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Iliohypogastric nerve

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Anatomy, course, function and clinical notes about the iliohypogastric nerve.
Iliohypogastric nerve (Nervus iliohypogastricus)

The iliohypogastric nerve (not to be confused with the hypogastric 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. It 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.
Contents
  1. Course 
  2. Branches
    1. Lateral cutaneous branch
    2. Anterior cutaneous branch
  3. Function
    1. Sensory function 
    2. Motor function
  4. Clinical notes: Iliohypogastric nerve damage
  5. Sources
+ Show all

Course 

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

After it emerges from the upper lateral border of the psoas major muscle, the iliohypogastric nerve passes inferolaterally, posterior to the lower pole of the kidneys and in front of the quadratus lumborum muscle.

As it runs toward the anterior abdominal wall, the iliohypogastric nerve pierces the transversus abdominis muscle posteriorly, just above the iliac crest and continues anteriorly 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: lateral cutaneous and anterior cutaneous branch

Lateral cutaneous branch

The lateral cutaneous branch pierces both the internal and external abdominal oblique muscles superior to the iliac crest to supply the posterolateral aspects of the gluteal skin.

Anterior cutaneous branch

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

Function

Sensory function 

The nerve supplies sensory fibers to the the external abdominal oblique, internal abdominal oblique and transversus abdominis 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)

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