Lower Limb Neurology Flashcards
Where is the L1 dermatome tested?
Inguinal region
Where is the L2 dermatome tested?
Anterolateral mid thigh
Where is the L3 dermatome tested?
Anteromedial distal thigh
Where is the L4 dermatome tested?
Medial leg
Where is the L5 dermatome tested?
Lateral leg/ Dorsal web of great toe
Where is the S1 dermatome tested?
Lateral foot
Where is the S2 dermatome tested?
Posterior inner thigh
What muscles do you test for L1 /L2 myotome?
L1/2/L3 (Ventral Rami of Lumbar Nerves; Femoral Nerve):
Psoas Major and Minor; Iliacus
Pt sup - knee bent, dr tries to pull knee down towards end of the bed
What muscles do you test for L3 /L4 myotome?
Quadriceps Femoris
Pt sup. knee bent, Dr push leg down - pt resist
What muscles do you test for L5 /S1 myotome?
L5/S1/S2 (Tibial Nerve; Fibular Nerve)
ST, SM & BF (Long Head); BF (Short Head)
L5/S1/S2 (Superficial Fibular Nerve):
Fibularis Longus & Brevis
Pt sup. knee bent. dr tries to lift lower leg up and pt resists
Foot - push foot into dorsi
What muscles do you test for L4 myotome?
L4/L5 (Deep Fibular Nerve):
Tibialis Anterior
Foot- dr pull foot towards end
What muscles do you test for L5 myotome?
L5/S1 (Deep Fibular Nerve):
Extensor Hallucis Longus
pull big toe
What muscles do you test for S1/S2 myotome?
S1/S2 (Tibial Nerve):
Gastrocnemius and Soleus
DR hand on base of foot and pt in plantarflexion - dr pushes foot - dr support and base of calf
What area is Pudendal nerve S2,S3 and S4?
Bladder, Rectum, Anal sphincter, muscles of the perineum and sensory to the genitalia
What is Jenddrassik Manoeuver?
Tendon jerk is reinforced by clenching fists or jaw
Gamma pathway is centrally facilitated rendering spindle more sensitive to stretch
