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Describe the innervation of the lower extremity.
The lower extremity is innervated by the lumbar plexus and the sciatic plexus.
The lumbar plexus consists of six nerves:
The upper part consists of three nerves: ilioinguinal, genitofemoral, and iliohypogastric. These nerves supply parts of the anterior abdominal wall, buttocks, and perineum. The lower part consists of three nerves: femoral, lateral cutaneous nerve of the thigh, and obtu-rator. The femoral is the main nerve of concern in a total knee arthroplasty. It supplies innervation to the anterior portion of the thigh and knee and to the quadriceps, sartorius, pectineal, and vastus muscles.
It continues as the saphenous nerve below the knee and provides sen-sory innervation to the medial aspect of the leg in this region. The lateral femoral cutaneous nerve provides sensory innervation to the lateral aspect of the thigh, and the obturator nerve provides innervation to the adduc-tors of the thigh and sensory innervation to the medial aspect of the thigh.
The sciatic plexus consists of the sciatic and the posterior cutaneous nerves of the thigh. The sciatic nerve provides innervation to the hamstring muscles. At the popliteal fossa the sciatic nerve splits into the common peroneal and posterior tibial nerves, which together provide all the motor innervation to the leg below the knee and sensory innervation to this area except for the medial part of the leg below the knee, which is provided by the saphenous nerve. The posterior cutaneous nerve provides sensory innerva-tion to the posterior aspect of the thigh.
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