Citation, DOI, disclosures and article data
At the time the article was created Chamath Ariyasinghe had no recorded disclosures.View Chamath Ariyasinghe's current disclosures
At the time the article was last revised Mohammad Taghi Niknejad had no financial relationships to ineligible companies to disclose.View Mohammad Taghi Niknejad's current disclosures
The iliohypogastric nerve arises from the anterior ramus of the L1 nerve root of the lumbar plexus along with the ilioinguinal nerve. It is a sensory nerve that provides lateral and anterior cutaneous branches supplying the posterolateral gluteal skin and skin in the pubic region.
The iliohypogastric nerve arises with the ilioinguinal nerve as a single trunk from the anterior ramus of the L1 nerve root of the lumbar plexus. This trunk enters the abdomen behind the medial arcuate ligament and runs anterolaterally parallel and superior to the iliac crests traversing the anterior surface of the quadratus lumborum muscle. The common trunk is short and the nerve soon divides in to iliohypogastric and ilioinguinal nerves at the lateral edge of the psoas muscle.
Course and branches
The iliohypogastric nerve emerges at the lateral edge of the upper part of the psoas muscle, coursing obliquely inferiorly to reach the iliac crest, anterior to the quadratus lumborum muscle and posterior to the kidney.
Immediately above the iliac crest, it gives off a lateral cutaneous branch which pierces the internal and external oblique muscles to supply the posterolateral gluteal skin.
The remaining part of the iliohypogastric nerve (anterior cutaneous branch) continues coursing anteriorly to reach just above and medial to the anterior superior iliac spine before piercing the internal oblique muscle. From there, it courses obliquely to reach just superior to the superficial inguinal ring, piercing the aponeurosis of the external oblique muscle to become cutaneous and supplying the surrounding skin.
The iliohypogastric nerve gives off anterior and lateral cutaneous branches and supplies branches to the abdominal musculature along its course.
The lateral cutaneous branch arises from the iliohypogastric nerve above the iliac crest and supplies the upper part of the buttock behind the area supplied by the subcostal nerve.
The anterior cutaneous branch is the continuation of the iliohypogastric nerve anteriorly. Approximately 2.5 cm above the superficial inguinal ring the nerve terminates by supplying the skin over the lower part of the rectus abdominis and mons pubis.
Proximally the iliohypogastric nerve lies on the anterior surface of the quadratus lumborum muscle and posterior to the kidney. The ilioinguinal nerve travels inferiorly to the iliohypogastric nerve and has a more oblique course as it travels to the iliac crest typically traversing the iliacus muscle.
The iliohypogastric nerve has been shown to be absent in ~20% of lumbar plexi examined in cadaveric studies. Occasionally, the iliohypogastric and ilioinguinal nerves remained conjoined (within a common epineurium) well after exiting the substance of the psoas major musculature although this variation was quite rare.
The size of the iliohypogastric nerve is inversely proportional to the size of the ilioinguinal nerve.
- 1. FAAA KLMMPFIACFRSM, Dalley AF, Agur AM. Clinically Oriented Anatomy, Sixth Edition. Lippincott Williams & Wilkins. ISBN:1605476528. Read it at Google Books - Find it at Amazon
- 2. Last's anatomy, regional and applied. Churchill Livingstone. ISBN:044304662X. Read it at Google Books - Find it at Amazon
- 3. FAAA RDP, FAAA AWVP, FRCR AWMMMBBSFRCS. Gray's anatomy for students. Churchill Livingstone. ISBN:0443066124. Read it at Google Books - Find it at Amazon
- 4. Anloague PA, Huijbregts P. Anatomical variations of the lumbar plexus: a descriptive anatomy study with proposed clinical implications. J Man Manip Ther. 2010;17 (4): e107-14. Free text at pubmed - Pubmed citation