Module 5: Unit 2-4 Flashcards
1
Q
Which of the following nerves supplies the cremaster muscle?
a. Obturator
B. Femoral
C. Genitofemoral
D. Ilioinguinal
A
C
2
Q
The nerve to the iliacus and Psoas is a ____________ division nerve derived from ____________ spinal nerves
A
Posterior; L2-4
3
Q
The ____________ nerve innervates the internal transversus abdominus, as well as the skin superior to a line between the pubic symphysis and the ASIS
A
Iliohypogastric
4
Q
The quadratic lumborun is innervated by:
A. Dorsal primary ramifications of T12-L4
B. The lumborsacral plexus
C. The iliogypogastric nerve
D. Ventral primary rami of T12-L4
A
D
5
Q
The nerve to the iliacus and Psoas muscles can be identified as a branch of the ___________ nerve
A
Femoral
6
Q
Femoral nerve is derived from _________ divisions of the ventral primary rami of ____________
A
Posterior; L2-4
7
Q
A pt complains of weakness of R knee extension. On examination, the pt’s quadriceps reflex is diminished on the R compared to the left. He also has obvious weakness of the quadriceps femoris, but not the tibialis anterior on the R. Which of the following nerves is likely damaged?
A. Obturator
B. Femoral
C. Tibial
D. Deep fibular
A
B
8
Q
Which of the following muscles is innervated by the obturator nerve?
A. Adductor Longus
B. Obturator inter us
C. Biceps femoris
D. Simitendinosus
A
A
9
Q
Which of the following cutaneous areas of the thigh is innervated by the obturator nerve?
A. Posterior
B. Anterior
C. Lateral
D. Medial
A
D
10
Q
Name two muscles innervated by the obturator nerve.
A
Pectineus, Adductor Magnus
11
Q
Name two muscles innervated by the obturator nerve.
A
Pectineus, Adductor Magnus
12
Q
T or F
The lateral leg and dorsal surface of the foot receive cutaneous branches of the common fibular nerve, whereas the posterior surface fo the leg and bottom of the foot receive cutaneous branches of the tibial nerve
A
T
13
Q
Which of the following muscles is innervated by the tibial nerve?
A. Extensor hallucis longus
B. Rectus femoris
C. Adductor Magnus
D. Tibialis posterior
A
D
14
Q
Which of the following nerves innervates the gluteus maximus?
A. Femoral
B. Inferior gluteal
C. Pudendal
D. Sciatic
A
B
15
Q
Which of the following nerves innervates the Fibularis tertius?
A. Tibial
B. Saphenous
C. Deep fib
A
C
16
Q
The superior gemellus muscle and the ______ ________ muscle are both enervated by the same nerve
A
Obturator internus
17
Q
The sciatic nerve branches into which of these jam or nerves at the popliteal fossa?
A. Greater fibular and tibial
B. Tibial and superficial fibular
C. Common fibular and tibial
D. Common fibular and deep tibial
A
C
18
Q
The sciatic nerve is the largest branch for the ___________ plexus
A
Lumbosacral
19
Q
The short head of the biceps femoris is innervated by the ______________
A
Common fibular nerve
20
Q
Which of the following muscles is innervated by the deep fib nerve?
A. Fibularis longus
B. Tibialis posterior
C. Extensor hallucis longus
D. Gastrocnemius
A
C
21
Q
Which one of the following innervates the flexor hallucis brevis?
A. Lateral tibial nerve
B. Medial tibial nerve
C. Dep fib nerve
A
B
22
Q
Name the distributions of the ventral primary ramifications. Name each nerve associated with the lumbar plexus and it division.
A
Ventral Primary Rami (L1-4)
- Iliohypogastric nerve; Anterior L1
- Ilioinguinal nerve; Anterior L1
- Genitofemoral nerve; Anterior L1 & 2
- Lateral Femoral Cutaneous Nerve; Posterior L2 & 3
- Nerve to the Psoas and Iliacus; Posterior L2-4
- Femoral Nerve; Posterior L2-4
- Obturator Nerve; Anterior L2-4
23
Q
Which neural division provides cutaneous fibers to skin more superior and posterior than the Ilioinguinal.
