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Questions and Answers
Lower limb peripheral nerve injuries are more common than upper limb injuries due to the lumbar and sacral plexuses being more susceptible to damage.
Lower limb peripheral nerve injuries are more common than upper limb injuries due to the lumbar and sacral plexuses being more susceptible to damage.
False (B)
Damage to the femoral nerve always results in complete loss of knee extension and significant weakening of hip flexion.
Damage to the femoral nerve always results in complete loss of knee extension and significant weakening of hip flexion.
True (A)
Sciatic nerve damage from misplaced gluteal injections causes anaesthesia across the entire thigh and lower leg.
Sciatic nerve damage from misplaced gluteal injections causes anaesthesia across the entire thigh and lower leg.
False (B)
Foot drop is a primary indicator of damage to the tibial nerve, leading to paralysis of the foot's flexor muscles.
Foot drop is a primary indicator of damage to the tibial nerve, leading to paralysis of the foot's flexor muscles.
Damage to the common peroneal nerve is often caused by direct trauma or pressure from casts at the ankle.
Damage to the common peroneal nerve is often caused by direct trauma or pressure from casts at the ankle.
If the sciatic nerve is damaged at the hip due to trauma, paralysis of the hamstrings will always be easy to test.
If the sciatic nerve is damaged at the hip due to trauma, paralysis of the hamstrings will always be easy to test.
The saphenous nerve, a branch of the sciatic nerve, provides sensory innervation to the medial side of the leg.
The saphenous nerve, a branch of the sciatic nerve, provides sensory innervation to the medial side of the leg.
During surgical exploration, the sciatic nerve is accessed through an incision lateral to the long head of the biceps femoris.
During surgical exploration, the sciatic nerve is accessed through an incision lateral to the long head of the biceps femoris.
A patient with a complete femoral nerve lesion will be unable to extend their hip.
A patient with a complete femoral nerve lesion will be unable to extend their hip.
In cases of sciatic nerve injury, anaesthesia on the back of the thigh always accompanies anaesthesia below the knee.
In cases of sciatic nerve injury, anaesthesia on the back of the thigh always accompanies anaesthesia below the knee.
The superficial peroneal branch supplies the peroneus longus and brevis muscles located in the medial compartment of the leg.
The superficial peroneal branch supplies the peroneus longus and brevis muscles located in the medial compartment of the leg.
A common peroneal nerve lesion invariably results in significant sensory loss over the entire lower lateral aspect of the leg and dorsum of foot.
A common peroneal nerve lesion invariably results in significant sensory loss over the entire lower lateral aspect of the leg and dorsum of foot.
Testing for dorsiflexion is a method used in the diagnosis of damage to the tibial nerve.
Testing for dorsiflexion is a method used in the diagnosis of damage to the tibial nerve.
The common peroneal nerve can be accessed surgically by locating it posterior to the biceps femoris tendon within the popliteal fossa.
The common peroneal nerve can be accessed surgically by locating it posterior to the biceps femoris tendon within the popliteal fossa.
Damage to the tibial nerve commonly results in paralysis of the anterior tibialis muscle.
Damage to the tibial nerve commonly results in paralysis of the anterior tibialis muscle.
Surgical exposure of the tibial nerve in the popliteal fossa requires incising the biceps femoris tendon.
Surgical exposure of the tibial nerve in the popliteal fossa requires incising the biceps femoris tendon.
Impairment of the tibial nerve can be assessed by testing a patient's ability to stand on their heels.
Impairment of the tibial nerve can be assessed by testing a patient's ability to stand on their heels.
The saphenous nerve is vulnerable to iatrogenic injury during varicose vein surgery near the lateral malleolus.
The saphenous nerve is vulnerable to iatrogenic injury during varicose vein surgery near the lateral malleolus.
The sciatic nerve is more likely to be damaged during varicose vein surgery than the saphenous nerve.
The sciatic nerve is more likely to be damaged during varicose vein surgery than the saphenous nerve.
The common fibular nerve is another name for the common peroneal nerve.
The common fibular nerve is another name for the common peroneal nerve.
Flashcards
Lower Limb Nerve Injuries
Lower Limb Nerve Injuries
Less common in the lower limb than the upper; common peroneal nerve is most frequently injured.
Femoral Nerve Lesion
Femoral Nerve Lesion
Knee extension lost, weakened hip flexion, anaesthesia over the front of the thigh. Pain may extend to saphenous nerve area.
