hi Niners in this video we're going to talk specifically about the lumbar plexus okay so the lumbar plexus is very important and we'll provide a little clinical correlation to it also all right now if we look at the actual lumbar plexus it's going to be coming usually it actually starts at about T12 actually we actually include T12 so let's put this down here we got T12 all right we're also going to have L1 L2 L3 L4 and L5 now T12 is actually going to give off a branch called the subcostal nerve okay so T12 will actually be giving off a branch here right and this main nerve of T12 is going to be the subcostal nerve it actually runs underneath the inferior border of the 12th rib that's why they called the subcostal nerve now the subcostal nerve is important because one of the things about the subcostal nerve is the subcostal nerve is going to give Motor Supply so it has uh two destinations of Motor Supply one of the motor supplies that it actually brings is it's actually going to go and Supply specifically What's called the pyramid Alice so the pyramid Alice and the pyramid Alice is important because it's one of the actual abdominal wall muscles very very deep muscle and what the pyramidalis muscle is actually doing is is it's tensing this appin neotic connective tissue sheath running down in the abdominal wall it's called the Linea Alba so it's actually responsible for tensing the actual Linea Alba another branch of the subcostal nerve is going to go to one of the other deep abdominal wall muscles called the transverse abdominis so it's also going to give another Branch off and this is going to be going to the transverse abdominis okay sweet deal that's a subcostal Nerf it does provide some cutaneous sensation but we're not going to talk about that okay L1 L1 is going to be important because one of the main things that's coming off L1 is going to be the ilango and iloh hypogastric and we'll talk about those so let's say I bring L1 and the primary nerve that's actually coming off of L1 is going to be the ILO inguinal inal nerve now what's important about this one second there's another nerve which is actually going to pick up some of the fibers from T2 and it's also going to pick up some fibers from L1 so this is going to pick up some of the fibers from T12 and it's going to pick up some of the fibers from L1 and it's going to form this nice little nerve and this nerve is called the ILO hypo gastric nerve okay iloh hypogastric nerve now the iloh hypogastric nerve is really cool because again it can actually have cutaneous branches and it can have motor branches so for the iloh hypogastric nerve let's actually Branch it out here into two different things it's going to have a cutaneous Supply and it's going to have a motor supply now for the iloh hypogastric nerve IT Supplies cutaneously two different areas one is it's going to supply the skin over the pubis okay so it's going to supply the skin over the pubus and it's going to supply the skin of the lateral buttocks okay or the booty cheeks so it's going to supply the skin above pubis and it's also going to supply the skin on lateral buts all right so that's the iloh hypogastric nerve okay then Motor Supply the motor supply of the iloh hypogastric nerve is actually going to be going to the internal oblique so it'll actually Supply the internal oblique and it'll Supply the transverse abdominis okay so this is actually going to supply the internal oblique leak and it's going to supply the transverse abdominis now if you guys know a little bit about your uh physiology of these muscles you know that the transverse abdominus is actually going to be responsible for helping whenever it contracts it compresses some of the contents within the abdomen to increase the intraabdominal pressure to push on the diaphragm to assist during the forced expiratory process whereas the internal oblique is going to be one of the actual skeletal muscles that are going to be primarily responsible for flexing the vertebral column so they play a role with inflexion of the vertebral column and they compress the contents of the abdomen to assist in the forced expiratory process now the ininal nerve is going to have two branches one is going to be a cutaneous branch and the other one is going to be a motor Branch so it's gonna have a cutaneous Supply and it's going to have a Motor Supply the cutaneous of the ilioinguinal nerve it's going to be primarily supplying okay if you're looking at the ilango nerve this is going to be having cutaneous sensation also so the ilal nerve is actually going to supply the skin on the proximal and medial part of the thigh so it's going to be supplying the skin on the proximal medial part of the thigh so it's going to supply the skin of proximal and medial thigh and it's also going to give cutaneous sensation to some of the actual external genitalia like structure so for example in the male it will supply the scrotum the upper part of the scrotum it'll also Supply the root of the penis so the sum of the skin on the root of the penis and for the the female it's also going to supply certain structures there so for the female it actually will give uh cutaneous sensation to the mons pubis you know the mons pubis is the fatty uh region okay and it's the fatty rounded