Lower extremity Flashcards
What is the most common location of a ruptured lumar disc?
L5-S1 (then L4-L5, then L3-L4)
What are the roots for the obturator nerve? How is it injured and what would be the clinical manifestations?
L2-L4. innervates the inner thigh. may be injured by pelvic surgery/prolonged labor. will cause decrease medial thigh sensation and decreased adduction
What are the roots for the femoral nerve? What are some causes of injury? Presentations?
L2-L4. caused by pelvic fracture. causes decreased thigh flexion and leg extension.
What is the sciatic nerve? Pathology? course?
sciatic nerve divides to the common peroneal/fibular and the tibial nerve just above the knee. it innervates the hamstrings. it is rarely injured becasue it is so deep.
What are the roots for the common peroneal nerve? How can the common peroneal nerve be injured, and what are the presentations?
roots L4-S2. injured by trauma or compression of the lateral leg (leg crossing, extremem weight loss), or fibular neck fracture. Consider with LCL knee injuries. when injured, you see foot drop: foot is inverted and plantarflexed at rest, with loss of eversion and dorsiflesion. loss of sensation to dorsum of foot. steppage gait
PED: peroneal everts and dorsiflexes: foot dropPED
What is sciatica?
lower limb pain that radiates in the distribution of the sciatic nerve. usually due to an L4-S2 radiculopathy
What are the roots for the tibial nerve? Where can it be injured?
roots L4-S3. can be injured via knee trauma, Baker cyst (proximal lesion, aka popliteal cyst), or tarsal tunnel syndrome (distal lesion)
What are the changes seen with tibial nerve injury?
inability to curl toes and loss of sensation on the sole of the foot. in proximal lesions, the foot is everted at rest with loss of inversion and plantarflexion.
(normally, the tibial nerve causes inversion and plantar flexion)
TIP: tibial inverts and plantarflexes. if injured you can’t stand on tip toes.
What are the roots for the superior gluteal nerve? How can it become injured?
roots are L4-S1. can be injured by posterior hip dislocation or polio
What are the clinical manifestations of superior gluteal nerve injury?
trendelenburg sign/gait. the pelvis tilts because the weight bearing leg can’t maintain alignment of pelvis through hip abduction (the superior nerve does the gluteus medius and minimus). lesion is contralateral to the side of the hip that dropis and ipsilateral to the extremity on which the patient stands
What are the roots for an inferior gluteal nerve? How can it be injured?
L5-S2. can be injured by posterior hip dislocation
What are the clinical manifestations of an inferior gluteal nerve problem?
difficulty climbing stairs, rising from a seated position. there is a loss of hip extension (inferior nerve does the gluteus maximus)
L4 root problem symptoms
loose knee jerk; pen on anterior thigh, medial calf
L5 problems
no reflex changes. lateral calf sensory loss
S1 problems
ankle jerk loss, sole of foot
