Lower body

Question 1

What are the ventral rami of the lumbar plexus

Answer 1

T12 - L5

Question 2

How many branches come off each ventral rami of the lumbar plexus

Answer 2

T12- 2
L1- 3
L2- 4
L3- 4
L4- 4
L5- 1

Question 3

What are the branches of the T12 ventral rami?

Answer 3

1. subcostal nerve

2. branch to L1

Question 4

What are the branches of the L1 ventral rami?

Answer 4

1. iliohypogastic
2. ilioinguinal
3. branch to genitofemoral

Question 5

What are the branches of the L2 ventral rami?

Answer 5

1. branch to genitofemoral
2. brach to lateral cutaneous of the tight
3. branch to femoral
4. branch to obturator

Question 6

What are the branches of the L3 ventral rami?

Answer 6

1. branch to lateral cutaneous of the thigh
2. branch to femoral
3. branch to accessory obturator
4. branch to obturator

Question 7

What are the branches of the L4 ventral rami?

Answer 7

1. branch to femoral nerve
2. branch to accessory obturator
3. branch to obturator
4. branch to lumbosacral trunk

Question 8

What are the branches of the L5 ventral rami?

Answer 8

lumbosacral trunk

Question 9

What are the ventral rami of the sacral plexus?

Answer 9

L4-S4

Question 10

What are the divisions of the sacral plexus?

Answer 10

posterior L4-S2

anterior L4-S4

Question 11

What are the terminal branches of the divisions of the sacral plexus?

Answer 11

posterior fibular nerve L4-S2

anterior tibial nerve L4-S3

Question 12

What branches off the posterior division of the sacral plexus?

Answer 12

1. superior gluteal (4-1)
2. inferior gluteal (5-2)
3. muscular to piriformis (1-2)
4. branch to posterior cutaneous (1-3)
5. branch to perforating cutaneous (2-3)
6. terminal fibular (4-2)

Question 13

What branches of the anterior division of the sacral plexus?

Answer 13

1. muscular to quadratus femoris and inferior gemelli (4-1)
2. muscular to obtruatur internus and superior gemelli (5-2)
3. branch to posterior cutaneous (1-3)
4. branch to perforating cutaneous (2-3)
5. pudendal (2-4)
6. levator ani (3-4)
7. 4th sacral

Question 14

Where is the sclerotome referral pattern for L1?

Answer 14

1. anteriorly-ASIS wrapping down to pubis along inguinal ligament
2. posteriorly-PSIS with a wide swath running down from lower thoracic to hip

Question 15

Where is the sclerotome referral pattern for L2?

Answer 15

1. anteriorly -iliac crest into pubis and a swath across the middle of the anterior thigh
2. posteriorly-similar to L1 but shift down a little to capture more glut

Question 16

where is the sclerotome referral pattern for L3?

Answer 16

1. anteriorly-lateral hip and thigh across the knee; lateral ankle
2. posteriorly- PSIS, lateral thigh and shin

Question 17

where is the sclerotome referral pattern for L4?

Answer 17

1. anteriorly- front of thigh with primary spot just about the knee
2. posteriorly-Down the central glut and outside of the tight

Question 18

Where is the sclerotome referral pattern for L5?

Answer 18

1. anteriorly- front of hip, pelvis and thigh running down the lateral shin
2. posteriorly- lumbar spine region and middle of thigh

Question 19

where is the sclerotome referral pattern for S!?

Answer 19

1. anteriorly- front of thigh with a primary spot in the groin
2. posteriorly- lateral pelvis, hip, thigh and shin

Question 20

Where is the sclerotome referral pattern for S2?

Answer 20

1. anteriorly- lateral hip and thigh with primary in the lateral thigh
2. posteriorly-medial lumbar, glut and lateral thigh with primary spot over the medial glut

Question 21

where is the sclerotome referral pattern for S3?

Answer 21

1. anteriorly- medial knee

2. posterioly- medial glut with primary spont over PSIS

Question 22

What are the cutaneous innervations of the groin along the inguinal ligament?

Answer 22

lateral -> medial

subcostal, genitofemoral, ilioinguinal

Question 23

What are the cutaneous innervations of the anterior thigh?

