Module 5: Unit 2-4 Flashcards
Which of the following nerves supplies the cremaster muscle?
a. Obturator
B. Femoral
C. Genitofemoral
D. Ilioinguinal
C
The nerve to the iliacus and Psoas is a ____________ division nerve derived from ____________ spinal nerves
Posterior; L2-4
The ____________ nerve innervates the internal transversus abdominus, as well as the skin superior to a line between the pubic symphysis and the ASIS
Iliohypogastric
The quadratic lumborun is innervated by:
A. Dorsal primary ramifications of T12-L4
B. The lumborsacral plexus
C. The iliogypogastric nerve
D. Ventral primary rami of T12-L4
D
The nerve to the iliacus and Psoas muscles can be identified as a branch of the ___________ nerve
Femoral
Femoral nerve is derived from _________ divisions of the ventral primary rami of ____________
Posterior; L2-4
A pt complains of weakness of R knee extension. On examination, the pt’s quadriceps reflex is diminished on the R compared to the left. He also has obvious weakness of the quadriceps femoris, but not the tibialis anterior on the R. Which of the following nerves is likely damaged?
A. Obturator
B. Femoral
C. Tibial
D. Deep fibular
B
Which of the following muscles is innervated by the obturator nerve?
A. Adductor Longus
B. Obturator inter us
C. Biceps femoris
D. Simitendinosus
A
Which of the following cutaneous areas of the thigh is innervated by the obturator nerve?
A. Posterior
B. Anterior
C. Lateral
D. Medial
D
Name two muscles innervated by the obturator nerve.
Pectineus, Adductor Magnus
Name two muscles innervated by the obturator nerve.
Pectineus, Adductor Magnus
T or F
The lateral leg and dorsal surface of the foot receive cutaneous branches of the common fibular nerve, whereas the posterior surface fo the leg and bottom of the foot receive cutaneous branches of the tibial nerve
T
Which of the following muscles is innervated by the tibial nerve?
A. Extensor hallucis longus
B. Rectus femoris
C. Adductor Magnus
D. Tibialis posterior
D
Which of the following nerves innervates the gluteus maximus?
A. Femoral
B. Inferior gluteal
C. Pudendal
D. Sciatic
B
Which of the following nerves innervates the Fibularis tertius?
A. Tibial
B. Saphenous
C. Deep fib
C
The superior gemellus muscle and the ______ ________ muscle are both enervated by the same nerve
Obturator internus
The sciatic nerve branches into which of these jam or nerves at the popliteal fossa?
A. Greater fibular and tibial
B. Tibial and superficial fibular
C. Common fibular and tibial
D. Common fibular and deep tibial
C
The sciatic nerve is the largest branch for the ___________ plexus
Lumbosacral
The short head of the biceps femoris is innervated by the ______________
Common fibular nerve
Which of the following muscles is innervated by the deep fib nerve?
A. Fibularis longus
B. Tibialis posterior
C. Extensor hallucis longus
D. Gastrocnemius
C
Which one of the following innervates the flexor hallucis brevis?
A. Lateral tibial nerve
B. Medial tibial nerve
C. Dep fib nerve
B
Name the distributions of the ventral primary ramifications. Name each nerve associated with the lumbar plexus and it division.
Ventral Primary Rami (L1-4)
- Iliohypogastric nerve; Anterior L1
- Ilioinguinal nerve; Anterior L1
- Genitofemoral nerve; Anterior L1 & 2
- Lateral Femoral Cutaneous Nerve; Posterior L2 & 3
- Nerve to the Psoas and Iliacus; Posterior L2-4
- Femoral Nerve; Posterior L2-4
- Obturator Nerve; Anterior L2-4
Which neural division provides cutaneous fibers to skin more superior and posterior than the Ilioinguinal.
Iliohypogastric
The Iliohypogastric and Ilioinguinal nerves consist of what two components?
Motor and sensory
T or F
Peripheral nerves will repair overtime about 2mm a day
T
What branch of the Genitofemoral nerve involves the cremaster muscle and anterior scrotal skin in males, and the skin of the mons pubis and labia majors in females
Genital branch
What Genitofemoral nerve branch supplies sensation to the upper anterior thigh?
Femoral (L1-2)
What is the entrapment of the upper lumbar plexus that bears most clinical significance and is that of the lateral femoral cutaneous nerve?
A. Lateral femoral nerve
B. TFL syndrome
C. Meralgia Paresthetics
D. Ebraheim lateral cutaneous
C
What is meraliga parenthetical?
Entrapment of the lateral femoral cutaneous nerve
What are the divisions of the lateral femoral cutaneous nerve?
