scholarly journals An extensive study and review of literature about multiple variations of the lumbar plexus

2017 ◽  
Vol 34 (02) ◽  
pp. 068-072
Author(s):  
S. Nayak ◽  
S. Surendran ◽  
D. Reghunathan ◽  
P. Maloor ◽  
P. Shetty
Keyword(s):  
Abdominal Wall ◽  
Femoral Nerve ◽  
Spinal Nerve ◽  
Extensive Study ◽  
Cutaneous Nerve ◽  
Lumbar Plexus ◽  
Genitofemoral Nerve ◽  
Lateral Cutaneous Nerve ◽  
Muscular Branch ◽  
Psoas Major

Abstract Introduction: Lumbar plexus involves the L1 - L5 spinal segments for the formation of the nerves which supply parts of the abdominal wall, pelvis and the upper part of the thigh (both sensory and motor). Our aim in this study was to compile all the rare variations found in a single cadaver, which is of the rarest possible kind. Methods: During the dissection of the abdomen and pelvis in approximately 70 year old cadaver, there were multiple variations observed in the anatomy of the lumbar plexus. The entire region was cleaned for visibility of the variations and all those were clearly documented for compiling purpose. Results: The following variations in the formation of the lumbar and sacral nerves were observed. 1. The genitofemoral nerve bifurcated at a higher level; genital branch of genitofemoral nerve gave branches to the anterior abdominal wall muscles, 2. A communicating branch was given from the lateral cutaneous nerve of thigh to the medial cutaneous nerve of thigh, 3. A muscular branch was given from femoral nerve to psoas major, 4. There was absence of contribution of L4 spinal nerve in the formation of the lumbosacral trunk, and 5. Lumbosacral trunk gave communicating branches to the femoral and obturator nerves. Most of the variations found were rare and finding all the above said variations in a single cadaver is even rare. Conclusion: Knowledge of the normal anatomy and any possible variations would help the clinicians and surgeons dealing with this region and avoid possible complications beforehand.

scholarly journals Human Cadaveric Study of Lumbar Plexus and its Clinical Implication

2017 ◽  
Vol 06 (01) ◽  
pp. 024-034
Author(s):  
Sameer Ram ◽  
Jitendra Patel ◽  
Sanjay Kanani
Keyword(s):  
Clinical Implication ◽  
Femoral Nerve ◽  
Cutaneous Nerve ◽  
Lumbar Plexus ◽  
Lumbar Plexus Block ◽  
Femoral Cutaneous Nerve ◽  
Lateral Cutaneous Nerve ◽  
Plexus Block ◽  
Age Range ◽  
Genital Branch

Abstract Background & Aims: The Lumbar plexus describes the origins of 4 of the nerves supplying the lower limb (femoral, lateral cutaneous nerve of the thigh, obturator and genitofemoral) along with the ilioinguinal and iliohypogastric nerves. Aim of this study is to study the abnormalities in formation of lumbar plexus and communication between the branches of lumbar plexus and its clinical implication. Material & Method: This study was conducted on 100 cadavers (67 male and 33 female) with an age range of 50 – 90 years. Results: No abnormality was found related to roots and trunk. Post fixed lumbar plexus (bilateral) were found in 6 cadavers. Genital branch and femoral branch was found to arise separately from the root in 22 cadavers (bilaterally). Accessory lateral femoral cutaneous nerve was observed on both sides in 4 cadavers. Femoral nerve was found to arise from dorsal division of L3-4-5 in 8 cadavers (bilateral). Accessory obturator nerve was found bilaterally in 26 cadavers and it was arising from L3-4. Conclusion:Knowledge of variations in the formation and branching pattem of lumbar plexus is very important during lumbar plexus block for various surgical and palliative procedures.

Macroanatomical Structure of the Lumbosacral Plexus and its Branches in the Indigenous Duck

2018 ◽  
Vol 52 (1-4) ◽  
pp. 1-9 ◽  
Author(s):  
MT Hussan ◽  
MS Islam ◽  
J Alam
Keyword(s):  
Hind Limb ◽  
Femoral Nerve ◽  
Morphological Structure ◽  
Spinal Nerve ◽  
The Body ◽  
Lumbar Plexus ◽  
Lumbosacral Plexus ◽  
Sacral Plexus ◽  
Spinal Nerves ◽  
Femoral Cutaneous Nerve

The present study was carried out to determine the morphological structure and the branches of the lumbosacral plexus in the indigenous duck (Anas platyrhynchos domesticus). Six mature indigenous ducks were used in this study. After administering an anesthetic to the birds, the body cavities were opened. The nerves of the lumbosacral plexus were dissected separately and photographed. The lumbosacral plexus consisted of lumbar and sacral plexus innervated to the hind limb. The lumbar plexus was formed by the union of three roots of spinal nerves that included last two and first sacral spinal nerve. Among three roots, second (middle) root was the highest in diameter and the last root was least in diameter. We noticed five branches of the lumbar plexus which included obturator, cutaneous femoral, saphenus, cranial coxal, and the femoral nerve. The six roots of spinal nerves, which contributed to form three trunks, formed the sacral plexus of duck. The three trunks united medial to the acetabular foramen and formed a compact, cylindrical bundle, the ischiatic nerve. The principal branches of the sacral plexus were the tibial and fibular nerves that together made up the ischiatic nerve. Other branches were the caudal coxal nerve, the caudal femoral cutaneous nerve and the muscular branches. This study was the first work on the lumbosacral plexus of duck and its results may serve as a basis for further investigation on this subject.

