Cutaneous Innervation Of Lower Limb Flashcards
Femoral nerve
Nerve roots: ___-___
L2-L4
Femoral nerve
Motor functions: Innervates the _________ muscles that ___ the hip joint (____,___,_____) and ____ the knee (_________),
anterior thigh
flex; pectineus, iliacus, sartorius
extend; quadriceps femoris: rectus femoris, vastus lateralis, vastus medialis and vastus intermedius
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).
Anterior;medial
anterior cutaneous
Medial; saphenous
The ____ nerve is the largest branch of the lumbar plexus.
It’s derived from???
femoral
It is derived from the anterior rami of nerve roots L2, L3 and L4.
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
inferiorly
psoas major
inguinal ligament
Lateral
Femoral nerve supplies branches to the _____ and _____ muscles prior to entering the thigh.
iliacus and pectineus
unlike the ____, the femoral ____ and _____ are enclosed within the femoral sheath
nerve
artery and vein
Approximately _cm below the inguinal ligament, the femoral nerve divides into _____ and ______ divisions
4cm
anterior and posterior
Anterior division of the femoral nerve
____________ branches
Branch to ____
Branch to _______
Anterior cutaneous
sartorius
pectineus
Posterior division of the femoral nerve
_______ nerve
Branches to ______
Saphenous
quadriceps femoris
The terminal cutaneous branch of the femoral nerve is the ______ nerve.
It travels through the ________ and exits prior to the _____.
saphenous
adductor canal
adductor hiatus
The saphenous nerve innervates the (medial or lateral?) aspect of the leg and the foot.
Medial
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.
problematic varicose
Long
paraesthesia
complete
Femoral nerve block (in combination with a ____ nerve block) may be indicated in patients requiring _______ surgery who cannot tolerate a general anaesthetic.
sciatic
lower limb
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
T
The sciatic nerve is a (thin or thick?) (round or flat?) band, approximately __cm wide
Thick
Flat
2
the largest nerve in the body is ????
Sciatic
Sciatic nerve
Nerve roots: ___ to ___
L4-S3.
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 ___
Posterior
adductor magnus
leg and foot.
Sciatic nerve has No direct sensory functions
T/F
T
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 ____
Lateral
dorsal and plantar; foot
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.
pelvis
gluteal
greater sciatic
inferiorly
inferior;lateral
Posterior
Deep; long head of biceps femoris
hamstring; adductor magnus
apex; tibial and common fibular
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 ____.
12
pelvis
To avoid damaging the sciatic nerve therefore, intramuscular injections are given only in the __________ quadrant of the gluteal region.
upper lateral
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.
L4-S3
posterior; lateral
Lateral ; sole
Posterior ; intrinsic
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.
apex; popliteal fossa
superficial posterior ; sural
Posterior; lateral
Posterior ; deep
Posteriorly ; inferiorly
tarsal
sole
This tarsal tunnel is covered superiorly by the _______. Within this tunnel, branches arise from the tibial nerve to supply cutaneous innervation to the ____
flexor retinaculum
heel
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.
tibial; sole
intrinsic foot
The management of tarsal tunnel syndrome can be conservative or surgical:
Conservative: ___therapy, ___s,____ injections
Surgical: _____ (cutting through the _____ to decompress the tarsal tunnel)
Physio; NSAID; corticosteroid
Tarsal tunnel release
flexor retinaculum
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.
L4 – S2
short
lateral and anterior
Lateral
Dorsum
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.
Apex
Medial
Lateral
Inferior
Lateral
gastrocnemius
neck; fibula
fibularis longus
superficial fibular and deep
The _______ nerve is most commonly damaged by a fracture of the fibula, or the use of a tight plaster cast.
common fibular
The anatomical course of the common fibular nerve causes it to _____________________________ , and so any fractures of the fibular neck can cause nerve palsy.
wrap round the neck of the fibular
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).
dorsiflex
plantarflexed
footdrop
dorsum
lateral
medial
saphenous
heel and sole; tibial
