Nerve Blocks. Anatomy of the Somatic Innervation of the Abdomino-Pelvic Cavity

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Algieri, Agustín Daniel; Bellía Mendiguren, María Milagros; Mazzoglio y Nabar, Martín Javier; Ferrante, María Soledad; Ottone, Nicolás E. & Algieri, Rubén Daniel


Abdominal pain is one of the symptoms that affect the abdominal-pelvic cavity. The abdominal-pelvic cavity has a somatic innervation involving the seventh to twelfth intercostal nerves, collateral and terminal branches of the lumbar plexus and the pudendal nerve. The objective of this work is the description of the lumbar plexus, intercostal nerves and pudendal nerve, its different patterns and structure variations, as well as its implications during pain management in patients. A descriptive, observational, and morphometric study of patterns and structure variations of the lum- bar plexus, intercostal nerves and pudendal nerve was conducted in 50 formalin-fixed cadaveric dissections of the Third Chair of Anatomy at the School of Medicine in the Universidad de Buenos Aires from August 2017 to December/2019. The standard description of the lumbar plexus was found in 35 cases; accessory femoral nerve was not present in any of the cases; absence of the iliohipogastric nerve was also not found in any case, while the accessory obturating nerve was found in 2 cases; genitofemoral nerve dividing within the muscle mass of psoas in 6 cases; lateral femoral cutaneous nerve emerging only from the second lumbar root in 6 cases and finally, presence of a branch of the obturating nerve was found joining the lumbosacral trunk in one case. The pudendal and intercostal nerve patterns presented a typical pathway in all cases. Adequate knowledge and description of the lumbar plexus, intercostal nerves and pudendal nerve is essential for an adequate approach of the abdominal-pelvic cavity in nerve blocks.

KEY WORDS: Lumbar plexus; Intercostal nerves; Pudendal nerve; Anatomical variations; Nerve blocks.

How to cite this article

ALGIERI, A. D.; BELLÍA MENDIGUREN, M. M.; MAZZOGLIO Y NABAR, M. J.; FERRANTE, M. S.; OTTONE, N. E. & ALGIERI, R. D. Nerve blocks. Anatomy of the somatic innervation of the abdomino-pelvic cavity. Int. J. Morphol., 41(4):1071-1076, 2023.