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Innervation
  • Motor
    • anterior division branches
      • topic sartorius 
      • topic pectineus 
    • posterior division branches
      • topic rectus femoris 
      • topic vastus medialis 
      • topic vastus lateralis 
      • topic vastus intermedius 
  • Sensory 
    • anterior division branches provides sensation to anteromedial asepct of the thigh, consists of 2 branches: 
      • medial cutaneous nerve of thigh 
      • intermediate cutaneous nerve
    • posterior division 
      • saphenous nerve   
        • provides sensation to anteromedial aspect of lower leg
      • infrapatellar branches to knee
        • piereces the sartorius and fasica lata medial to the knee, and provides cutaneous innervation to the skin anteriorly over the patella
Origin
  • L2 to L4 nerve roots
    • lumbosacral plexus  
      • femoral nerve
        • anterior division branches
        • posterior division branches
Course
  • Through psoas
    • courses through the psoas major muscle
    • emerges from lateral border of psoas; then passes downward between psoas and iliacus
  • Deep to inguinal ligament
    • Runs deep to the inguinal ligament to enter the thigh
    • branches 4 cm inferior to the inguinal ligament (anterior and posterior branches)
  • Terminal Branches
    • anterior division branches
      • medial cutaneous nerve of thigh
      • intermediate cutaneous nerve
      • motor branch to sartorius 
      • motor branch to pectineus
    • posterior division branches
      • saphenous nerve
      • motor branches to
        • rectus femoris 
        • vastus medialis 
        • vastus lateralis 
        • vastus intermedius 
      • articular branches to knee
Injury & Clinical Conditions
  • Femoral nerve damage 
    • causes
      • direct trauma is most common 
      • iatrogenic (ie. percutaneous proximal interlocking screw placement through IM nail)
      • compression from tumor or hematoma
    • clinical signs
      • motor
        • quadriceps wasting
        • loss of knee extension and some hip flexion (iliacus, pectinues)
      • sensory
        • loss of sensation over front and medial side of thigh (anterior and medial cutaneous nerves of the thigh)
        • loss of sensation over medial aspect of lower leg and foot (saphenous nerve)
 

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