Leg Nerve Fuck Ups

Question 0

Patient = trauma/compression of lateral part of leg

+ gets a fibula neck fracture

Answer 0

Common peroneal (L4 – S2)

Foot dropP(peroneal)ED –
loss of Eversion/Dorsiflexion
-> inverted + plantarflexed @rest!!!

Can’t feel dorsum of foot!!!!!!!!

Question 1

Patient goes through a pelvic surgery

Patient goes through pelvic fracture

Answer 1

Pelvic surgery: obturator (L2 – L4)

⬇medial thigh sensation
⬇️adduction

Pelvic fracture: femoral (L2 – L4)
⬇thigh flexion
⬇️leg extension

Question 2

Patient has a Baker’s cyst (prox) + tarsal tunnel syndrome (distal)

+ knee trauma

Answer 2

Tibial (L4 – S3)

Can’t T(tibial)IPtoe –
loss of inversion/Plantarflexion
-> everted + dorsiflexed @rest!!!

Can’t curl toes
Can’t feel SOLE of foot

Question 3

Patient undergoes intramuscular injection in the upper medial gluteal region and received an iatrogenic injury

Answer 3

Superior gluteal (L4 – S1) - gluteus medius/minimus

Trendelenberg sign –
weight-bearing leg can’t do hip abduction ->
can’t maintain alignment of pelvis – >
Pelvis tilts

Question 4

Patient has a posterior hip dislocation

Answer 4

Inferior gluteal (L5 – S2) - gluteus maximus

Can’t climb stairs/get up from chair

Question 5

In what direction to invertible discussed generally herniate?
Why in this direction?

Answer 5

Posterolaterally

Due to thin posterior longitudinal ligament +
thicker anterior longitudinal ligament
@ midline of vertebral bodies

Question 6

What are lumbosacral radiculopathies

Answer 6

Paresthesias/weakness
in distribution of specific lumbar or sacral
spinal nerves

Question 7

Why do lumbosacral radiculopathies often occur?

Answer 7

Due to INTERvertebral disc herniation

Nerve associated with the inferior vertebral body = impinged e.g.
L3 – L4 disc herniation – > L4 spinal nerve

Question 8

Radiculopathy @ L3 – L4?

Answer 8

Weakness of knee extension

Decreased patellar reflex

Question 9

Radiculopathy @ L4 – L5?

Answer 9

Weakness of dorsiflexion

Difficulty in heel – walking

Question 10

Radiculopathy @ L5 – S1?

Answer 10

Weakness of plantarflexion
Difficulty in toe walking
Decreased ACHILLE(S1) reflex