Lower extremity nerves

Question 1

Iliohypogastric: roots

Answer 1

T12-L1

Question 2

Iliohypogastric: innervation sensory

Answer 2

Suprapubic region

Question 3

Iliohypogastric: innervation motor

Answer 3

Transversus abdominis and internal oblique

Question 4

Iliohypogastric: causes of injury

Answer 4

Abdominal surgery

Question 5

Iliohypogastric: presentation

Answer 5

Burning or tingling pain in surgical incision site radiating to inguinal and suprapubic region

Question 6

Genitofemoral: roots

Answer 6

L1-L2

Question 7

Genitofemoral: innervation sensory

Answer 7

Scrotum/labia majora
Medial thigh

Question 8

Genitofemoral: motor innervation

Answer 8

Cremaster

Question 9

Genitofemoral: cause of injury

Answer 9

Laparoscopic injury

Question 10

Genitofemoral: presentation

Answer 10

Decreased medial/anterior thigh sensation beneath the inguinal ligament

Question 11

Lateral femoral cutaneous: roots

Answer 11

L2-L3

Question 12

Lateral femoral cutaneous: innervation (sensory only)

Answer 12

Anterior and lateral thigh

Question 13

Lateral femoral cutaneous: cause of injury

Answer 13

Tight clothing, obesity, pregnancy, pelvic procedures

Question 14

Lateral femoral cutaneous: presentation

Answer 14

Decreased thigh sensation

Meralgia paresthetica: compression -> tingling, numbness, burning pain in anterolateral thigh

Question 15

Obturator: roots

Answer 15

L2-L4

Question 16

Obturator: innervation sensory

Answer 16

Medial thigh

Question 17

Obturator: innervation motor

Answer 17

Obturator externus, adductor longus/magnus/brevis, gracilis, pectineus

Question 18

Obturator: cause of injury

Answer 18

Pelvic surgery

Question 19

Obturator: presentation

Answer 19

Decreased thigh sensation
Decreased adduction

Question 20

Femoral: roots

Answer 20

L2-L4

Question 21

Femoral: innervation sensory

Answer 21

Anterior thigh and medial leg

Question 22

Femoral: innervation motor

Answer 22

quadriceps, iliacus, pectineus, sartorius

Question 23

Femoral: cause of injury

Answer 23

Pelvic fracture

Question 24

Femoral: presentation

Answer 24

Decreased leg extension
(decreased patella reflex)

Question 25

Sciatic: roots

Answer 25

L4-S3

Question 26

Sciatic: innervation (motor only)

Answer 26

Semitendinosus, semimembranosus, biceps femoris, adductor magnus

Question 27

Sciatic: cause of injury

Answer 27

Herniated disc, posterior hip dislocation

Question 28

Sciatic: splits into which nerves?

Answer 28

Common peroneal and tibial nerves

Question 29

Common (fibular) peroneal: roots

Answer 29

L4-S2

Question 30

Common (fibular) peroneal: splits into which nerves?

Answer 30

Superficial and deep peroneal

Question 31

Superficial peroneal: roots

Answer 31

L4-S2

Question 32

Deep peroneal: roots

Answer 32

L4-S2

Question 33

Superficial peroneal: innervation sensory

Answer 33

Dorsum of feet (except space between hallux and 2nd digit)

Question 34

Superficial peroneal: innervation motor

Answer 34

Peroneus longus and brevis

Question 35

Deep peroneal: innervation sensory

Answer 35

Space between hallux and 2nd digit

Question 36

Deep peroneal: innervation motor

Answer 36

Tibialis anterior

Question 37

Common (fibular) peroneal: cause of injury

Answer 37

Trauma/compression to lateral leg Fibular nek fracture

Question 38

Common (fibular) peroneal: presentation

Answer 38

Loss of sensation on dorsum of foot Foot drop: inverted and plantarflexed at rest (loss of eversion and dorsiflexion) -> Steppage gait (klapvoet)

Question 39

Tibial: roots

Answer 39

L4-S3

Question 40

Tibial: innervation sensory

Answer 40

Sole of foot

Question 41

Tibial: innervation motor

Answer 41

Biceps femoris, triceps surea (gastrocnemicus and soleus), plantaris, popliteus, flexor muscles of foot

Question 42

Tibial: cause of injury

Answer 42

Proximal: knee trauma, Bakers cyst Distal: tarsal tunnel syndrome (distal lestion)

Question 43

Tibial: presentation

Answer 43

Loss of sensation sole Inability to curl toes Proximal: foot everted at rest, weakened inversion and plantar flexion (Tibial inverts and platarflexes)

Question 44

Superior gluteal: roots

Answer 44

L4-S1

Question 45

Superior gluteal: innervation (motor only)

Answer 45

Gluteus medius, minimus, tensor fascia latae

Question 46

Superior gluteal: cause of injury

Answer 46

Iatrogenic during intramuscular injection to superomedial region Prevent by choosing superolateral quadrant

Question 47

Superior gluteal: presentation

Answer 47

Trendelenburg sign: pelvis tilts because weight bearing leg cannot maintain alignment of pelvis through hip abduction Lesion is in contralateral side of the hip that drips, ipsilateral to extremity on which the patient stands

Question 48

Inferior gluteal: roots

Answer 48

L5-S2

Question 49

Inferior gluteal: innervation (motor only)

Answer 49

Gluteus maximus

Question 50

Inferior gluteal: cause of injury

Answer 50

Posterior hip dislocation

Question 51

Inferior gluteal: presentation

Answer 51

Loss of hip extension Difficulty climbing stairs, rising from seated position

Question 52

Pudendal: roots

Answer 52

S2-S4

Question 53

Pudendal: innervation (sensory)

Answer 53

perineum

Question 54

Pudendal: innervation (motor)

Answer 54

External urethral and anal sphincters

Question 55

Pudendal: cause of injury

Answer 55

Stretch injury during childbirth, prolonged cycling, horseback riding

Question 56

Pudendal: presentation

Answer 56

Decreased sensation in perineum and genital area: can cause fecal/urinary incontinence

Question 57

Pudendal: when can this be anesthetically blocked and what is the landmark?

Answer 57

During childbirth, using ischial spine as a landmark for injection