Lower Extremity Nerves Overview

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Questions and Answers

Which nerve is responsible for providing sensation to the scrotum and labia majora?

  • Iliohypogastric
  • Obturator
  • Lateral Femoral Cutaneous
  • Genitofemoral (correct)

What is the primary motor function of the Superior Gluteal nerve?

  • Flexion of the hip
  • Adduction of the hip
  • Abduction of the hip (correct)
  • Extension of the hip

Which nerve is most commonly associated with the condition known as Meralgia Paresthetica?

  • Lateral Femoral Cutaneous (correct)
  • Iliohypogastric
  • Obturator
  • Femoral

Which of the following nerve injuries could result in a loss of sensation on the sole of the foot?

<p>Tibial (C)</p> Signup and view all the answers

Which nerve is responsible for providing motor innervation to the muscles involved in eversion of the foot?

<p>Common Peroneal (A)</p> Signup and view all the answers

Which of the following is NOT a potential cause of injury to the Obturator nerve?

<p>Piriformis syndrome (B)</p> Signup and view all the answers

What is the most common presenting symptom of a Lateral Femoral Cutaneous nerve injury?

<p>Decreased sensation in the anterolateral thigh (D)</p> Signup and view all the answers

Which of the following nerves is responsible for providing sensory innervation to the suprapubic region?

<p>Iliohypogastric (A)</p> Signup and view all the answers

Which of the following nerves is NOT involved in hip flexion?

<p>Superior Gluteal (D)</p> Signup and view all the answers

What is a common presentation of an injury to the Tibial nerve?

<p>Inability to flex the toes (D)</p> Signup and view all the answers

Which of the following is a potential cause of injury to both the Sciatic and Common Peroneal nerves?

<p>All of the above (D)</p> Signup and view all the answers

Which nerve is primarily responsible for the ability to extend the leg at the knee?

<p>Femoral (B)</p> Signup and view all the answers

What is a common sign of a Common Peroneal nerve injury?

<p>Inability to dorsiflex the foot (A)</p> Signup and view all the answers

Which of the following is NOT a common presentation associated with an injury to the Iliohypogastric nerve?

<p>Foot drop (A)</p> Signup and view all the answers

Which nerve is most likely to be affected by a posterior hip dislocation?

<p>Sciatic (B)</p> Signup and view all the answers

Which nerve is responsible for providing motor innervation to the muscles involved in plantarflexion of the foot?

<p>Tibial (B)</p> Signup and view all the answers

Which nerve is most directly involved in both hip flexion and knee extension?

<p>Femoral (B)</p> Signup and view all the answers

Which of the following nerves is NOT directly involved in the classic 'steppage gait' associated with foot drop?

<p>Superior Gluteal (B)</p> Signup and view all the answers

A patient presents with decreased sensation in the webspace between the big toe and second toe. Which nerve is most likely affected?

<p>Common Peroneal (A)</p> Signup and view all the answers

Which nerve is most frequently involved in surgical procedures within the pelvic region?

<p>Sciatic (C)</p> Signup and view all the answers

Which nerve is most likely responsible for the ability to perform the following movements: toe curling and foot inversion?

<p>Tibial (B)</p> Signup and view all the answers

Which nerve is most commonly affected by compression in a patient with pregnancy or obesity?

<p>Lateral Femoral Cutaneous (B)</p> Signup and view all the answers

Which nerve is directly affected by a herniated disc in the lumbar spine, potentially leading to leg pain and weakness?

<p>Sciatic (A)</p> Signup and view all the answers

A patient has difficulty extending their leg at the knee and reports pain in the anterior thigh. Which nerve is most likely involved based on this presentation?

<p>Femoral (D)</p> Signup and view all the answers

Which nerve is most likely to be affected by an injury to the leg that results in loss of sensation on the dorsal side of the foot (except for the webspace between the big toe and 2nd toe)?

<p>Common Peroneal (D)</p> Signup and view all the answers

Which nerve is most commonly associated with burning or tingling pain in the suprapubic region, often radiating to the groin?

