A 45-year-old male entered the emergency department with a complaint of severe abdominal pain. During physical examination it is observed that his cremasteric reflex is absent. Which of the following nerves is responsible for the efferent limb of the cremasteric reflex?
The genitofemoral nerve originates from the ventral rami of L1 and L2. The femoral part supplies skin to the femoral triangle area, whereas the "genito" part in males travels with the spermatic cord and supplies the cremaster muscle and scrotal skin. The ilioinguinal nerve arises from L1 and supplies the skin over the root of the penis and upper part of the scrotum in the male. The iliohypogastric nerve arises from L1 (and possibly fibers from T12) and supplies skin innervation over the hypogastric region and anterolateral gluteal region. The pudendal nerve provides innervation to the external genitalia for both sexes but does not innervate the cremaster muscle in males. The ventral ramus of T12 is also associated with the lower portion of the anterior abdominal wall and the iliohypogastric nerve; it does not contribute to the cremasteric reflex.
Ilioinguinal
Iliohypogastric
Genitofemoral
Pudendal
Abdomen & Pelvis