Injuries to Lower Limb Nerves
Terms
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- Deep Fibular Nerve
- FOOT DROP, paresthesia in webspace between big toe and second toe
- Femoral Nerve
-
(from posterior division of L2, L3, L4)
longest branch is saphenous nerve - sensation over area of great saphenous vein; impaired ability to flex at hip and extend knee; decreased patellar reflex - Superior Gluteal Nerve
- (L4, L5, S1 - exits via greater sciatic foramen above piriformis) innervates gluteus medius, minimus and tensor fascia latae; impaired hip abduction , in walking - "Trendlenburg" gait: pelvic tilt (sag) toward opposite side form lesion
- Inferior Gluteal Nerve
-
(L5-S2; gluteus maximus - exits greater sciatic foramen below piriformis w/ pudendal and sciatic)
impaired lateral rotation and extension of thigh at hip, DIFFICULTY GETTING UP FROM A CHAIR, gluteus minimus gait = thrust torso posteriorly - Superficial Fibular Nerve
- impaired eversion and dorsal sensation, but extension is intact
- Tibial Nerve
- "tarsal tunnel syndrome" = decreased flexion of big toe, difficulty standing on tiptoe
- Obdurator Nerve
-
(L2-4, anterior division, medial thigh-adductors- exits via obdurator canal)
impaired adduction of thigh at hips - Terrible triad
-
anterior cruciate ligament
medial collateral ligament
medial meniscus - Anterior drawer sign
-
tibia displaced anteriorly to femur in flexed knee
indicated ACL tear - Sx of torn Medial collateral ligament
- pain when leg is rotated medially at the knee (abnl passive abduction)
- Foot drop (loss of dorsiflexion)
-
tibialis anterior
Comon peroneal nerve
(L4-S2)
(PED: Peroneal Everts and Dorsiflexes) - Loss of plantar flexion
-
gastroc and soleus
Tibial N
(L4-S3)
TIP: Tibial Inverts and Plantarflexes (if injured, can't stand on TIPtoes) - Loss of knee jerk
-
Femoral Nerve
L2,3,4 - Loss of hip adduction
- Obdurator (L2,3,4)
- Vertebral disk herniation usu occurs between which vertebrae?
-
between L5 and S1
Sciatica! - Lumbar puncture pierces which structures?
-
SLEDsA to CSF
Skin/superficial fascia
Ligaments (supraspinous, interspinous and ligmentum flavum if puncture is off midline)
Epidural space and intralaminal space
Dura mater
subdural potential space
Arachnoid
CSF is in the subarachnoid space - Which nerve extends the knee?
- femoral
- Which nerve flexes the knee?
- Tibial