region and it's actually going to supply the skin over the mons pubis and it's also going to supply the labia majora okay that's the ilal nerve the iloo nerve can give a little bit of supply to the internal oblique in the transverse abdominis too okay so it can give a little bit of motor supply to the internal oblique and a little bit to the transverse abdominis but primarily this is going to be more of an actual cutaneous nerve so we'll put a little AST conect to this it's mainly a cutaneous Supply but it does have a little bit of motor supply that can give to the internal oblique and the transverse abdominus okay now let's go to the next one now we're going to come to the next branch which is going to be called the genit oforal nerve and I'm going to give you guys a nice little pneumonic here in a little bit to help you guys with this process here okay so let's come here and now what happens is let's do this one in green if I bring this Branch here I bring L1 and L2 together so now I'm going to bring L1 and L2 together if I bring these guys together this is going to form another nerve which is actually going to be coming off of the anterior division okay so it's coming off the anterior division of the lumbar plexus so let's actually put this here this is coming off the anterior division of the lumbar plexus this nerve is going to be specifically called the genito femoral nerve and the genital femoral nerve is pretty much what you can actually hear it within the name it has cutaneous and Motor Supply so the cutanous is pretty much similar to the ilioinguinal so if you think about the cutaneous for this guy it's actually going to supply the scrotum in the male all right so for the male it's obviously going to supply the scrotum and within the female it's going to supply the labia majora and it's also going to supply the anterior thigh but it's going to supply the skin of the anterior thigh that's going to be just below the middle inguinal region okay so it's going to supply the anterior thigh Superior to Middle inguinal region okay Motor Supply though what's important about the motor supply IT Supplies one of the muscles that actually helps to elevate those testes the ball bag right so it helps to uh the cre Master muscle so the cre Master muscle this this muscle is really funny so helps to be able to supply the creas muscle so again it supplies the creas muscle which helps to elevate the testes so if you look at the genal femoral nerve it has Motor Supply to the cre Master muscle which elevates the testes and has cutaneous supply to the scrotum the labium Majora and the anterior thigh just superior to the middle inguinal region all right so we deal then let's bring another Branch here let's have L3 it's actually going to have some fibers that will be picked up with L2 so now look at this I'm going to have some fibers from L3 come up here and Supply L2 so L2 and L3 will come together let's actually make this line a little bit nicer here and it's going to give fibers to L2 and this will come together and this will form this important nerve and this nerve is actually called the lateral femoral cutaneous nerve and you can obviously tell by the name of this nerve that it's only going to be having cutaneous Supply what is the cutaneous Supply it's going to be mainly supplying the lateral thigh pretty much it so it's supplying the lateral thigh and it does give sensory cutaneous Supply to What's called the Peroni which is a double layered Cirrus membrane and it's actually going to house some of the actual gastrointestinal organs that we'll talk about within the GI okay so it's going to have cutaneous sensation to lateral thigh and to the paronian now here's a kind of a next little one here so we've gone over iloh hypogastric nerve IL angal nerve genital femoral lateral FOC cutaneous now we're going to do another one this one is going to be picking up fibers from L2 so it's actually going to be picking up fibers from L2 it's going to be picking up fibers from L3 and it's going to pick up fibers from L4 let's actually draw L4 right here okay so it's also going to be picking up fibers from L4 so let's have them moving through here and picking up fibers here so if I have this nice little blue nerve here this is a really important nerve because as this nerve is is leaving it's actually going to be a part of the uh anterior division here this is actually a part of the anterior division of the specifically what anterior division of the lumbar plexus so this is going to be coming off the anterior division this nerve will actually come off and move through a nice little hole here what is this hole here that it moves through it moves through a hole here which is called the one of the biggest holes in the body this is called the operator foran so it'll move through a nice little hole called the operator foran what do you think this nerve is opat nerve okay so this is actually called the opter nerve this is called the opor nerve now the opter nerve supplies many many many different structures before we go over that let's do one other nerve now this nerve is actually going to come as kind of an accessory branch of the operator nerve but it doesn't come from L2 it only comes from L3 and L4 so it's only going to be picking up fibers from