Iliohypogastric Nerve

The iliohypogastric nerve is the first significant branch of the lumbar plexus. Iliohypogastric nerve is a sensory nerve which supplies lateral and anterior cutaneous branches supplying the posterolateral gluteal skin as well as skin in the pubic region.

Origin

The iliohypogastric nerve generally emerges from the ventral ramus of the LI spinal nerve. Iliohypogastric nerve emerges via the upper lateral border of psoas major and intercrosses in front of quadratus lumborum and obliquely behind the lower renal pole.

Above the iliac crest, it goes into the posterior part of transversus abdominis.In between the transversus abdominis and internal oblique, iliohypogastric nerve splits into lateral and anterior cutaneous branches.

Iliohypogastric Nerve: Origin

Insertion

• Iliohypogastric nerve emerges underneath the lateral border of the psoas major muscle, passes down and sideways in front of the quadratus lumborum.
• At the lateral border of quadratus lumborum it enters aponeurotic origin of the transversus abdominis simply superior to the iliac crest and runs in the anterior abdominal wall.
• It supplies anterior abdominal wall in the hypogastric region and cutaneous innervation to the skin of gluteal region.
• It is originated from the anterior primary ramus of the LI spinal nerve.
• It goes in the neurovascular plane (i.e., in between the internal oblique and transversus abdominis) and enters the internal oblique about 2.5 cm in front of the anterior superior iliac spine.
• It ends up being cutaneous by entering the external oblique aponeurosis about 2.5 cm superior to the superficial inguinal ring.
• It does not go into the rectus sheath and its lateral cutaneous branch supplies the skin of the gluteal region.

Supply

The iliohypogastric nerve produces anterior and lateral cutaneous branches and supplies branches to the abdominal musculature along its course.

• The lateral cutaneous branch emerges via the iliohypogastric nerve above the iliac crest. It supplies the upper part of the butt behind the area supplied by the subcostal nerve.
• The anterior cutaneous branch is the extension of the iliohypogastric nerve anteriorly. Around 2.5 cm above the superficial inguinal ring the nerve ends by providing the skin over the lower part of the rectus abdominis and mons pubis.

Relations

Proximally the iliohypogastric nerve lays on the anterior surface of the quadratus lumborum muscle and posterior to the kidney The ilioinguinal nerve has a more oblique course as it takes a trip to the iliac crest usually passing through the iliacus muscle and takes a trip inferiorly to the iliohypogastric nerve

Clinical and Surgical Significance

• Iliohypogastric nerve block work in the assessment and management of groin pain believed to be subserved by the iliohypogastric nerve, consisting of the pain associated with iliohypogastric neuralgia.
• When integrated with ilioinguinal and genitofemoral nerve block, the method likewise works to supply surgical anesthesia for groin surgery, consisting of inguinal herniorrhaphy.
• When peripheral nerve entrapment versus lumbar radiculopathy is being examined, Iliohypogastric nerve block with local anesthetic can be utilized diagnostically throughout differential neural blockade on an anatomic basis in the assessment of groin pain.
• If damage of the iliohypogastric nerve is being taken into consideration, this method works as a prognostic indication of the degree of motor and sensory disability.
• Iliohypogastric nerve block with regional anesthetic might be utilized to diminish sharp pain emergency situations, consisting of postoperative pain relief, while one is awaiting pharmacologic techniques to become efficient.