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The lumbar plexus is a critical neural network located within the posterior abdominal wall, formed by the anterior rami of the L1 to L4 spinal nerves, with occasional contribution from T12. It plays a vital role in the motor and sensory innervation of the lower abdominal wall, pelvis, and lower limbs. From a diagnostic perspective, conditions involving the lumbar plexus may present with a variety of symptoms depending on the specific nerve affected. For instance, compression or injury to the femoral nerve (L2–L4) can lead to weakness in hip flexion and knee extension, accompanied by sensory loss over the anterior and medial thigh, and possibly the medial leg. Damage to the obturator nerve, also from L2–L4, can result in impaired thigh adduction and sensory deficits in the medial thigh. In cases such as meralgia paresthetica, where the lateral femoral cutaneous nerve (L2–L3) is compressed, patients may experience burning pain, numbness, or tingling over the lateral thigh. Accurate diagnosis often involves clinical evaluation of sensory and motor deficits, nerve conduction studies, and imaging if a compressive lesion is suspected. Understanding the anatomical pathway and functions of each branch of the lumbar plexus is essential for pinpointing the level and nature of the neurological impairment.
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