USG GUIDED FEMORAL & LATERAL CUTANEOUS NERVE BLOCK AS SAVIOUR- ANAESTHETIC MANAGEMENT OF PATIENT OF CKD-ESRD WITH DIFFICULT AIRWAY & COAGULOPATHY POSTED FOR NOVEL PROSTHETIC FEMORO-FEMORAL AV FISTULA.

2021 ◽  
pp. 122-123
Author(s):  
Vipan Kumar ◽  
Vishal Vashist ◽  
Bhanu Gupta
Keyword(s):  
Nerve Block ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Prosthetic Graft ◽  
Anaesthetic Management ◽  
Cutaneous Nerve ◽  
Av Fistula ◽  
Early Maturation ◽  
Ckd Stage ◽  
Lateral Cutaneous Nerve

Anaesthetic management for creation of a novel prosthetic femoro-femoral arteriovenous stula (AV) in 65 years old male patient k/c/o hypertension with CKD (Stage V, [ESRD] haemodialysis dependent for last 1.5 years with difcult airway and deranged coagulation prole. AV stula was initially created in upper limb which blocked 6 weeks back. Subsequently dialysis was done by dialysis catheter as temporary method and femoro-femoral AV stula creation using prosthetic graft was planned due to its early maturation time (7 days). Central neuraxial blocks were contraindicated because of deranged coagulation prole. Patient is also high risk for GA i/v/o ESRD and difcult airway. Therefore we planned for RA in the form of USG guided Femoral Nerve Block and Lateral Cutaneous Nerve (LCN) of thigh block. Femoral Nerve Block (FNB) and Lateral Cutaneous Nerve block (LCN) was performed under ultrasound guidance in real time using 20 and 10ml of 0.25% Bupivacaine respectively. After establishing block effect, surgery was performed solely under block with stable perioperative course.

scholarly journals ANATOMICAL VARIABILITY OF CUTANEOUS NERVES OF ANTERIOR FEMORAL REGION IN HUMAN FETUSES

2021 ◽  
Vol 74 (2) ◽  
pp. 207-212
Author(s):  
Pavlina V. Hryhorieva ◽  
Тatiana V. Khmara ◽  
Аlina О. Palamar ◽  
Тetyana B. Sykyrytska ◽  
Maryna Yu. Leka
Keyword(s):  
Human Development ◽  
Femoral Nerve ◽  
Lower Extremities ◽  
Obturator Nerve ◽  
Fascia Lata ◽  
Cutaneous Nerve ◽  
Lumbar Plexus ◽  
Human Fetuses ◽  
Fetal Period ◽  
Photo Documentation

The aim: Is to find out the features of innervation of the skin of the anterior femoral region and the fascia lata during the fetal period of human development. Materials and methods: The study was carried out on 64 preparations of the lower extremities of human fetuses of 4-10 months using macromicroscopic preparation and morphometry. Macropreparations of the skin nerves of the lower extremities of different age fetuses with anatomical variants were subject to photo documentation. Results: The features of cutaneous nerve fetal topography of the anterior femoral region and the broad fascia of the femur were revealed, their connections were established, and their layering was determined. It was found that in human fetuses, not only the lateral cutaneous femoral nerve but in most cases the branches of other nerves of the lumbar plexus, except for the obturator nerve, are directed to the skin of the anterior-lateral femur surface. The innervation of the medial femur surface is provided by the following nerve complex: obturator, femoral, saphenous and genitofemoral nerves. Conclusions: Taking into account the fact that the terminal branches of adjacent cutaneous nerves of the femoral region intersect and overlap, innervation bypasses are formed, due to which, in case of possible damage to one of the nerves, its insufficiency is compensated to a certain extent. Anastomoses were found between the cutaneous nerves, in the form of loops of various shapes and sizes, namely: between the cutaneous-fascia branches of the femoral and ilioinguinal nerves and the femoral and obturator nerves.

scholarly journals Unilateral variant motor innervations of flexure muscles of arm

