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Ilioinguinal
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 ilioinguinal nerve then perforates the transversus abdominis near the anterior part of the iliac crest, and communicates with the iliohypogastric nerve between the transversus and the internal oblique muscle. It then pierces the internal oblique muscle, distributing filaments to it, and then accompanies the spermatic cord (in males) or the round ligament of uterus (in females) through the superficial inguinal ring. Its fibres are then distributed to the skin of the upper and medial part of the thigh, and to the following locations in the male and female: * In the male (" anterior scrotal nerve"): to the skin over the root of the penis and upper part of the scrotum. * In th ...
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Inguinal Canal
The inguinal canal is a passage in the anterior abdominal wall on each side of the body (one on each side of the midline), which in males, convey the spermatic cords and in females, the round ligament of the uterus. The inguinal canals are larger and more prominent in males. Structure The inguinal canals are situated just above the medial half of the inguinal ligament. The canals are approximately 4 to 6 cm long, angled anteroinferiorly and medially. In males, its diameter is normally 2 cm (±1 cm in standard deviation) at the deep inguinal ring.The diameter has been estimated to be ±2.2cm ±1.08cm in Africans, and 2.1 cm ±0.41cm in Europeans. A first-order approximation is to visualize each canal as a cylinder. Walls To help define the boundaries, these canals are often further approximated as boxes with six sides. Not including the two rings, the remaining four sides are usually called the "anterior wall", "inferior wall ("floor")", "superior wall ("roof")", and "po ...
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Deep Inguinal Ring
The inguinal canal is a passage in the anterior abdominal wall on each side of the body (one on each side of the midline), which in males, convey the spermatic cords and in females, the round ligament of the uterus. The inguinal canals are larger and more prominent in males. Structure The inguinal canals are situated just above the medial half of the inguinal ligament. The canals are approximately 4 to 6 cm long, angled anteroinferiorly and medially. In males, its diameter is normally 2 cm (±1 cm in standard deviation) at the deep inguinal ring.The diameter has been estimated to be ±2.2cm ±1.08cm in Africans, and 2.1 cm ±0.41cm in Europeans. A first-order approximation is to visualize each canal as a cylinder. Walls To help define the boundaries, these canals are often further approximated as boxes with six sides. Not including the two rings, the remaining four sides are usually called the "anterior wall", "inferior wall ("floor")", "superior wall ("roof")", and "poste ...
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Cremasteric Reflex
The cremasteric reflex is a superficial (i.e., close to the skin's surface) reflex observed in human males. This reflex is elicited by lightly stroking or poking the superior and medial (inner) part of the thigh—regardless of the direction of stroke. The normal response is an immediate contraction of the cremaster muscle that pulls up the testicle ipsilaterally (on the same side of the body). The reflex utilizes sensory and motor fibers from two different nerves. When the inner thigh is stroked, sensory fibers of the ilioinguinal nerve are stimulated. These activate the axon, motor fibers of the genital branch of the genitofemoral nerve which causes the cremaster muscle to contract and elevate the testis. Clinical conditions In some males this reflex may be exaggerated which can occasionally lead to a misdiagnosis of cryptorchidism. The cremasteric reflex may be absent with testicular torsion, upper and lower motor neuron disorders, as well as a spine injury of L1-L2. It can ...
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Iliohypogastric Nerve
The iliohypogastric nerve is a nerve that originates from the lumbar plexus that supplies sensation to skin over the lateral gluteal and hypogastric regions and motor to the internal oblique muscles and transverse abdominal muscles. Structure Origin The iliohypogastric nerve originates from the superior branch of the anterior ramus of spinal nerve L1. It also receives fibers from T12 via the subcostal nerve. The branch below it is the ilioinguinal nerve. Course It emerges from the upper lateral border of the psoas major. It then crosses in front of the quadratus lumborum muscle to an area superior to the iliac crest. It runs behind the kidneys. Just superior to the iliac crest, it pierces the posterior part of the transversus abdominis muscle and continues anteriorly in the abdominal wall between the transversus abdominis and internal oblique muscles. It divides into a lateral cutaneous branch and an anterior cutaneous branch between the transversus abdominis muscle a ...