Answer 23

lateral -> medial

1. lateral femoral (lumbar plexus 2,3)
2. intermediate femoral (femoral 2,3)
3. medial femoral (femoral 2-4)
4. cutaneous branch of obturator

Question 24

What are the cutaneous innervations of the anterior knee and shin?

Answer 24

lateral knee- lateral sural (tibial SI)
medial knee- infrapatellar branch of saphenous (femoral 3,4)
lateral shin- superficial fibular
medial shin- saphenous (femoral 3,4)

Question 25

what are the cutaneous innervations of the dorsal aspect of the foot?

Answer 25

lateral- sural (fibular SI) mid- superfiscial fibular (4,5) medial- saphenous (femoral 3,4) b/w digit 1 and 2- deep fibular

Question 26

What are the cutaneous innervations of the glut region?

Answer 26

1.across the top of the illiac crest are the cutaneous branches of the subcostal nerve and dorsal rami L1-3 2.distal and medial are the cutaneous branch of S1-S3 3.preforating cutaneuos posterior femoral cutaneous

Question 27

What are the cutaneous innervations of the posterior thigh?

Answer 27

Medial -> lateral 1. cutaneous brach of obtruator 2. posterior femoral cutaneous 3. lateral femoral cutaneous

Question 28

What are the cutaneous innervations of the posterior lower leg?

Answer 28

medial -> lateral saphenous (femoral 3,4) sural (tibial SI) superficial fibular (4,5)

Question 29

What nerves innervate muscles crossing the hip?

Answer 29

``` inferior gluteal (sacral plexus L4-S1) superior gluteal (sacral plexus L5-S2) Obturator (lumbar plexus L2-L4) femoral (lumbar plexus L2-L4) Sciatic (L4-S2) ```

Question 30

What muscles does the superior gluteal innervate at the hip?

Answer 30

``` gluteus medius (L4-S1) gluteus minimus (L4-S1) tensor fascia latae (L4-5) ```

Question 31

What muscles does the inferior gluteal innervate at the hip?

Answer 31

1. gluteus maximus

Question 32

What muscles does the obturator innervate at the hip?

Answer 32

gracilis (2-3) adductor longus (2-4) adductor brevis (2-4) adductor magnus (3-4) with tibial branch of sciatic (4-1) obturator externeus (3-4) pectineus (accessory obturator with femoral)

Question 33

What is the pathway of the gluteal nerves at the hip?

Answer 33

come off posterior division of sacral plexus | pass through greater sciatic foramen above piriformis

Question 34

What muscles does the femoral nerve innervate at the hip?

Answer 34

satorius (2-3) rectus femoris (2-4) iliacus (1-4) pectineus (with accessory obturator)

Question 35

What is the pathway of the obturator nerves at the hip?

Answer 35

branch off lumbar plexus pass through psoas major emerges near pelvis brim passes behind the iliac arteries running along the pelvis wall at about the path of the SIJ passes through the obturator foremen between acetbulum and pubic symphysis divides into anterior and posterior branches

Question 36

What muscles does the sciatic nerve innervate at the hip?

Answer 36

semitendonosus (tibial branch 4-1) sememembranosus (tibial branch 4-1) biceps femoris long head (tibial branch 5-2) biceps femoris short head (fibular branch 5-2)

Question 37

What is the pathway of the femoral nerve at the hip?

Answer 37

pass through psoas major emerges at lower end between it and illiacus passes under the inguinal ligament dividing into anterior and posterior divisions anterior gives off muscular and cutaneous branches posterior gives off muscular and articular branches

Question 38

What muscles of the hip have branches directly off the lumbar plexus?

Answer 38

``` psoas major (1-4) psoas minor (1-2) ```

Question 39

what muscles of the hip have branches directly off the sacral plexus?

Answer 39

``` piriforis (5-2) obturator internus (5-2) gemellus superior (5-2) gemellus inferior (5-2) quadratus femoris (4-2) ```

Question 40

What nerves innervate the hip capsule?

Answer 40

``` obturator- anterior medial femoral- anterior sciatic- posterior nerve to quadratus femoris- posterior medial superior gluteal- posterior lateral ```

Question 41

What nerves innervate muscles crossing the knee?

Answer 41

``` femoral obturator sciatic tibial distal end of HS fibular distal end of BF short head Superior gluteal ```

Question 42

What muscles does the femoral nerve innervate at the knee?

