Survey
* Your assessment is very important for improving the work of artificial intelligence, which forms the content of this project
Download Lower Extremity Nerve Roots Pain Distribution Causative lesions
Document related concepts
Neural engineering wikipedia , lookup
Caridoid escape reaction wikipedia , lookup
Central pattern generator wikipedia , lookup
Evoked potential wikipedia , lookup
Sensory substitution wikipedia , lookup
Embodied language processing wikipedia , lookup
Neuroregeneration wikipedia , lookup
Transcript
Lower Extremity Nerve Roots Pain Distribution Causative lesions Reflex Arc Tests Notes Obturator L2-L3-L4 Medial thigh Sensory – Medial surface of thigh Motor – Obturator Externus Pectineus Adductors Gracilis Pelvic neoplasm Pregnancy Pelvic surgery Adductor jerk (L3) Hip adductors (L2, L3) – adductors Pectineus may be innervated by obturator or femoral nerves Femoral L2-L3-L4 Ant thigh Med leg to ankle Sensory – Anterior aspect of thigh & medial aspect of leg down to medial malleolus Motor – Quads Pectineus Iliacus Diabetes Femoral hernia Retroperitoneal – haematoma Femoral art. Aneurysm Post. Abdomen Neoplasm Psoas abscess Knee jerk L3-L4 Knee extension L3L4 Fem n. lesion will affect both knee ext & hip Flex. (psoas not affected tho) NB: Reflex arc conveyed purely in L4. Pressure palsy at fibula neck Hip fracture / dislocation Penetrating trauma to buttock Piriformis syndrome Lateral hamstring jerk (S1) Lateral cutaneus nerve of the thigh L2-L3 Sciatic – Fibular L4-L5-S1 Diabetic Amyotrophy – mm wasting in front of thigh w/ weakness & wastage due to vasc changes supplying n Sensory – anterolateral aspect of thigh Often only dorsum of foot Sensory – Anterolateral leg dorsum of ankle & foot up to distal interphalangeal joints Deep branch 1st interdigital cleft Motor – Short head biceps femoris Fibularis Longus & Brevis (Sup Fibular Foot dorsiflexion L4L5 – Tibialis anterior Big toe ext L5 - EHL Ext of toes (L5, S1) – EDL Foot eversion L5-S1 – Fib longus & brev5s Medial hamstring jerk – Medial reflex is carried in the tibial div Cause foot drop x6 more likely to be damaged than tibial div nerve) Tibialis anterior, EDL, EHL. P tertius (Deep fibular nerve) Sciatic – Tibial L4-L5-S1S2 Often painless uncommon Sensory – Sole and lat border of foot, around nail beds Motor – Hamstrings (not short head biceps fem) plantaris, popliteus TP, Gastroc, soleus, FDL, FHL and small foot muscles Posterior cutaneus nerve of the thigh S1-S2-S3 Sensory – central posterior thigh Superior gluteal nerve L4-L5-S1 Gluteus minimus Gluteus medius Tensor fascia lata Inferior gluteal nerve L5-S1-S2 Gluteus Maximus Rarely injured even in buttock Misplaced injections! Piriformis syndrome Ankle jerk S1 Medial hamstring jerk S1 Knee flexion L5-S1 – hamstrings Plantarflexion S1 – Gastrocnemius Foot inversion L4, L5 – tibialis Post. Medial hamstring jerk – Medial reflex is carried in the tibial div
