Download 22-nerve injuries (L..

FEMORAL NERVE INJURY
(A) Motor 
1. Wasting of the 
quadriceps femoris.
2. Loss of knee 
extension.
This can be compensated
by the adductors in
walking.
3. Some loss of hip 
flexion ( iliacus &
pectineus).

FEMORAL NERVE INJURY
(B) Sensory Loss
Over:
1. The front and 
medial side of the
thigh (anterior and
medial cutaneous
nerves of the
thigh).

FEMORAL NERVE
2. The medial side
of the lower part of
the leg.
3. The medial 
border of the foot
as far as the ball of
the big toe
(Saphenous
nerve).

OBTURATOR NERVE INJURY
Causes : 
Pressure of the fetal 
head during labour.
Pelvic wall malignancy.
Motor : 
Incomplete loss of 
adduction ( ischial part
of adductor magnus is
functioning).

OBTURATOR NERVE INJURY
Sensory loss : 
Minimal over the 
middle of the medial
thigh.
SCIATIC NERVE INJURY
Causes : 
1. Badly placed
intramuscular
injection.

SCIATIC NERVE INJURY
2. Posterior 
dislocation of the
hip joint.
3. Fracture of the
pelvis.

SCIATIC NERVE INJURY
Motor : 
1. Marked wasting of the
muscles below the knee.
2. Weak flexion of the 
knee ( sartorius & gracilis
are functioning).
3. The foot assumes the 
position of foot drop
(planter flexed position) by
its weight.

SCIATIC NERVE INJURY
Sensory loss : 
Below the knee. 
EXCEPT : 
The area supplied 
by the Saphenous
nerve.
Trophic ulcers in 
the sole.
SCIATICA
It is pain in the leg 
extending from the
buttock towards the heel.
Causes : 
Pressure on the sciatic 
nerve or its roots by
prolapsed intervertebral
disc (L4-5) or cancer
deposits adjacent to the
nerve.
SCIATICA
Diagnosis : 
1. Straight leg 
raising is diminished
by the pain of
sciatica.
2. Sensory loss over
the lateral side of the
leg .
3. Loss of ankle 
reflex.

COMMON PRONEAL NERVE
INJURY
It is the most liable 
nerve to be injured in
the lower limb. Because
of its superficial
position.
The nerve may be 
severed during fracture
of the neck of fibula or
when the knee joint is
injured or dislocated.
COMMON PRONEAL NERVE
INJURY
Motor 
Loss of: 
1. Dorsiflexion 
(extensor muscles)
2. Eversion (
peronei).
The foot – drops. 
And becomes 
inverted.
COMMON PRONEAL NERVE
INJURY
The toes drag on the
floor in walking.
The patient has to 
raise his foot high to
keep the toes from
hitting the ground.
The foot comes down
suddenly.


COMMON PRONEAL NERVE
INJURY
Sensory loss 
over:
1. Lateral and 
anterior sides of
the leg.
2. Dorsum of the
foot and toes.
3. Medial side of
the big toe.


DEEP PERONEAL NERVE
INJURY
Motor : 
Loss of dorsiflexion of
the foot and toes. The
foot becomes planter
flexed and inverted
because of the
unopposed action of
Tibialis posterior.
An attitude referred to
as Equinovarus.


DEEP PERONEAL NERVE
INJURY
Sensory Loss : 
Between the first
and second toes.

SUPERFICIAL PERONEAL
NERVE INJURY
Motor : 
Evertion by the 
peroni is lost.
The foot becomes 
inverted.
SUPERFICIAL PERONEAL
NERVE INJURY
Sensory Loss : 
1. Lateral side of 
the leg.
2. Dorsum of the 
foot and toes.
3. Medial side of 
the big toe.
TIBIAL NERVE INJURY
Motor : 
All the muscles in the
back of the leg and
sole of the foot are
paralysed.
The foot is 
dorsiflexed and
everted.
An attitude referred to
as Calcaneovalgus.


TIBIAL NERVE INJURY
Sensory loss 
over :
1. Lateral side of 
the leg and foot.
2. Trophic ulcers in
the sole.

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