A
Iliohypogastric
24
Q
The Iliohypogastric and Ilioinguinal nerves consist of what two components?
A
Motor and sensory
25
T or F
Peripheral nerves will repair overtime about 2mm a day
T
26
What branch of the Genitofemoral nerve involves the cremaster muscle and anterior scrotal skin in males, and the skin of the mons pubis and labia majors in females
Genital branch
27
What Genitofemoral nerve branch supplies sensation to the upper anterior thigh?
Femoral (L1-2)
28
What is the entrapment of the upper lumbar plexus that bears most clinical significance and is that of the lateral femoral cutaneous nerve?
A. Lateral femoral nerve
B. TFL syndrome
C. Meralgia Paresthetics
D. Ebraheim lateral cutaneous
C
29
What is meraliga parenthetical?
Entrapment of the lateral femoral cutaneous nerve
30
What are the divisions of the lateral femoral cutaneous nerve?
L2, 3 posterior division
31
T or F
The lateral femoral cutaneous nerve and femoral nerve exit the inguinal tunnel
T
The femoral nerve exits the inguinal tunnel much more meidally
32
What are the divisions of the psoas and iliacus?
Posterior division VPRs of L2-4
33
What nerve innervates the quadriceps, Pectineus, and sartorius?
Femoral nerve
34
Name three aspects of the quadratus lumborum.
Derived from the hypomere
Innervated by the ventral primary rami of T12-L4
Involved in LBP associated with acute and -repetitive traumas
35
T or F
Trigger points are formed in muscles that are sedentary and hydrated
F
Trigger points are formed in muscles that have been injured. These are discrete areas of muscle tightness that when compressed result in a consistent pattern of pain
36
What is the treatment called that releases trigger points?
Myofascial release
37
What are the largest branches of the Lumbar Plexus, and what are there distributions?
Femoral (Posterior L2-4) and obturator nerves (Anterior L2-4)
38
The femoral nerve innervates which muscles of the thigh?
Cutaneous —> anterior cutaneous branches: anterior thigh; saphenous nerve: medial knee, leg, and medial ankle
Muscular branches —> Muscles that flex the thigh at the hip: Pectineus (L2, 3), iliopsoas (L2-4), sartorius (l2, 3), rectus femoris (L2-4), Muscles that extend the leg at the knee: quadriceps femoris (L2-4)
39
What would happen if there was femoral nerve entrapment?
Quadriceps weakness, decreased patellar reflex, anterior thigh pain and medial calf pain.
—> swing phase gait dysfunction
40
What group of muscles are innervated by the obturator nerve?
Adductors of the thigh,
Includes:
Obturator externus (L3, 4)
Adductor longus (L2-4)
Adductor brevis (L2-4)
Gracilis (L2-4)
Pectineus (L2, 3)
Adductor Magnus, anterior portion(L2-4)
41
What nerve is most vulnerable? Can be injured while in the pelvis by pubic ramus fracture, hematomas, and pregnancy.
Obturator nerve
42
____________ patterns of symptoms will indicate spinal nerve entrapments due to injuries related to the spine
Dermatomal
43
_____________ patterns of symptoms will indicate peripheral nerve entrapments due to local trauma
Cutaneous
44
Differentiating L4 from Femoral Nerve
Compare the pain patterns of L4 Radiculopathy with femoral neuropathy
L4 radivulopathy - Deep, aching, sclerotogenous type pain; shooting pain in the dermatomal pattern; L4 (medial foot and great toe)
Femoral Neuropathy - Cutaneous pain, sharp at first. Chronically: numbness in the cutaneous pattern: anterior cutaneous branch or saphenous nerve (anterior thigh, medial leg and foot, but NOT great toe)
Think about it like this, radiculopathy refers to nerve root compression or irritation. These nerve roots exit the spinal cord and give rise to peripheral nerves that transit signals to parts of the body. Related to nerve root problems at the level of the spine…..NEUROPATHY refers to damage to the peripheral nerves outside the spine. The nerves outside the brain and spinal cord.
