Nerve Root Lower Extremity and Lumbars Spine

Question 1

Nerve Root Lesion Evaluation Lower Extremity & Lumbar Spine

L4

Answer 1

1) Disc Level – L3

2) Muscle test (1)
• Foot dorsiflexion & inversion: tibialis anterior (deep peroneal nerve), “Lateral side of pull down and out”

3) Reflex – Patellar Tendon, “Taylor Hammer”
4) Sensation L3-L-5 – Medial aspect of leg, medial foot, medial aspect of big toe

Question 2

Nerve Root Lesion Evaluation Lower Extremity & Lumbar Spine

L5

Answer 2

1) Disc Level – L4

2) Muscle tests (4)
• Foot dorsiflexion: (name two muscles for this action
•Big toe dorsiflexion: extensor digitorum longus & brevis (deep peroneal nerve)
• Toes 2,3,4 dorsiflexion: extensor digitorum longus & brevis(deep peroneal nerve)
• Hip and Pelvis abduction: gluteus medius & minimus (superior gluteal nerve)

3) Reflex - NONE
4) Sensation L4-S1 – Lateral leg, dorsum of foot, and middle 3 toes

Question 3

Nerve Root Lesion Evaluation Lower Extremity & Lumbar Spine

S1

Answer 3

1) Disc Level – L5 “Lay patient down quickly”

2) Muscle tests (3)
• Foot Plantarflexion: Gastrocnemius and Soleus (Tibial Nerve)
• Foot plantar flexion and eversion: peroneus longus & brevis (Superficial Peroneal Nerve)
• Hip extension: gluteus maximus (Inferior Glueal Nerve)

3) Reflex –Achilles
4) Sensation – L5-S1 Posterior aspect of the leg, lateral aspect of foot, and lateral aspect of little toe

Question 4

Nerve Root Lesion Evaluation Lower Extremity & Lumbar Spine

S2

Answer 4

1) Disc Level – S1

2) Sensation – Posterior aspect of thigh over popliteal fossa onto posteromedial calf