Femoral Nerve

INTRODUCTION:
  • The femoral nerve is one of the major peripheral nerves of the lower limb.
  • Nerve Roots: L2-L4
  • Motor: Innervates the anterior thigh muscles that flex the hip joint (pectineus, iliacus, sartorius) and extend the knee (quadriceps femoris: rectus femoris, vastus lateralis, vastus medialis and vastus intermedius),
  • Sensory: Supplies cutaneous branches to the anteromedial thigh (anterior cutaneous branches of the femoral nerve) and the medial side of the leg and foot (saphenous nerve).
ANATOMICAL COURSE:
  • The femoral nerve is the largest branch of the lumbar plexus. It is derived from the nerve roots L2 – L4.
  • The nerve descends from the lumbar plexus in the abdomen through the psoas major muscle.
  • The nerve then travels through the pelvis to approximately the mid-point of the inguinal ligament.
  • It then traverses behind the inguinal ligament into the thigh and splits into an anterior and posterior division.
  • It passes through the femoral triangle lateral to the femoral vessels (enclosed within the femoral sheath) and gives off articular branches to the hip and knee joints.
  • The terminal cutaneous branch of the femoral nerve is the saphenous nerve which continues, with the femoral artery and vein, through the adductor canal.
BRANCHES:
  • From the main trunk :- Nerve supply to iliacus, nerve supply to pectineus and a few vascular branches.
  • From anterior division :- Intermediate femoral cutaneous nerve (intermediate cutaneous nerve of thigh), medial femoral cutaneous nerve (medial cutaneous nerve of thigh) and muscular branch to sartorius.
  • From posteior division :- Saphenous nerve, nerve supply to quadriceps femoris (rectus femoris, vastus medialis, vastus lateralis, vastus intermedius).
  • Articular supply :- Hip joint is supplied by nerve to rectus femoris; knee joint is supplied by nerve to three vasti.
FUNCTIONS:
  • Motor Functions
  • The femoral nerve supplies some of the muscles of the anterior thigh
  1. Hip Flexors
  2. Pectineus – adducts and flexes the thigh, assists with medial rotation of the thigh.
  3. Iliacus – acts with psoas major and psoas minor (forming iliopsoas) to flex the thigh at the hip joint and stabilise the hip joint.
  4. Sartorius – flexes, abducts and laterally rotates the thigh at the hip joint. Flexes the leg at the knee joint.
  • Knee Extensors
  1. Quadriceps femoris (rectus femoris, vastus lateralis, vastus intermedius) – extends the leg at the knee joint. Rectus femoris also steadies the hip joint and assists iliopsoas in flexing the thigh.
Sensory Functions
  • The first cutaneous branches of the femoral nerve are the anterior cutaneous branches that arise in the femoral triangle. They supply the skin on the anteromedial thigh.
  • The last cutaneous branch of the femoral nerve is the saphenous nerve which supplies the skin on the medial side of the leg and the foot.
CLINICAL SIGNIFICANCE:
  • Skin overlying the region where a venous "cut-down" is made to access the Great saphenous vein is supplied by femoral nerve

ORIGIN MUSCULAR INNERVATION AND MOVEMENTS Extensors of leg CUTANEOUSINNERVATION
Lumbo - sacral Plexus (L2,L3,L4) Flexors of thigh Vastus lateralis Extensors of leg & Flexors of thigh Anterior & medial branches Supply the anterior and lateral thigh.
Psoas major Iliacus Pectineus Vastus intermedius Vastus medialis RectusFemoris (kicking muscle)
Sartorius
Exam Question
  • Skin overlying the region where a venous "cut-down" is made to access the Great saphenous vein is supplied by Great saphenous vein is supplied by femoral nerve
  • Saphenous nerve is a branch of femoral nerve
  • Femoral nerve supplies anterior thigh muscles that flex the hip joint (pectineus, iliacus, sartorius) and extend the knee (quadriceps femoris: rectus femoris, vastus lateralis, vastus medialis and vastus intermedius)
  • Anterior division of femoral nerve gives Intermediate femoral cutaneous nerve (intermediate cutaneous nerve of thigh), medial femoral cutaneous nerve (medial cutaneous nerve of thigh) and muscular branch to sartorius.
Don't Forget to Solve all the previous Year Question asked on Femoral Nerve