Femoral Nerve is the main nerve of anterior compartment of thigh. It originates from the dorsal sections of the anterior primary rami of L2, L3, L4 nerves and is the largest branch of lumbar plexus. It goes into the thigh  behind the inguinal ligament and lateral to femoral sheath while descending via psoas major and appearing on its lateral order between psoas and illiacus.

It digs into posterior and anterior section in femoral triangle 2 cm distal to the inguinal ligament. The lateral circumflex femoral artery is straddled by both sections. The illiacus in the abdomen and all the muscles of anterior compartment of the thigh is supplied by motor branches of it. The large cutaneous area on the anterior and medial part of thigh, medial side of leg and foot is supplied by the cutaneous branches of femoral artery. Hip and knee joints are also supplied by its articular branches.

 

Anterior section: It produces 2 cutaneous branches and 1 muscular branch:

(a) The cutaneous nerves are: (a) medial cutaneous nerve of the thigh and (b) intermediate cutaneous nerve of the thigh.

(b) The muscular branch provides the sartorius.

Posterior section: It produces 1 cutaneous branch, the saphenous nerve, and 4 muscular branches to provide the quadriceps femoris.

Clinical Significance

Injury of The Femoral Nerve

It’s uncommon but may be injured by a stab, gunshot wounds, or a pelvic fracture. Listed here are the characteristic clinical features:

Motor loss.

  • Poor flexion of the thigh, because of paralysis of the iliacus and sartorius muscles.
  • Inability to extend the knee, because of paralysis of the quadriceps femoris.

Sensory decrease

  • Sensory decline over the anterior and medial aspects of the thigh, as a result of engagement of the intermediate and lateral cutaneous nerves of the thigh.
  • Sensory loss on the medial side of the leg and foot up to the ball of the great toe (first metatarsophalangeal joint), because of engagement of the saphenous nerve.

Femoral Nerve Neuropathy

The primary trunk of the femoral nerve isn’t subject to an entrapment neuropathy . However, it might be compressed by the retroperitoneal tumors. A localized neuropathy of the femoral nerve may happen in diabetes mellitus. Listed here are the characteristic clinical features:

  • Wasting and weakness of quadriceps resulting in significant trouble in walking.
  • Pain and paraesthesia on the anterior and medial aspects of the thigh going down along the medial aspect of the leg and foot along the distribution of the saphenous nerve.