Lower Limb Nerve Injuries Flashcards

1
Q

What system is used to classify nerve inhuries?

A

Seddon classification

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2
Q

What is the Seddon classification?

A
Neurapraxia = conduction block 
Axonotmesis = axons divided 
Neurotmsis = nerve divided
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3
Q

What does a nerve lesion to the nerves to psoas and illiacus cause?

A

No pelvic swing when walking

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4
Q

What does a nerve lesion to the femoral nerve cause?

A

Loss of hip flexion
Loss of knee extension

Loss of sensation

  • anterior thigh
  • medial leg
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5
Q

What does a nerve lesion to the obturator nerve cause?

A

Loss of adduction of thigh

Loss of sensation to inner thigh

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6
Q

What does a nerve lesion to the superior gluteal nerve cause?

A

Loss of abduction at hip - pelvic dip on walking

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7
Q

What does a nerve lesion to the inferior gluteal nerve cause?

A

Loss of extension at hip

Buttock wasting

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8
Q

What does a nerve lesion to the sciatic nerve cause?

A

Loss of all motor functions except

  • adduction of knee
  • flexion of thigh
  • extension of knee

Loss of sensation

  • lower leg
  • foot
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9
Q

What does a nerve lesion to the tibial nerve cause?

A

Loss of toe flexion
Loss of foot inversion

Loss of sensation

  • sole of foot
  • inferior aspect of toes
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10
Q

What does a nerve lesion to the common fibular nerve cause?

A

Loss of toe extension
Loss of foot extension = foot drop

Loss of sensation

  • lateral lower leg
  • upper foot
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11
Q

What can cause neuropathy?

A
Injury - stretch/division 
Extrinsic pressure - abscess/tumour
Diabetes
Vasculitis 
Alcohol excess
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12
Q

What is the path of the sciatic nerve?

A

Exits sciatic notch anterior to piriformis
Travels between adductor magnus + long head of biceps femoris
Bifurcates into tibial and common peroneal nerve in popliteal fossa

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13
Q

What is piriformis syndrome?

A

Sciatica symptoms involving the overlying piriformis muscle

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14
Q

What is the path of the lateral cutaneous nerve of the thigh?

A

Passes from lateral border of psoas major across iliac fossa to pierce inguinal ligament

Travels medial to ASIS

Enters thigh deep to fascia lata

Becomes superficial 10cm below inguinal ligament

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15
Q

What does the lateral cutaneous nerve supply?

A

Supplies the anterolateral aspect of the thigh

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16
Q

What is meralgia paraesthetica?

A

Compression of the lateral cutaneous nerve of the thigh as it passes through the inguinal ligament or as it pierces the fascia lata

17
Q

What can cause meralgia paraesthetica?

A

Obesity
Pregnancy
Tight clothing
Wearing a tool belt

18
Q

What are the symptoms of meralgia paraesthetica?

A

Burning or stinging sensation over anterolateral thigh
Tenderness on palpation
Reduced sensation

19
Q

What aggravates meralgia paraesthetica?

A

Walking

Standing

20
Q

What relieves meralgia paraesthetica?

A

Lying down with hip flexed

21
Q

What are the effects of a femoral nerve injury?

A

Weakness of quadriceps
Weakness of hip flexors
Loss of saphenous nerve
Loss of medial + intermediate cutaneous nerves of the thigh

22
Q

What is the path of the superior gluteal nerve?

A

Originates from L5-S1 roots

Runs with superior gluteal artery and vein about 5cm from greater trochanter

23
Q

What is a sign of a superior gluteal nerve injury?

A

Trendelenburg sign

24
Q

What is the trendelenburg sign?

A

Drop of pelcis when lifting leg opposite to weak gluteus medius

25
Q

What can cause injury to the superior gluteal nerve?

A

L5 radiculopathy

Surgical trauma during total hip replacement

26
Q

What is the path of the tibial nerve?

A

Branch of sciatic nerve
Crosses popliteal fossa
Passes deep to soleus
In posterior compartment between FDL + FHL
Passes deep to flexor retinaculum
Gives off medial calcaneal nerve
Divides into medial and lateral plantar nerves

27
Q

What is the effect of a tibial nerve injury?

A

Paralysis of posterior compartment of the leg

Loss of plantar sensation

28
Q

What is the effect of a superficial peroneal nerve injury?

A

Loss of active eversion
Sensory loss over dorsum of foot (spares 1st webspace)
Sensory loss to lower anterolateral leg

29
Q

What can cause injury to the superficial peroneal nerve?

A

Ankle surgery - lateral approach

Ankle arthroscopy

30
Q

What is the effect of a the deep peroneal nerve?

A

Loss of active dorsiflexion = foot drop

Sensory loss in 1st webspace

31
Q

What can cause saphenous nerve injury?

A

Venous cut-down

Vein harvest for bypass surgery

32
Q

What is the effect of a saphenous nerve injury?

A

Loss of sensation over medial leg

33
Q

What is the effect of sural nerve injury?

A

Loss of sensation to lateral border of the foot