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Z MD1 Hip and leg anatomy > nerves of lower limb > Flashcards

nerves of lower limb Flashcards

0
Q

where is the lumbar plexus

A

within the substance of psoas major muscle

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1
Q

two plexuses of the lower limb

A

sacral and lumbar

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2
Q

which ventral rami form the lumbar plexus

A

L1-4

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3
Q

what are the 3 divisions emerging from the lateral surfae of the lumbar plexus as they emerge from psoas

A
  • iliohypogastric and ilioinguinal nerves (ilioinguinal is like a branch of iliohypogastric) - lateral cutaneous nerve of thigh - femoral nerve
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4
Q

which ventral rami contribute to the iliohypogastric and ilioinguinal nerves

A

L1

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5
Q

what is the sensory innervation of the ilioinguinal and iliohypogastric nerves

A

cutaneous supply of the skin over the inguinal region and the front of the scrotum

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6
Q

what is the motor innervation of the iliohypogastric and ilioinguinal nerves

A
  • the lowermost fibres of internal oblique and transversus abddominus
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7
Q

which ventral rami contribute to the lateral cutaneous nerve of thigh

A

L2 and L3

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8
Q

what is the sensory innervation of the lateral cutaneous nerve of thigh

A

supplies the skin of the lateral part of the thigh

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9
Q

route of the lateral cutaneous nerve of thigh

A

emerge from the lateral border of psoas major and onto iliacus –> beneath the inguinal ligament and into the anterior compartment of the thigh

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10
Q

which ventral rami contribute to the femoral nerve

A

L2,3,4

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11
Q

onto what surface does the femoral nerve go onto of the thigh

A

the anterior compartment

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12
Q

which nerve of the lumbar plexus emerges from the anterior surface of psoas

A

genitofemoral nerve

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13
Q

which ventral rami contribute to the genitofemoral nerve

A

L1,2

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14
Q

what does the femoral branch of the genitofemoral nerve supply

A

sensory supply to the area of skin immediately beneath the middle of the inguinal ligament

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15
Q

what does the genital branch of the genitofemoral nerve supply

A

the sensory supply to the spermatic cord

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16
Q

which nerve of the lumbar plexus emerges from the medial border of psoas

A

obturator

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17
Q

which ventral rami contribute to the obturator nerve

A

L2,3,4

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18
Q

what are all the nerves of the lumbar plexus

A

iliohypogastric and ilioinguinal nerves lateral cutaneous nerve of thigh femoral nerve genitofemoral nerve obturator nerve

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19
Q

which nerves contribute to the sacral plexus

A

S1-4 (and also what is left of L4 and L5)

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20
Q

where is the sacral plexus

A

formed on the surface of piriformis on the posterior wall of the pelvis

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21
Q

what is the motor innervation of the femoral nerve

A

to quads, sartorius and pectineus (muscles of the anterior thigh)

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22
Q

what is the sensory innervation of femoral nerve

A
  • anteromedial thigh (via anterior cutaneous branches) - medial side of knee, leg and ankle (saphenus nerve)
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23
Q

what other innervation, other than sensory and motor, does the femoral nerve do

A

articular branches to hip and knee

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24
Q

what is the positioning of the femoral nerve as it passes beneath the inguinal ligament and into the anterior compartment of the thigh

A

it is lateral to vascular structures, OUTSIDE the femoral sheath

25
Q

where abouts does the femoral nerve branch into its terminal branches

A

about 2.5cm below the inguinal ligament

26
Q

which group of muscles does the obturator nerve supply

A

the adductor muscles (medial)

27
Q

describe the route of the obturator nerve

A

emerges from medial border of psoas –> drops onto lateral wall of pelvis –> through obturator canal –> medial compartment of thigh

28
Q

which muscles specifically does the obturator nerve supply

A

adductor longus and brevis - via anterior division adductor magnus and gracilis - via posterior division and pectineus

29
Q

where is the sensory innervation of the obturator nerve

A

sensory to inferomedial thigh (just above the medial side of knee)

