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The lumbar nerves are the five pairs of emerging from the . They are divided into posterior and anterior divisions.


Structure
The lumbar nerves are five which arise from either side of the below the thoracic spinal cord and above the sacral spinal cord. They arise from the spinal cord between each pair of lumbar and travel through the intervertebral foramina. The nerves then split into an , which travels forward, and a posterior branch, which travels backwards and supplies the area of the back.


Posterior divisions
The middle divisions of the posterior branches run close to the articular processes of the vertebrae and end in the multifidus muscle. The outer branches supply the erector spinae muscles.

The nerves give off branches to the skin. These pierce the of the greater trochanter.


Anterior divisions
The anterior divisions of the lumbar nerves () increase in size from above downward.

The anterior divisions communicate with the sympathetic trunk. Near the origin of the divisions, they are joined by gray rami communicantes from the of the sympathetic trunk. These rami consist of long, slender branches which accompany the around the sides of the vertebral bodies, beneath the . Their arrangement is somewhat irregular: one ganglion may give rami to two lumbar nerves, or one lumbar nerve may receive (branches) from two . The first and second, and sometimes the third and fourth lumbar nerves are each connected with the lumbar part of the sympathetic trunk by a white ramus communicans.

The nerves pass obliquely outward behind the , or between its , distributing filaments to it and the Quadratus lumborum.

As the nerves travel forward, they create . The first three lumbar nerves, and the greater part of the fourth together form the . The smaller part of the fourth joins with the fifth to form the lumbosacral trunk, which assists in the formation of the .

The fourth nerve is named the , from the fact that it is subdivided between the two plexuses.


Divisions

First lumbar nerve
The first lumbar spinal nerve (L1) American Medical Association Nervous System -- Groups of Nerves originates from the spinal column from below the lumbar vertebra 1 (L1). The three terminal branches of this nerve are the , , and the genitofemoral nerves.

L1 supplies many muscles, either directly or through nerves originating from L1. They may be innervated with L1 as single origin, or be innervated partly by L1 and partly by other spinal nerves. The muscles are:


Second lumbar nerve
The second lumbar spinal nerve (L2) American Medical Association Nervous System -- Groups of Nerves originates from the spinal column from below the lumbar vertebra 2 (L2).

L2 supplies many muscles, either directly or through nerves originating from L2. They may be innervated with L2 as single origin, or be innervated partly by L2 and partly by other spinal nerves. The muscles are:

  • quadratus lumborum (partly)
  • (partly)


Third lumbar nerve
The third lumbar spinal nerve (L3) American Medical Association Nervous System -- Groups of Nerves originates from the spinal column from below the lumbar vertebra 3 (L3).

L3 supplies many muscles, either directly or through nerves originating from L3. They may be innervated with L3 as single origin, or be innervated partly by L3 and partly by other spinal nerves. The muscles are:

  • quadratus lumborum (partly)
  • (partly)
  • obturator externus (partly)


Fourth lumbar nerve
The fourth lumbar spinal nerve (L4) American Medical Association Nervous System -- Groups of Nerves originates from the spinal column from below the lumbar vertebra 4 (L4).

L4 supplies many muscles, either directly or through nerves originating from L4. They are not innervated with L4 as single origin, but partly by L4 and partly by other spinal nerves. The muscles are:

  • quadratus lumborum
  • gluteus medius muscle
  • gluteus minimus muscle
  • tensor fasciae latae
  • obturator externus
  • inferior gemellus
  • quadratus femoris
  • tibialis anterior
  • vastus lateralis


Fifth lumbar nerve
The fifth lumbar spinal nerve 5 (L5) American Medical Association Nervous System -- Groups of Nerves originates from the spinal column from below the lumbar vertebra 5 (L5).

L5 supplies many muscles, either directly or through nerves originating from L5. They are not innervated with L5 as single origin, but partly by L5 and partly by other spinal nerves. The muscles are:

  • gluteus maximus muscle mainly S1
  • gluteus medius muscle
  • gluteus minimus muscle
  • tensor fasciae latae
  • tibialis anterior
  • tibialis posterior
  • extensor digitorum brevis
  • extensor hallucis longus


Function
==Additional images==


See also

Hsu, Philip S., MD, Carmel Armon, MD, and Kerry Levin, MD. "Acute Lumbosacral Radiculopathy: Pathophysiology.Clinical, Features, and Diagnosis." www.uptodate.com. Uptodate, 11 Jan. 2011.Web. 26 Sept. 2012. https://www.uptodate.com/contents/acute-lumbosacral-radiculopathy-pathophysiology-clinical-features-and-diagnosis

Loizidez, Alexander, MD, Siegfried Peer, MD, Michaela Plaikner, MD, Verena Spiss, MD, and HannesGruber, MD. "Ultrasound-guided Injections in the Lumbar Spine." www.medultrason.ro. Medical Ultrasonography, 20 Jan. 2011. Web. 26 Sept. 2012. http://www.medultrason.ro/assets/Magazines/Medultrason-2011-vol13-no1/10loizides.pdf

Zhu, Jie, MD, and Obi Onyewu, MD. "Alternative Approach for Lumbar Transforaminal Epidural Steroid Injections." www.painphysicianjournal.com. Pain Physician, 21 Apr. 2011. Web. 26 Sept. 2012. http://www.painphysicianjournal.com/2011/july/2011;14;331-341.pdf

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