L3 and it's going to be picking up fibers from L4 this is actually called the accessory opter nerve so this one is actually called the accessory opter nerve now the accessory operator nerve is going to be in 30% of certain patient cases you're actually going to find this nerve and what this nerve does is it's actually going to supply cutaneous Supply it's mainly going to be having a cutaneous branch and then cutaneous branch is going to be specifically going to the hip joint so it's going to be supplying the skin around the hip joint okay so it's really really good for cutaneous supply to the hip joint it's also going to have motor fibers and these motor fibers are actually going to be primarily supplying What's called the pectineus muscle so it's call supplying the pectineus muscle which is an important muscle for flexion at the hip okay the Alor nerve SI supplies so many different structures we're going to talk about him in just a second let me actually move and bring L5 in here okay out of the way here so now I'm going to bring the opter nerve just a little bit more down here so we can talk about what it's supplying because it's supplies a lot of different structures here okay so the opter nerve is actually going to supply many many different types of structures so it has two different uh supplies it obviously is going to have cutaneous Supply and it's going to have Motor Supply so if it is cutaneous it's going to mainly be supplying the actual medial thigh so it's going to supply the medial thigh so this is actually going to give cutaneous sensation to the medial thigh pretty simple for this one it's primarily only going to give cutanous sensation to the medial thigh the motor supply though is going to supply a lot of different muscles so the opp op terator nerve it can actually Supply what let's actually look here at the operator nerve it can supply the adductor muscles so for example the adductor longus the adductor Magnus the adductor brevis it can even Supply the gillus so it can supply these muscles here and it even can supply the operator extern F so it can have a lot of different muscles that this guy supplies right so it can supply the adductor longus aductor Magnus aductor brevis which are all adductor muscles IT Supplies the gillus which helps to perform flexion at the hip it also helps to perform adduction and it can even rotate the hip right all right that's the opat nerve right now so we've gone over the accessory opat we've gone over the opat let's do another really important nerve here let's do this one in pink okay so we're going to actually no we'll do it in black but we'll write the things in pink here now this nerve is really important this nerve is actually going to be getting branches from L4 it's going to be picking up branches from L3 and it's also going to be picking up branches from L2 so it picks up branches from L2 L3 and L4 and this is going to form one of the really really important nerves here which is called the femoral nerve so this is going to supply the this is going to form What's called the femoral nerve which is actually coming for the posterior division of this part right here so femoral nerve now what's important about the femoral nerve is that it's actually going to have cutaneous Supply but they actually kind of give a little name to these branches here so one of the branches of the femoral nerve for the cutaneous so it has cutaneous Supply one of the Tous branches is actually called the anterior feal cutaneous branch and you can obviously tell what this is going to supply this one will supply primarily the anterior it'll Supply the anterior and a little bit of the lateral aspect of the thigh so this supplies anterior and and lateral Sensations from the thigh the other branch is going to be What's called the saffin branch the saffin branch and the saffin branch is actually going to be a really cool one because it supplies the medial hip joint IT Supplies the medial thigh the medial aspect of the knee joint IT Supplies the medial aspect of the calf and even the medial aspect of the heel so a lot of different cutaneous Sensation from this branch of the fal nerve so you can imagine if there was any damage to the femal nerve the type of paresthesia that you would experience from that guy now like anything it has Motor Supply son of a gun let's bring this facial nerve I'm sorry not facial nerve femoral nerve here let's have another part over here and this is obviously going to be the motor supply but we're going to do this in red and this is going to be the motor supply he supplies a boatload of muscles that's why if there is ever any types of herniated discs or some type of situation where there's compression of the femoral nerve it could affect the way the person has the ability to walk why because the motor supply is out ridiculous it supplies the iliacus which is a prime mover for flexion it at the hip it also supplies the ptinus which is also another mover for flexion at the hip IT Supplies the quadriceps femoris and for those of you who know that it consists of the vastis medialis lateralis and intermedius and you'll know that these all do extension at the knee and it's actually consists of the rectus foror right and a really big one is the sartorious muscle it also