After completion of this session, students should be able to discuss, identify, and describe: The anatomical factors predisposing to nerve injuries. The anatomy of deformity, weakness and sensory loss following the nerve injury. The applied anatomy of clinical examination for specific nerves. Surgical anatomy of treating nerve injuries.

1. Dr.AkramJaffar
Applied Anatomy of Nerve Injuries in the Lower LimbApplied Anatomy of Nerve Injuries in the Lower Limb
Femoral nerveFemoral nerve
Akram Jaffar, Ph.D.
Subscribe to Human Anatomy Education Channel
https://www.youtube.com/user/akramjfr
Human Anatomy Education platforms by Akram Jaffar
Follow @AkramJaffar Like Human Anatomy Education Page
https://www.facebook.com/AnatomyEducation

2. Dr.AkramJaffar
References and suggested reading
• Ellis H (2006): Clinical anatomy, A revision and applied anatomy for clinical students.
11th
Ed. Blackwell Publishing. Massachusetts
• Moore KL & Dalley AF (2006): Clinically oriented anatomy. 5th
ed. Lippincott Williams
& Wilkins. Baltimore
• Brust JCM (2007): Current Diagnosis & Treatment in Neurology. 2nd
ed. McGraw-Hill
Professional.

3. Dr.AkramJaffar
Objectives
After completion of this session, students should be able to discuss, identify, and describe:
– The anatomical factors predisposing to nerve injuries.
– The anatomy of deformity, weakness and sensory loss following the nerve injury.
– The applied anatomy of clinical examination for specific nerves.
– Surgical anatomy of treating nerve injuries.

4. Dr.AkramJaffar
Femoral nerve
• Is the nerve of the anterior
compartment of the thigh.
• Branch of the lumbar
plexus in the abdomen
(L2, 3, & 4).
• Traverses the lateral wall
of the false pelvis
between psoas major and
iliacus muscles.
Femoral n.

5. Dr.AkramJaffar
Femoral nerve
• Enters the thigh deep to the inguinal
ligament lateral to the femoral
artery.
• Breaks up into a number of
branches an inch below the inguinal
ligament.
• Injury: rare
– Acetabular fracture.
– Anterior dislocation of the hip
joint.
– Stab wounds.
– Compression of nerve roots by
intervertebral disc.
– Complication of pelvic surgery
and gynecologic laparoscopy.
Femoral n.

6. Dr.AkramJaffar
Branches of the femoral nerve
• Muscular branches:
– Sartorius, quadriceps femoris, pectineus,
and iliacus.
• Articular branches:
– To the hip and knee joints.
• Cutaneous branches:
– Medial and intermediate cutaneous nerves
of the thigh
– saphenous nerve, which becomes
cutaneous in the leg and foot.
• Injury results in
• Loss of knee extension
• Loss of quadriceps reflex
• Atrophy of quadriceps
• Weakness of hip flexion
• Loss of cutaneous sensation on anterior thigh
and medial side of the leg and foot.
• Pain may be felt over the femoral nerve
distribution due to compression of the L2,3,4
nerve roots by an intervertebral disc.

7. Dr.AkramJaffar
Quadriceps reflex (knee jerk)
• Tapping the ligamentum patellae produces reflex
contraction of quadriceps muscle i.e. extension of
the knee.
• Tests the integrity of L2, 3, & 4 spinal segments
and the femoral nerve.
• A reflex arc requires
– sensory receptor
– sensory neuron (afferent pathway)
– central synapse
– motor neuron (efferent pathway)
– effecter (e.g. muscle fibers, glands etc.)