45
Differentiating L4 from Femoral Nerve
Compare the motor function of L4 Radiculopathy with femoral neuropathy
L4 radiculopathy - Tibialis anterior weakness (as this is the indicator muscle for L4): Dorsiflexion, inversion of the foot… May present as foot drop
Femoral Neuropathy - Hip Flexor weakness, knee extensors weakness; may appear with atrophy of chronic; NO FOOT DROP
46
Differentiating L4 from Femoral Nerve
Compare the reflex of L4 Radiculopathy with femoral neuropathy
L4 Rad - 1+/4+ patellar reflex
FN - Diminished due to loss of the quadriceps innervation
47
Differentiating L4 from Femoral Nerve
Compare the gait changes of L4 Radiculopathy with femoral neuropathy
L4 rad - may exhibit stoppage gait with foot drop
FN - Difficult with the swing phase due to hip flexor weakness
48
Differentiating L4 from Femoral Nerve
Compare the palpation/ortho of L4 Radiculopathy with femoral neuropathy
N/A
Haven’t done
49
Distinguish the distribution of the muscular from the cutaneous branches of the lumbosacral plexus.
Muscular (motor) - primarily provide motor innervation to muscles of the lower limb, pelvis, and perineum. These include major nerves like the femoral, obturator, sciatic, and gluteal nerves which control movement.
Cutaneous (sensory) - provide sensory innervation to the skin and other sensory areas. Examples, include th femoral nerve (saphenous branch), lateral femoral cutaneous nerve, and posterior femoral cutaneous nerve, which relay sensory input from various regions of the lower body.
50
Lumbar Plexus (L1-4)
Name the division of the femoral nerve and what muscles it innervates. What are the actions of these muscles?
L2-4
Innervates the quadriceps, iliacus, and sartorius muscles
Actions are hip flexion, and extension at the knee joint
51
Name the division of the obturator nerve and the muscles it innervates. What are the actions of these muscles?
L2-4
Innervates the adductor muscles of the thigh. Including the adductor Longus, adductor breves, and part of the adductor Magnus, and gracilis
Actions
Adductor longus - adducts the thigh, rotates hip medically
Adductor breves - adduction and flexion of the thigh at the hip joint
Adductor magnus - abduction and extension of the thigh at the hip joint
Gracilis - adduction and flexion of the thigh at the hip joint; flexion and medial rotation of the lower leg at the knee joint
52
Name the division of the Sacral Plexus, as well as all nerves within this plexus.
L4-S4
Some
Idiots
Sit
Pondering
Pervertedly
Superior Gluteal Nerve L4-S1
Inferior Gluteal nerve L5-S2
Posterior femoral cutaneous S1-S3
Pudenal S2-S4
53
What muscles are innervated by the sciatic nerve? What division does the sciatic nerve stem from?
Posterior thigh muscles (sciatic nerve tibial division)
- Biceps femoris, semitendinosus, and semimembranosus
L4-S3
54
The superior gluteal nerve innervates what muscles and stems from where?
Same question for inf. Gluteal.
Thinks:
some
idiots
sit
pondering
pervertedly
Sup. Gluteal - L4-S1; gluteus minimus, medius and TFL
Inf. Gluteal - L5-S2; gluteaus Maximus
55
The nerve to the piriformis muscle stems from where?
S1-S2
56
What spinal nerves innervate the quadratic femoris and inferior gemellus muscles?
L4-S1
Nerve to the Quadratus Femoris
57
Nerve to the obturator internus and superior gemellus originates from?
L5-S2
58
What is the ventral primary rami (VPR)?
What is the Dorsal Primary Rami (DPR)?
VPR - Refers to the anterior branches of the spinal nerves that arise from the spinal cord. The VPR is the anterior branch of the spinal nerve after it exits the vertebral foramen.
- Supplies the anterior and lateral parts of the body, including the muscles and skin of the limbs, chest, abdomen, and some areas of the head and neck
DPR - innervates the muscles and skin of the posterior body, including the back and parts of the neck.
