Lumbar plexus

a simple brief over view of lumbar plexus

1. Lumbar plexus By :K.N.ANKITHA

2. Where is the lumbar region? Lumbar region is referred as the lower spine or the back of the torso in its proximity

3. Where is the lumbar plexus located? Lies within the posterior p art of Psoas major ,anterior to the transverse p rocess of the lumbar vertebrae

4. Why do we need to know about lumbar plexus as physiotherapists? It is crucial as physical therapists to have a strong knowledge base and understanding of the lumbar plexus in the treatment of our orthopedic patients. In order to accurately determine the cause of our patients' pain or dysfunction, analyzing which level is affected can help us to make better intervention choices, which in turn will create better outcomes.Many times our patients present with only lower extremity deficits, however these often times, are initiated from the lumbar plexus, and not the extremity. Being able to utilize our anatomy and physiology in treating our patients with musculoskeletal dysfunctions can help our patients progress more effectively and quicker, which will help decrease costs of extended treatment due to misdiagnosis. Applying this anatomy with our patients who receive spinal blocks and epidurals can also help us determine the most effective treatment approach and better understand our patient's presentation in the clinic.

5. Formation and root values of branches ROOTS T12 L1 L2 L3 L4 ROOT VALUES OF BRANCHES Muscular T12, L1–4 Iliohypogastric L1 Ilioinguinal L1 Genitofemoral L1, L2 Lateral femoral cutaneous L2, L3 Femoral L2–4 dorsal divisions Obturator L2–4 ventral divisions Accessory obturator L3, L4

6. Differences between lumbar plexus and brachial plexus. Brachial plexus The first intercostal thoracic nerve is involved(T1) Prefixed plexus is due to C4 Postfixed plexus is due to T2 There are different stages from roots to branches i.e roots,trunk,division,cord and branches Lumbar plexus The last intercostal thoracic nerve is involved(T12) Prefixed plexus is due to L3 Postfixed plexus is due to L5 There are only 3 stages i.e roots ,divisions and branches.

7. Clinical importance of lumbar plexus The nerves of the lumbar plexus pass in front of the hip joint and mainly support the anterior portion of the thigh. So, when you think about this ventral aspect, you should think about it supporting the anterior portion of the thigh . Inflammation in the posterior abdomen wall in the tissues anterior to psoas major ,such as retrocaecal appendicites on the right and diverticula abcess of the left may cause irritation to the lumbar plexus and result in pain in buttock region, hip and thigh. Injuries to nerves will effect the muscular attachments and hence cause pain or dysaesthesia in buttock skin, thigh and hip region