Overview
1. Femoral nerve and it’s branches
2. Cutaneous nerve of thigh
3. Patellar plexus
4. Muscles of anterior compartment of thigh
5. Hip joint nerve supply
6. Knee joint nerve supply
7. Clinicals
In lower limb anatomy we study five main nerves
1. Femoral nerve
2. Obturator nerve
3. Sciatic nerve
4. Tibial nerve
5. Common peroneal nerve (CPN)
Here we are discuss about femoral nerve.
Femoral nerve is originated from lumbar plexus (L2, L3, L4) and supplies to the thigh muscles and skin.
Branches of femoral nerve –
Femoral nerve gives muscular branch (to the muscles), cutaneous branch (to the skin), articular branch (to the joint) and vascular branch (to the blood vessel).
Before crossing Inguinal ligament femoral nerve gives two muscular branch, nerve to iliacus muscle and nerve to pectineus muscle.
After crossing inguinal ligament femoral nerve divides into two division, that are given below.
Both AD and PD of femoral nerve are separated by lateral circumflex femoral artery (LCFA).
NOTE – LCFA is the branch of profunda or deep femoris artery.
A. Anterior division (AD) of femoral nerve –
AD gives three branches, two cutaneous and one muscular branch.
1. Medial cutaneous nerve of thigh
2. Intermediate cutaneous nerve of thigh
3. Nerve to sartorius muscle
NOTE – Cutaneous nerve of thigh.
A. Medial cutaneous nerve of thigh – From AD of femoral nerve.
B. Intermediate cutaneous nerve – From AD of femoral nerve.
C. Lateral cutaneous nerve of thigh – It is arise from lumbar plexus (L2, L3).
D. Posterior cutaneous nerve of thigh – It is arise from sacral plexus.
NOTE – Cutaneous nerve A, B, and C take participate to form patellar plexus.
B. Posterior division (PD) of femoral nerve –
PD gives five branches, four muscular and one cutaneous branch.
1. Nerve to vastus lateralis (VL) muscle – It supplies to the VL muscle and knee joint.
2. Nerve to vastus medialis (VM) muscle – It supplies to the VM muscle, and knee joint.
3. Nerve to vastus intermedius (VI) muscle – It supplies to the VI muscle, articular genu, and knee joint.
4. Nerve to rectus femoris muscle – It supplies to the rectus femoris muscle and hip joint.
Question. Hip joint nerve supply?
Question. Knee joint nerve supply?
5. Saphenous nerve –
It is the longest cutaneous branch of femoral nerve, because it extends from thigh to foot.
NOTE – Quadriceps femoris muscle (Not quadratus femoris)
All nerve to vastus muscle (VL, VM, VI) supply to the knee joint and nerve to rectus femoris (RF) muscle supply to the hip joint.
Muscles that are supplied by femoral nerve
Femoral nerve supply to the anterior compartment of thigh muscles, iliacus, and pectineus (Don’t get confused with pectinate muscle – It is the muscle of heart) muscle.
Pectineus is the muscle of medial compartment of thigh and iliac is the muscle of hip region.
Anterior Compartment of thigh muscles –
1. Quadriceps femoris (Don’t get confused with quadratus femoris muscle – It is the muscle of gluteal region)
a. Vastus lateralis (VL) muscle
b. Vastus medialis (VM) muscle
c. Vastus intermedius (VI) muscle
d. Rectus femoris (RF) muscle
2. Sartorius muscle – It is the longest muscle in body.
3. Articular genu (AG)
Medial compartment of thigh muscles –
1. Pectineus muscle – It has dual nerve supply by femoral and obturator nerve.
Hip muscles –
1. iliacus muscle – It is present inside the hip bone. (ilio psoas muscle)
NOTE – Nerve supply of all these muscles are given above in this blog. (See AD and PD of femoral nerve)
Clinical
1. Saphenous nerve neuralgia –
The saphenous nerve is damaged or injured during varicose vein (GSV) surgery and patient feel pain on medial side of leg.
Neuralgia or Nerve pain.
GSV – Great Saphenous Vein
2. Venous cutdown –
In many emergency conditions (Shock, burn) we give a Incision on great saphenous vein (GSV) which is present in front of the medial malleolus and put catheter inside the GSV.
Saphenous nerve is also present in front of medial malleolus and during venous cutdown surrounding structure (Saphenous nerve) of vein are injured.
3. Femoral nerve injury –
A. Due to trauma, compression of nerve, hip bone fracture the femoral nerve is injured and as result the motor and sensory supply of nerve are affect.
B. Muscles that are supplied by femoral nerve –
NOTE – For more detail see muscular branches of femoral nerve that are given above in this blog.
1. Quadriceps femoris muscle (VL, VM, VI, and RF) – Action – Extension of knee joint.
2. iliac muscle – Action – Flexion of hip joint.
C. So as result due to femoral nerve injury flexion movement around hip joint and extension movement around knee joint are affect.
4. Knee jerk or patellar reflex
When we tap on ligament of patella, the quadriceps femoris muscle contracts and knee joint is extend.
