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Locomotor > Nerves of lower limb > Flashcards

Nerves of lower limb Flashcards

1
Q

Which spinal segments contribute to the lumbar plexus?

A

Ventral rami L1-4

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2
Q

Where is the lumbar plexus situated?

A

Within psoas major

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3
Q

Describe the position of the terminal branches of the lumbar plexus as they emerge from psoas?

A

From lateral border: iliohypogastric and ilioinguinal, lateral cutaneous nerve of thigh, femoral nerve

Onto anterior surface: genitofemoral nerve

Medial border: obturator nerve

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4
Q

Describe the pathway of the iliohypogastric and ilioinguinal nerves?

A

From lateral border of psoas > emerge onto QL > slip into neurovascular plane where QL meets fascia

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5
Q

What do the iliohypogastric and ilioinguinal nerves innervate?

A

Cuatneous supply: inguinal region and front of scrotum

Motor supply: lowermost fibres of IO and TA

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6
Q

Describe the outcome of injury to iliohypogastric and ilioinguinal nerve?

A

Indirect inguinal hernia

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7
Q

Describe the spinal segments that contribute to each of the terminal branches of the lumbar plexus?

A

Iliohypogastric and ilioinguinal nerves: L1

Lateral cutaneous nerve of thigh: L2,3

Femoral nerve: L2,3,4

Genitofemoral nerve: L1,2

Obturator nerve: L2,3,4

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8
Q

Describe the pathway of the lateral cutaneous nerve of thigh?

A

Emerges from lateral border of psoas > onto iliacus > swings wide and tucks into ASIS beneath inguinal ligament

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9
Q

Describe the consequences of the pathway of the lateral cutaneous nerve of thigh?

A

In pregnant women and morbidly obese people, can become compressed against inguinal ligament > pins and needles in thigh

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10
Q

Describe the pathway of the femoral nerve?

A

Emerges from lateral border of psoas > onto iliacus > tucks into gutter of iliopsoas > continues with converging fibres beneath inguinal ligament > divides into terminal branches just distal to ligament

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11
Q

Describe the breakdown of the genitofemoral nerve?

A

Two nerves in one sheath

Genital branch: L2

Femoral branch: L1

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12
Q

Describe what each branch of the genitofemoral nerve supplies?

A

Genital branch: spermatic cord

Femoral branch: skin immediately beneath inguinal ligament (over femoral triangle)

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13
Q

Which spinal segments contribute to the sacral plexus?

A

S1-4

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14
Q

Which spinal segments contribute to the lumbosacral trunk?

A

L4,5 and S1-4

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15
Q

Which muscular sturcture does the scaral plexis lie on?

A

Piriformis

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16
Q

Where does the lumbosacral trunk join S1-4?

A

Piriformis

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17
Q

What does the femoral nerve supply?

A

MOTOR: quads, sartorius, pectineus

SENSORY: anteromedial thigh and medial side of knee, leg and ankle

  • anterior cutaneous branches (medial and intermediate cutaneous nerve of thigh)
  • saphenous nerve
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18
Q

How does the femoral nerve relate to other structures in the femoral triangle?

A

Lateral to vascular structures

Outside femoral sheath (sheath contains vein, artery and canal)

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19
Q

Describe the sensory innervation of the femoral nerve?

A

Anterior cutaneous branches of femoral nerve > intermediate and medial cutaneous nerve of thigh

Saphenous nerve > infrapatellar branch and medial crural cutaneous branches

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20
Q

Describe the pathway of the obturator nerve?

A

Emerges from medial border of psoas > lateral wall of pelvis > obturator canal > medial compartment of thigh

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21
Q

What does the obturator nerve innervate?

A

MOTOR: adductor muscles (+ pectineus, - hamstring part of adductor magnus)

SENSORY: inferomedial thigh, pelvic peritoneum

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22
Q

Describe the divisions of the obturator nerve?

A

After it exits obturator canal divides into:

Anterior division: between adductor longus and adductor brevis

Posterior division: between adductor brevis and adductor magnus

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23
Q

Which spinal segments contribute to the sciatic nerve?

A

L4,5, S1,2,3

Anterior and posterior divisions

24
Q

Describe the pathway of the sciatic nerve?

A

Exits pelvis via GSF > emerges beneath piriformis in gluteal region > posterior to hip > descends in posterior thigh under biceps > divides at apex of politeal fossa

25
Q

What does the sciatic nerve supply?

A

MOTOR: hamstrings (all tibial excpet SHOB)

SENSORY: via terminal branches only

26
Q

Describe where the sciatic nerve lies as it passes posterior to the hip joint?

