Neurology of the lower limb

Question 1

How can spinal roots be tested following lower limb nerve injuries?

Answer 1

Test dermatomes and myotomes

Question 2

What region of skin is in the L1 dermatome?

Answer 2

Groin level

Question 3

What region of skin is in the L4 dermatome?

Answer 3

Anywhere on medial aspect of leg.

Question 4

What region of skin is in the S2 dermatome?

Answer 4

Middle/back of thigh

Question 5

What region of skin is in the S3 dermatome?

Answer 5

Gluteal region

Question 6

Which dermatome do you walk on?

Answer 6

S1

Question 7

Which dermatome do you sit on?

Answer 7

S3

Question 8

What symptoms would a patient with S1 lesion experience?

Answer 8

Can’t feel interaction with the ground.

Question 9

What do the cluneal nerves supply?

Answer 9

Cutaneous nerves of the buttocks

Question 10

Which nerve supplies the first web space?

Answer 10

Deep peroneal nerve (L4, L5)

Question 11

If a patient has a suspected peroneal injury, which areas of the lower limb should be tested?

Answer 11

Test dorsum of foot and first web space (lost deep branch as well as superficial?)

Question 12

What does the lateral femoral cutaneous nerve supply? (L2, L3)

Answer 12

Skin over lateral aspect of thigh

Question 13

Which region of skin does the femoral nerve supply?

Answer 13

Anterior thigh

Medial aspect of leg

Question 14

Which region of skin does the superficial peroneal nerve supply (L5, S1)?

Answer 14

Lower lateral leg

Dorsum of foot (except first web space)

Question 15

Which region of skin does the tibial nerve supply?

Answer 15

Sole of foot and posterior part of leg

Question 16

Which myotomes are involved in flexion of the hip?

Answer 16

L2 and L3

Question 17

Which myotomes are involved in extension of the hip?

Answer 17

L4 and L5

Question 18

Which myotomes are involved in extension of the knee?

Answer 18

L3 and L4

Question 19

Which myotomes are involved in flexion of the knee?

Answer 19

L5 and S1

Question 20

Which myotomes are involved in extension of the ankle?

Answer 20

L4 and L5

Question 21

Which myotomes are involved in flexion of the ankle?

Answer 21

S1 and S2

Question 22

Which myotomes are involved in the inversion of the foot?

Answer 22

L4 and L5

Question 23

Which myotomes are involved in the eversion of the foot?

Answer 23

L5 and S1

Question 24

Which nerve roots supply the intrinsic muscles of the foot?

Answer 24

S2 and S3

Question 25

Which nerve root is responsible for dorsiflexion of the big toe?

Answer 25

L5

Question 26

Which nerve roots are responsible for moving the toes closer together?

Answer 26

S2 and S3

Question 27

Which of femoral and obturator is A and P?

Answer 27

Anterior - obturator nerve | Posterior - femoral nerve

Question 28

Which nerves supply the hip joint and knee joint?

Answer 28

Obturator nerve | Femoral nerve

Question 29

Under what conditions may the nerves of the lumbar plexus be damaged?

Answer 29

Inflammation of psoas major | Pus in psoas sheath (TB)

Question 30

Which muscle protects the nerves of the lumbar plexus?

Answer 30

Psoas major

Question 31

What is the position of the femoral nerve relative to psoas?

Answer 31

Lateral

Question 32

What is the position of the obturator nerve relative to psoas?

Answer 32

Medial

Question 33

Which muscles protect the femoral nerve?

Answer 33

Abdominal muscles

Question 34

Where might hip joint pain be referred to?

Answer 34

Knees

Question 35

Why is the lateral femoral cutaneous nerve easily damaged?

Answer 35

Becomes cutaneous almost immediately after it comes through inguinal ligament

Question 36

What is meralgia paresthetica/

Answer 36

Compression of the lateral femoral cutaneous nerve

Question 37

What are the nerve roots of the lumbar plexus?

Answer 37

T12-L4

Question 38

What are the nerve roots of the sacral plexus?

Answer 38

L4-S3

Question 39

Paralysis of which nerve causes a positive Trendelenburg sign?

Answer 39

Superior gluteal nerve

Question 40

Parlalysis of which nerve causes difficulty in climbing stairs?

Answer 40

Inferior gluteal nerve

Question 41

What are the anterior divisions of the sacral plexus?

Answer 41

Tibial nerve Nerve to obturator internus Nerve to quadratus femoris

Question 42

What are the posterior divisions of the sacral plexus?

Answer 42

Common peroneal Superior gluteal Inferior gluteal

Question 43

Which nerve can be damaged by sitting on a hard chair?

Answer 43

Posterior cutaneous nerve of thigh

Question 44

Which muscles are supplied by the superior gluteal nerve?

Answer 44

Gluteus medius Gluteus minimus Tensor fasica lata Hip joint

Question 45

Which muscle is supplied by the inferior gluteal nerve?

Answer 45

Gluteus maximus

Question 46

Which nerve supplies the hamstrings then divides into the tibial nerve and common fibular nerve?

Answer 46

Sciatic nerve

Question 47

What condition occurs due to damage of the sciatic nerve?

Answer 47

Sciatica

Question 48

What is piriformis syndrome?

Answer 48

Compression of common peroneal component of sciatic nerve | Causes loss of muscle tone in anterior leg (foot drop)

Question 49

Where is the sciatic nerve prone to injury?

Answer 49

Where it goes through tarsal tunnel

Question 50

Which nerve is it more common to damage - tibial nerve or common peroneal nerve?

Answer 50

Common peroneal - either as it comes up the piriformis or when it goes around the neck of fibula after going through popliteal fossa

Question 51

Damage to which nerve at the level of the neck of the fibula can cause an important neurological problem?

Answer 51

Common peroneal nerve

Question 52

Which area of skin does the obturator nerve supply sensory innervation?

Answer 52

Inner thigh

Question 53

Which area of skin does the femoral nerve supply sensory innervation?

Answer 53

Anterior part of thigh and leg

Question 54

Which area of skin does the tibial nerve supply sensory innervation?

Answer 54

Posterior part of leg and sole of foot

Question 55

Which area of skin does the common peroneal nerve supply sensory innervation?

Answer 55

Lateral part of leg