2010 ◽  
Vol 01 (01) ◽  
pp. 51-53 ◽  
Author(s):  
A S Yogesh ◽  
M Joshi ◽  
V K Chimurkar ◽  
R R Marathe
Keyword(s):  
Median Nerve ◽  
Biceps Brachii ◽  
Musculocutaneous Nerve ◽  
Cutaneous Nerve ◽  
Lateral Cord ◽  
Separate Branch ◽  
Male Cadaver ◽  
Lateral Cutaneous Nerve ◽  
Muscular Branch ◽  
The Right

ABSTRACTThe musculocutaneous nerve usually branches out from the lateral cord of brachial plexus. It innervates the corcobrachialis, biceps brachii and brachialis muscles and continues as the lateral cutaneous nerve of forearm without exhibiting any communication with the median nerve or any other nerve. We report unilateral variation in motor innervations of the left arm in a 58-year-old male cadaver. The musculocutaneous nerve was found to be absent. A muscular branch of the median nerve was supplying the coracobrachialis muscle. In the middle of arm, the median nerve was found to be branching out, bifurcating and supplying the long and short head of biceps. The median nerve was found to be giving a separate branch, which supplied the brachialis muscle and continued as the lateral cutaneous nerve of forearm. The right sided structures were found to be normal. Surgeons should keep such variations in mind while performing arm surgeries.

scholarly journals Anatomy of Lumbar Plexus and Implications to Regional Anaesthesiologist

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
G. Amudha ◽  
Sandeep Diwan
Keyword(s):  
Abdominal Wall ◽  
Regional Anaesthesia ◽  
Anterior Part ◽  
Ventral Surface ◽  
Lumbar Plexus ◽  
Knee Joints ◽  
Medial Side ◽  
Psoas Major Muscle ◽  
Psoas Major ◽  
Plexus Block

Lumbar plexus is one of the two nerve plexuses which supply the lower limb. It is formed in the posterior abdominal wall within the psoas major muscle. The branches of the plexus exit via the medial and lateral borders as well as its ventral surface. It is a complex plexus which gives a branch to complete the formation of lumbo sacral plexus. The branches mainly supply the groin, anterior and medial compartments of thigh. They also supply the hip and knee joints. The cutaneous innervation by the branches of lumbar plexus is limited to the anterior, lateral and medial parts of the thigh, medial side of the leg and foot and also the lower part of anterior abdominal wall and perineum. Regional anaesthesia is a highly skilled and precise technique used widely in the patients to reduce the drug usage and decrease the intra and post operative complications. Lumbar plexus block can be used in surgeries related to hip joint and anterior part of thigh and groin. To execute the procedure successfully, sound knowledge in anatomy of lumbar plexus is required. Keywords: Lumbar plexus, Branches, Regional anaesthesia.

scholarly journals Accidental Surgical Division of Lateral Cutaneous Nerve of Thigh

BMJ ◽  
1964 ◽  
Vol 1 (5383) ◽  
pp. 607-608 ◽  
Author(s):  
K. Hingorani
Keyword(s):  
Cutaneous Nerve ◽  
Lateral Cutaneous Nerve

Motor nerve injuries following the minimally invasive lateral transpsoas approach

2012 ◽  
Vol 17 (3) ◽  
pp. 227-231 ◽  
Author(s):  
Kevin S. Cahill ◽  
Joseph L. Martinez ◽  
Michael Y. Wang ◽  
Steven Vanni ◽  
Allan D. Levi
Keyword(s):  
Abdominal Wall ◽  
Injury Risk ◽  
Interbody Fusion ◽  
Motor Nerve ◽  
Femoral Nerve ◽  
Nerve Injuries ◽  
Disc Space ◽  
Fusion Procedure ◽  
Lateral Interbody Fusion ◽  
Lateral Interbody

Object The aim of this study was to determine the incidence of motor nerve injuries during the minimally invasive lateral interbody fusion procedure at a single academic medical center. Methods A retrospective chart review of 118 patients who had undergone lateral interbody fusion was performed. Both inpatient and outpatient records were examined to identify any new postoperative motor weakness in the lower extremities and abdominal wall musculature that was attributable to the operative procedure. Results In the period from 2007 to 2011 the lateral interbody fusion procedure was attempted on 201 lumbar intervertebral disc levels. No femoral nerve injuries occurred at any disc level other than the L4–5 disc space. Among procedures involving the L4–5 level there were 2 femoral nerve injuries, corresponding to a 4.8% injury risk at this level as compared with a 0% injury risk at other lumbar spine levels. Five patients (4.2%) had postoperative abdominal flank bulge attributable to injury to the abdominal wall motor innervation. Conclusions The overall incidence of femoral nerve injury after the lateral transpsoas approach was 1.7%; however, the level-specific incidence was 4.8% for procedures performed at the L4–5 disc space. Approximately 4% of patients had postoperative abdominal flank bulge. Surgeons will be able to minimize these motor nerve injuries through judicious use of the procedure at the L4–5 level and careful attention to the T-11 and T-12 motor nerves during exposure and closure of the abdominal wall.

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