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Lower limb nerve inj
Nerve lesions of the lower limb
Question | Answer |
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Describe the motor deficit in a sciatic nerve injury | Hamstring muscles paralyzed, weak flexion of the knee possible due sartorius (femoral n.) and gracilus (obturator n.); ALL muscles below knee paralyzed; weight of foot->plantar flexed |
Describe the sensory deficit in a sciatic nerve injury | Sensation lost below knee EXCEPT for narrow area on medial side of lower part of the leg and along the medial border of the foot as far as the ball of the big toe, which is supplied by saphenous branch of femoral nerve |
Describe the motor and sensory deficit in a femoral nerve lesion | Quadriceps femoris muscle is paralyzed and knee cannot be extended; skin sensation lost over anterior and medial sides of thigh, over medial part of leg, and along medial border of foot as far as ball of big toe |
What's a common way in which the sciatic nerve is injured? Which branch is most commonly injured? | Penetrating wounds, fractures of pelvis, dislocations of hip joints-->INJECTIONS SHOULD BE ON UPPER LATERAL QUADRANT OF BUTTOCK; common fibular nerve most damaged (most superficial) |
What is sciatica? | Pain in lower back + hip region radiating down back of thigh and leg; may be caused by herniation of intervetebral disc with pressure on roots of lower lumbar or sacral spinal nerves or pressure on sacral plexus or sciatic nerve by intrapelvic mass |
What is the most commonly injured nerve of the lower limb? How can it be damaged? | Common fibular nerve; fractures of the fibular neck or may be entrapped in callus that forms in healing; superficial course over NECK OF FIBULA --> may be damaged in sports |
What are the motor deficits of a common fibular nerve lesion? | Muscles of anterior and lateral compartment paraylzed (DORSIFLEXORS AND EVERTERS)-->foot is plantar flexed and inverted (foot drop and equinovarus) |
What is the sensory deficit of a common fibular nerve injury? | Down ant. + lat. sides of leg and dorsum of foot and toes + medial side of big toe; lat. side of foot and lat. side of little toe unaffected (due to sural branch of tibial nerve); medial border of foot as far back as ball of big toe OK (saphenous n) |
What is the motor deficit of a tibial nerve lesion? | hamstring muscles, all muscles of leg, and all muscles of sole of foot paralyzed; opposing dorsiflexors + everters --> dorsiflex and evert foot |
What is the snesory deficit of a tibial nerve lesion? | Sensation lost on sole of foot |
What is the sensory deficit in an obturator nerve lesion? | Minimal sensory loss on medial aspect of thigh |
What is the motor deficit in an obturator nerve lesion? | Paralysis of the adductor muscles |
How can the obturator nerve be injured? | occasionally injured in penetrating wounds, anterior dislocations of hip joint, abdominal herniae through obturator foramen; may be compressed by babies head perineum |