Cutaneous Innervation Of Lower Limb

Question 1

Femoral nerve

Nerve roots: ___-___

Answer 1

L2-L4

Question 2

Femoral nerve

Motor functions: Innervates the _________ muscles that ___ the hip joint (____,___,_____) and ____ the knee (_________),

Answer 2

anterior thigh

flex; pectineus, iliacus, sartorius

extend; quadriceps femoris: rectus femoris, vastus lateralis, vastus medialis and vastus intermedius

Question 3

Femoral nerve

Sensory functions: Supplies cutaneous branches to the (anterior or posterior?) (medial or lateral?) thigh (______ branches of the femoral nerve) and the (medial or lateral?) side of the leg and foot (______ nerve).

Answer 3

Anterior;medial

anterior cutaneous

Medial; saphenous

Question 4

The ____ nerve is the largest branch of the lumbar plexus.

It’s derived from???

Answer 4

femoral

It is derived from the anterior rami of nerve roots L2, L3 and L4.

Question 5

After arising from the lumbar plexus, the femoral nerve travels (superiorly or inferiorly?) through the _____ muscle of the posterior abdominal wall.

The femoral nerve then passes underneath the _________ to enter the femoral triangle.

Within this triangle, the nerve is located (medial or lateral?) to the femoral vessels

Answer 5

inferiorly

psoas major

inguinal ligament

Lateral

Question 6

Femoral nerve supplies branches to the _____ and _____ muscles prior to entering the thigh.

Answer 6

iliacus and pectineus

Question 7

unlike the ____, the femoral ____ and _____ are enclosed within the femoral sheath

Answer 7

nerve

artery and vein

Question 8

Approximately _cm below the inguinal ligament, the femoral nerve divides into _____ and ______ divisions

Answer 8

4cm

anterior and posterior

Question 9

Anterior division of the femoral nerve

____________ branches
Branch to ____
Branch to _______

Answer 9

Anterior cutaneous

sartorius

pectineus

Question 10

Posterior division of the femoral nerve

_______ nerve
Branches to ______

Answer 10

Saphenous

quadriceps femoris

Question 11

The terminal cutaneous branch of the femoral nerve is the ______ nerve.

It travels through the ________ and exits prior to the _____.

Answer 11

saphenous

adductor canal

adductor hiatus

Question 12

The saphenous nerve innervates the (medial or lateral?) aspect of the leg and the foot.

Answer 12

Medial

Question 13

The saphenous vein is often stripped in individuals with ______ ——— veins.

The (long or short?) saphenous vein is accompanied in its course by the saphenous nerve.

Damage to the saphenous nerve during this procedure can lead to pain, _____ or (partial or complete?) loss of sensation the medial side of the lower leg.

Answer 13

problematic varicose

Long

paraesthesia

complete

Question 14

Femoral nerve block (in combination with a ____ nerve block) may be indicated in patients requiring _______ surgery who cannot tolerate a general anaesthetic.

Answer 14

sciatic

lower limb

Question 15

A femoral nerve block can also be used as peri- and post-operative analgesia for patients with a fractured neck of femur who cannot tolerate particular analgesics.

T/F

Answer 15

T

Question 16

The sciatic nerve is a (thin or thick?) (round or flat?) band, approximately __cm wide

Answer 16

Thick

Flat

2

Question 17

the largest nerve in the body is ????

Answer 17

Sciatic

Question 18

Sciatic nerve

Nerve roots: ___ to ___

Answer 18

L4-S3.

Question 19

Sciatic nerve

Motor functions:
Innervates the muscles of the (anterior or posterior?) thigh and the hamstring portion of the _______

Indirectly innervates (via its terminal branches) all the muscles of the ____ and ___

Answer 19

Posterior

adductor magnus

leg and foot.

Question 20

Sciatic nerve has No direct sensory functions

T/F

Answer 20

T

Question 21

Sciatic nerve

Sensory functions: Indirectly innervates (via its terminal branches) the skin of the (medial or lateral?) leg, heel, and both the ___ and ____ surfaces of the ____

Answer 21

Lateral

dorsal and plantar; foot

Question 22

The sciatic nerve is derived from the lumbosacral plexus. After its formation, it leaves the ____ and enters the ___ region via _____ foramen. It emerges (superiorly or inferiorly?) to the piriformis muscle and descends in an (superior or inferior?) (Medial or lateral?) direction.

As the nerve moves through the gluteal region, it crosses the (anterior or posterior?) surface of the superior gemellus, obturator internus, inferior gemellus and quadratus femoris muscles. It then enters the posterior thigh by passing (superficial or deep?) to the ____ of the ____

Within the posterior thigh, the nerve gives rise to branches to the ____ muscles and ____. When the sciatic nerve reaches the ___ of the popliteal fossa, it terminates by bifurcating into the _____ and ____ nerves.