What is the consequence of this?

A

Halfway between medial tuberosity medially and greater trochanter laterally

Directly over back of hip joint

So, damaged in posterior hip dislocation

27
Q

Describe the components of the sciaitc nerve?

A

Tibial nerve

Common fibular nerve

28
Q

Describe the superior and inferior gluteal nerves, including their pathways and structures that they supply?

A

SUPERIOR GLUTEAL NERVE: emerges above piriformis, supplies gluteus medius and minimus

INFERIOR GLUTEAL NERVE: emerges below piriformis, supplies gluteus maximus

29
Q

Describe the pathway of the posterior cutaneous nerve of thigh?

Which structures does it supply?

A

Emerges beneath sciatic nerve (often unseen)

Supplies skin down back of thigh

30
Q

Where does the sciatic nerve divide into its terminal branches?

A

Varies

Commonly at apex of politeal fossa

Sometimes divides while it is still in pelvis (common fibular arises above pirifiromis)

31
Q

Describe why intramuscular injections are given in the lateral thigh, and not in the buttocks?

A

Trying to avoid sciatic nerve

Lateral thigh: no chance of sciatic nerve being here

Buttocks: if sciatic has divided early, common fibular nerve will arise above piriformis > in upper quadrant of buttocks

32
Q

Describe the innervation of the hamstrings?

A

Tibial component of sciatic nerve supplies all excpet SHOB

SHOB supplied by common fibular component

33
Q

Which spinal segments contribute to the tibial nerve?

A

L4,5, S1,2,3

Anterior divisions

34
Q

Describe the pathway of the tibial nerve?

A

Vertical descent through popliteal fossa > beneath fibrous arch of soleus > descends on tibialis posterior in calf > posterior to medial malleolus > sole of foot > medial and lateral plantar nerves

35
Q

What does the tibial nerve supply?

A

MOTOR: muscles of posterior leg and sole of foot

SENSORY: posterior leg (sural nerve) and sole of foot ( medial calcaneal, medial and lateral plantar nerves)

36
Q

Which spinal segments contribute to the common fibular nerve?

A

L4,5, S1,2

Posterior divisions

37
Q

Describe the pathway of the common fibular nerve?

A

Medial to biceps > superficial to lateral head of gastrocnemius > winds around neck of fibula > sinks into substance of fibularis longus > terminal branches

38
Q

What are the terminal branches of the common fibular nerve?

A

Deep fibular nerve

Superficial fibular nerve

39
Q

What does the common fibular nerve supply?

A

SENSORY: upper lateral leg via lateral sural cutaneous nerve

40
Q

What does the deep fibular nerve supply?

A

MOTOR: anterior compartment of leg and EDB

SENSORY: 1st toe cleft

41
Q

What does the superificial fibular nerve supply?

A

MOTOR: lateral compartment of leg

SENSORY: lower lateral leg and dorsum of foot

42
Q

Describe the pathway of the deep fibular nerve?

A

Begins in fibularis longus > descends deep to EDL, anterior to interosseus membrane > beneath extensor retinaculum > dorsum of foot

43
Q

Describe the pathway of the superificial fibular nerve?

A

Descends in lateral compartment of leg > supplies fibulairs longus > becomes superificial to supply skin over lower lateral leg and dorsum of foot

44
Q

Describe the innervation of the large muscles in the gluteal region?

A

Gluteus medius and minimus: supeficial gluteal nerve

Gluteus maximus: inferior gluteal nerve

45
Q

Describe the innervation of the muscles of the anterior compartment of the thigh?

A

Femoral nerve

46
Q

Describe the innervation of the muscles of the medial compartment of the thigh?

A

Obturator nerve

47
Q

Describe the innervation of the muscles of the posterior compartment of the thigh?

A

Tibial part of sciatic nerve (except SHOB)

48
Q

Describe the innervation of the muscles of the posterior compartment of the leg?

A

Tibial part of sciatic nerve

49
Q

Describe the innervation of the muscles of the sole of the foot?

A

Tibial part of the sciatic nerve

50
Q

Describe the innervation of the muscles of the anterior compartment of the leg?

A

Common fibular part of sciatic nerve

51
Q

Describe the innervation of the muscles of the lateral compartment of the leg?

A

Common fibular part of sciatic nerve

52
Q

Describe the innervation of the muscles in the dorsum of the foot?

A

Common fibular part of the sciatic nerve

53
Q

Describe the sensory innervation to the lower limb?

A
54
Q

Describe the dermatomes of the lower limb?

A
55
Q

Describe the myotomes of the lower limb?

A

Locomotor (28 decks)

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