59
What does the dorsal root do?
What does the ventral root do?
Dorsal root carries sensory fibers
Ventral root carries motor fibers
60
What are the distributions of VPR (ventral primary ramifications) vs DPR (dorsal primary rami)?
Ventral - supples the anterior and lateral regions of the body. Forms the plexuses (brachial, lumbar, and sacral plexuses), which innervate the muscles and skin of the upper and lower limbs, as well as the pelvis area.
Dorsal - Supplies the posterior region of the body, including the deep back muscles and the skin of the back. In the cervical, thoracic, and lumbosacral regions, the dorsal rami innervate the erector spinae muscles, the multifidus, and other deep back muscles.
61
What are GSE (motor) fibers?
General somatic efferent fibers that carry signals from the CNS to skeletal muscles. These fibers cause contraction of muscles and are responsible for voluntary movement.
*Motor innervation to skeletal muscles (Voluntary movement)
62
What are some examples of nerves carrying GSE?
Femoral nerve innervating quadriceps, iliacus, and sartorius
Obturator nerve innervating adductor muscles
Sciatic nerve innervating posterior thigh
Etc.
63
What is GSA?
General Somatic Afferent - sensory fibers from the skin and muscles
Carry sensory information from the body (skin and joints) back to the CNS. These detect pain, temperature, and proproception.
Examples: femoral nerve provides sensation to the skin of the anterior thigh (via cutaneous branches like the saphenous nerve)
Obturator nerve provides sensory input form the medial thigh
Sciatic nerve provides sensory innervation to parts of the lower leg and foot via branches like the aural nerve
64
What is GVA?
General Visceral Afferent - Sensory fibers from internal organs (Visceral sensory)
Sensory signals from the internal organs, BV, and glands. They are involved in relaying visceral sensations to the CNS, including sensations like fullness, discomfort or changes in BP.
Example: vagus nerve carries GVA fibers rom the thoracic and abdominal organs, such as the heart and gastrointestinal tract
65
What is GSA?
General Somatic Afferent (Sensory) - Sensory innervation from skin, joints, and muscles
Examples: femoral, obturator, sciatic. HOWEVER, via saphenous and sural nerves
66
What is GVE?
General Viseral Efferent (autonomic) - autonomic motor fibers to smooth muscle glands, BV
Examples: sympathetic trunk, vagus, splanchinic nerves
67
Practice Question:
The component axons of the dorsal root:
GSA and GVA
68
T or F
Sympathetic preganglionic and postganglionic are general visceral efferent
T
69
T or F
Postganglionic nerves are myelinated
F!!
Sympathetic PREganglionic GVE are myelinated = white matter
70
Sympathetic Postganglionic neurons originate where?
The cell bodies of the postganglionic neurons are locted in sympathetic ganglia. These can be: sympathetic chain ganglia (series of ganglia running parallel to the spinal cord) or prevertebral ganglia: ganglia located near major BV.
71
Sympathetic Preganglionic Neurons originate where?
The cell bodies of SPN are located in the lateral horn of the spinal cord in the thoracic and lumbar regions. (Relatively short becuase they synapse with postganglionic neurons at a ganglion relatively close to the spinal cord)
72
GVE function:
Sympathetic motor fibers to smooth muscle, glands, and BV
73
Practice Question:
What are the component cell bodies of the dorsal root ganglion?
GSA and GVA
74
The component axons of the gray ramus.
Postganglionic GVE sympathetic
75
T or F
The component axons of the T5 ventral root use GSE pre ganglion GVE sympathetic neurons
T,
The ventral roots from T1-L2,3 will transmit both GSE axons and preganglionic GVE sympathetic axons becuase the preganglionic axons arise from those segments
76
The components axons of the ventral primary ramus are?
GSA, GVA, GSE, Postganglionic GVE sympathetic
*all but preganglionic
77
Name all the axons that stem from the ventral root of the spinal cord and what they supply.
