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Anatomy > Nerves of the Lower Limb > Flashcards

Nerves of the Lower Limb Flashcards

1
Q

Dermatome L1

A

Inguinal ligament

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2
Q

Dermatome L2

A

Lateral side of thigh

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3
Q

Dermatome L3

A

Lower medial side of thigh

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4
Q

Dermatome L4

A

Medial side of great toe (I)

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5
Q

Dermatome L5

A

Medial side of second toe

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6
Q

Dermatome S1

A

Little toe

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7
Q

Dermatome S2

A

Back of thigh / popliteal fossa

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8
Q

Dermatome S3

A

Skin over gluteal does

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9
Q

Myotome L1/L2

A

Flexion of the hip

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10
Q

Myotome L3/L4

A

Extension of the knee

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11
Q

Myotome L5- S2

A

Knee flexion

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12
Q

Myotome S1/S2

A

Dorsiflexion ankle

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13
Q

Myotome S2/S3

A

Adduction of digits (toes)

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14
Q

Patellar reflex spinal roots

A

L3 and L4

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15
Q

Achilles tendon reflex spinal roots

A

S1 and S2

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16
Q

Cutaneous test for femoral nerve

A

Anterior thigh, medial side of leg, medial side of ankle

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17
Q

Cutaneous test for obturator nerve

A

Medial side of thigh (upper)

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18
Q

Cutaneous test for tibial part of sciatic nerve

A

Lateral side of ankle and foot

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19
Q

Cutaneous test of common fibular nerve

A

Lateral side of leg and dorsum of foot

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20
Q

Common fibular branch of sciatic nerve

A

Passes laterally around neck of fibula when passing from the popliteal fossa into the leg

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21
Q

Constituents of lumbar plexus

A

L1 - L3 and part of L4

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22
Q

Constituents of lumbosacral trunk

A

Remainder of L4 and L5

This goes on to join S1 - S3 + 1/2 S4 to form the sacral plexus

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23
Q

Constituents of the sacral plexus

A

Part of L4, L5
S1 - S3 and part of S4

Lumbosacral trunk in form of L4 and L5 joins with S1-S3 to form sacral plexus

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24
Q

Spinal roots of the femoral nerve

A

L2 - L4

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25
Q

Spinal roots of the obturator nerve

A

L2 - L4

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26
Q

Femoral nerve

A

L2 - L4

Passes under inguinal ligament –> femoral triangle

Innervates all muscles in the anterior thigh

Innervates skin: Anterior thigh, anteromedial knee, medial side of the leg, medial side of the foot

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27
Q

Obturator nerve

A

L2 - L4

Passes into the pelvic cavity and the enters obturator canal
(between obturator groove and obturator membrane)

Innervates all muscles in the medial compartment with exception of the portion of adductor magnus or perctineus

Supplies obturator externus

Supplies skin on medial side of upper thigh

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28
Q

Spinal roots of the sciatic nerve

A

L4 - S3

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29
Q

Spinal roots of the common fibular nerve

A

Branch of sciatic nerve

L4 - S2

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30
Q

Spinal roots of the tibial nerve

A

Branch of the sciatic nerve

L4 - S3

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31
Q

Spinal roots of the superior gluteal nerve

A

L4 - S1

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32
Q

Spinal roots of the inferior gluteal nerve

A

L5 - S2

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33
Q

Sciatic nerve

A

L4 - S3

Passes through greater sciatic foramen INFERIOR to piriformis

Enters gluteal region and then posterior thigh

Divides into common fibular nerve (L4 - S2) and tibial nerve (L4 - S3)

Innervates all muscles in posterior thigh
Innervates all muscles in leg and foot
Innervates portion of adductor magnus arising from ischium

