches: -N. pudendus (S2-4) -N. ischiadicus (L4-S3) -N. peroneus communis -N. tibialis

N. plantaris medialis

N. plantaris lateralis

N. cutaneus surae lateralis N. peroneus profundus N. cutaneus surae medialis

N. peroneus superficialis

N. suralis

Variations in the course and bifurcation of the sciatic nerve

Normal High origin of n. peroneus communis

Segmental cutaneous innervation of the lower limb ( There is considerable overlap of the cutaneous segments) Front of the Thigh L1, L2, L3

Antero-Medial of the Leg

Aspect L4

Antero-Lateral Aspect L5 of the Leg and Medial Side of the Foot Lateral Side of the Foot S1 and the Sole Posterior Surface of the S1,S2 Leg and Thigh Buttock and Perianal S3, 4 Region

Segmental innervation of the muscles of the lower limb (by affected joints ) Hip Flexors, Adductors and Medial Rotators Extensors, Abductors and Lateral Rotators Knee Extensors Flexors Ankle Dorsiflexors. Plantar Flexors Foot Invertors Evertors Intrinsic Muscles L4,5 L5,S1 S2,3 L4,5 S1,2 L3,4 L5,S1 L1,2,3 L5,S1