Iliohypogastric Nerve
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The iliohypogastric nerve is a
nerve A nerve is an enclosed, cable-like bundle of nerve fibers (called axons) in the peripheral nervous system. A nerve transmits electrical impulses. It is the basic unit of the peripheral nervous system. A nerve provides a common pathway for the e ...
that originates from the
lumbar plexus The lumbar plexus is a web of nerves (a nervous plexus) in the lumbar region of the body which forms part of the larger lumbosacral plexus. It is formed by the Ventral ramus of spinal nerve, divisions of the first four lumbar nerves (L1-L4) and ...
that supplies
sensation Sensation (psychology) refers to the processing of the senses by the sensory system. Sensation or sensations may also refer to: In arts and entertainment In literature * Sensation (fiction), a fiction writing mode * Sensation novel, a Britis ...
to
skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other cuticle, animal coverings, such as the arthropod exoskeleton, have diffe ...
over the lateral
gluteal The gluteal muscles, often called glutes are a group of three muscles which make up the gluteal region commonly known as the buttocks: the gluteus maximus, gluteus medius and gluteus minimus. The three muscles originate from the ilium and sacr ...
and hypogastric regions and motor to the internal oblique muscles and transverse abdominal muscles.


Structure

The iliohypogastric nerve originates from the superior branch of the
anterior ramus The ventral ramus (pl. ''rami'') (Latin for ''branch'') is the anterior division of a spinal nerve. The ventral rami supply the antero-lateral parts of the trunk and the limbs. They are mainly larger than the dorsal rami. Shortly after a spinal n ...
of spinal nerve L1. It also receives fibers from T12 via the
subcostal nerve The subcostal nerve (anterior division of the twelfth thoracic nerve) is larger than the others. It runs along the lower border of the twelfth rib, often gives a communicating branch to the first lumbar nerve, and passes under the lateral lumbocost ...
. The branch below it is the
ilioinguinal nerve The ilioinguinal nerve is a branch of the first lumbar nerve (L1). It separates from the first lumbar nerve along with the larger iliohypogastric nerve. It emerges from the lateral border of the psoas major just inferior to the iliohypogastric, an ...
. It emerges from the upper lateral border of the
psoas major The psoas major ( or ; from grc, ψόᾱ, psóā, muscles of the loins) is a long fusiform muscle located in the lateral lumbar region between the vertebral column and the brim of the lesser pelvis. It joins the iliacus muscle to form the iliop ...
. It then crosses in front of the
quadratus lumborum muscle The quadratus lumborum muscle, informally called the ''QL'', is a paired muscle of the left and right posterior abdominal wall. It is the deepest abdominal muscle, and commonly referred to as a back muscle. Each is irregular and quadrilateral in sh ...
to an area superior to the
iliac crest The crest of the ilium (or iliac crest) is the superior border of the wing of ilium and the superiolateral margin of the greater pelvis. Structure The iliac crest stretches posteriorly from the anterior superior iliac spine (ASIS) to the posterior ...
. It runs behind the
kidney The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blood ...
s. Just superior to the iliac crest, it pierces the posterior part of the
transversus abdominis muscle The transverse abdominal muscle (TVA), also known as the transverse abdominis, transversalis muscle and transversus abdominis muscle, is a muscle layer of the anterior and lateral (front and side) abdominal wall which is deep to (layered below) t ...
and continues anteriorly in the abdominal wall between the transversus abdominis and internal oblique muscles. It divides into a lateral cutaneous branch and an anterior cutaneous branch between the transversus abdominis muscle and the internal oblique muscle.


