Plexus

LUMBOSACRAL PLEXUS
Pain Specialist
Dr. QAISAR ALI KHAN
SACRAL PLEXUS
The sacral plexus is a network of nerve fibres that
supplies the skin and muscles of the pelvis and lower limb. It is
located on the surface of the posterior pelvic wall, anterior to
the piriformis muscle.
The plexus is formed by the anterior rami (divisions) of the
sacral spinal nerves S1, S2, S3 and S4. It also receives
contributions from the lumbar spinal nerves L4 and L5.
Superior Gluteal Nerve
The superior gluteal nerve leaves the pelvis via the greater
sciatic foramen, entering the gluteal region superiorly to the
piriformis muscle. It is accompanied by the superior gluteal
artery and vein for much of its course.
Roots: L4, L5, S1.
Motor Functions: Innervates the gluteus minimus, gluteus
medius and tensor fascia lata.
Sensory Functions: None.
Inferior Gluteal Nerve
The inferior gluteal nerve leaves the pelvis via the greater
sciatic foramen, entering the gluteal region inferiorly to the
piriformis muscle.
It is accompanied by the inferior gluteal artery and vein for
much of its course.
Roots: L5, S1, S2.
Motor Functions: Innervates gluteus maximus.
Sensory Functions: None.
Posterior Femoral Cutaneous
The posterior cutaneous nerve of thigh leaves the pelvis via the
greater sciatic foramen, entering the gluteal region inferiorly to
the piriformis muscle. It descends deep to the gluteus maximus
and runs down the back of the thigh to the knee.
Roots: S1, S2, S3
Motor Functions: None
Sensory Functions: Innervates the skin on the posterior surface
of the thigh and leg. Also innervates the skin of the perineum.
Sciatic Nerve
•Roots: L4, L5, S1, S2, S3
•Motor Functions:
• Tibial portion – Innervates the muscles in the posterior
compartment of the thigh (apart from the short head
of the biceps femoris), and the hamstring component
of adductor magnus. Innervates all the muscles in the
posterior compartment of the leg and sole of the foot.
• Common fibular portion – Short head of biceps
femoris, all muscles in the anterior and lateral
compartments of the leg and extensor digitorum
brevis.
•Sensory Functions:
• Tibial portion: supplies the skin of the posterolateral
leg, lateral foot and the sole of the foot.
• Common fibular portion: supplies the skin of the lateral
leg and the dorsum of the foot.
Pudendal Nerve
This nerve leaves the pelvis via the greater sciatic foramen,
then re-enters via the lesser sciatic foramen. It moves
anterosuperiorly along the lateral wall of the ischiorectal fossa,
and terminates by dividing into several branches.
Roots: S2, S3, S4
Motor Functions: Innervates the skeletal muscles in the
perineum, the external urethral sphincter, the external anal
sphincter, levator ani.
Sensory Functions: Innervates the penis and the clitoris and
most of the skin of the perineum.
LUMBAR PLEXUS
Iliohypogastric Nerve
The iliohypogastric nerve is the first major branch of the lumbar
plexus. It runs to the iliac crest, across the quadratus lumborum
muscle of the posterior abdominal wall. It then perforates the
transversus abdominis, and divides into its terminal branches.
Roots: L1 (with contributions from T12).
Motor Functions: Innervates the internal oblique and
transversus abdominis.
Sensory Functions: Innervates the skin of the posterolateral
gluteal and pubic
Ilioinguinal Nerve
The ilioinguinal nerve follows the same anatomical course as
the larger iliohypogastric nerve. After innervating the muscles
of the anterior abdominal wall, it passes through the
superficial inguinal ring to innervate the skin of the genitalia
and middle thigh.
Roots: L1.
Motor Functions: Innervates the internal oblique and
transversus abdominis.
Sensory Functions: Innervates the skin of the superior
anteromedial thigh. In males, it also supplies the skin over the
root of the penis and anterior scrotum. In females, it supplies
the skin over mons pubis and labia majora.
Genitofemoral Nerve
After leaving the psoas major muscle, the genitofemoral nerve
quickly divides into a genital branch, and a femoral branch.
Roots: L1, L2.
Motor Functions: The genital branch innervates the
cremasteric muscle.
Sensory Functions: The genital branch innervates the skin of
the anterior scrotum (in males) or the skin over mons pubis and
labia majora (in females). The femoral branch innervates the
skin on the upper anterior thigh.
Lateral Cutaneous Nerve of
the Thigh
This nerve has a purely sensory function. It enters the
thigh at the lateral aspect of the inguinal ligament,
where it provides cutaneous innervation to the skin
there.
Roots: L2, L3
Motor Functions: None.
Sensory Functions: Innervates the anterior and lateral
thigh down to the level of the knee.
Obturator Nerve
Roots: L2, L3, L4.
Motor Functions: Innervates the muscles of
the medial thigh – the obturator externus,
adductor longus, adductor brevis, adductor
magnus and gracilis.
Sensory Functions: Innervates the skin over
the medial thigh.
Femoral Nerve
Roots: L2, L3, L4.
Motor Functions: Innervates the muscles of the
anterior thigh – the illiacus, pectineus, sartorius
and quadriceps femoris.
Sensory Functions: Innervates the skin on the
anterior thigh and the medial leg.

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LUMBOSACRAL PLEXUS

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