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2.1.15 Obturator and femoral nerves

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Now that we've looked at the blood vessels of the hip region, we can move on to look at the nerves. We'll look first at the femoral nerve and the obturator nerve, which supply the front and the medial aspect of the thigh, then we'll look at the gluteal nerves and the sciatic nerves, which supply the buttock and the back of the thigh. All the nerves of the lower extremity come from the anterior rami of the second to the fifth lumbar nerves, and the first, second and third sacral nerves. To see where these arise, let's take a look at the lumbar spine and the sacrum.

Below each vertebra there’s an intervertebral foramen. An anterior ramus emerges through each foramen. The anterior rami of the sacral nerves emerge from the anterior sacral foramina. Each anterior ramus is numbered according to the vertebra, or the sacral segment, that’s above it. Here's the third lumbar vertebra, here's where the L3 ramus emerges.

We’ll start by looking at the femoral nerve, and the obturator nerve. This is the femoral nerve, this is the obturator nerve. The white structure between them is the psoas major tendon. Both these nerves arise from the lumbar plexus, which lies up here within the thickness of the psoas major muscle.

The femoral nerve emerges lateral to psoas major, the obturator nerve medial to it. We’ll follow the femoral nerve. It runs across the iliacus muscle, and passes under the inguinal ligament just lateral to the femoral artery. Below the inguinal ligament the femoral nerve breaks up into several branches.

The femoral nerve supplies iliacus, all four heads of quadriceps, and also pectineus, and sartorius.

Now lets look at the obturator nerve. Emerging below the medial border of psoas major, it crosses the wing of the ...

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(2.50)

Now that we've looked at the blood vessels of the hip region, we can move on to look at the nerves. We'll look first at the femoral nerve and the obturator nerve, which supply the front and the medial aspect of the thigh, then we'll look at the gluteal nerves and the sciatic nerves, which supply the buttock and the back of the thigh. All the nerves of the lower extremity come from the anterior rami of the second to the fifth lumbar nerves, and the first, second and third sacral nerves. To see where these arise, let's take a look at the lumbar spine and the sacrum.

Below each vertebra there’s an intervertebral foramen. An anterior ramus emerges through each foramen. The anterior rami of the sacral nerves emerge from the anterior sacral foramina. Each anterior ramus is numbered according to the vertebra, or the sacral segment, that’s above it. Here's the third lumbar vertebra, here's where the L3 ramus emerges.

We’ll start by looking at the femoral nerve, and the obturator nerve. This is the femoral nerve, this is the obturator nerve. The white structure between them is the psoas major tendon. Both these nerves arise from the lumbar plexus, which lies up here within the thickness of the psoas major muscle.

The femoral nerve emerges lateral to psoas major, the obturator nerve medial to it. We’ll follow the femoral nerve. It runs across the iliacus muscle, and passes under the inguinal ligament just lateral to the femoral artery. Below the inguinal ligament the femoral nerve breaks up into several branches.

The femoral nerve supplies iliacus, all four heads of quadriceps, and also pectineus, and sartorius.

Now lets look at the obturator nerve. Emerging below the medial border of psoas major, it crosses the wing of the sacrum, then runs along the back of the ischio-pubic ramus. It leaves the pelvis by passing forward through the obturator canal, just above obturator internus. To see where it emerges, we’ll remove pectineus.

Here’s the obturator nerve, emerging over the top of obturator externus. Its branches run down between the adductor muscles. The obturator nerve supplies obturator externus, adductor brevis, and longus, and the anterior part of adductor magnus.

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