Nerve Palsies of the Limbs Flashcards
What is Hilton’s law?
Give a clinical example of why this is important
The nerves crossing a joint supply the muscles acting on it and the joint itself
May supply 2 joints e.g. hip and knee supplied by femoral, sciatic and obturator nerves ->
HIP DISEASE MAY GIVE RISE TO KNEE PAIN
Name 3 nerves that supply the hip joint
Obturator nerve (predominantly)
Femoral nerve
Lateral femoral cutaneous nerve
What is a myotome?
Group of muscles supplied by one segment of spinal cord
Give a pneumonic to remember the development of the brachial plexus from roots
Rob = Roots Trenson = Trunks Drinks = Divisions Cold = Cords Beer = Branches
What are the roots of the radial nerve?
C5-T1
The radial nerve enters the forearm by passing between which two mucles?
Brachioradialis and brachialis
posterior interosseous branch of radial nerve passes between 2 planes of supinator
What 2 locations are the radial nerve at risk of damage?
Spiral grrove of humerus
Lateral intermuscular septum
What deficit occurs in radial nerve damage?
Motor = wrist drop (extensors)
Sensory = 1st web space dorsally
-Dorsum of hand, web between thumb and index and middle finger
What are the roots of the median nerve?
C7, 8 and T1
How does the median nerve enter the forearm?
By passing between the two heads of pronator teres
What is the clinical significance of struther’s ligament?
Its clinical significance arises from the fact that the median nerve and brachial artery may pass through the “arch” formed by the process and ligament over the humeral body. Within this space the nerve may be compressed leading to supracondylar process syndrome.
What are the roots of the ulnar nerve?
C7-T1
What is the deficit of ulnar nerve damage?
Motor = claw hand, hypothenar and 1st dorsal interosseous wasting
Sensory = little finger
Where does the lumbar plexus lie?
On the surface of quadratus lumborum and within body of posts muscle
What major nerves about the hip do not exit the pelvis by the sciatic foramen?
Genitofemoral Ilioinguinal Femoral Lateral femoral cutaneous Obturator nerves
What are the roots of the femoral nerve?
L2-4
The femoral nerve terminates in a long fine sensory branch called the saphenous nerve.
Describe the route of this nerve
Accompanies femoral artery in subsartorial canal of thigh and long saphenous vein in lower leg and in front of medial malleolus at ankle to supply breat toe
The lateral femoral cutaneous nerve lies on the surface of which muscle?
Iliacus muscle
usually exits pelvis under lateral end of inguinal ligament but variable
What does the lateral femoral cutaneous nerve supply?
What occurs when it is compressed?
Purely sensory to lateral aspect of thigh
Compression causes meralgia parasthetica
What are the roots of the sciatic nerve?
L4-S3
What does the sciatic nerve supply?
Hamstring muscles in thigh (posterior) and part of adductor magnus and all lower leg and foot muscles via terminal branches
What can cause damage to sciatic nerve?
At risk from posterior dislocation of hip, intra-muscular injections and during surgery
What is the most commonly injured nerve in lower limb?
What deficit does it cause?
Common fibular nerve
Foot drop and slapping gait
Where is the common fibular nerve at risk?
Passes around lateral aspect of neck of fibula
