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Abdomen
Published in Bobby Krishnachetty, Abdul Syed, Harriet Scott, Applied Anatomy for the FRCA, 2020
Bobby Krishnachetty, Abdul Syed, Harriet Scott
The genitofemoral nerve runs retroperitoneally on the body of psoas major dividing into its two branches. The genital branch passes through the inguinal canal, supplying the cremaster and scrotal skin or the mons pubis and labia majora. The femoral branch enters the femoral sheath, supplying the skin of the upper thigh.
Blocks of Nerves of the Trunk
Published in Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand, Pediatric Regional Anesthesia, 2019
The genitofemoral nerve is a branch from the lumbar plexus which results from the union of two branches originating from the anterior rami of the first and second lumbar spinal nerves (Figure 4.14). It perforates the psoas muscle obliquely and then runs on its anterior aspect towards the inguinal ligament. It then divides into two terminal branches, at a variable distance from its origin: The femoral branch (lumboinguinal nerve), which accompanies the external iliac artery, passes behind the inguinal ligament and supplies the skin covering Scarpa’s triangle.The genital branch, which enters the inguinal canal, accompanies the spermatic cord and contributes fibers to the cremaster, the scrotum, and, usually, the skin covering the base of the penis. In the female, the nerve runs close to the round ligament of the uterus and supplies the labius majus (and usually the mons pubis).
Paper 2 Answers
Published in James Day, Amy Thomson, Tamsin McAllister, Nawal Bahal, Get Through, 2014
James Day, Amy Thomson, Tamsin McAllister, Nawal Bahal
The lateral cutaneous nerve of the thigh as the name suggests is purely a sensory nerve. The genitofemoral nerve splits into a genital branch, which supplies the cremaster muscle and the femoral branch, which supplies sensation to skin on the thigh. The femoral nerve is the largest branch of the lumbar plexus.
Intraoperative Complications and Conversion to Laparatomy in Gynecologic Robotic Surgery
Published in Journal of Investigative Surgery, 2022
Ayse Filiz Gokmen Karasu, Gürkan Kıran, Fatih Şanlıkan
Most of the complications were managed within minutes and with robotic assisted suturing when necessary. After three attempts of failed Veress needle entry, a 10 mm trocar entry was accomplished successfully in all cases. There were 9 cases of vascular injury. Six of these were venous of origin (left common iliac vein (n = 1), inferior vena cava (n = 3), external iliac vein (n = 1), and trocar site bleeding (n = 1)). Three cases of bleeding were of arterial origin (uterine artery (n = 1), inferior mesenteric artery (n = 1), and abdominal aorta (n = 1)). All bleeding was managed with robotic instruments utilizing either bipolar coagulation, suturation or surgical clip placement. There was one case of nerve injury. The genitofemoral nerve was cut during lymphadenectomy. It was sutured robotically. All cases of visceral injuries were serosal and managed with suturing There were 4 cases in which uterine rupture (solid organ injury) happened; these were either due to initial manipulator placement or excessive manipulation during surgery. There were no other intraabdominal solid organ injuries. The intraoperative complications are presented in Table 3.
Effect of perineural bupivacaine infiltration on reducing inguinodynia in patients undergoing inguinal meshplasty – a randomized controlled trial
Published in Acta Chirurgica Belgica, 2022
Angeline Mary Samy, Amaranathan Anandhi, Gubbi Shamanna Sreenath, Sathasivam Sureshkumar, Srinivasan Swaminathan
Patients in both the control and intervention groups were administered spinal anaesthesia. Patients in the intervention group received perineural bupivacaine infiltration in addition to spinal anaesthesia. After spinal anaesthesia was given, all patients underwent Lichtenstein tension-free meshplasty. There was no difference in the type and dosage of local anaesthetic used in spinal anaesthesia. All the surgical procedures in the present study were carried out by a group of 6 surgeons at or above the level of the surgical registrar who are well experienced in performing hernia surgery. Intraoperatively Ilioinguinal, iliohypogastric, and genital branch of the genitofemoral nerve were identified. A total of 2 mL of perineural infiltration of 0.5% bupivacaine was given along these 3 nerves [6].
The importance of the clinical examination of the lower sacral segments: Four case reports
Published in The Journal of Spinal Cord Medicine, 2019
Maria João Andrade, Tiago Felix Soares
The problem lies in patients with urological symptoms that may have a neurological cause. So, for a person with unexplained bladder dysfunction, we must perform a neuro-urological examination, testing the integrity of the sacral segments and, in male, testing the dartos reflex (T12-L2 spinal level).5,6 The dartos muscle is a sympathetically innervated dermal muscle layer within the scrotum, distinct from the somatically innervated cremaster muscle. We elicit the dartos reflex by cutaneous stimulation of the thigh, which produces a slow, writhing, vermicular contraction of the scrotal skin. This reflex can be used to evaluate the thoracolumbar sympathetic and genitofemoral nerve pathway. If it is abnormal, this points to a sympathetic lesion. In men and women, a patulous anus suggests a loss of both striated and smooth sphincter tone.3 Dartos and anal reflexes must be tested bilaterally.6 In women, the muscular strength of the pelvic floor muscles should also be assessed.8,9