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Iliohypogastric nerve: want to learn more about it?

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Iliohypogastric nerve

Iliohypogastric nerve (Nervus iliohypogastricus)

The iliohypogastric nerve is a mixed branch of the lumbar plexus. It arises as a single trunk along with the ilioinguinal nerve from the anterior/ventral ramus of the L1 spinal nerve root. The nerve starts its course on the posterior abdominal wall, emerging from the upper border of the psoas major muscle, and then crosses obliquely to the anterior abdominal wall, running between the anterior abdominal muscles.

Being a mixed nerve, the iliohypogastric nerve supplies both motor and sensory innervation to the abdominal muscles, as well as sensory innervation to the skin of the posterolateral gluteal and suprapubic regions.

This article will describe the anatomy and function of the iliohypogastric nerve, as well as some clinical notes.

Key facts about the iliohypogastric nerve
Origin Lumbar plexus (L1)
Branches Anterior cutaneous branch, lateral cutaneous branch
Innervation Motor: Transversus abdominis, internal abdominal oblique, conjoint tendon.
Sensory:  External abdominal oblique, transversus abdominis, internal abdominal oblique; Skin of the suprapubic region and posterolateral aspect of gluteal region.

Course 

The iliohypogastric arises from the anterior ramus of the L1 root of lumbar plexus, along with the ilioinguinal nerve. 

The iliohypogastric nerve emerges from the upper lateral border of the psoas major muscle before crossing obliquely posterior to the kidneys and in front of the quadratus lumborum muscle.

Upon reaching the anterior abdominal wall, the iliohypogastric nerve enters the transversus abdominis muscle posteriorly at a level just above the iliac crest. By then, the iliohypogastric nerve runs between the transversus abdominis and the internal abdominal oblique muscles. 

Branches

Whilst passing between the transversus abdominis and internal abdominal oblique, the iliohypogastric nerve gives off two branches: anterior cutaneous and lateral cutaneous branch

Anterior cutaneous branch

The anterior cutaneous branch continues to run between the internal abdominal oblique and transversus abdominis muscles, innervating both. It runs through the internal oblique muscle about 2 cm medial to the anterior superior iliac spine, then passes through the aponeurosis of the external abdominal oblique muscle about 3 cm superior to the superficial inguinal ring before being distributed to the abdominal skin superior to the pubic area.

Lateral cutaneous branch

The lateral cutaneous branch runs through both the internal and external abdominal oblique muscles at a level superior to the iliac crest and posterior to the iliac branch of T12. It is then distributed to the posterior and lateral aspects of the gluteal skin.

Function

Sensory function 

The nerve supplies sensory fibers to the external abdominal oblique, transversus abdominis and internal abdominal oblique muscles. The iliohypogastric also supplies the skin of the suprapubic region and the posterolateral aspect of the gluteal region.

Motor function

The iliohypogastric nerve also supplies motor fibers to the transversus abdominis and the internal abdominal oblique muscles. It also innervates the conjoint tendon, a tendon formed from the common aponeurosis of the transversus abdominis and internal oblique muscles.

Internal oblique, external oblique, and transversus abdominus muscles (from left to right)

Iliohypogastric nerve: want to learn more about it?

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“I would honestly say that Kenhub cut my study time in half.” – Read more. Kim Bengochea Kim Bengochea, Regis University, Denver

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