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Abdominal Internal Oblique Muscle
The abdominal internal oblique muscle, also internal oblique muscle or interior oblique, is an abdominal muscle in the abdominal wall that lies below the external oblique muscle and just above the transverse abdominal muscle. Structure Its fibers run perpendicular to the external oblique muscle, beginning in the thoracolumbar fascia of the lower back, the anterior 2/3 of the iliac crest (upper part of hip bone) and the lateral half of the inguinal ligament. The muscle fibers run from these points superomedially (up and towards midline) to the muscle's insertions on the inferior borders of the 10th through 12th ribs and the linea alba. In males, the cremaster muscle is also attached to the internal oblique. Nerve supply The internal oblique is supplied by the lower intercostal nerves, as well as the iliohypogastric nerve and the ilioinguinal nerve. Function The internal oblique performs two major functions. Firstly as an accessory muscle of respiration, it acts as an ...
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Psoas Major
The psoas major ( or ; from ) is a long fusiform muscle located in the lateral lumbar region between the vertebral column and the brim of the lesser pelvis. It joins the iliacus muscle to form the iliopsoas. In other animals, this muscle is equivalent to the tenderloin. Structure The psoas major is divided into a superficial and a deep part. The deep part originates from the transverse processes of lumbar vertebrae L1–L5. The superficial part originates from the lateral surfaces of the last thoracic vertebra, lumbar vertebrae L1–L4, and the neighboring intervertebral discs. The lumbar plexus lies between the two layers. Together, the iliacus muscle and the psoas major form the iliopsoas, which is surrounded by the iliac fascia. The iliopsoas runs across the iliopubic eminence through the muscular lacuna to its insertion on the lesser trochanter of the femur. The iliopectineal bursa separates the tendon of the iliopsoas muscle from the external surface of the hip-j ...
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Transversus Abdominis
The transverse abdominal muscle (TVA), also known as the transverse abdominis, transversalis muscle and transversus abdominis muscle, is a muscle layer of the anterior and lateral (front and side) abdominal wall, deep to (layered below) the internal oblique muscle. It serves to compress and retain the contents of the abdomen as well as assist in exhalation. Structure The transverse abdominal, so called for the direction of its fibers, is the innermost of the flat muscles of the abdomen. It is positioned immediately deep to the internal oblique muscle. The transverse abdominal arises as fleshy fibers, from the lateral third of the inguinal ligament, from the anterior three-fourths of the inner lip of the iliac crest, from the inner surfaces of the cartilages of the lower six ribs, interdigitating with the diaphragm, and from the thoracolumbar fascia. It ends anteriorly in a broad aponeurosis (the Spigelian fascia), the lower fibers of which curve inferomedially (medially and do ...
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Lumbar Plexus
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. Additionally, the ventral rami of the fourth lumbar nerve pass communicating branches, the lumbosacral trunk, to the sacral plexus. The nerves of the lumbar plexus pass in front of the hip joint and mainly support the anterior part of the thigh.''Thieme Atlas of anatomy'' (2006), pp 470-471 The plexus is formed lateral to the intervertebral foramina and passes through psoas major. Its smaller motor branches are distributed directly to psoas major, while the larger branches leave the muscle at various sites to run obliquely down through the pelvis to leave under the inguinal ligament with the exception of the obturator nerve which exits the pelvis through the obturator foramen. ...
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Nerve Block
Nerve block or regional nerve blockade is any deliberate interruption of signals traveling along a nerve, often for the purpose of pain relief. #Local anesthetic nerve block, Local anesthetic nerve block (sometimes referred to as simply "nerve block") is a short-term block, usually lasting hours or days, involving the injection of an anesthetic, a corticosteroid, and other agents onto or near a nerve. Neurolytic block, the deliberate temporary degeneration of nerve fibers through the application of chemicals, heat, or freezing, produces a block that may persist for weeks, months, or indefinitely. Neurectomy, the cutting through or removal of a nerve or a section of a nerve, usually produces a permanent block. Because neurectomy of a sensory nerve is often followed, months later, by the emergence of new, more intense pain, sensory nerve neurectomy is rarely performed. The concept of nerve block sometimes includes ''central nerve block'', which includes epidural and spinal anaesthe ...
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Anterior Labial Nerve
The anterior labial nerves are branches of the ilioinguinal nerve. The nerves labia majora. The equivalent nerves in the male are the anterior scrotal nerves. See also * Posterior labial nerves The posterior labial nerves are superficial branches of the perineal nerve, which in itself is a branch of the pudendal nerve. The posterior labial nerves provide sensation to the labia majora and labia minora The labia minora (Latin for 'smalle ... References Nerves of the lower limb and lower torso {{neuroanatomy-stub ...
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