Lower limb

Question 1

Sciatic n. damage

Answer 1

• deficits from damage in proximal thigh
• motor:
  
  • hamstrings
  • 1/2 adductor magnus
  • short biceps
  • all muscles in leg & foot
• sensory:
  
  • lateral leg
  • all foot except medial border

Question 2

Tibial n. damage

Answer 2

• deficits from damage in popliteal fossa
  
  • motor:
  • all post. leg muscles (severely weakend plantar flexion & inversion)
  • all muscles on plantar surface of foot
  • Sensory:
  • lateral 1/2 post. leg, plantar surface of foot
• deficits from damage just proximal to medial malleolus
  
  • motor: all muscles in plantar surface of foot
  • sensory: plantar surface of foot

Question 3

Common fibular n. damage

Answer 3

• deficits from damage in popliteal fossa or at neck of fibula
  
  • motor:
  • ant. leg muscles (foot drop)
  • lat. leg (weakened plantar flexion & severely weakened eversion)
  • sensory:
  • lateral leg
  • dorsal surface
  • lateral border of foot

Question 4

Superficial fibular n. damage

Answer 4

• deficits from damage just distal to neck of fibula
• motor: all muscles in lateral leg
• sensory:
• lower 1/2 lateral leg
• lateral border
• dorsal surface of foot except 1st web space

Question 5

Deep fibular n. damage

Question 6

Lymph drainage

Answer 6

• Superficial drainage
  
  • Lateral/Plantar Foot & Posterolateral Leg: POPLITEAL nodes
  • Anteromedial & Dorsal foot, Anteromedial Leg, most of Thigh: VERTICAL GROUP of S. INGUINAL nodes
• Deep drainage:
  
  • Leg & Foot: POPLITEAL nodes -> Deep inguinal nodes
  • Thigh: Deep inguinal nodes

Question 7

Thigh muscle innervation nerve roots

Answer 7

• Femoral n.: L2-4 (anterior)
• Tibial n.: (posterior)
  
  • L4-S3 (biceps long head, 2 semis
  • L4-S2 (biceps short head)
• Obturator n.: L2-4 (medial)
• L1-3 ventral rami: Psoas major

Question 8

Leg & Foot cutaneous nerve innervation nerve roots

Answer 8

• Anterior thigh:
  
  • Lateral femoral cutaneous: L2-L3 (not branch of femoral n.)
  • Ant. Femoral cutaneous (femoral br,): inlcudes knee
  • Genitofemoral: L1-2
  • Ilioinguinal: L1
• Posterior thigh:
  
  • Post. femoral cutaneous: S1-3; includes knee
  • Lateral femoral cutaneous: L2-3
• Anterior leg & foot:
  
  • Saphenous: femoral br.
  • Lateral Sural: common fibural br.
  • S. Fibular
  • Deep Fibular: Digits 1 & 2
• Posterior leg & foot:
  
  • Lateral sural
  • S. Fibular
  • Medial Sural: tibial br.

Question 9

Genicular anastomosis

Answer 9

1. Medial & Lateral S & I Genicular aa from Popliteal
2. Descending Br from Lateral Circumflex Femoral
3. Descending Genicular Br from Femoral
4. Recurrent Br from Ant & Post Tibial aa.

Question 10

Popliteal fossa

Answer 10

• borders
  
  • hamstrings superiorly
  • gastroc inferiorly
• contents
  
  • popliteal a, v & branches
  • tibial & common fibular nn
  • sural nn branches
  • popliteal nodes
  • end of small saphenous v

Question 11

Muscles of foot

Answer 11

1st layer

• AB-ductor Digiti Minimi
• Flexor Digitorum Brevis
• AB-ductor Hallucis

2nd layer

• Lumbrical
• Quadratis Plantae
• Flexor Accesosoriasis

3rd layer

• Flexor Digiti Minimi
• Flexor Hallucis Brevis
• AD-ductor Hallucis

4th layer

• Interossei
• Midline: 2nd digit

Dorsal muscles

• Extensor Digitorum Brevis
• Extensor Hallucis Brevis

Question 12

Innervation of intrinsic foot muscles

Answer 12

• Tibial n
  
  • enters foot thru tarsal tunnel
  • immediately divides into:
  • Medial Plantar n.
    
    • Lumbrical
    • AB-ductor Hallucis
    • Flexor Digitorum Brevis
    • Flexor Hallucis Brevis
  • Lateral plantar n: all other plantar muscles
  • Deep Fibular n.
    
    • Extensor Hallucis Brevis
    • Extensor Digitorum Brevis

Question 13

Ankle joint ligaments

Answer 13

• Lateral:
  
  • Calcaneofibular
  • Ant. Talofibular (weak): INVERSION SPRAINS
  • Post. Talofibular
• Medial:
  
  • Deltoid
  • Malleolus to talus: Basketball sprain (falling on foot of opponent)
  • Calcaneus
  • Navicular