Anatomy of Lower Limb Flashcards
Cutaneous Innervation of Gluteal Region and Thigh
Superior and medial cluneal = dorsal rami; coming from posterior sacrum
Inferior cluneal – see a nerve that comes out of piriformis and gives off inferior gluteal nerves and because comes off of sacral plexus = ventral rami
S1-3 takes care of posterior aspect of thigh; S2-3 is inferior cluneal
S1 goes through posterior thigh to lateral aspect of leg and foot
Cutaneous Innervation of ASIS and Inguinal
Top of hip: subcostal nerve (T12) and iliohypogastric (L1), so as we go from inguinal region to top crest of ASIS and continue back, that is basically all L1
Top of buttocks part of L1 too
Cutaneous Innervation of the Thigh
Going from lateral to medial, see lateral femoral cutaneous nerve from lumbar plexus L2-4 and cutaneous and medially get obturator
If you have the inguinal region being L1 and have 2-4 lateral cutaneous of thigh and medial from cutaneous branches of obturator
Meralgia Paresthetica
Entrapment of lateral cutaneous nerve of thigh under inguinal ligament
Common causes: Obesity Pregnancy Heavy tool belt; tight clothing Local Trauma Diabetes
Cutaneous Innervation of Distal Lower Limb
Continuation of femoral n. (saphenous n.)
Cutaneous nn. off common fibular n. (lateral sural cut., superficial fibular, deep fibular)
Cutaneous nn. off tibial n.(medial sural cut., medial calcaneal, med & lat plantar)
Cutaneous Innervation of Leg, Ankle, and Foot: Femoral Nerve
Anterior femoral cutaneous nn.= anterior thigh
Saphenous n.= medial leg & foot (including medial malleolus)
Everything else cutaneous lower than knee is done by sciatic (other than anteriolateral aspect and medial malleolus)
Cutaneous Branches of Common Fibular Nerve
Common Fibular nerve: gives off the following branches:
Lateral sural cutaneous n.: upper lateral leg
Superficial fibular n.: anterolateral, distal third of leg and dorsum of foot
Deep fibular n.: 1st interdigital cleft between 1st and 2nd toes
Cutaneous Branches of Tibial Nerve
Sensory in leg:
Medial sural cutaneous n.: upper calf (posteriorly)
Sural n.: posterolateral leg and lateral side of foot
Tibial gives off motor innervation in posterior leg and then goes through tarsal tunnel and go to foot to give off medial calcaneal branch and then medial and lateral plantar nerves
Dorsiflexion vs. Plantarflexion
Dorsiflexion (flexion): deep fibular n.
Tibialis anterior, EHL, EDL, fibularis tertius
Plantarflexion (extension): tibial n.
triceps surae,, plantaris, tibialis posterior
(Superficial fibular n.: weak fibularis longus & brevis)
Eversion vs. Inversion Muscles
Eversion: Fibularis longis & brevis (superficial fibular n.) Fibularis tertius (deep fibular n.)
Inversion: Tibialis anterior (deep fibular n.) Tibialis posterior (tibial n.)
Steppage Gait
Lesion of the Common or Deep Fibular Nerve
When they lift their foot for swing, they cannot lift the foot by itself (dorsiflexion) aka footd drop, and they bring the hip up instead
Trendellenburg Sign
Superior gluteal goes to gluteus medius and minimis muscles that abduct the hip and this is Trendellenburg sign is to stand and hip drop on UNsupported side and leg becomes too long because hip being dropped
Affected Side will be upwards, and the unaffected side will be tilted downwards
Walking: patient will lurch towards affected side during stance phase and have a waddling gait
Tendon Reflexes
Achilles: S1-2
Patellar: L3-4
Biceps: C5-6
Triceps: C7-8
Femoral Triangle
NAVL from lateral to medial
Lesion would cause weak hip flexion and no knee extension
Innervates anterior thigh muscles including gracilis, Sartorius, rectus femoris, vastus medialis, vastus lateralis, and some of the adductor longus and pectineus
Jack Knife Gait
Weakness in hip extension Gluteus maximus (Inferior gluteal n.) & Hamstring (Tibial n.)
