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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
Spinal roots of the obturator nerve
L2 - L4
26
Femoral nerve
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
27
Obturator nerve
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
28
Spinal roots of the sciatic nerve
L4 - S3
29
Spinal roots of the common fibular nerve
Branch of sciatic nerve L4 - S2
30
Spinal roots of the tibial nerve
Branch of the sciatic nerve L4 - S3
31
Spinal roots of the superior gluteal nerve
L4 - S1
32
Spinal roots of the inferior gluteal nerve
L5 - S2
33
Sciatic nerve
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
34
Superior gluteal nerve
L4 - S1 Exits through greater sciatic foramen SUPERIOR to piriformis Innervates gluteus medius, gluteus minimus, and tensor fascia lata
35
Inferior gluteal nerve
L5 - S2 Exits through greater sciatic foramen INFERIOR to piriformis Innervates gluteus maximums
36
Ilioinguinal nerve
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
37
Lateral cutaneous nerve of the thigh
L2 L3 Passes under / through medial inguinal hernia Supplies skin on lateral thigh
38
Nerve to quadratus femoris
L4 - S1 Passes through greater sciatic foramen INFERIOR to piriformis Supplies quadrates femoris and superior gemellus
39
Nerve to obturator internus
L5 - S2 Passes through greater sciatic foramen INFERIOR to piriformis Supplies obturator internus and inferior gemellus
40
Innervation of piriformis
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
Innervation of obturator internus
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
Innervation of gemellus superior
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
Innervation of gemellus inferior
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
Innervation of quadrates femoris
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
Innervation of gluteus minimus
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
Innervation of gluteus medium
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
Innervation of gluteus maximus
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
Innervation of tensor fascia latae
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
Passes above piriformis
Superior gluteal nerve
50
Muscles supplied by the superior gluteal nerve
Gluetus minimus Gluteus medius Tensor fascia latae
51
Only nerve not to leave through greater sciatic foramen
Perforating cutaneous nerve Pierces sacrotuberous ligament
52
Innervation of psoas major
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
Innervation of iliacus
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
Innervation of vastus medialis
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
Innevration of vastus intermedius
Innervated by the femoral nerve (L2) L3 L4 O: Upper 2/3s of femur I: Quadriceps tendon on patella F: Knee extension
56
Innervation of vastus lateralis
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
Innervation of rectus femoris
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
Innervation of sartorius
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
Innervation of gracilis
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
Innervation of pectineus
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
Innervation of adductor longus
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
Innervation of adductor brevis
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
Innervation of adductor magnus
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
Innevration of obturator externus
Innervated by posterior branch of obtruatornerve (L3) L4 O: External suface of obturator membrane I: Tochanteric fossa F: Lateral rotation of hip
65
Innervation of biceps femoris
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
Innervation of semintendinosus
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
Innervation of semimembranosus
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
The Femoral Nerve
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
Saphenous nerve
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
The obturator nerve
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
Anterior branch of obturator nerve
Anterior: Descends on anterior surface of adductor brevis behind pectineus and adductor longus Supplies: Adductor longus, gracilis, adductor brevis, and cutaneous medial thigh
72
Posterior branch of obturator nerve
Posterior: Descends behind adductor braves and then on anterior surface of adductor Magnus Supplies: Obturator externus, adductor brevis, adductor magnum (hamstring part)
73
Tibial nerve
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
Common fibular nerve
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
Innervation of the posterior compartment of leg
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
Innervation of gastrocnemius
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
Innervation of plantaris
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
Innervation of soleus
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
The Tibial Nerve
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
Sural nerve
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
Medial calcaneal nerve
Branch of tibial nerve Supplies skin on medial surface and sole of heel
82
Innervation of the lateral compartment of the leg
Superficial fibular never Branch of common fibular nerve Two muscles: Peroneus (fibularis) longus Peroneus (fibularis) brevis
83
Innervation of peroneus longus
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
Innervation of peroneus brevis
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
Cutaneous branches of the common peroneal nerve
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
Innervation of the skin covering the web space between 1st and 2nd toes
Deep fibular nerve
87
Innervation of the skin covering the lateral side of the little toe
Sural branch of the tibial nerve
88
Cutaneous innervation of the dorsum of the foot
Superifcial fibular nerve Except: Lateral little toes: sural nerve Web space bwteen 1st and 2nd toe: deep fibular nerv e
89
Innervation to the anterior compartment of the leg
Deep fibular nerve Branch of common fibular nerve ``` Muscles: Tibialis anterior Extensor digitorum longus Extensor hallucis longus Peroneus tertius ```
90
Innervation of Tibialis anterior
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
Innervation of extensor hallucis longus
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
Innervation of etxensor digitroum longus
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
Innervation of peroneus tertius
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
Groove for tibias posterior tendon
= tibia
95
Groove for peroneus long and braves tendon
= fibula
96
Borders of the tarsal tunnel
Depression on medial malleolus of tibia Medial and posterior surfaces of talus Inferior surface of sustentaculum tali Overlying flexor retinaculum
97
Contents of tarsal tunnel
= flexor retinaculum =medial malleolus Anteriomedial --> - tibialis posterior - flexor digitorum longus - posterior tibial artery and veins - tibial nerve - flexor hallucis longus - ->Posterolateral
98
Attachments of flexor retinaculum
Superior: medial malleolus Inferior: inferomedial margin of calcaneus

Anatomy (22 decks)

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