Answer 22

pelvis

gluteal

greater sciatic

inferiorly

inferior;lateral
Posterior
Deep; long head of biceps femoris

hamstring; adductor magnus

apex; tibial and common fibular

Question 23

the sciatic nerve can be described as two individual nerves bundled together in the same connective tissue sheath – the tibial and common fibular nerves. These usually separate at the apex of the popliteal fossa, however in approximately ____% of people they separate as they leave the ____.

Answer 23

12

pelvis

Question 24

To avoid damaging the sciatic nerve therefore, intramuscular injections are given only in the __________ quadrant of the gluteal region.

Answer 24

upper lateral

Question 25

Tibial nerve

Nerve roots:____-___

Sensory: Innervates the skin of the (anterior or posterior?) (medial or lateral?) leg, (medial or lateral?) foot and the ___ of the foot.

Motor: Innervates the (anterior or posterior?) compartment of the leg and the majority of the _____ foot muscles.

Answer 25

L4-S3

posterior; lateral

Lateral ; sole

Posterior ; intrinsic

Question 26

The tibial nerve is a branch of the sciatic nerve, and arises at the ___ of the ____.

It travels through the popliteal fossa, giving off branches to muscles in the _____ compartment of the leg. Here, the tibial nerve also gives rise to branches that contribute towards the __ nerve, which innervates the (anterior or posterior?) (medial or lateral?) aspect of the leg.

The tibial nerve continues its course down the leg, (anterior or posterior?) to the tibia. During its descent, it supplies the ___ muscles of the posterior leg.

At the foot, the nerve passes (anteriorly or posteriorly?) and (superiorly or inferiorly?) to the medial malleolus, through a structure known as the ___ tunnel.

Immediately distal to the tunnel, the tibial nerve terminates by dividing into sensory branches, which innervate the ___ of the foot.

Answer 26

apex; popliteal fossa

superficial posterior ; sural

Posterior; lateral

Posterior ; deep

Posteriorly ; inferiorly

tarsal

sole

Question 27

This tarsal tunnel is covered superiorly by the _______. Within this tunnel, branches arise from the tibial nerve to supply cutaneous innervation to the ____

Answer 27

flexor retinaculum

heel

Question 28

Tarsal tunnel syndrome refers to entrapment and compression of the ____ nerve as it passes through the tarsal tunnel.

Patients may experience altered sensation in the sensory distribution of the tibial nerve – the ___ of the foot.

The motor function of the nerve can also be affected in severe disease, causing weakness and wasting of the ____ muscles.

Answer 28

tibial; sole

intrinsic foot

Question 29

The management of tarsal tunnel syndrome can be conservative or surgical:

Conservative: ___therapy, ___s,____ injections

Surgical: _____ (cutting through the _____ to decompress the tarsal tunnel)

Answer 29

Physio; NSAID; corticosteroid

Tarsal tunnel release

flexor retinaculum

Question 30

Common fibular nerve

Nerve roots: ___-____

Motor: Innervates the ___ head of the biceps femoris directly. Also supplies (via branches) the muscles in the _____ and ____ compartments of the leg.

Sensory: Innervates the skin of the (medial or lateral?) leg and the (plantar or dorsum?) of the foot.

Answer 30

L4 – S2

short

lateral and anterior

Lateral

Dorsum

Question 31

The common fibular nerve begins at the (base or apex?) of the popliteal fossa, where the sciatic nerve bifurcates into the tibial and common fibular nerves.

The common fibular nerve follows the (medial or lateral?) border of the biceps femoris, running in a (medial or lateral?) and (superior or inferior?) direction, over the (medial or lateral?) head of the _______ .

At this point, the nerve gives rise to two cutaneous branches, which contribute to the innervation of the skin of the leg.

To enter the lateral compartment of the leg, the nerve wraps around the ___ of the ____, passing between the attachments of the ________ muscle. Here, the common fibular nerve terminates by dividing into the _____ and _____ fibular nerves.

Answer 31

Apex

Medial

Lateral

Inferior

Lateral

gastrocnemius

neck; fibula

fibularis longus

superficial fibular and deep

Question 32

The _______ nerve is most commonly damaged by a fracture of the fibula, or the use of a tight plaster cast.

Answer 32

common fibular

Question 33

The anatomical course of the common fibular nerve causes it to _____________________________ , and so any fractures of the fibular neck can cause nerve palsy.

Answer 33

wrap round the neck of the fibular

Question 34

Patients with common fibular nerve damage will lose the ability to ____ the foot at the ankle joint. Hence the foot will appear permanently _____ – known as ____. They may also present with a characteristic gait, as a result of the footdrop (for more information, see Walking and Gaits).

There will also be a loss of sensation over the ____ of the foot, and ____ side of the leg.

Innervation is preserved on the ____ side of the leg (supplied by the _____ nerve, a branch of the femoral), and the ___ and __ of the foot (supplied by the ___ nerve, a branch of the sciatic).

Answer 34

dorsiflex

plantarflexed

footdrop

dorsum

lateral

medial

saphenous

heel and sole; tibial