Saphenous nerve

The Saphenous Nerve (n. saphenus; long or internal saphenous nerve) is the largest cutaneous branch of the femoral nerve.

The posterior division of the femoral nerve gives off the saphenous nerve, and muscular and articular branches. The saphenous nerve approaches the femoral artery where this vessel passes beneath the Sartorius, and lies in front of it, behind the aponeurotic covering of the adductor canal, as far as the opening in the lower part of the Adductor magnus. Here it quits the artery, and emerges from behind the lower edge of the aponeurotic covering of the canal; it descends vertically along the medial side of the knee behind the Sartorius, pierces the fascia lata, between the tendons of the Sartorius and Gracilis, and becomes subcutaneous. The nerve then passes along the tibial side of the leg, accompanied by the great saphenous vein, descends behind the medial border of the tibia, and, at the lower third of the leg, divides into two branches: one continues its course along the margin of the tibia, and ends at the ankle; the other passes in front of the ankle, and is distributed to the skin on the medial side of the foot, as far as the ball of the great toe, communicating with the medial branch of the superficial peroneal nerve.

BRANCHES.

—The saphenous nerve, about the middle of the thigh, gives off a branch which joins the subsartorial plexus.

 At the medial side of the knee it gives off a large infrapatellar branch, which pierces the Sartorius and fascia lata, and is distributed to the skin in front of the patella. This nerve communicates above the knee with the anterior cutaneous branches of the femoral nerve; below the knee, with other branches of the saphenous; and, on the lateral side of the joint, with branches of the lateral femoral cutaneous nerve, forming a plexiform net-work, the plexus patellæ. The infrapatellar branch is occasionally small, and ends by joining the anterior cutaneous branches of the femoral, which supply its place in front of the knee.

Below the knee, the branches of the saphenous nerve are distributed to the skin of the front and medial side of the leg, communicating with the cutaneous branches of the femoral, or with filaments from the obturator nerve.

The muscular branches supply the four parts of the Quadriceps femoris. The branch to the Rectus femoris enters the upper part of the deep surface of the muscle, and supplies a filament to the hip-joint. The branch to the Vastus lateralis, of large size, accompanies the descending branch of the lateral femoral circumflex artery to the lower part of the muscle. It gives off an articular filament to the knee-joint. The branch to the Vastus medialis descends lateral to the femoral vessels in company with the saphenous nerve. It enters the muscle about its middle, and gives off a filament, which can usually be traced downward, on the surface of the muscle, to the knee-joint. The branches to the Vastus intermedius, two or three in number, enter the anterior surface of the muscle about the middle of the thigh; a filament from one of these descends through the muscle to the Articularis genu and the knee-joint. The articular branch to the hip-joint is derived from the nerve to the Rectus femoris.

The articular branches to the knee-joint are three in number. One, a long slender filament, is derived from the nerve to the Vastus lateralis; it penetrates the capsule of the joint on its anterior aspect. Another, derived from the nerve to the Vastus medialis, can usually be traced downward on the surface of this muscle to near the joint; it then penetrates the muscular fibers, and accompanies the articular branch of the highest genicular artery, pierces the medial side of the articular capsule, and supplies the synovial membrane. The third branch is derived from the nerve to the Vastus intermedius.