Lower Limb Nerve Injury Flashcards

1
Q

Sacral roots come out?

A

T12 to L1

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2
Q

Lumbar puncture happens at?

A

L3/4

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3
Q

Cauda equina symptoms?

A

Radicular pain, spreading out electrical
Unilateral pain
Sensory disturbance unilateral
Sexual Function is less impaired

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4
Q

Disc herniation that compressing cauda equina happens at what level?

A

L5/S1

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5
Q

Knee jerk at which level?

A

L4

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6
Q

ANkle jerk at which level?

A

S1

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7
Q

Femoral nerve comes off which level?

A

L2,3 and 4

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8
Q

Sciatic nerve comes off

A

L4/5 S 1 2 3

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9
Q

Femoral nerve organisation?

A

Psoas iliacus before inguinal ligament

Then below, innervation to knee extensors

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10
Q

Lateral cutaneous nerve comes off?

A

L2/3, below inguinal ligament

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11
Q

Numbness outer lateral thigh will be due to?

A

Lateral cutaneous nerve damage

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12
Q

Common perineal winds around?

A

Fibular head

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13
Q

Tibial nerve is responsible for?

A

Inversion and flexion of everything

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14
Q

Which nerve would you use for nerve biopsy?

A

Sural nerve

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15
Q

Plexopathy?

A

When proximal part of limb affected

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16
Q

Differences between cauda equina and conus medullaris?

A
Conus:
Less severe pain,
Symmetrical 
Bilateral
Ankle reflex only reduced
Bowel/bladder symptoms are early
Sexual function impairement is more
17
Q

What is sciatica caused by?

A

usually L5, s1 n root impingement

18
Q

Dermatomes?

A
L1, inguinal area
L2, front of thigh
L3 front of knee
L4, front - inner medial leg
L5, outer leg, dorsum o foot inner sole
S1, little toe, rest of sole, back of leg
S2, thighs to top of buttock
S3-s5 concentric rings around anus, genitalia
19
Q

Femoral nerve damage can happen due to?

A

Gynaecological reasons and pelvic fracture

20
Q

Isolated hip fracture affects what and what does pelvic and sacral fractures affect?

A

Sciatic nerve

Sacral plexus

21
Q

What can cause sciatic nerve injury?

A
Hip dislocation,
Acetabular fracture
Surgical trauma
Injections
Radiation
Tourniquets
Positioning during anaesthesia
22
Q

If you injure the tibial nerve then you can’t?

A

Stand on tip toes
Weak foot inversion
Painful numb sole

23
Q

Tibial nerve gives branches off to?

A

Gastrocnemius, popliteus, soleus, plantaris and the sural nerve

24
Q

What are the causes of tibial nerve injury?

A

Trauma.
Bakers cyst
Nerve tumour
Entrapment by the tendinous arch of the soleus muscle

25
Q

Sural nerve supplies?

A

Lateral foot

26
Q

Common fibular nerve damaged by?

A

Tight plaster casts, leg crossing, prolonged squatting

Strawberry’s pickers
Slimmers palsy

27
Q

Common peroneal nerve damage?

A

Sensory loss in dorsum of foot and outer aspect of leg

Weakness of dorsi flexion and eversion of foot

28
Q

Length dependent poly neuropathy causes?

A
Alcohol
Vit b12 deficiency
Diabetes
Idiopathic 
Chemotherapy
29
Q

Clinical symptoms of length dependent polyneuropathy?

A

Numbness
Paraesthesia
Weakness
Pain

30
Q

Non-length dependent polyneuropathy?

A

Guillian barre syndrome
Post infection inflammatory condition that picks off peripheral nerves

Antibody injures myelin membranes or axonal

31
Q

Symptoms of GB syndrome?

A

Rapidly progressive days to weeks
Weakness including limbs facial respiratory and bulbar muscles

Absent reflexes

32
Q

Neuronopathy?

A

Affecting the cell body of the nerve

33
Q

What is compartment syndrome?

A

Increases in pressure within a myofascial compartment which has limited ability to expand. This leads to compromised circulation and function of the tissues

Acutely it is a surgical emergency

34
Q

Commonest site for compartment syndrome?

A

Leg and forearm

35
Q

What percent of tibial fractures are associated with compartment syndrome?

A

1-10%

36
Q

Signs of compartment syndrome?

A
Pain on passive movement
Tense limb
Reduced sensation 
Muscle weakness paralysis
Pallor
Reduced pulse
37
Q

Investigations for compartment syndrome?

A

CK
Raised lactate
Myoglobinuria