Lower Extremity

Question 1

Sciatic Nerve-anatomy

Answer 1

L4-S1

1.)leaves pelvis via sciatic notch under pyriformis

2. )supplies hamstrings:
   - -> semimembranosus and semitendisosus
   - ->long and short head of biceps femoris

short head of biceps only hamstring muscle innervated by peroneal fibers

3.) mid-thigh–> separates into tibial and common peroneal nerve

Question 2

Sciatic Neuropathy

Answer 2

1. )Motor: foot drop, knee flexion weakness, all akle movements
2. ) Sensory: loss over lateral knee and below (except medial side–> saphenous)
3. ) decrease DTR

Many causes, divide them into region: hip/gluteal region, thigh

Question 3

Peroneal Nerve-Anatomy

Answer 3

1. ) lateral cutaneous nerve of knee
2. ) around fibular neck
3. ) divide into a.) deep and b.) superficial peroneal nerve

a. ) deep peroneal nerve
- ->Motor:
- Tibialis anterior
- extensor digitorum longus
- extensor digitorum brevis

• -> Sensory:
• toe 1 + 2 webspace

b. ) superficial peroneal never
- ->Motor:
- peroneus longus
- peroneus brevis

• ->Sensory:
• mid/lateral lower calf and dorsum of foot and toes 3-5

Question 4

Peroneal Neuropathy

Answer 4

Motor: weakness of foot and toe dorsiflexion (deep) AND ankle eversion (Superficial)

**Ankle inversion done by Tibialis POSTERIOR (TIBIAL NERVE)**

Question 5

Femoral Anatomy

Answer 5

L2-L4

1. ) passes behind psoas and above ilacus muscle
   - -> psoas
   - -> iliacus
2. ) Posterior and anterior division
   - -Anterior (provides Sensory): medial cutaneous nerve of thigh, intermediate cutaneous nerve of thigh

–Posterior: Quads, saphenous nerve (medial knee and calf)

Question 6

Femoral Neuropathy

Answer 6

1. ) hip flexion and knee extension issue
2. ) sensory loss over anterior and medial thigh and calf

Lateral femoral cutaneous nerve supplies lateral thigh, comes directly L2-L3)**

Causes: abdominal, pelvic surgery (lithotomy position), hematoma, pelvic mass, inguinal lymph node, etc.

Question 7

Tarsal Tunnel syndrome

Answer 7

Tibial nerve
-descends behind medial maleus under flexor retinaculum via Tarsal Tunnel

• sensory: calcaneal sensory nerve, mediall/lateral plantar nerves dysfunction
• motor: intrinsic foot muscles