Femoral Nerve (Thigh Branches)

nervus femoralis (rami femorales)

In the femoral triangle, the femoral nerve divides into anterior and posterior divisions. The anterior division provides the medial and intermediate cutaneous nerves of the thigh and the nerve to sartorius. The posterior division supplies the quadriceps (rectus femoris, vastus lateralis, vastus medialis, vastus intermedius), articularis genu, and continues as the saphenous nerve into the adductor canal.

Region: Thigh

Clinical Relevance

Clinical Notes

Femoral nerve branching in the thigh is relevant in regional anaesthesia, where a femoral nerve block at the inguinal crease anaesthetises the entire anterior thigh and knee via its posterior division branches. The nerve to vastus medialis branches most distally and is the last to be blocked. Selective posterior division blocks (adductor canal blocks) spare quadriceps strength while anaesthetising the saphenous territory. Femoral nerve injury from haematoma or retraction during vascular surgery produces quadriceps weakness and anterior thigh numbness.

Pathology

Common Injuries & Conditions

Femoral Nerve Iatrogenic Injury

Traction or compression injury to femoral nerve branches during hip arthroplasty, vascular surgery, or inguinal procedures producing quadriceps weakness, anterior thigh numbness, and loss of the patellar reflex.