Innervates skin on lateral side of leg and lateral side of sole

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34
Q

Superior gluteal nerve

A

L4 - S1

Exits through greater sciatic foramen SUPERIOR to piriformis

Innervates gluteus medius, gluteus minimus, and tensor fascia lata

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35
Q

Inferior gluteal nerve

A

L5 - S2

Exits through greater sciatic foramen INFERIOR to piriformis

Innervates gluteus maximums

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36
Q

Ilioinguinal nerve

A

L1

Arises superior aspect of lumbar plexus

Descends in plane between transversus andominis and internal oblique

Passes into inguinal canal and then leaves through superficial inguinal ring

Supplies skin around medial upper thigh and perineum

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37
Q

Lateral cutaneous nerve of the thigh

A

L2 L3

Passes under / through medial inguinal hernia

Supplies skin on lateral thigh

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38
Q

Nerve to quadratus femoris

A

L4 - S1

Passes through greater sciatic foramen INFERIOR to piriformis

Supplies quadrates femoris and superior gemellus

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39
Q

Nerve to obturator internus

A

L5 - S2

Passes through greater sciatic foramen INFERIOR to piriformis

Supplies obturator internus and inferior gemellus

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40
Q

Innervation of piriformis

A

Innervated by branches from L5, S1 s2

O: Anterior surface of sacrum between anterior sacral foramina

I: Medial side of superior border of greater trochanter of femur

F: Laterally rotates the extended femur at hip
Abducts flexed femur at hip

41
Q

Innervation of obturator internus

A

Innervated by nerve to obturator internus (L5) S1

O: Anterolateral wall of true pelvis, deep surface of obturator membrane and surrounding bone

I: Medial side of greater trochanter of femur

F: Laterally rotates extended femur at hip
Abducts flexed femur at hip joint

42
Q

Innervation of gemellus superior

A

Innervated by nerve to obturator internus (L5) S1

O: External surface of ischial spine

I: Along obturator internus tendon and medical side of the greater trochanter with tendon

F: Laterally rotates the extended femur at hip
Abducts flexed femur at hip

43
Q

Innervation of gemellus inferior

A

Nerve to quadrates femoris L5 S1

O: Upper ischial tuberous

I: Along obturator internus tendon and medical side of the greater trochanter with tendon

F: Laterally rotates the extended femur at hip
Abducts flexed femur at hip

44
Q

Innervation of quadrates femoris

A

Innervated by nerve to quadrates femoris L5 S1

O: Ischium anterior to ischial tuberosity

I: Quadrate tubercle on intertrochanteric crest

F: Laterally rotates femur at hip

45
Q

Innervation of gluteus minimus

A

Innervated by the superior gluteal nerve L4 L5 (S1)

O: External surface of ileum between inferior and anterior gluteal lines

I: Linear facet on GT

F: Abducts femur at hip joint
Prevents pelvic drop during walking
Medial rotation of thigh

46
Q

Innervation of gluteus medium

A

Innervated by superior gluteal nerve L4 L5 (S1)

O: External surface of ileum between inferior and anterior gluteal lines

I: Elongate facet of GT

F: Abducts femur at hip joint
Prevents pelvic drop during walking
Medial rotation of thigh

47
Q

Innervation of gluteus maximus

A

Innervated by inferior gluteal nerve L5 S1 (S2)

O: Fascia covering gluteus medius, external surface of ileum behind posterior gluteal line, fascia of erector spinae, dorsal lower sacrum, sacrotuberous ligament

I: Posterior iliotibial tract of fascia lata anf gluteal tuberosity on femur

F: Powerful hip extensor, lateral stabiliser of hip and knee, laterally rotates and abducts thigh

48
Q

Innervation of tensor fascia latae

A

Innervated by superior gluteal nerve L4 L5 (S1)

O: Lateral crest of ileum between ASIS and tubercle

I: Iliotibial tract of fascia lata

F: stabilised knee in extension

49
Q

Passes above piriformis

A

Superior gluteal nerve

50
Q

Muscles supplied by the superior gluteal nerve

A

Gluetus minimus

Gluteus medius

Tensor fascia latae

51
Q

Only nerve not to leave through greater sciatic foramen

A

Perforating cutaneous nerve

Pierces sacrotuberous ligament

52
Q

Innervation of psoas major

A

Innervated by the anterior rami of L1 L2 (L3)

O: Posterior abdominal wall, lumbar transverse process, intervertebral discs and adjacent bones T12- L5

