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Lateral cutaneous nerve of thigh

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This is an old revision of this page, as edited by Bibeyjj (talk | contribs) at 22:44, 26 February 2022 (Removing {{No footnotes}}. Lead expansion. →Structure: Reference for many details, and branches. →Ultrasound: Reused reference for patient position and probe technique. →Nerve block: Reused reference for ultrasound guidance of needle. →Meralgia paraesthetica: Reused reference for specific changes, and side comparison.). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

Lateral cutaneous nerve of thigh
Plan of lumbar plexus. (Lateral femoral cutaneous visible at left.)
Cutaneous nerves of the right lower extremity. Front and posterior views.
Details
FromLumbar plexus (L2–L3)
InnervatesSkin on the lateral part of the thigh
Identifiers
Latinnervus cutaneus femoris lateralis
TA98A14.2.07.011
TA26521
FMA16485
Anatomical terms of neuroanatomy

The lateral cutaneous nerve of the thigh (also called the lateral femoral cutaneous nerve) is a cutaneous nerve of the thigh. It originates from the dorsal divisions of the second and third lumbar nerves from the lumbar plexus. It passes under the inguinal ligament to reach the thigh. It supplies sensation to the skin on the lateral part of the thigh by an anterior branch and a posterior branch.

The lateral cutaneous nerve of the thigh can be investigated using ultrasound. Local anaesthetic can be injected around the nerve for skin grafts and surgery around the outer thigh. Nerve compression (usually around the inguinal ligament) can cause meralgia paraesthetica.

Structure

The lateral cutaneous nerve of the thigh is a nerve of the lumbar plexus.[1][2] It arises from the dorsal divisions of the second and third lumbar nerves (L2-L3).[1][3] It passes through psoas major muscle, and emerges from its lateral border.[3] It crosses the iliacus muscle obliquely, toward the anterior superior iliac spine (ASIS).[2] It is crossed by the deep circumflex iliac artery and the deep circumflex iliac vein.[3] It then passes under the inguinal ligament.[1] It passes through the muscular lacuna. It then passes over the sartorius muscle into the thigh, travelling from medial to lateral.[2] It is usually between 1 and 2 mm thick.[2]

Branches

The lateral cutaneous nerve of the thigh usually divides into an anterior (or anterolateral) branch and a posterior branch.[3]

Anterior branch

The anterior branch becomes superficial about 10 cm below the inguinal ligament. It divides into branches which are distributed to the skin of the anterior and lateral parts of the thigh, as far down as the knee.[3] The terminal filaments of this nerve frequently communicate with the anterior cutaneous branches of the femoral nerve, and with the infrapatellar branch of the saphenous nerve, forming with them the peripatellar plexus.

Posterior branch

The posterior branch pierces the fascia lata. It subdivides into filaments, which pass backward across the lateral and posterior surfaces of the thigh. It supplies the skin around the greater trochanter.[3]

Variation

The lateral cutaneous nerve of the thigh may have multiple branches.[2] Its position with relation to the ASIS can be very variable.[3] It may partially pass through sartorius muscle rather than over its surface.[2] It may be absent, and the sensory supply replaced by branches of the femoral nerve and the ilioinguinal nerve.[2]

Function

The lateral cutaneous nerve of the thigh is a sensory nerve.[1][2] It supplies the skin on the lateral (outer) part of the thigh.[1][2]

Clinical significance

Ultrasound

The lateral cutaneous nerve of the thigh can be studied using ultrasound.[2] A patient lies on a bed facing upwards (supine).[3] The ultrasound probe is moved along the length of the nerve, often starting from near the ASIS.[3] The nerve is easier to see over the sartorius muscle than in other subcutaneous tissue, as there is greater contrast.[2] It can sometimes be difficult to see due to surrounding soft tissue.[2]

Nerve block

The lateral cutaneous nerve of the thigh can be blocked with local anaesthetic.[2] Ultrasound is used to guide needle insertion.[3] This is used for procedures in the supplied area of skin, such as surgical incisions over the outer thigh, and skin grafts.[2]

Meralgia paraesthetica

Main article: Meralgia paraesthetica

Entrapment of the lateral cutaneous nerve of the thigh is caused by compression of the nerve near the anterior superior iliac spine and the inguinal ligament.[1] This causes meralgia paraesthetica (Bernhardt-Roth syndrome).[1][4] This may be diagnosed with ultrasound, which changes the morphology of the nerve.[2] Changes can include general enlargement,[2] and a hypoechoic appearance.[3] In patients who only have meralgia paraesthetica on one side, ultrasound scans are performed on both thighs to compare the appearance of the nerve.[3]

History

The lateral cutaneous nerve of the thigh may also be known as the lateral femoral cutaneous nerve.[2]

Additional images

  • Lateral cutaneous nerve of thigh and other structures passing behind the inguinal ligament
    Lateral cutaneous nerve of thigh and other structures passing behind the inguinal ligament
  • The great saphenous vein and its tributaries at the fossa ovalis.
    The great saphenous vein and its tributaries at the fossa ovalis.
  • The lumbar plexus and its branches.
    The lumbar plexus and its branches.
  • Deep and superficial dissection of the lumbar plexus.
    Deep and superficial dissection of the lumbar plexus.
  • Diagram of segmental distribution of the lateral cutaneous nerve (shaded) and other nerves of the right leg. Front view.
    Diagram of segmental distribution of the lateral cutaneous nerve (shaded) and other nerves of the right leg. Front view.
  • Cutaneous nerves of the right lower extremity. Front and posterior views.
    Cutaneous nerves of the right lower extremity. Front and posterior views.

See also

References

Public domain This article incorporates text in the public domain from page 953 of the 20th edition of Gray's Anatomy (1918)

  1. ^ a b c d e f g David, W. S. (2014). "Meralgia Paresthetica". Encyclopedia of the Neurological Sciences - Reference Module in Neuroscience and Biobehavioral Psychology (2nd ed.). Academic Press. pp. 1099–1100. doi:10.1016/B978-0-12-385157-4.00666-7. ISBN 978-0-12-385158-1.
  2. ^ a b c d e f g h i j k l m n o p q Gray, Andrew T. (2019). "39 - Lateral Femoral Cutaneous Nerve Block". Atlas of Ultrasound-Guided Regional Anesthesia (3rd ed.). Elsevier. pp. 143–149. doi:10.1016/B978-0-323-50951-0.00039-6. ISBN 978-0-323-50951-0.
  3. ^ a b c d e f g h i j k l Becciolini, Marco; Pivec, Christopher; Riegler, Georg (2021-08-13). "Ultrasound of the Lateral Femoral Cutaneous Nerve". Journal of Ultrasound in Medicine. doi:10.1002/jum.15809. ISSN 0278-4297.
  4. ^ Waldman, Steven D. (2009). "177 - Meralgia Paresthetica". Pain Review. Saunders. p. 301. doi:10.1016/B978-1-4160-5893-9.00177-5. ISBN 978-1-4160-5893-9.
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