Sciatic Nerve Damage Causes
Sciatic Nerve Damage Causes
Misplaced gluteal injections or trauma to the hip are the common causes.
Sciatic Nerve Lesion Deficits
Sciatic Nerve Lesion Deficits
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Sciatic Nerve Lesion Sensory Loss
Sciatic Nerve Lesion Sensory Loss
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Area of Sciatic Nerve Supply
Area of Sciatic Nerve Supply
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Surgical Approach to Sciatic Nerve
Surgical Approach to Sciatic Nerve
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Common Peroneal Nerve Damage Causes
Common Peroneal Nerve Damage Causes
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Common Peroneal Nerve Lesion
Common Peroneal Nerve Lesion
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Frequency of Common Peroneal Nerve Injury
Frequency of Common Peroneal Nerve Injury
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Peroneus longus and brevis
Peroneus longus and brevis
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Common peroneal nerve lesion: Anaesthesia area
Common peroneal nerve lesion: Anaesthesia area
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Test for dorsiflexion
Test for dorsiflexion
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Surgical approach: Common peroneal nerve
Surgical approach: Common peroneal nerve
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Tibial nerve damage: Main effect
Tibial nerve damage: Main effect
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Test for tibial nerve function
Test for tibial nerve function
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Surgical approach: Tibial nerve
Surgical approach: Tibial nerve
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Saphenous nerve: Surgical risk
Saphenous nerve: Surgical risk
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Saphenous nerve damage location
Saphenous nerve damage location
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Varicose vein surgery
Varicose vein surgery
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Study Notes
- Peripheral nerve injuries are less common in the lower limb than in the upper limb
- Complete brachial plexus damage is rare in the lumbar and sacral plexuses
- The common peroneal nerve is the most frequently injured nerve in the lower limb
Femoral Nerve
- Damage is more likely from penetrating injuries in the lower abdomen than the limb itself due to the nerve breaking into branches upon entering the thing
- Pelvic masses such as haematoma or neoplasm can affect it
- Can be damaged by catheterization of the femoral artery
- Complete lesion leads to loss of knee extension by the quadriceps, and some weakness of hip flexion
- Anaesthesia occurs over the front of the thigh
- Pain may extend to the knee in lesions causing nerve pain
Sciatic Nerve
- Misplaced gluteal injections are a common cause of damage
- Other causes include pelvic disease and severe trauma to the hip (7% of dislocations, 16% of fracture dislocations)
- Paralysis of the hamstrings and all muscles of the leg and foot occurs due to tibial and common peroneal nerve involvement
- Foot drop is evident
- Anaesthesia occurs below the knee, excluding the medial side of the leg (supplied by the saphenous branch of the femoral nerve)
- Anaesthesia on the back of the thigh indicates damage to the posterior femoral cutaneous nerve
- The sciatic nerve only supplies skin below the knee via its main branches
- Assess plantarflexion and dorsiflexion
Surgical Approach to the Sciatic Nerve
- Explored via exposure at the lower border of gluteus maximus and medial to the long head of biceps
- Can be traced upwards or downwards from this point
Common Peroneal (Fibular) Nerve
- Direct trauma or pressure from plaster casts at the neck of the fibula makes it the most commonly damaged nerve in the lower limb
- Foot drop is the main sign, resulting from paralysis of extensor muscles supplied by the deep peroneal branch
- This causes a high-stepping gait, to avoid scraping the toes
- Peroneus longus and brevis are affected, due to the superficial peroneal branch
- Anaesthesia extends over the lower lateral leg and the dorsum of the foot
- Sensory loss may be minimal
- Test for dorsiflexion
Surgical Approach to the Common Peroneal (Fibular) Nerve
- Exposed by tracing it down from behind the biceps tendon on the lateral side of the popliteal fossa
Tibial Nerve
- Damage is uncommon
- Paralysis of the calf muscles occurs
- Test for standing on tiptoe
Surgical Approach to the Tibial Nerve
- Easily exposed in the popliteal fossa
- Can be followed lower down by splitting gastrocnemius and soleus vertically in the midline
Saphenous Nerve
- The lower part of the nerve, in front of the medial malleolus, is vulnerable during varicose vein surgery
- Damage can occur by inclusion in ligatures
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Description
Overview of femoral and sciatic nerve injuries, including causes such as penetrating injuries, pelvic masses, misplaced gluteal injections and trauma. Complete femoral nerve lesions lead to loss of knee extension and anesthesia over the front of the thigh. Sciatic nerve injuries can cause paralysis.
