What is the anatomy of the iliohypogastric nerve in nerve entrapment syndromes of the lower extremity?

Updated: Oct 15, 2019
  • Author: Minoo Hadjari Hollis, MD; Chief Editor: Thomas M DeBerardino, MD  more...
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Answer

The iliohypogastric nerve arises primarily from the ventral primary rami of L1 and occasionally with a twig from T12. Its pathway resembles that of the intercostal nerves in the thoracic region.

The iliohypogastric nerve traverses the psoas major, piercing the lateral border of the muscle anterior to the quadratus lumborum and posterior to the kidney to traverse the lateral abdominal wall. It penetrates the transversus abdominis near the iliac crest, coming between it and the internal oblique muscle. The nerve supplies the lower fibers of the transversus abdominis and the internal oblique muscle and divides into lateral and anterior cutaneous branches.

The anterior cutaneous branch of the iliohypogastric nerve continues anteriorly between the internal oblique muscle and the transversus abdominis muscle, then pierces the internal oblique muscle and becomes cutaneous through an opening in the fascial aponeurosis of the external oblique muscle, approximately 2-3 cm cephalad to the superficial inguinal ring. The distribution of the cutaneous sensation is a small region just superior to the pubis.


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