Lateral cutaneous branch

The lateral cutaneous branch ("iliac branch") pierces the internal oblique muscles and the external oblique muscles immediately above the
iliac crest The crest of the ilium (or iliac crest) is the superior border of the wing of ilium and the superiolateral margin of the greater pelvis. Structure The iliac crest stretches posteriorly from the anterior superior iliac spine (ASIS) to the posterior ...
. It is distributed to the skin of the gluteal region, behind the lateral cutaneous branch of the
subcostal nerve The subcostal nerve (anterior division of the twelfth thoracic nerve) is larger than the others. It runs along the lower border of the twelfth rib, often gives a communicating branch to the first lumbar nerve, and passes under the lateral lumbocost ...
; the size of this branch bears an inverse proportion to that of the lateral cutaneous branch of the
subcostal nerve The subcostal nerve (anterior division of the twelfth thoracic nerve) is larger than the others. It runs along the lower border of the twelfth rib, often gives a communicating branch to the first lumbar nerve, and passes under the lateral lumbocost ...
. When harvesting bone from the anterior iliac crest (AICBG), the lateral cutaneous branch of the Iliohypogastric nerve (L1) is most likely to be injured. File:Gray826and831.PNG, Area supplied by the lateral cutaneous branch can be seen in blue near the hip.


Anterior cutaneous branch

The anterior cutaneous branch ("hypogastric branch") continues onward between the abdominal internal oblique and transverse muscles. It then pierces the internal oblique, becomes
cutaneous Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other animal coverings, such as the arthropod exoskeleton, have different d ...
by perforating the
aponeurosis An aponeurosis (; plural: ''aponeuroses'') is a type or a variant of the deep fascia, in the form of a sheet of pearly-white fibrous tissue that attaches sheet-like muscles needing a wide area of attachment. Their primary function is to join musc ...
of the external oblique about 2.5 cm above the
subcutaneous inguinal ring The inguinal canals are the two passages in the anterior abdominal wall of humans and animals which in males convey the spermatic cords and in females the round ligament of the uterus. The inguinal canals are larger and more prominent in males. T ...
, and is distributed to the skin of the hypogastric region.


Communication

The iliohypogastric nerve communicates with the
subcostal nerve The subcostal nerve (anterior division of the twelfth thoracic nerve) is larger than the others. It runs along the lower border of the twelfth rib, often gives a communicating branch to the first lumbar nerve, and passes under the lateral lumbocost ...
and
ilioinguinal nerve The ilioinguinal nerve is a branch of the first lumbar nerve (L1). It separates from the first lumbar nerve along with the larger iliohypogastric nerve. It emerges from the lateral border of the psoas major just inferior to the iliohypogastric, an ...
s.


Variation

The iliohypogastric nerve may be absent in up to 20% of people. Its fibres are instead carried on other nerves, such as the ilioinguinal nerve.


Function

The iliohypogastric nerve partially supplies the internal oblique muscles. It also provides sensory innervation to the superior gluteal region and part of the
suprapubic region The hypogastrium (also called the hypogastric region or suprapubic region) is a region of the abdomen located below the umbilical region. Etymology The roots of the word ''hypogastrium'' mean "below the stomach"; the roots of ''suprapubic'' m ...
.


Clinical significance

The iliohypogastric nerve may be damaged at the points where it passes through the
internal oblique muscle The abdominal internal oblique muscle, also internal oblique muscle or interior oblique, is an abdominal muscle in the abdominal wall that lies below the external oblique muscle and just above the transverse abdominal muscle. Structure Its fibe ...
and the external oblique muscles. It is most often damaged by
medical error A medical error is a preventable adverse effect of care (" iatrogenesis"), whether or not it is evident or harmful to the patient. This might include an inaccurate or incomplete diagnosis or treatment of a disease, injury, syndrome, behavior ...
. It may also be damaged by a nerve lesion.


References


External links

* * - "Posterior Abdominal Wall, Dissection, Anterior View" * - "Anterior Abdominal Wall: The Iliohypogastric and IlioInguinal Nerves" * - "Posterior Abdominal Wall: Nerves of the Lumbar Plexus" * * * * () {{Authority control Nerves of the lower limb and lower torso