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The lumbar plexus is a web of nerves (a nerve plexus) in the lumbar region of the body which forms part of the larger lumbosacral plexus. It is formed by the divisions of the first four lumbar nerves (L1-L4) and from contributions of the subcostal nerve (T12), which is the last thoracic nerve .
The lumbar plexus block is an advanced technique indicated for hip, anterior thigh, and knee surgery. [54] The lumbar plexus is composed of nerves originating from L1 to L4 spinal roots such as the iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, femoral, and obturator nerves. [54]
The ventral rami of L1–L5 spinal nerves with a contribution of T12 form lumbar plexus. This plexus lies within the psoas major muscle. Nervi of the plexus serve the skin and the muscles of the lower abdominal wall, the thigh and external genitals. The largest nerve of the plexus is the femoral nerve.
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 third lumbar spinal nerve (L3) [3] originates from the spinal column from below the lumbar vertebra 3 (L3). L3 supplies many muscles, either directly or through nerves originating from L3. They may be innervated with L3 as single origin, or be innervated partly by L3 and partly by other spinal nerves.
The anterior divisions of the lumbar nerves, sacral nerves, and coccygeal nerve form the lumbosacral plexus, the first lumbar nerve being frequently joined by a branch from the twelfth thoracic. For descriptive purposes this plexus is usually divided into three parts: lumbar plexus; sacral plexus; pudendal plexus
The brachial plexus is most compact at the level of the trunks formed by the C5–T1 nerve roots, so nerve block at this level has the greatest likelihood of blocking all of the branches of the brachial plexus. This results in rapid onset times and, ultimately, high success rates for surgery and analgesia of the upper extremity, excluding the ...
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.