Motor (Efferent) think exit
GSE (to skeletal muscles)
GVE (to smooth muscles, cardiac muscle, and glands)
78
Name all axons that stem from the dorsal root and what they innervate.
Sensory (Afferent) - Towards
GSA (from skin, muscles, joints)
GVA (from internal organs and BV)
79
What does IML stand for? What is it?
Intermediolateral nucleus
Consists of pregangionic sympathetic neurons part of the sympathetic nervous system
As well as postganglionic neurons which send axons to target organs, such as the heart, lungs, BV, sweat glands and smooth muscles in the body.
80
Compare white rami vs gray rami communicantes.
White rami communicates are the pathways through which preganglionic sympathetic fibers enter the sympathetic chain from the spinal cord. This ramifications contain myelinated fibers.
*Carry preganglionic sympathetic fibers from the spinal cord to the sympathetic trunk.
The gray rami communicantes carry postganglionic fibers from the sympathetic ganglia to the spinal nerves. These fibers are unmyelinated and extend to peripheral structural like BV, sweat glands and smooth muscles.
*Carry postganglionic fibers from the sympathetic trunk to the spinal nerves.
81
How do the axons enter and exit the ventral primary rami?
Dorsal root contains sensory axons that carry Afferent (Incoming) signals from the body to the spinal cord
Ventral root contains motor axons that carry efferent (outgoing) signals from the spinal cord to the muscles and glands.
82
T or F
The lateral leg and dorsal surface of the foot receive cutaneous branches of the common fibular nerve, whereas the posterior surface of the leg and bottom of the foot receive cutaneous branches of the tibial nerve.
T
83
You have a new patient today who was carrying heavy boxes down two flights of stairs while helping his friend move. The next day the patient had significant low back pain and kept tripping over the front of his foot as he was walking. You perform the lower extremity MSR tests on this patient and find that they cannot raise their great toe against a small amount of pressure on the affected slide. What segment and what muscle are being tested?
A. L5, extensor hallucis longus
B. L4, tibialis anterior
C. S1, fibular is longus and brevis
A
84
A new patient presents with pain and tingling from their medial leg into their medial foot that continues into the great toe. You ask them to do a heel walk and notice that their toes drop to the floor, and they complain of feeling weakness. When you perform specific muscle tests, you find that their tibialis anterior is weak (4/5) while there is no weakness on great toe extension nor on eversion. Where is the likely lesion?
A. L5 spinal root
B. Deep fibular nerve
C. S1 spinal root
D. L4 spinal root
D
85
A 54-year-old new patient presents with a primary complaint of weakness on walking. The weakness has been progressive since helping a friend move some heavy boxes about 2 months ago. They notice that the toe-off portion of their stride and ascending stairs seems weakest. On specific muscle testing you find that indeed, plantar flexion is weak on the right compared to the left. Additionally, the right Achilles reflex is noticeably diminished as compared to the left. The patellar reflex is normal bilaterally. Finally, on testing the sensation of the foot, the patient does not feel the lateral right foot as much as the lateral left foot. Which spinal nerve root is likely damaged?
A. Right side L4
B. Right side S1
C. Right side lateral plantar nerve
D. Left side L5
B
86
When distinguishing between a spinal nerve injury and a peripheral nerve injury, which one of these is characteristic of a peripheral nerve injury?
A. Dermatome pattern of sensory loss
B. Decrease or loss of the reflex
C. Cutaneous pattern of sensory loss
C
87
The presence of a foot drop would be a good way to distinguish that a lesion is at the L4 spinal nerve level and not a lesion of the femoral nerve.
T or F
T
88
A patient complains of weakness on dorsiflexion of her right foot. She describes this as her “foot dropping when she walks forward… so that I drag my toe”. Your examination reveals that she has a normal patellar reflex bilaterally, but weakness of both the extensor hallucis longus and the tibialis anterior on the right as compared to the left. Further, upon sensory examination, she can feel most of the dorsum of her foot on the right, except for a very specific sensory deficit in the web area between her great and second toes. Where is the lesion?
A. L4 spinal nerve
B. Deep fib nerve
C. L5 spinal nerve
B
89
Which of the following muscles is used to test the integrity of spinal nerve L5?
