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They are the terminal ends of the L1-L3 spinal nerve dorsal rami lateral branches. They are one of three different types of cluneal nerves (the middle and inferior cluneal nerves being the other two). They travel inferiorly through multiple layers of muscles, then traverse osteofibrous tunnels between the thoracolumbar fascia and iliac crest.
The ilioinguinal nerve is a branch of the first lumbar nerve (L1). It separates from the first lumbar nerve along with the larger iliohypogastric nerve.It emerges from the lateral border of the psoas major just inferior to the iliohypogastric, and passes obliquely across the quadratus lumborum and iliacus.
The sacroiliac joint or SI joint (SIJ) is the joint between the sacrum and the ilium bones of the pelvis, which are connected by strong ligaments. In humans, the sacrum supports the spine and is supported in turn by an ilium on each side. The joint is strong, supporting the entire weight of the upper body.
The lateral cutaneous branch ("iliac branch") pierces the internal oblique muscles and the external oblique muscles immediately above the iliac crest. [4] It is distributed to the skin of the gluteal region, behind the lateral cutaneous branch of the subcostal nerve; the size of this branch bears an inverse proportion to that of the lateral cutaneous branch of the subcostal nerve.
The dorsal ramus then turns to course posterior-ward before splitting into a medial branch and a lateral branch. Both these branches provide motor innervation to deep back muscles. In the neck and upper back, the medial branch is also responsible for providing sensory innervation of the skin; in the lower back, the lateral branch does so.
Areas of distribution of the cutaneous branches of the posterior divisions of the spinal nerves. The areas of the medial branches are in black, those of the lateral in red. Cutaneous nerves of the right lower extremity.
It passes lateral-ward in between the gluteus medius muscle and the gluteus minimus muscle, [1] [5] accompanied by the deep branch of the superior gluteal artery. It divides into a superior branch and an inferior branch. [5] [1] The inferior branch continues to pass between the two muscles [5] to end in the tensor fasciae latae muscle. [1]
Over-diagnosis and attention on herniated discs has led to the SI joint becoming an underappreciated pain generator in an estimated 15% to 25% of patients with axial low back pain. [1] [8] [3] [5] [6] [7] The ligaments in the sacroiliac are among the strongest in the body and are not suspected by many clinicians to be susceptible to spraining ...
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