LL Peripheral Nerve Flashcards

1
Q

Obturator Nerve

A

From L2-4

MOI:
rare but can occur
due to hip dislocation/during surgery involving the pelvis or abdomen

Sensory loss:
- Numbness@medial thigh

Motor loss:
- Hip adduction impaired
–>abnormalities in gait

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2
Q

Femoral Nerve

A

From L2-4

MOI:
* Trauma (penetrating pelvic injury)
* Compression (prolonged hip flexion)
* Pelvic, abdominal, or spinal surgery

Sensory loss:
- Numbness@ anteromedial thigh & medial leg/foot

Motor loss:
- Weak hip flexion (psoas still intact)
*Circumduction to step leg through
- Impaired knee extension
* hyperextension/instability

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3
Q

Saphenous Nerve

A

From L3-4

MOI:
* Trauma to medial aspect of leg or knee
* Leg or ankle fracture
* Entrapment in adductor canal

Sensory loss:
Numbness @ anteromedial leg and ankle

No motor loss

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4
Q

Lateral Femoral Cutaneous Nerve

A

From L2-3

MOI:
Compression due to:
- Compression under inguinal ligament
- Pregnancy
- Tight clothing
- Obesity

Sensory loss:
Numbness @ anterolateral thigh

No motor loss

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5
Q

Posterior Femoral Cutaneous Nerve

A

From S1-S3

MOI: Trauma to posterior aspect of thigh

Sensory loss:
Numbness @ posterior thigh and knee

No motor loss

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6
Q

Superior Gluteal Nerve

A

From L4-S1

MOI:
* Posterior hip dislocation
* Injection to upper medial gluteal region

No sensory loss

Motor loss:
- Impaired hip abduction
+Ve Trendelenburg sign and gait

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7
Q

Inferior Gluteal Nerve

A

From L5-S2

MOI:
Rare but can occur during hip replacement

No sensory loss

Motor loss:
Impaired hip extension
* Difficulty with climbing stairs, step ups onto curb, arising from chair
* Backward trunk lean or throwing the trunk backward after initial contact

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8
Q

Sciatic Nerve

A

From L4-S3

MOI:
* Trauma: lumbar IV disc herniation
* Hip surgery

Sensory loss:
Numbness over
- posterolateral leg and foot (via sural N)
- dorsum of the foot and anterolateral leg (via superficial fibular N)
- first webspace (via deep fibular N)
- plantar aspect of foot (via tibial N)

Motor loss:
- Impaired knee flexion
*circumduction gait or increased hip flexion to clear foot during swing
- Impaired ankle dorsiflexion, plantarflexion, inversion and eversion
* AFO required to stabilize ankle

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9
Q

Tibial Nerve

A

From L4-S3

MOI: Post. knee dislocation

Sensory loss:
before branching->Numbness @
- posterolateral leg and foot (via sural N, which also receives innervation from the common fibular nerve)
- heel (via medial calcaneal N)
- plantar aspect of foot (via medial plantar N and lateral plantar N)

within tarsal tunnel
@heel and plantar aspect of the foot

Motor loss:
Before branching:
- Impaired ankle plantarflexion
- Weak ankle inversion (tibialis anterior can still invert the foot)
- Impaired toe flexion

within tarsal tunnel:
Intrinsic foot weakness
* loss of toe motion, arch support and foot stability

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10
Q

Common Fibular Nerve

A

From L4-S3

MOI:
- Compression (e.g., tight cast)
- Trauma: fracture of fibular neck (aka bumper fracture)

Sensory loss:
Numbness @
- anterior and lateral leg
- dorsum of the foot including first webspace

Motor loss:
- Impaired ankle dorsiflexion/eversion
- Impaired toe extension
- Weak ankle inversion (tibialis posterior still intact)
*Foot drop–>steppage gait (exaggerated hip and knee flexion to clear foot during swing)

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11
Q

Superficial Fibular Nerve

A

From L4-S1

MOI:
* Trauma: fibula fractures
* Nerve entrapment
* Compression (e.g., compartment syndrome)

Sensory loss:
Numbness @ anterolateral leg and dorsum of foot (except 1st webspace)

Motor loss:
- Impaired ankle eversion
*ankle instability
- Mild weakness in PF

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12
Q

Deep Fibular Nerve

A

From L4-L5

MOI:
* Compression (tight laces/ski boots)
* Trauma: anterior ankle trauma
* Nerve palsy (due to inflammatory disorders, diabetes, demyelinating diseases)

Sensory loss:
Numbness @ first webspace

Motor loss:
- Impaired ankle dorsiflexion
* foot drop –> steppage gait
- Impaired toe extension
- Weak ankle inversion (tibialis posterior intact)

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