<p>Iliohypogastric (A)</p> Signup and view all the answers

A patient has difficulty plantarflexing their foot and reports pain in the calf. Which nerve is most likely involved?

<p>Tibial (D)</p> Signup and view all the answers

Which nerve is most likely to be affected by a pelvic fracture, leading to loss of sensation on the medial thigh?

<p>Obturator (D)</p> Signup and view all the answers

Which TWO nerves are most commonly affected by compression from a tight clothing or obesity?

<p>Iliohypogastric (A), Lateral Femoral Cutaneous (C)</p> Signup and view all the answers

Which nerve is MOST likely affected in a patient with an inability to flex their knee and pain radiating down the posterior aspect of the thigh and leg?

<p>Sciatic (C)</p> Signup and view all the answers

Which nerve is responsible for innervating the muscles responsible for hip abduction?

<p>Superior Gluteal (B)</p> Signup and view all the answers

Which nerve is most likely to be damaged in a patient presenting with fecal incontinence and loss of sensation in the perineum?

<p>Pudendal (D)</p> Signup and view all the answers

Flashcards

Iliohypogastric Nerve

Innervates transversus abdominis and internal oblique, supplies suprapubic region sensory.

Genitofemoral Nerve

Innervates cremaster muscle, provides sensation to scrotum/labia majora and medial thigh.

Lateral Femoral Cutaneous Nerve

Supplies sensory to anterior and lateral thigh, no motor innervation.

Obturator Nerve

Motor innervation to adductor muscles and sensory to medial thigh.

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Femoral Nerve

Innervates quadriceps and provides sensation to anterior thigh and medial leg.

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Sciatic Nerve

Innervates hamstring muscles and splits into common peroneal and tibial nerves; varies in sensation.

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Common Peroneal Nerve

Sensory to dorsum of foot; motor to peroneus longus and tibialis anterior.

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Tibial Nerve

Supplies motor to posterior leg muscles and sensory to sole of foot.

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Superior Gluteal Nerve

Innervates gluteus medius, gluteus minimus; important for hip stabilization.

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Inferior Gluteal Nerve

Innervates gluteus maximus, involved in hip extension.

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Pudendal Nerve

Sensory to perineum; motor to sphincters for bowel and bladder control.

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Meralgia Paresthetica

Condition caused by compression of lateral femoral cutaneous nerve, causing thigh numbness.

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Steppage Gait

Gait abnormality caused by common peroneal nerve injury, leading to foot drop.

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Pelvic Fracture

Injury affecting multiple lower extremity nerves, influencing function and sensation.

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Compression Syndromes

Nerve problems often caused by hematomas or muscle compression in lower extremities.

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Iliohypogastric Nerve Injury

Caused by surgery, tight clothing; leads to pain in suprapubic area.

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Genitofemoral Nerve Functions

Provides sensations to scrotum/labia and innervates cremaster muscle.

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Lateral Femoral Cutaneous Nerve Injury

Results from compression; affects sensory in anterior/lateral thigh.

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Obturator Nerve Functions

Innervates adductor muscles; sensory to medial thigh.

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Femoral Nerve Injury Causes

Injury can occur from pelvic surgery, fractures, or compression.

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Sciatic Nerve Split

Divides into common peroneal and tibial nerves; affects leg sensation.

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Common Peroneal Nerve Effects

Injury causes loss of dorsiflexion and eversion; steppage gait.

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Tibial Nerve Functions

Innervates muscles of the back of the leg; sensation on the foot's sole.

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Superior Gluteal Nerve Role

Innervates gluteus medius and minimus for hip stability.

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Inferior Gluteal Nerve Functions

Innervates gluteus maximus for hip extension during movement.

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Pudendal Nerve Importance

Sensation in perineum and motor control for urination and defecation.

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Meralgia Paresthetica Symptoms

Condition from lateral femoral cutaneous nerve compression; thigh numbness.

