The anterior branch of the femoral nerve gives off the intermediate and the medial cutaneous nerves of the thigh

– the intermediate cutaneous nerve of the thigh innervates the skin of the
anterior thigh

– the medial cutaneous nerve of the thigh innervates the skin of the medial
thigh and knee

The posterior branch of the femoral nerve gives off the saphenous nerve, which is a sensory nerve innervating the antero-medial parts of the knee and the leg – sometimes as far distal as the big toe

The femoral nerve splits into the anterior and the posterior branch

The femoral nerve innervates the muscles in the anterior compartment of the thigh

The anterior branch of the femoral nerve innervates the sartorius muscle – and sometimes the pectineus muscle

The posterior femoral nerve branch innervates most of the muscles in the anterior compartment of the thigh – i.e. the quadriceps femoris (the rectus femoris and the three vastus muscles)

Before the femoral nerve emerges from under the inguinal ligament it also innervates the iliac muscle and the femoral artery

In the inguinal region the femoral nerve (FN) runs lateral to the femoral vessels and on top of the iliopsoas muscle

The femoral nerve runs below the iliacus fascia

To reach the nerve with your needle you have to penetrate two fascia: fascia lata and the iliacus fascia

The branches of the femoral nerve innervate the anterior side of:

– the hip joint

– the femoral bone

– the knee joint including the patella

– the medial tibial epicondyle

A femoral branch to the hip joint arises from the nerve to rectus femoris

Branches to the knee joint arise from each of the nerves supplying the vastus muscles with a fourth branch from the saphenous nerve

The femoral nerve runs below the iliacus fascia and on top of the iliacus muscle

The lumbar part of the lumbosacral plexus emerges from five spinal nerves: T12, L1, L2, L3 and L4

It gives origin to three important nerves in lower limb innervation: The femoral, the obturator and the lateral femoral cutaneous nerves

The most important lumbar plexus nerve concerning basic peripheral nerve blockade is the femoral nerve

It originates from the L2, L3, and L4 spinal nerves of the lumbar plexus

Local anaesthetic is injected just lateral to the femoral artery in the triangular space between the femoral artery, the sartorius muscle and the medial vastus muscle

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Position: place the patient supine, rotate the thigh external

Probe: select a linear, high-frequency transducer

Place/Plane: place the transducer mid-thigh medially and perpendicular to the adductor canal

First locate the pulsatile femoral artery

You may track the artery from the inguinal ligament until it dives under the sartorius muscle

The saphenous nerve is a branch of the posterior branch of the femoral nerve

The saphenous nerve innervates the antero-medial part of the knee and the leg including the medial malleolus and and the anterior side of the ankle joint and the subtalar joints

The saphenous nerve is the biggest branch from the femoral nerve

The saphenous nerve runs in the thigh in the femoral triangle and the adductor canal alongside the femoral vessels. In the femoral triangle and the upper part of the adductor canal the saphenous nerve is lateral to the vessels

The saphenous nerve is 100% sensitive innervating the medial part of the knee capsule, the skin and subcutaneous tissue antero-inferior to the knee, of the medial leg, the medial ankle joint and the subtalar joints

Indications: For surgical anaesthesia or pain management of the leg you should combine a sciatic and a saphenous nerve block