HUMAN ANATOMY &

PHYSIOLOGY I

SKELETAL SYSTEM 2
NERVE SUPPLY OF LOWER LIMB

DR WAN SAFWANI WAN KAMARUL ZAMAN

 DEFINITIONS

• Lumbosacral= involving the lumbar and sacral

regions

• Plexus= A structure in the form of a network,

especially of nerves, blood vessels, or
lymphatics
 LUMBOSACARAL PLEXUS – INNERVATION OF THE
LOWER LIMBS

• The anterior divisions of the lumbar nerve, sacral nerve, and

coccygeal nerves form the lumbosacral plexus.

• The first lumbar nerve being frequently joined by a branch from

the twelfth thoracic.

• For descriptive purposes this plexus is usually divided into 2

parts:
1. lumbar plexus
2. sacral plexus
 LUMBAR PLEXUS
• Arise from spinal nerves L1 – L4 & located
within psoas major muscle.

• Major branches innervate the anterior and

medial thigh.

1) Femoral nerve – largest

• Runs deep to inguinal ligament to enter thigh &
divides into several branches.
a) Motor branches – anterior thigh muscles
(quadriceps)
b) Cutaneous branches – skin of anterior thigh &
medial surface of leg from knee to foot.

2) Obturator nerve
• Enters medial thigh via obturator foramen &
innervates adductor muscles.

 Other smaller branches of lumbar plexus –

lateral femoral cutaneous, illiohypogastric,
illioinguinal, genitofemoral.
 FEMORAL NERVE
• Innervates: muscles of the anterior thigh
• Action: Flex hip, extend knee 
• Injury to nerve: Weakness of hip flexion, loss
of knee
extension (no patellar reflex), sensory loss on
anteromedial thigh, knee, leg, and foot

• Lateral Femoral Cutaneous Nerve 

somatosensory only to skin of lateral aspect of
thigh.
Femoral nerve innervates:

• Skin of anterior and lateral
thigh, medial leg and foot

• Anterior muscles of thigh
and extensors of leg; iliacus,ps
oas major, pectineus,
quadriceps femoris (rectus
femoris, vastus intermedius, v
astus lateralis and vastus
medialis), and sartorius
• Posterior division
femoral nerve

• Anterior division
Cutaneous nerve
posterior
 SACRAL PLEXUS
• Arise from spinal nerved L4 – S4 & located caudal to lumbar plexus.
• Some fibers of lumbar plexus contribute to sacral plexus via lumbosacral trunk.
• Major branches:

1) Sciatic nerve – thickest & longest

• Supplies almost the entire lower limb
• Projects from pelvis through greater sciatic notch of os coxae & extends into
posterior region of thigh
• Subdivision a) tibial and b) common fibular –wrap in common sheath.

a) Tibial nerve
• Formed from anterior division of sciatic nerve.
• Innervates hamstring except short head of biceps femoris
• In posterior compartment of leg – supplies plantar flexors of foot & toe flexors.
 SACRAL PLEXUS

b) Common fibular nerve (peroneal)

• Formed from posterior division of sciatic nerve
• Supplies short head of biceps femoris muscle.
• Laterally it wraps around neck of fibula & split into 2 main
branches
1) deep fibular nerve
2) superficial fibular nerve
Deep fibular nerve (Deep peroneal)
• In anterior compartment of leg
• Terminates between 1st & 2nd toes
• Receive sensory innervation from
skin between 1st & 2nd toe on
dorsum of foot.

Superficial fibular nerve (superficial

peroneal)
• In lateral compartment of leg
• Proximal to ankle
• Innervates lateral compartment
muscles of leg – foot evertors &
weak plantar flexors.
• Superior and inferior
gluteal nerves –
innervate the gluteal
muscles

• Pudendal nerve –
innervates muscles of
the perineum