L2, 3 posterior division
T or F
The lateral femoral cutaneous nerve and femoral nerve exit the inguinal tunnel
T
The femoral nerve exits the inguinal tunnel much more meidally
What are the divisions of the psoas and iliacus?
Posterior division VPRs of L2-4
What nerve innervates the quadriceps, Pectineus, and sartorius?
Femoral nerve
Name three aspects of the quadratus lumborum.
Derived from the hypomere
Innervated by the ventral primary rami of T12-L4
Involved in LBP associated with acute and -repetitive traumas
T or F
Trigger points are formed in muscles that are sedentary and hydrated
F
Trigger points are formed in muscles that have been injured. These are discrete areas of muscle tightness that when compressed result in a consistent pattern of pain
What is the treatment called that releases trigger points?
Myofascial release
What are the largest branches of the Lumbar Plexus, and what are there distributions?
Femoral (Posterior L2-4) and obturator nerves (Anterior L2-4)
The femoral nerve innervates which muscles of the thigh?
Cutaneous —> anterior cutaneous branches: anterior thigh; saphenous nerve: medial knee, leg, and medial ankle
Muscular branches —> Muscles that flex the thigh at the hip: Pectineus (L2, 3), iliopsoas (L2-4), sartorius (l2, 3), rectus femoris (L2-4), Muscles that extend the leg at the knee: quadriceps femoris (L2-4)
What would happen if there was femoral nerve entrapment?
Quadriceps weakness, decreased patellar reflex, anterior thigh pain and medial calf pain.
—> swing phase gait dysfunction
What group of muscles are innervated by the obturator nerve?
Adductors of the thigh,
Includes:
Obturator externus (L3, 4)
Adductor longus (L2-4)
Adductor brevis (L2-4)
Gracilis (L2-4)
Pectineus (L2, 3)
Adductor Magnus, anterior portion(L2-4)
What nerve is most vulnerable? Can be injured while in the pelvis by pubic ramus fracture, hematomas, and pregnancy.
Obturator nerve
____________ patterns of symptoms will indicate spinal nerve entrapments due to injuries related to the spine
Dermatomal
_____________ patterns of symptoms will indicate peripheral nerve entrapments due to local trauma
Cutaneous
Differentiating L4 from Femoral Nerve
Compare the pain patterns of L4 Radiculopathy with femoral neuropathy
L4 radivulopathy - Deep, aching, sclerotogenous type pain; shooting pain in the dermatomal pattern; L4 (medial foot and great toe)
Femoral Neuropathy - Cutaneous pain, sharp at first. Chronically: numbness in the cutaneous pattern: anterior cutaneous branch or saphenous nerve (anterior thigh, medial leg and foot, but NOT great toe)
Think about it like this, radiculopathy refers to nerve root compression or irritation. These nerve roots exit the spinal cord and give rise to peripheral nerves that transit signals to parts of the body. Related to nerve root problems at the level of the spine…..NEUROPATHY refers to damage to the peripheral nerves outside the spine. The nerves outside the brain and spinal cord.
Differentiating L4 from Femoral Nerve
Compare the motor function of L4 Radiculopathy with femoral neuropathy
L4 radiculopathy - Tibialis anterior weakness (as this is the indicator muscle for L4): Dorsiflexion, inversion of the foot… May present as foot drop
Femoral Neuropathy - Hip Flexor weakness, knee extensors weakness; may appear with atrophy of chronic; NO FOOT DROP
Differentiating L4 from Femoral Nerve
Compare the reflex of L4 Radiculopathy with femoral neuropathy
L4 Rad - 1+/4+ patellar reflex
FN - Diminished due to loss of the quadriceps innervation
Differentiating L4 from Femoral Nerve
Compare the gait changes of L4 Radiculopathy with femoral neuropathy
L4 rad - may exhibit stoppage gait with foot drop
FN - Difficult with the swing phase due to hip flexor weakness
Differentiating L4 from Femoral Nerve
Compare the palpation/ortho of L4 Radiculopathy with femoral neuropathy
N/A
Haven’t done
Distinguish the distribution of the muscular from the cutaneous branches of the lumbosacral plexus.
Muscular (motor) - primarily provide motor innervation to muscles of the lower limb, pelvis, and perineum. These include major nerves like the femoral, obturator, sciatic, and gluteal nerves which control movement.
Cutaneous (sensory) - provide sensory innervation to the skin and other sensory areas. Examples, include th femoral nerve (saphenous branch), lateral femoral cutaneous nerve, and posterior femoral cutaneous nerve, which relay sensory input from various regions of the lower body.
Lumbar Plexus (L1-4)
Name the division of the femoral nerve and what muscles it innervates. What are the actions of these muscles?
L2-4
Innervates the quadriceps, iliacus, and sartorius muscles
Actions are hip flexion, and extension at the knee joint