1) Several cutaneous nerves innervate the skin of the lower limb, originating from lumbar and sacral spinal nerves. 2) The femoral, obturator, superior and inferior gluteal nerves innervate the thigh. The sciatic, common peroneal, tibial and sural nerves innervate the leg. 3) Injury to major nerves like the femoral or sciatic can result in sensory loss over large areas, placing the individual at risk for trophic ulcers. Precise patterns of sensory loss depend on the specific nerve injured.

1. CUTANEOUS
INNERVATION OF THE
LOWER LIMB

2. CUTANEOUS INNERVATION OF THIGH:
*THE ILIO-LINGUAL NERVE (L1), a branch of the
lumbar plexus, supplies the skin:
-at the root of penis in the male or
over the mons pubis in the female,
-at the anterior one-third of the
scrotum (male) or labium majus(female),
-at the superomedial part of the thigh.
*THE FEMORAL BRANCH OF GENITO FEMORAL
NERVE(L1,L2), which is in turn a branch of the
lumbar plexus, supplies the skin over the femoral
triangle.

4. *THE LATERAL CUTANEOUS NERVE OF THIGH(L2,L3), also a
branch of the lumbar plexus, supplies the skin:
-on the anterolateral side of thigh &
-the anterior part the gluteal region,
-by dividing into anterior and posterior
branches.
*THE INTERMEDIATE CUTANEOUS NERVE OF THIGH(L2,L3) is
a branch of the anterior division of femoral nerve
and supplies a strip of skin on the front of thigh
extending from the sartorius muscle to the knee.
*THE MEDIAL CUTANEOUS NERVE OF THIGH(L2.L2) is also a
branch of the anterior division of the femoral nerve.
It supplies the skin on the medial side of the lower
two-thirds of the thigh.

5. THE PATELLAR PLEXUS:
-a plexus of fine nerves situated in
the front of the patella, the ligamentum
patellae, and the upper end of the tibia.
-formed by the contributions from:
1)The anterior division of the lateral
cutaneous nerve,
2)The intermediate cutaneous of thigh,
3)The anterior division of the medial
cutaneous nerve,
4)The infrapatellar branch of the saphenous
nerve.

6. CUTANEOUS INNERVATION OF THE GLUTEAL
REGION:
The cutaneous nerves converge on the gluteal
region from all directions.
1)The upper and anterior part is supplied by the
LATERAL CUTANEOUS BRANCHES OF THE SUBCOSTAL T12
and ILIOHYPOGASTRIC L1 nerves.
2)The upper and posterior part is supplied by
the posterior primary rami of spinal nerves
L1, L2, L3 and S1, S2, S3.
3)The lower and the anterior part is supplied
branches from the posterior division of the
LATERAL CUTANEOUS NERVE OF THE THIGH(S1, S2)

8. 4)The lower and the posterior part is supplied by the
branches from the posterior cutaneous nerve of the
thigh (s1, s2, s3) and the perforating cutaneous
Nerve (S2, S3).

9. CUTANEOUS INNERVATION OF THE LEG and
dorsum of foot:
1)THE SAPHENOUS NERVE is a branch of the femoral
nerve. It supplies the skin of the medial sid eof
the leg and the medial border of the foot up to
the ball of the big toe.
2)THE INFRAPATELLAR BRANCH of the Saphenous nerve
suplies the skin over the ligamentum patellae.
3)THE LATERAL CUTANEOUS NERVE OF THE CALF is a
branch of the common peroneal nerve. It supplies
the skin of the upper two-thirds of the lateral
side of the leg.

11. 4)THE SUPERFICIAL PERONEAL NERVE is a branch of the
common peroneal. It supplies
-the skin over the lower one-third of the
lateral of the lateral side of the leg,
-the skin over the dorsum of the foot
except the lateral border(sural nerve), medial
border(saphenous nerve), and the cleft between 1st
and 2nd toes(deep peroneal nerve).
5)THE SURAL NERVE is a branch of the tibial nerve.
It supplies the skin of the lower half of the back
of leg and the whole lateral border of the foot up
to the tip of the little toe.
6)THE DEEP PERONEAL NERVE supplies the skin on the
cleft between 1st and 2nd toes.

12. 7)THE DIGITAL BRANCHES OF THE MEDIAL AND LATERAL
PLANTAR NERVES supply the distal parts of the
dorsum of the toes.
Medial plantar nerve-medial 3 1/2 toes.
Lateral plantar nerve-lateral 1 ½ toes.

13. Cutaneous innervation of sole of foot:
1)LATERAL PLANTAR NERVE supplies lateral one fourth of
foot .
2)MEDIAL PLANTAR NERVE supplies medial three fourths of
foot .
3)MEDIAL CALCANEOUS NERVE, a branch of TIBIAL nerve
(just before it divides into medial and lateral plantar nerves)
supplies the skin over calcaneus .

14. Applied aspects:
AFFECTED SENSORY LOSS
NERVE
FEMORAL NERVE Anterior side of thigh and medial side of leg upto big toe.
SCIATIC NERVE Back and lateral side of leg, most of dorsum of foot, sole of
foot.
COMMON
PERONEAL Lateral & anterior side of leg, most of dorsum of foot, most of
digits.
TIBIAL Skin of sole. Trophic ulcers can develop.
OBTURATOR Small area on the medial side of thigh.
SUPERIOR GLUTEAL -
INFERIOR GLUTEAL -
PUDENDAL Skin of perineum
DEEP PERONEAL 1st inter digital cleft
SUPERFICIAL Lateral side of leg, most of dorsum of foot.
PERONEAL

15. INJURED NERVE SENSORY LOSS
MEDIAL PLANTAR Medial 2/3 rd of sole and digital
nerves to medial 3 ½ toes,
including nail beds.
LATERAL PLANTAR Lateral 1/3 rd of sole and digital
nerves to lateral 1 ½ toes,
including nail beds.