Le Nerve Injuries Flashcards
What are the Lumbar dermatomes of the leg?
L1 - Uppermost leg at level of ASIS spiraling anterior and down to perineum (Actual perineum is S2/3)
L2 - Upper thigh from just below ASIS spiraling anterior Down to inner thigh below perineum
L3 - Upper middle Lateral thigh spiraling anterior Down to medial side from mid thigh to middle of the medial leg
L4 - Lower Lateral thigh spiraling anterior and down across skin above patella down anterior leg and around to medial side of lower leg, ankle, and foot
L5 - Lateral lowest part of thigh and skin Lateral to knee spiraling anterior and down to front of leg and middle foot
What are the Sacral dermatomes?
S1 - Lateral aspect of the posterior thigh down to lateral foot
S2 - Medial aspect of posterior thigh down to medial bottom of foot; perineum
S3 - part of buttcheeck; Perineum
Damage to which nerve presents as medial knee and leg pan?
Saphenous nerve
Which nerve, when damaged, has a clinical presentation of sensory disturbance in lateral lower leg and foot with possible foot drop and pain at sire of compression?
Common peroneal
Which nerve, when damaged, has a clinical presentation of shooting pain in the cutaneous distribution of the nerve?
Sural Nerve
Which nerve, when damaged, has a clinical presentation of Numbness and/or pain in lateral Left; vague pain over Dorsal of foot; symptoms increase with cavity.?
Superficial peroneal nerve
Trace the path of the Ilioinguinal nerve.
- Pierces internal obliques 4cm medial to ASIS
- Enters inguinal canal
- Leaves through superficial ring
- Supplies skin of medial thigh and adjoining scrotum/labia
What are characteristics of inguinal entrapment?
Pain from:
- increased abdominal wall tension
- Hyperextension of hip
- Tenderness 4 cm media to ASIS
Trace path of genitofemoral nerve.
From L1/2 follow2s anterior aspect of splash major and separates into genital and femoral branch
Genital: Enters inguinal ring ; union with ilioinguinal nerve on anterior aspect of spermatic cord; Suppliew Ventral aspect of scrotum and adductor region; cutaneous branches on dorsocaudal aspect
Femoral: Lies on lateral side of femoral artery; Pierces anterior wall of sweat and supplies skin below inguinal ligament;
Describe the path of lateral cutaneous nerve
- Forms from lumbar plexus within Psoas Major
- Through lateral aspect of Psoas
- Pierces inguinal ligament
- lies in fibrous tunnel, divides into two and pierces deep fascia.
What is characteristic of Lat cut nerve of thigh injury?
- entrapment in fasciae tunnel
- Assymetic bars in gymmnastics
- causes Meralgia paraesthetica
- also, damagecaused by post laparoscopic surgery
What are the branches of the femoral nerve?
Muscular: Quads, sartorius, pectineus
Cutaneous: Medial cutaneous, intermediate cutaneous, saphenous
Articular: Hip and knee joint
What is characteristic of femoral nerve damage?
- stretch by dancers via prolonged hyperextension of hip
- Compress under inguinal ligament
- Also compressed from hematoma following teat of iliacus
Describe posterior Obturator entrapment
- Supplies adductor muscles above hiatus
- Spasms of adducator muscles
- May be entrapped as it leaves pelvis or btwn fasciae planes
What is Howship Romberg sign?
• Pressure on obturator nerve • Pain on inner aspect of thigh relieved by flexion of hip • Increased by extension, adduction and medial rotation
