CUTANEOUS INNERVATION OF THE LOWER LIMB

CUTANEOUS INNERVATION OF THIGH: *THE ILIO-LINGUAL NERVE (L1), a branch of the lumbar plexus, supplies the skin: -at the root of penis in the male or over the mons pubis in the female, -at the anterior one-third of the scrotum (male) or labium majus(female), -at the superomedial part of the thigh.

*THE FEMORAL BRANCH OF GENITO FEMORAL NERVE(L1,L2), which is in turn a branch of the lumbar plexus, supplies the skin over the femoral triangle.

*THE LATERAL CUTANEOUS NERVE OF THIGH(L2,L3), also a branch of the lumbar plexus, supplies the skin: -on the anterolateral side of thigh & -the anterior part the gluteal region, -by dividing into anterior and posterior branches.

*THE INTERMEDIATE CUTANEOUS NERVE OF THIGH(L2,L3) is a branch of the anterior division of femoral nerve and supplies a strip of skin on the front of thigh extending from the sartorius muscle to the knee.

*THE MEDIAL CUTANEOUS NERVE OF THIGH(L2.L2) is also a branch of the anterior division of the femoral nerve.It supplies the skin on the medial side of the lower two-thirds of the thigh.

THE PATELLAR PLEXUS: -a plexus of fine nerves situated in the front of the patella, the ligamentum patellae, and the upper end of the tibia.

-formed by the contributions from: 1)The anterior division of the lateral cutaneous nerve, 2)The intermediate cutaneous of thigh, 3)The anterior division of the medial cutaneous nerve, 4)The infrapatellar branch of the saphenous nerve.

CUTANEOUS INNERVATION OF THE GLUTEAL REGION: The cutaneous nerves converge on the gluteal region from all directions.

1)The upper and anterior part is supplied by the LATERAL CUTANEOUS BRANCHES OF THE SUBCOSTAL T12 and ILIOHYPOGASTRIC L1 nerves.

2)The upper and posterior part is supplied by the posterior primary rami of spinal nerves L1, L2, L3 and S1, S2, S3.

3)The lower and the anterior part is supplied branches from the posterior division of the LATERAL CUTANEOUS NERVE OF THE THIGH(S1, S2)

4)The lower and the posterior part is supplied by the branches from the posterior cutaneous nerve of the thigh (s1, s2, s3) and the perforating cutaneous

Nerve (S2, S3).

CUTANEOUS INNERVATION OF THE LEG and dorsum of foot:

1)THE SAPHENOUS NERVE is a branch of the femoral nerve. It supplies the skin of the medial sid eof the leg and the medial border of the foot up to the ball of the big toe.

2)THE INFRAPATELLAR BRANCH of the Saphenous nerve suplies the skin over the ligamentum patellae.

3)THE LATERAL CUTANEOUS NERVE OF THE CALF is a branch of the common peroneal nerve. It supplies the skin of the upper two-thirds of the lateral side of the leg.

4)THE SUPERFICIAL PERONEAL NERVE is a branch of the common peroneal. It supplies -the skin over the lower one-third of the lateral of the lateral side of the leg, -the skin over the dorsum of the foot except the lateral border(sural nerve), medial border(saphenous nerve), and the cleft between 1st and 2nd toes(deep peroneal nerve).

5)THE SURAL NERVE is a branch of the tibial nerve.It supplies the skin of the lower half of the back of leg and the whole lateral border of the foot up to the tip of the little toe.

6)THE DEEP PERONEAL NERVE supplies the skin on the cleft between 1st and 2nd toes.

7)THE DIGITAL BRANCHES OF THE MEDIAL AND LATERAL PLANTAR NERVES supply the distal parts of the dorsum of the toes.

Medial plantar nerve-medial 3 1/2 toes. Lateral plantar nerve-lateral 1 ½ toes.

Cutaneous innervation of sole of foot:

1)LATERAL PLANTAR NERVE supplies lateral one fourth of foot .2)MEDIAL PLANTAR NERVE supplies medial three fourths of foot .3)MEDIAL CALCANEOUS NERVE, a branch of TIBIAL nerve (just before it divides into medial and lateral plantar nerves) supplies the skin over calcaneus . 

AFFECTED NERVE

SENSORY LOSS

FEMORAL NERVE

SCIATIC NERVE

COMMON PERONEAL

TIBIAL

OBTURATOR

SUPERIOR GLUTEAL

INFERIOR GLUTEAL

PUDENDAL

DEEP PERONEAL

SUPERFICIAL PERONEAL

Anterior side of thigh and medial side of leg upto big toe.

Back and lateral side of leg, most of dorsum of foot, sole of foot.

Lateral & anterior side of leg, most of dorsum of foot, most of digits.

Skin of sole. Trophic ulcers can develop.

Small area on the medial side of thigh.

-

-

Skin of perineum

1st inter digital cleft

Lateral side of leg, most of dorsum of foot.

Applied aspects:

INJURED NERVE SENSORY LOSS

MEDIAL PLANTAR

LATERAL PLANTAR

Medial 2/3 rd of sole and digital nerves to medial 3 ½ toes, including nail beds.

Lateral 1/3 rd of sole and digital nerves to lateral 1 ½ toes, including nail beds.