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Steppage Gait Cause

Gait abnormality from common peroneal nerve injury; foot drop.

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Pelvic Fracture Effects

May impact multiple lower extremity nerves leading to loss of function.

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Compression Syndromes Overview

Nerve issues from hematomas or muscle pressure in lower extremities.

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Study Notes

Lower Extremity Nerves

  • Iliohypogastric nerve (T12-L1):

    • Sensory: Suprapubic region
    • Motor: Transversus abdominis, internal oblique
  • Genitofemoral nerve (L1-L2):

    • Sensory: Scrotum/labia majora, medial thigh
    • Motor: Cremaster
  • Lateral femoral cutaneous nerve (L2-L3):

    • Sensory: Anterior and lateral thigh
  • Obturator nerve (L2-L4):

    • Sensory: Medial thigh
    • Motor: Obturator externus, adductor longus, adductor brevis, gracilis, pectineus, adductor magnus
  • Femoral nerve (L2-L4):

    • Sensory: Anterior thigh, medial leg
    • Motor: Quadriceps, iliacus, pectineus, sartorius, semitendinosus, semimembranosus, biceps femoris, adductor magnus
  • Sciatic nerve (L4-S3):

    • Splits into common peroneal and tibial nerves.
    • Sensory: Dorsum of foot (except webspace between hallux and 2nd digit), deep peroneal nerve sensory webspace between hallux and 2nd digit, tibial nerve sensory sole of foot.
    • Motor: Semitendinosus, semimembranosus, biceps femoris; deep peroneal nerve motor tibialis anterior, superficial peroneal nerve motor peroneus longus and brevis.
  • Common (Fibular) peroneal nerve (L4-S2):

    • Sensory: Dorsum of foot (except webspace between hallux and 2nd digit), sensory webspace between hallux and 2nd digit.
    • Motor: Peroneus longus and brevis
  • Tibial nerve (L4-S3):

    • Sensory: Sole of foot
    • Motor: Biceps femoris (long head), triceps surae, plantaris, popliteus, flexor muscles of foot
  • Superior gluteal nerve (L4-S1):

    • Motor: Gluteus medius, gluteus minimus, tensor fascia latae
  • Inferior gluteal nerve (L5-S2):

    • Motor: Gluteus maximus
  • Pudendal nerve (S2-S4):

    • Sensory: Perineum
    • Motor: External urethral and anal sphincters

Lower Extremity Nerve Injuries - Cause & Presentation

  • Causes: Abdominal surgery, laparoscopic surgery, tight clothing, obesity, pregnancy, pelvic procedures, pelvic fracture, compression from retroperitoneal hematoma, psoas abscess, herniated disc, posterior hip dislocation, piriformis syndrome, trauma or compression of lateral aspect of leg, fibular neck fracture, knee trauma, Baker cyst, tarsal tunnel syndrome.

    • Specific causes may include iatrogenic injury during intramuscular injection.
  • Presentation/Comments (varies per nerve):

    • Burning or tingling pain (may radiate); decreased thigh sensation; absent cremasteric reflex; meralgia paresthetica; numbness; tingling; thigh sensation loss; adduction loss; leg extension loss; patellar reflex loss; loss of sensation on dorsum of foot (steppage gait, foot drop); inverted and plantarflexed foot at rest; loss of eversion; loss of dorsiflexion; inability to curl toes; foot everted at rest with weakened inversion and plantar flexion; loss of sensation on sole; Trendelenburg gait (pelvis tilts, difficulty climbing stairs, difficulty rising from seated position, loss of hip extension); sensation loss in perineum and genital area (possible fecal/urinary incontinence).
    • Presentation may include lower extremity pain, radiating pain, loss of sensation, weakness in muscles, and specific gait abnormalities.

Important Note

  • Specific presentations depend on the affected nerve, location, and specific cause.
  • Injuries require accurate diagnosis and treatment.
    • Iatrogenic injuries can be prevented by choosing an appropriate injection site.

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