MS - Anat & Phys (Lower extremity nerves & Neurovascular pairing) Flashcards
Pg. 416 in First Aid 2014 Sections include: -Lower extremity nerves -Neurovascular pairing
What spinal level(s) is (are) associated with the obturator nerve?
Obturator (L2-L4)
What is the main cause of injury to the obturator nerve (L2-L4)? How does this present?
Pelvic surgery; Decreased thigh sensation (medial) and Decreased adduction
What spinal level(s) is (are) associated with the femoral nerve?
Femoral (L2-L4)
What is the main cause of injury to the femoral nerve (L2-L4)? How does this present?
Pelvic fracture; Decreased thigh flexion & leg extension
What spinal level(s) is (are) associated with the common peroneal nerve?
Common peroneal (L4-S2)
What are the main causes of injury to the common peroneal nerve (L4-S2)? How does this present?
Trauma or compression of the lateral aspect of leg, Fibular neck fracture; Foot drop - inverted and plantarflexed at rest, loss of eversion and dorsiflexion. “Steppage gait” Loss of sensation on dorsum of foot.; Think: “PED = Peroneal Everts and Dorsiflexes; if injured, foot dropPED”
What spinal level(s) is (are) associated with the tibial nerve?
Tibial (L4-S3)
What are the main causes of injury to the tibial nerve (L4-S3)? How does this present?
Knee trauma, Baker cyst (proximal lesion) or Tarsal tunnel syndrome (distal lesion); Inability to curl toes and loss of sensation on sole of foot. In proximal lesions, foot everted at rest with loss of inversion and plantarflexion.; Think: “TIP = Tibial Inverts and Plantarflexes; if injured, can’t stand on TIPtoes.”
What spinal level(s) is (are) associated with the superior gluteal nerve?
Superior gluteal (L4-S1)
What are the main causes of injury to the superior gluteal nerve (L4-S1)? How does this present?
Posterior hip dislocation, polio; Trendelenburg sign/gait - pelvis tilts because weight-bearing leg cannot maintain alignment of pelvis through hip abduction (superior nerve => medius and minimus). Lesion is contralateral to the side of the hip that drops, ipsilateral to extremity on which the patient stands.
With what nerve injury is Trendelenburg sign/gait seen? Explain this.
Superior gluteal nerve (L4-S1); Trendelenburg sign/gait - pelvis tilts because weight-bearing leg cannot maintain alignment of pelvis through hip abduction (superior nerve => medius and minimus)
What is the main cause of injury to the inferior gluteal (L5-S2)? How does this present?
Posterior hip dislocation; Difficulty climbing stairs, rising from seated position. Loss of hip extension (inferior nerve => maximus)
What spinal level(s) is (are) associated with the the sciatic nerve? What does it innervate, and into what nerves does it split?
Sciatic nerve (L4-S3) - posterior thigh, splits into common peroneal and tibial nerves
What is the usual naming convention of neurovascular pairs? What are 6 exceptions?
Nerves and arteries are frequently named together by the bones/regions with which they are associated. The following are exceptions to this naming convention: (1) Axilla/lateral thorax (long thoracic nerve & lateral thoracic artery) (2) Surgical neck of humerus (axillary nerve & posterior circumflex artery) (3) Midshaft of humerus (radial nerve & deep brachial artery) (4) Distal humerus/cubital fossa (median nerve & brachial artery) (5) Popliteal fossa (tibial nerve & popliteal artery) (6) Posterior to medial malleolus (tibial nerve & posterior tibial artery)
What are the names of the nerve and artery in the axilla/lateral thorax?
Long thoracic nerve; Lateral thoracic artery