A. Extensor hallucis longus
B. Fibular is longus
C. Tibialis anterior
D. Gastrocenemius
A
90
The _ reflex used to assess the integrity of S1?
A. Dorsiflexion
B. Achilles
C. Partellar
D. Elbow
B
91
The ______ reflex used to test the integrity of L5 spinal nerve?
A. Achilles
B. Plantar flexor
C. Medial hamstring
D. Patellar
C
92
Which nerve is more vulnerable than the femoral nerve and what type of injuries can this nerve sustain.
Obturator nerve,
Can be injured while in the pelvis by pubic ramus fracture, hematomas, pregnancy, among other.
93
Describe piriformis syndrome.
When the piriformis traps the sciatic nerve causing sciatica. The piriformis muscle will irritate the sciatic nerve and the pain will go down into the back of the buttock, into the posterior thigh and into the back of the leg.
94
Name the tibial nerve entrapment components and the primary innervations in the calf:
Terminal branches: medial and lateral plantar nerves (very similar innervations to median and ulnar nerves in the hand)
Fairly free from entrapment after the popleteal fossa…
Primary innervation in the calf: - Gastroc/ soleus; poplieus, plantaris, tibialis posterior, flexor digitorum longus, flexor hallucis longus (“TOM, DICK, and HARRY”)
95
What does Morton’s neuroma involve?
Irritation of the medial plantar nerve between the third and fourth digits.
96
What spinal nerves are biomechanically most vulnerable to entrapment by disc disease?
L4, L5, and S1
The L4 nerve is entrapped by the side between L3-4 vertebrae and L5 between L4-L5 vertebrae and S1 by the disc between L5 and the sacrum
97
What are the three hamstring muscles of the posterior thigh? (Hint: hamstring muscles)
Biceps femoris (long and short)
Long: O:ischial tuberosity I: lateral surface of head of fibula
Short: O:Linear aspera of femor I: lateral surface of the head of the fibula
Semitendinosus
O:ischial tuberosity I: medial surface of the superior shaft of tibia via PES ANSERINUS
Semimebranosus
O: Ischial tuberosity I: Posterior surface of the medial condyle
98
When MSR testing at L4 would be the muscle tested, and Reflex tested
L4 — Tibialis Anterior — Patellar
99
At the spinal nerve level L5 what muscle would be tested and what reflex would be tested?
L5 — Extensor Hallucis Longus — Medial Hamstring
100
When MSR testing at spinal nerve level S1 what muscle would be tested and reflex tested?
S1 — Fibularis longus — Achilles
101
FITB
The _________ _________ divides into the common fibular and __________ ________ in the _________ _______.
Sciatic nerve divides into the common fibular and tibial nerves in the popliteal fossa
102
FITB
______ ______ innervates the posterior calf and bottom of the foot
Tibial nerve
103
FITB
________ _________ nerve innervates anterior and lateral calf and top of the foot
Common fibular nerve
104
Name all muscles innervated by the tibial nerve in the posterior calf.
Gastroncemius
Plantaris
Popliteus
Soleus
Tibialis posterior
Flexor dig long
Flexor hallucis long
Abductor hallucis
Flexor digitorum brevis
Flexor hallucis brevis
Lumbricals
105
What is tibial compartment syndrome? What are the two types?
Acute compartment syndrome - swelling of muscles causing compression of nerves and BV. Medial emergency (pressure from bleeding and inflammatory products)
Chronic compartment syndrome - still dangerous… from chronic use/ overuse of muscles. = solution is to decrease working out
106
Medial plantar nerve
Name the muscles and its divisions
Adductor hallucis: L5-S1
Flexor hallucis brevis: L5-S1
Flexor digitorum brevis: L5-S1
First lumbrical: L5-S1
107
Lateral Plantar Nerve
Name the muscles and divisions.