I: Lesser trochanter of the femur

F: Flexion of the hip

53
Q

Innervation of iliacus

A

Innervated by the femoral nerve L2 (L3)

O: Iliac fossa

I: Lesser trochanter of the femur

F: Flexion of the hip

Merges with psoas major to form iliopsoas

54
Q

Innervation of vastus medialis

A

Innervated by the femoral nerve (L2) L3 L4

O: Medial femur (intertrochanteric, linea aspera, supracondylar line)

I: Quadriceps tendon on patella +medial border of patella

F: Knee extension

55
Q

Innevration of vastus intermedius

A

Innervated by the femoral nerve (L2) L3 L4

O: Upper 2/3s of femur

I: Quadriceps tendon on patella

F: Knee extension

56
Q

Innervation of vastus lateralis

A

Innervated by the femoral nerve (L2) L3 L4

O: Lateral femur (GT, intertrochanteric, linea aspera)

I: Quadriceps tendon on patella + lateral border of patella

F: Knee extension

57
Q

Innervation of rectus femoris

A

Innervated by the femoral nerve (L2) L3 L4

O:
Striaght head: AIIS
Reflected head: Ilium superior to acetabulum

I: Quadriceps tendon on patella

F: Knee extension + flexion of the hip

58
Q

Innervation of sartorius

A

Innervated by the femoral nerve L2 L3

O: ASIS

I: Medial surface of the tibia, just inferolateral to tibial tuberosity

F: Knee extension + Hip flexion

59
Q

Innervation of gracilis

A

Innevrated by the obturator nerve L2 (L3)

O: external surface of the body of the pubis, the inferior pubic ramus and the ramus of the ischium

I: Medial surface of the tibia at pes anserinus just inferior to sartorius

F: Adducts the hip + Flexion of knee

60
Q

Innervation of pectineus

A

Innervated by the femoral nerve L2 (L3)

O: Pectineal line (pecten pubis) and adjacent bone of pelvis

I: obliquely from LT to linea aspera on posterio rfemur

F: Adduction and flexion of thigh

61
Q

Innervation of adductor longus

A

Innervated by the anterior division of the obturator nerve L2 L3 (L4)

O: Body of the pubis

I: Linea aspera on middle third of femur

F: ADduction and medial rotation of hip

62
Q

Innervation of adductor brevis

A

Innervated by the obturator nerve L2 L3

O: Body of pubis and inferior pubic ramus

I: Posterior surface of proximal femur and upper third of linear aspera

F: ADduction of hip

63
Q

Innervation of adductor magnus

A

Adductor part - Obtruator nerve L2 L3 (L4)

Hamstring part - Tibial division of the sciatic nerve : L2 L3 (L4)

O
Adductor part: ischiopubic ramus
Hamstring part: ischial tuberosity

I:
Adductor: posterior femur and linea aspera abd medial supracondylar line
Hamstring: adductor tubercle and supracondylar line

F: Adduction and medial rotation of the hip

64
Q

Innevration of obturator externus

A

Innervated by posterior branch of obtruatornerve (L3) L4

O: External suface of obturator membrane

I: Tochanteric fossa

F: Lateral rotation of hip

65
Q

Innervation of biceps femoris

A

Innervated by the sciatic nerve (L5) S1 (S2)
Long head: tibial division of sciatic nerve
Short head: common fibular division of sciatic nerve

O
Long head: Inferomedial part of upper ischial tuverosity
Short head: lateral lip of linea aspera

I: Head of fibula

F: Flexion amd lateral rotation at knee, extension and lateral rotation of the hip

66
Q

Innervation of semintendinosus

A

Innervated by tibial division of sciatic nerve (L5) S1 (S2)

O: Inferomedial ischial tuberosity

I: Medial surface of tibia

F: Flexion and medial rotation at the knee, extension and medial rotation at hip

67
Q

Innervation of semimembranosus

A

Innervated by the tibial division of sciatic nerve (L5) S1 (S2)