supplies the sartorious muscle and if you know the rectus foror can do flexion at the hip and extension at the knee the sorus can Flex the knee can Flex the hip and it can even do rotation of the hip primarily that of uh lateral rotation so you can see here that if the femoral nerve is actually damaged what could actually again what could actually cause the compression of this for moral nerve one of the more common causes is going to be some type of herniated disc herniated disc within around the region of L2 L3 and L4 that's why it's important sometimes to actually know what branches are supplying this nerve because if you have a herniated disc within this region here what what is a herniated disc you know if I actually have here let's say here I draw a vertebrae let's say here's a vertebrae here just the body of it here's a vertebrae here and then you have this structure here in the middle it's like a jelly like material it's called let's actually do this in a different color because let's do the anulus fibus within a different color let's have here this jelly-like material which is actually derived from the the not cord it's actually called the nucleus pulses right so the nucleus pulsus is actually going to be this jelly-like material derived from the notic cord and around it you're actually going to have these interweaving fibers right here which is made up of lot of collagen they call this the anulus fibrous fibrosis right so the anulus fibrosis and this is going to consist of a lot of cartilage fibrocartilage primarily right when these spinal nerves so this is actually where the spinal nerves run through right they run through that intervertebral foran right here right they run through there if there's some type of bulging let's say by for whatever some situation there's too much compression there's some type of situation in which this actual nucleus pulsus is herniated out and if it is herniated out from that annulus fibrous connective tissue that fibrocartilage right what can it do it can compress these nerves and if it compresses these nerves what can happen it can affect the actual motor supply so what might happen with these people they might not have they might have a hard time being able to obviously from a lot of the flexors of the hip they might have a have a hard time being able to flex at the hip they might also have loss or paresthesia so they might have pain numbness tingling within the a lot of these different areas so the medial aspect of the hip joint the medial aspect of the thigh the medial knee the medial calf the medial heel the anterior and lateral thigh a lot of different things can be coming from that femoral nerve right okay so this could be one of the big things and also if the femoral nerve is if for whatever reason it's due to this herniated disc what else could happen it could affect them being able to walk so they might have a strange gate like of walk because it's affecting the primary flexors of the hip all right one more Branch here and this is going to lead into our next video that we're going to have on the sacral plexus is L4 and L5 are actually going to come together and when L4 and L5 come together they form this nice thick like trunk and this thick trunk here is actually called the lumbo sacral trunk so this is this right here is actually called the lumbo sacral trunk this is really important because it's going to lead into the sacral plexus all right this is called the lumbo sacral trunk okay and so again this is pretty much giving us the entire lumbar plexus now let me give you a quick little pneumonic to help you to remember most of the branches it's not going to cover all of them but it's going to cover the major branches so it kind of goes like this there's different versions out there trying to provide the most you know sensible one not inappropriate so it goes I twice got lost on freeways and again this is the main branches okay so I'm going to put in parenthesis twice here so I twice so there's two eyes what is those two eyes one of them is going to be ILO hypogastric then twice ILO inguinal got genitofemoral lost lateral femoral cutaneous on operator and F femoral so these are the main branches of the lumbar plexus right so I just wanted to give you that little monic because that can kind of help you out to really really get that down and then you can focus more on specifically what like actual branches are coming from from lumbar plexus and you can focus a little bit more on what actually is a supply all right Ninja nerds so in this video we did Cover a lot of information we covered the lumbar plexus in great detail we covered all the branches we covered the cutaneous and the motor supply and we covered the more common uh clinical correlations with that being that of herniated disc or any type of trauma or damage or lesion that can develop within the L2 L3 L4 region obviously can damage the femal nerve and if this Legion develops a little bit more anteriorly it can affect the opat nerve and that could also cause a lot of problems too all right all right Engineers I hope all this made sense I hope you guys did enjoy it if you did like it please hit the like button comment down in the comment section and please subscribe all right Engineers as always until next time