Three lateral lumbricals, quadratic planae: L5-S1
Flexor digitorum minimi bravis: S1, 2
Abductor digits minimi: S1, 2
Adductor hallucis: S1, 2
Plantar interossei (PAD): Adduction of Toes
Dorsal interossei (DAB): S1, 2
Abduction of toes
108
Medial and Lateral Plantar nerves Cutaneous Portions:
Describe the locations and divisions of the Sural, tibial, saphenous (femoral), medial plantar and lateral plantar.
Sural S1, 2 - posterior lateral portion of the calf to plantar
Saphenous L3, 4 (terminal branch of femoral) - Medial side of plantar
Tibial S1,2 - by itself, bottom of heel calcaneus branches, then the medial plantar.
Medial plantar L4, 5 - medial 1-3.5 digits
Lateral plantar S1, 2 - lateral portion of cutaneous plantar. Rest of digits and lateral above Sural
109
Trigger point overview: tell me what you know
TP are formed in muscles that have been injured. When compressed they result in consistent pattern pain. Treatment is myofascial release or tigger point therapy. Somewhat reminiscent of the distribution of the lateral femoral cutaneous nerve.
110
FITB
________ _______ _______ ________ affects the deep branch separately as the nerve crosses the joint at the metatarsal — cuneiform bones just distal to the extensor retinaculum
Anterior tarsal tunnel syndrome
111
GSA and GVA associated with which root of the spinal cord?
Dorsal Root - contains sensory (Afferent) nerve fibers that carry sensory information from the body to the spinal cord.
112
GSE and pre sympathetic ganglion is associated with what spinal root?
Ventral root - carries motor (efferent) commands to muscles and gland. GSE and GVE.
113
When muscle testing (MSRs) group the nerve, muscle, sensory and reflex together.
L4 - Tibialis anterior - To the tip of the great toe - patellar reflex
L5 - Ext. Hallucis Longus - Dorsum of the foot - Medial hamstring
S1 - Fib. Longus and brevis - Tip of the little toe - Achilles
114
With peripheral nerve entrapments:
How do they happen?
How much low can there be?
Could you have whole limb “paralysis” of the lower extremity with a peripheral or spinal nerve problem?
Happen by being tight/injured/spasming muscles direct trauma.
There would be a lot of loss
No, one spinal nerve and peripheral nerve does not innervate the entire leg. Entire limb paralysis is not a peripheral problem.
115
Where are the white rami (segments wise)?
T1-L2/3
Grey Rami is found at all spinal levels, carry postganglionic sympathetic fibers.
116
FITB
Name the axons (GVA, GVE, GSA, GSE)
_______ arrive from organs
_______ exit it to capillary
______ arrive from skin (Joint muscle)
______ exit to skin (joint muscle)
GVA
GVE
GSA
GSE
117
How are VPR and VR different from each other?
Ventral Root has just motor axons, and VPR has all components
118
The VPR makes up what portions of the spinal regions?
Brachial plexus
Cervical plexus
Intercostal nerves
Subcostal nerve
Lumbar plexus
Sacral plexus
Coccygeal plexus
119
The Dorsal Primary ramus makes up what portions of the spinal region?
Innervates back muscles
And provides sensory innervation to the Posterior neck, back, lower back, buttocks, skin over coccyx
120
Why does the cutaneous nerve have postganglionic sympathetic GVE?
Erector pilli, and BVs vascular smooth, and sweat glands. Has GVA but does not have GSE because no skeletal muscle.
121
T or F
Cutaneous nerves do not have GSE
T
122
T or F
If you have a femoral nerve entrapment you will have motor and sensory loss
T
123
Describe the path of the Pre-synaptic neuron.
Describe the path of the Post-synaptic neuron.
From cell body in lateral grey horn —> ventral root —> spinal nerve —> white ramus communicants —> synapse in the sympathetic chain ganglion
From cell body in sympathetic chain ganglion —> gray ramus communicantes —> spinal nerve —> ventral ramus —> skin
124
Name the divisions of the common fibular nerve and the spinal divisions associated with those divisions.
Superficial fibular nerve L4-S1
The deep fibular nerve L4-S2
125
What are the divisions of the tibial nerve
L4-S3
