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USMLE MSK > Lower extremity nerves > Flashcards

Lower extremity nerves Flashcards

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USMLE® Step 1 flashcards
1
Q

What lower extremity nerves are at risk in abdominal surgery?

A
  • Iliohypogastric (T12-L1) (open)
  • Genitofemoral (L1-2) (laproscopic)
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2
Q

Iliohypogastric nerve supplies sensory innervation to where?

A

Suprapubic region

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3
Q

The iliohypogastric nerve supplies motor sensation to what muscles?

A
  • Transverse abdominis
  • Internal oblique
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4
Q

Burning or tingling sensation in surgical incision site radiating to inguinal and suprapubic region indicates injury to what nerve?

A

Iliohypogastric nerve (T12-L1)

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5
Q

The Genitofemoral nerve (L1-2) supplies sensory innervation to where?

A
  • scrotum/labia majora
  • Medial thigh
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6
Q

The genitofemoral nerve is involved in what reflex?

A

Cremastor reflex
(if damaged sensation to medial thigh beneath inguinal ligament will be impaired)

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7
Q

The lateral femoral cutaneous nerve (L2-3) supplies sensation to where?

A

Anterior and lateral thigh
- Injury will decrease sensation

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8
Q

How may the lateral cutaneous nerve (L2-3) be damaged?

A
  • Tight clothing
  • Obesity
  • Pregnancy
  • Pelvic procedures
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9
Q

What nerve supplies sensation to the medial thigh?

A

Obturator (decreased sensation to this area if damaged)

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10
Q

How may the obturator nerve be damaged?

A

Pelvic surgery

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11
Q

Obturator nerve supplies motor innervation to what muscles?

A
  • Obturator externus
  • Adductor longus
  • Adductor brevis
  • Gracilis
  • Pectineus
  • Adductor magnus
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12
Q

How may the femoral nerve (L2-4) be damaged?

A

Pelvic fracture

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13
Q

What muscles does the femoral nerve innervate?

A
  • Quadraceps
  • Iliacus
  • Pectineus
  • Sartorius
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14
Q

What will injury to the femoral nerve (eg pelvic surgery) result in?

A
  • Decreased leg extension
  • Decreased patellar reflex
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15
Q

What muscles does the sciatic nerve innervate?

A
  • Semitendinosus
  • Semimembranosus
  • Biceps femoris
  • Adductor magnus
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16
Q

What does the sciatic nerve (L4 - S3) divide into?

A
  • Common peroneal (fibular) nerve
  • Tibial nerve
17
Q

What can cause injury to the sciatic nerve?

A
  • Herniated disc
  • Posterior hip dislocation
18
Q

How may the common peroneal (fibular) nerve be injured?

A
  • Trauma or compression of lateral aspect of leg
  • Fibular neck fracture
19
Q

What does the common peroneal (fibular) nerve supply sensation to?
Superifical and deep peroneal nerve

A

Superficial peroneal nerve:
- Dorsum of foot (except webspace between hallux and 2nd digit)

Deep peroneal nerve:
- Webspace between hallux and 2nd digit

20
Q

What muscle does the superificial peroneal nerve innervate?

A

Peroneus longus and brevis

21
Q

What muscle does the deep peroneal nerve innervate?

A

Tibialis anterior

22
Q

Injury to the common peroneal nerve will result in what?

A
  • Loss of sensation to dorsum of foot
  • Foot drop - cannot dorsiflex
23
Q

The tibial nerve supplies sensory innervation to where?

A

Sole of foot

24
Q

How can the tibial nerve be injured?

A
  • Knee trauma
  • Baker cyst (proximal lesion)
  • Tarsal tunnel syndrome (distal lesion)
25
Q

The tibial nerve innervates what muscles?

A
  • Flexor muscles of foot (plantarflexion)
  • Biceps femoris (long head)
  • Triceps surae
  • Plantaris
  • Popliteus
26
Q

What will injury to the tibial nerve (L4- S3) result in?

A
  • Loss of plantarflexion, inversion
  • Foot everted at rest
  • Inability to curl toes
  • Loss of sensation to sole of foot
27
Q

What muscles does the superior gluteal muscle innervate?

A
  • Gluteus medius
  • Gluteus minimus
  • Tensor fascia latae
28
Q

Trandelenburg sign is a result of an injury to what nerve?

A

Superior gluteal

29
Q

What can cause injury to the superior gluteal nerve?

A

IM injection to superomedial gluteal region

30
Q

Describe Trandelenburg sign

A

Pelvis tilts becuase wight-bearing leg cannot maintain alignment of pelvis through hip abduction
- Lesion is to contralateral side of hip that drops
- Ipsilateral to leg which patient stands on

31
Q

The inferior gluteal nerve innervates what muscle?

A

Gluteus maximus

32
Q

What can injury to the inf gluteal nerve (gluteus maximus) result in?

A

Difficulty climbing stairs, rising from seated position; loss of hip extension

33
Q

Injury to the inferior gluteal nerve (L5-S2) can be caused by whaat?

A

Posterior hip dislocation

34
Q

Sensory innervation to the perineum is supplied by what nerve?

A

Pudendal (S2-4)

35
Q

What does the pudendal nerve innervate (motor)?

A

External urethral and anal sphincters

36
Q

How can injury to the pudendal nerve occur?

A
  • Stretch injury during childbirth
  • Cycling, horesriding
37
Q

What may injury to the pudendal nerve result in?

A
  • Decreased sensation to the perineum and genital area
  • Fecal and urinary incontinance
38
Q

Where is used as a landmark for injection to target the pudendal nerve during childbirth?

A

Ischial spine

USMLE MSK (3 decks)

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