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Injuries to Lower Limb Nerves


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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
(PED: Peroneal Everts and Dorsiflexes)
Loss of plantar flexion
gastroc and soleus
Tibial N
TIP: Tibial Inverts and Plantarflexes (if injured, can't stand on TIPtoes)
Loss of knee jerk
Femoral Nerve
Loss of hip adduction
Obdurator (L2,3,4)
Vertebral disk herniation usu occurs between which vertebrae?
between L5 and S1
Lumbar puncture pierces which structures?
Skin/superficial fascia
Ligaments (supraspinous, interspinous and ligmentum flavum if puncture is off midline)
Epidural space and intralaminal space
Dura mater
subdural potential space

CSF is in the subarachnoid space
Which nerve extends the knee?
Which nerve flexes the knee?

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