Anterior compartment of leg nerve11/8/2023 ![]() ![]() The anterior compartment is innervated by the femoral nerve which has two major branches, the anterior and the posterior. The obturator nerve then splits into its anterior and posterior divisions and innervates surrounding structures in the medial compartment of the thigh. It then moves laterally along the pelvis towards to obturator foramen and then crosses into the obturator canal. The obturator nerve travels inferiorly through the psoas major and exits on the medial border of the muscle. The obturator nerve gets its major contributions from the lumbar plexus. While authors agree that the sciatic nerve separates into the two individual nerves at the apex of the popliteal fossa, it has been discussed that approximately 12% of people have separation of the sciatic nerve as it leaves the pelvis. Recent literature has described the sciatic nerve as two individual nerves, the tibial nerve and the common fibular nerve, that have been bundled together in a common connective tissue sheath. The nerve moves through the gluteal area and begins to enter the posterior compartment of the thigh by traveling posterior to the long head of the biceps femoris. As it passes through the greater sciatic foramen, it emerges with the piriformis muscle being anterior to its exit point and then descends inferiorly. The sciatic nerve comes from the sacral plexus and introduces itself through the greater sciatic foramen. The posterior compartment of the thigh is innervated by divisions of the large sciatic nerve. It is after passing the inguinal ligament that the femoral nerve divides into its anterior and posterior divisions. It is after it passes through the psoas major that the nerve goes in through the pelvis where it travels posteriorly to the inguinal ligament into the thigh. ![]() The femoral nerve, which supplies the muscles of the anterior compartment, travels inferiorly from the lumbar plexus and passes through the psoas major. It has been discussed that ventral axonal attraction may be mediated by binding of netrins, a chemoattractant, to an axonal receptor but this is still being investigated. Other studies have also shown that manipulating the position of the target muscle does not interfere with the nerve’s ability to progress toward it for innervation. It has been described that nerve trunks advance with a filopodium of the pioneer growth cone in order to allow guidance of the nerves to their assigned tissues. Some theories about how these nerves advance from the spinal cord to their target muscles have been put forth, but none have been confirmed. How these nerves make their way to the target cells of the muscles of the thigh is yet to be determined. The sciatic nerve, however, is a major division of the sacral plexus taking in inputs from L4 through S3. The specific spinal nerve roots of the obturator nerve and the femoral nerve are the same, L2 through L4. It is from the lumbar plexus that the obturator nerve and the femoral nerve arise. ![]() The sacral plexus is formed by the anterior rami of the sacral spinal nerves S1 through S4, while also receiving branches from spinal nerves L4 and L5. The lumbar plexus is formed by the anterior rami of nerve roots L1 through L4 while also receiving contributions from T12. The lumbar and sacral plexuses both contribute fibers towards the three major nerves that serve to innervate the thigh. ![]()
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