O: Superolaterl ischial tuberosity

I: Medial tibial condyle

F: Flexion and medial rotation at the knee, extension and medial rotation at hip

68
Q

The Femoral Nerve

A

Originates from lumbar plexus L2-L4

Supplies Iliacus and pectineus prior to entering thigh

Passes under inguinal ligament into femoral triangle

Lies lateral, outside of femoral sheath next to femoral artery

Divides into anterior and posterior branches just after passing under the inguinal ligament

Supplies:
Cutaneous sensation over front of thigh and knee

Motor
Quadriceps: rectus femoris, vastus lateralis, vastus medialis, vastus intermedius
Sartorius
(Pectinous and Iliacus)

Saphenous nerve: long nerve supplying cutaneous sensation over medial foot

69
Q

Saphenous nerve

A

Branch of femoral nerve

Accompanies the superficial femoral artery and femoral nerve down into adductor canal BUT does not pass through adductor hiatus

Penetrates connective tissue at end of canal to appear between sartorius and gracilis on medial side of the knee

Penetrates deep fascia and continues down the leg to the foot

Supplies skin on medial side of the knee, leg and foot

70
Q

The obturator nerve

A

Arises from lumbar plexus L2 - L4

Descends in psoas major and exits out of the medial side of the muscle to enter pelvis

Passes into the thigh through the obturator canal

Divides into anterior and posterior branches

Posterior: Descends behind adductor braves and then on anterior surface of adductor Magnus
Supplies: Obturator externus, adductor brevis, adductor magnum (hamstring part)

Anterior: Descends on anterior surface of adductor brevis behind pectineus and adductor longus
Supplies: Adductor longus, gracilis, adductor brevis, and cutaneous medial thigh

20% of people have obturator supply to pectineus

71
Q

Anterior branch of obturator nerve

A

Anterior: Descends on anterior surface of adductor brevis behind pectineus and adductor longus

Supplies: Adductor longus, gracilis, adductor brevis, and cutaneous medial thigh

72
Q

Posterior branch of obturator nerve

A

Posterior: Descends behind adductor braves and then on anterior surface of adductor Magnus

Supplies: Obturator externus, adductor brevis, adductor magnum (hamstring part)

73
Q

Tibial nerve

A

Branch of sciatic nerve

Supplies muscles in the posterior thigh:
Long head of biceps femoris
Semimembranosus
Semitendinosus

All the muscles in the posterior leg

All intrinsic muscles in the sole of the foot except first two dorsal interossei (deep fibular)

Cutaneous supply: posterolateral side of leg, ankle, foot, little toe and sole

74
Q

Common fibular nerve

A

Branch of the sciatic nerve

Supplies
Short head of the biceps femoris

All muscles in the lateral and anterior compartments of the leg

One muscle in the dorsum of the foot: extensor digitorum brevis

First two dorsal interossei of the foot

Skin over lateral leg, ankle and foot

75
Q

Innervation of the posterior compartment of leg

A

All innervated by the tibial nerve

Plantarflex, invert and flex

Superficial:
Gastrocnemius
Plantaris
Soleus

Deep: 
Popliteus
Flexor hallucis longus
Flexor digitorum longus
Tibialis posterior
76
Q

Innervation of gastrocnemius

A

Innervated by tibial nerve S1 S2

One lateral and one medial head

O: Lateral femoral condyle and medial supracondylar line
I: Calcaneal tendon
F: Plantar flexion of foot and flexes knee

77
Q

Innervation of plantaris

A

Innervated by tibial nerve S1 S2

O: Inferior lateral supracondylar line of femur and oblique popliteal ligament

I: Calcaneal tendon

F: Plantar flexion of ankle and flexion of knee

78
Q

Innervation of soleus

A

Innervated by tibial nerve S1 S2

O: Soleal line and medial border of tibia
Posterior aspect of fibular

I: Calcaneal tendon

F: Plantar flexion of foot

79
Q

The Tibial Nerve

A

Associated with posterior compartment of the leg

Major branch of sciatic nerve

Passes under tendinous arch of soleus and runs on surface of tibialis posterior muscle with posterior tibial vessels

Passes in tarsal tunnel behind medial malleolus

Enters root to supply intrinsic muscles and skin

Branches:

  • Sural nerve
  • Medial calcaneal nerve
80
Q

Sural nerve

A

Originates high in the leg between the two heads of gastrocnemius

Branch of the tibial nerve

Penetrates the fascia in the middle of the leg, joined by sural communicating branch of the common fibular nerve

Passes around lateral malleolus

Supples skin over lower posterolateral leg and lateral side of foot and little toe

81
Q

Medial calcaneal nerve

A

Branch of tibial nerve

Supplies skin on medial surface and sole of heel

82
Q

Innervation of the lateral compartment of the leg

A

Superficial fibular never

Branch of common fibular nerve

Two muscles:
Peroneus (fibularis) longus
Peroneus (fibularis) brevis

83
Q

Innervation of peroneus longus

A

Innervated by the superficial fibula nerve L5 S1 (S2)
–> Branch of common fibular nerve

O: Upper lateral surface of fibula, head of fibula, and lateral tibial condyle

I: Inferior surface of medial cuneiform and metatarsal I

F: Eversion and plantar flexion of the foot

84
Q

Innervation of peroneus brevis

A

Innervated by superficial fibular nerve L5 S1 (S2)
–> Branch of common fibular nerve

O: Lower 2/3rds of lateral surface of shaft of fibula

I: Lateral tubercle at base of metatarsal V

F: Eversion of foot

85
Q

Cutaneous branches of the common peroneal nerve

A

Sural communicating nerve

  • Joins sural branch of tibial nerve
  • Innervates skin over lower posterolateral skin of leg

Lateral sural cutaenous nerve
-Innervates skin over upper lateral leg

86
Q

Innervation of the skin covering the web space between 1st and 2nd toes

A

Deep fibular nerve

87
Q

Innervation of the skin covering the lateral side of the little toe

A

Sural branch of the tibial nerve

88
Q

Cutaneous innervation of the dorsum of the foot

A

Superifcial fibular nerve

Except:
Lateral little toes: sural nerve
Web space bwteen 1st and 2nd toe: deep fibular nerv e

89
Q

Innervation to the anterior compartment of the leg

A

Deep fibular nerve

Branch of common fibular nerve

Muscles:
Tibialis anterior
Extensor digitorum longus
Extensor hallucis longus
Peroneus tertius
90
Q

Innervation of Tibialis anterior

A

Innervated by the deep fibular nerve L4 (L5)

O: Lateral surface of tibia and interosseous membrane

I: Medial and inferior surface of medial cuneiform and metatarsal I

F: Dorsiflexion of foot, inversion, support of medial arch

91
Q

Innervation of extensor hallucis longus

A

Innervated by the deep fibular nerve L4 (L5)

O: Middle 1/2 of medial surface of fibula and interosseous membrane

I: Base of distal phalanx of great toe

F: Extension of great toe, dorsiflexion of foot

92
Q

Innervation of etxensor digitroum longus

A

Innervated by deep fibular nerve L4 (L5)

O: Proximal 1/2 of medial surface of fibula and lateral tibial condyle

I: Digital expansion into distal and middle phalanges of lateral four toes

F: Extension of lateral four toes and dorsiflexion of the foot

93
Q

Innervation of peroneus tertius

A

Innervated by deep fibular nerve L4 (L5)

O: Distal medial surface of tibia

I: Dorsomedial surface of base of metatarsal V

F: Dorsiflexion and eversion of foot

94
Q

Groove for tibias posterior tendon

A

= tibia

95
Q

Groove for peroneus long and braves tendon

A

= fibula

96
Q

Borders of the tarsal tunnel

A

Depression on medial malleolus of tibia

Medial and posterior surfaces of talus

Inferior surface of sustentaculum tali

Overlying flexor retinaculum

97
Q

Contents of tarsal tunnel

A

= flexor retinaculum
=medial malleolus

Anteriomedial –>

  • tibialis posterior
  • flexor digitorum longus
  • posterior tibial artery and veins
  • tibial nerve
  • flexor hallucis longus
  • ->Posterolateral
98
Q

Attachments of flexor retinaculum

A

Superior: medial malleolus

Inferior: inferomedial margin of calcaneus

Anatomy (22 decks)

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