Answer 42

sartorius (2-3) quadriceps (2-4) articularis genu (2-4)

Question 43

What muscles does the obturator innervate at the knee?

Answer 43

1. gracillis (2-4)

Question 44

What muscles does the sciatic nerve innervate at the knee?

Answer 44

1. semitendonosus (tibial branch 4-1) 2. sememembranosus (tibial branch 4-1) 3. biceps femoris long head (tibial branch 5-2) 4. biceps femoris short head (fibular branch 5-2)

Question 45

What muscles does the tibial nerve innervate at the knee?

Answer 45

1.branches to semimenbranousus and tendonosis 2,popliteus (5,1) 3.gastroc (1,2) 4.plantaris (1,2)

Question 46

What are the articular innervations of the knee?

Answer 46

1. tibial- posteriorly 2. common fibular- laterally 3. saphenous- anterior medial 4. tibial recurrent of common fibular- anteriorly

Question 47

What are the common sites of compression for the tibial nerve?

Answer 47

popliteal fossa by a fibrous band connecting the heads of the gastroc or arch of the soleus posterior tarsal tunnel

Question 48

What nerves innervate muscles crossing the ankle?

Answer 48

1. tibial | 2. fibular

Question 49

What muscles does the tibial nerve innervate that cross the ankle or are in the foot?

Answer 49

1. gastroc (1,2) 2. soleus (1,2) 3. plantaris (1,2) 4. tibialis posterior (5-1) 5. FHL (2,3) 6. FDL (2,3) 7. AbDH, FHB, FDB, Lumbrical (medial plantar 2.3) 8. AdDH, QP, interossi, lumbrical, FDM, AbDDM (lateral plantar 2,3)

Question 50

What are common compression sites for the fibular nerve?

Answer 50

1,fibular head 2. fibrous arch of fibularis muscle 3. extensor retinaculum or anterior tarsal tunnel

Question 51

What pathologies are associated with fibular nerve compression?

Answer 51

1. ganglion cysts 2. hematoma 3. baker’s cyst 4. fabellar of lateral gastroc 5. ankle fractures or sprains

Question 52

what is the pathway of the fibular nerve after branching off sciatic?

Answer 52

1. separates from tibial at the top of the popliteal fossa running medial to biceps formis 2. wraps around the fibular head 3. passes into the fibular tunnel through the fibularis longus dividing into superficial and deep

Question 53

what is the pathway of the tibial nerve after branching off sciatic?

Answer 53

1. separates from the fibular at the top of the popliteal fossa bisecting the fossa 2. runs dow the back of the tibia to the posterior aspect of the medial malleolus 3. passes under the flexor retinaculum with posteior tibial artery 4. divides into medial and lateral plantars

Question 54

What is the accessory fibular nerve and its clinical significance?

Answer 54

1.continuation of the superficial fibular that can innervate extensor digitorum brevis masking deep peroneal injuries

Question 55

What are the branches of the fibular nerve?

Answer 55

1. superficial 2. deep 3. lateral sural 4. accesory fibular

Question 56

What are the branches of the tibial nerve?

Answer 56

1. medial sural 2. medial plantar 3. lateral plantar

Question 57

what is the pathway of the saphenous nerve?

Answer 57

1. continuation of femoral descending to medial side of knee 2. piercing facia between tendons of sartorius and gracilis becoming superficial and passing down the medial side of the tibia 3. continues down the medial side of the foot and can join with superficial fibular

Question 58

What muscles does the fibular nerve innervate?

Answer 58

1. superficial - FL, FB (1,2) | 2. deep- TA (4,5), EDL, EDB, EHB (1,2)

Question 59

What are the cutaneous innervations of the fibular nerve?

Answer 59

1. lateral sural (1,2)- posterior lateral lower leg and lateral foot 2. deep fibular cutaneous- web space digits 1/2 3. superficial peroneal- anterior lateral and dorsum of foot

Question 60

What are the cutaneous innervations of the tibial nerve?

Answer 60

1. medial sural (1,2)- posterior lateral lower leg and lateral foot 2. medial tibial cutaneous- medial heel 3. lateral plantar 4. medial plantar