30
Q

what other supply does the obturator nerve do apart from sensory and motor

A

articular branches to hip

31
Q

which two branches of the sacral plexus contribute to the innervation of the leg

A

posterior cutaneous nerve of thigh sciatic nerve

32
Q

what is the supply of the posterior cutaneous nerve of thigh

A

sensory supply over the back of the thigh

33
Q

what are the two “components” of the sciatic nerve

A

tibial nerve common fibular nerve

34
Q

what is the route of the sciatic nerve through the leg

A

exits pelvis via greater sciatic foramen –> emerges beneath piriformis, onto the posterior of the hip joint –> descends in the posterior thigh under biceps femoris and on obturator internus and gemeli –> divides into terminal branches at the apex of the popliteal fossa

35
Q

which type of hip dislocation can take out the sciatic nerve

A

posterior

36
Q

what is the motor innervation of the sciatic nerve

A

to the hamstrings (via the tibial component of sciatic nerve - apart from SHOB)

37
Q

what articular branches does the sciatic nerve give

A

articular branches to hip

38
Q

which rami contribute to the tibial nerve

A

L4-5, S1-3

39
Q

the tibial nerve is the nerve of which compartment of the leg

A

the posterior compartment (calf - flexors)

40
Q

what is the route of the tibial nerve

A

continues the vertical descent of sciatic nerve through the popliteal fossa behind the knee joint –> beneath fibrous arch of Soleus –> descends between the superficial and deep muscles of the calf on tibialis posterior –> posterior to medial malleolus –> sole of foot –> divides into medial and lateral plantar nerves

41
Q

what is the motor innervation of the tibial nerve

A

the to posterior muscles of the leg

42
Q

what is the sensory innervation of the tibial nerve

A

posterior leg and lateral side of foot - sural nerve sole of foot - medial calcaneal, medial and lateral plantar nerves

43
Q

which part of the sole of the foot is supplied by the saphenous nerve

A

very medial part

44
Q

what is the route of the common fibular nerve

A

remains next to (medially) biceps femoris –> superficial to lateral head of gastrocnemius on route –> winds around the neck of fibula –> into substance of fibularis longus –> divides into terminal branches (deep and superficial fibular nerves)

45
Q

if you take out the common fibular nerve what is the sign

A

“Foot drop”

46
Q

what is the motor innervation of the common fibular nerve

A

nothing

47
Q

what is the sensory innervation of the common fibular nerve

A
  • sensory to upper lateral leg via sural cutaneous nerve - gives communicating branch to sural nerve (from tibial nerve)
48
Q

which nerve roots contribute to the common fibular nerve

A

L4-5, S1-2 (no S3)

49
Q

the common fibular nerve is the nerve of which compartment

A

the anterior compartment of the leg (extensors)

50
Q

two divisions of the common fibular nerve

A

deep and superficial fibular nerves

51
Q

route of the deep fibular nerve

A

begins in substance of fibularis longus –> descends deep to EDL, anterior to interosseous membrane –> beneath extensor retinaculum -> dorsum of the foot –> between toe cleft of 1st and 2nd toes

52
Q

motor innervation of deep fibular nerve

A

anterior compartment of the leg - tibialis anterior, EDL, EHL extensor digitorum brevis (on dorsum of the foot)

53
Q

what is the sensory innervation of the deep fibular nerve

A

sensory to the skin between the 1st and 2nd toes

54
Q

what is the motor innervation of the superficial fibular nerve

A

lateral compartment of the leg - fibularis longus and brevis

55
Q

what is the sensory innervation of the superficial fibular nerve

A

lower lateral leg and dorsum of the foot (sparing the first web space)

56
Q

explain the innervation of the muscles in the gluteal region

A

superior gluteal nerve - supplies gluteus minimus and medius inferior gluteal nerve supplies gluteus maximus

57
Q

which nerves innervate the anterior, medial and posterior compartments of the thigh

A

anterior - femoral medial - obturator posterior - sciatic nerve

58
Q

how do you get a dermatomal or myotomal disruption to the lower limb

A

disruption of the nerves at the root level

59
Q

what are the roots of the superior and inferior gluteal nerves

A

superior - L5,5,S1 - emerges above piriformis inferior - L5, S1,2 - emerges below piriformis

Z MD1 Hip and leg anatomy (8 decks)

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