T2 L13: Lower limb nerve injuries and compression syndrome (RC)
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Questions and Answers

Which nerve is responsible for hip flexion?

  • Femoral nerve (correct)
  • Deep peroneal nerve
  • Sciatic nerve
  • Tibial nerve

    • Which nerve is responsible for knee extension?

  • Sciatic nerve
  • Deep peroneal nerve
  • Tibial nerve
  • Femoral nerve (correct)

    • Which nerve is responsible for ankle dorsiflexion?

  • Femoral nerve
  • Tibial nerve
  • Deep peroneal nerve (correct)
  • Superficial peroneal nerve

    • Which nerve is responsible for ankle plantar flexion?

    <p>Tibial nerve</p> Signup and view all the answers

    Which nerve is responsible for ankle inversion?

    <p>Tibialis posterior</p> Signup and view all the answers

    Which nerve is responsible for knee flexion?

    <p>Sciatic nerve</p> Signup and view all the answers

    Which nerve is responsible for hip extension?

    <p>Inferior gluteal nerve</p> Signup and view all the answers

    Which nerve is responsible for ankle eversion?

    <p>Superficial peroneal nerve</p> Signup and view all the answers

    Which nerve is responsible for sensory loss in the thigh?

    <p>Lateral cutaneous nerve</p> Signup and view all the answers

    Which nerve is responsible for sensory loss in the dorsum of the foot?

    <p>Superficial peroneal nerve</p> Signup and view all the answers

    Which of the following is NOT a common cause of peripheral neuropathy?

    <p>Hypertension</p> Signup and view all the answers

    What is the other name for Guillain Barre syndrome?

    <p>Acute inflammatory demyelinating polyneuropathy</p> Signup and view all the answers

    Which of the following is NOT a symptom of Guillain Barre syndrome?

    <p>Fever</p> Signup and view all the answers

    Which type of peripheral neuropathy specifically affects the population of neurons?

    <p>Neuronopathy</p> Signup and view all the answers

    What is compartment syndrome?

    <p>An increase in pressure within a myofascial compartment</p> Signup and view all the answers

    Which of the following is NOT a common site for compartment syndrome?

    <p>Chest</p> Signup and view all the answers

    What is the consequence of untreated compartment syndrome?

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

    Which muscles are commonly affected in acute anterior compartment syndrome of the leg?

    <p>Tibialis anterior</p> Signup and view all the answers

    What are the signs of compartment syndrome?

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

    What is the management of acute compartment syndrome?

    <p>Surgical intervention</p> Signup and view all the answers

    Which nerve roots are involved in lower limb nerve injuries?

    <p>Lumbar and sacral plexus</p> Signup and view all the answers

    What is the common cause of foot drop?

    <p>Peripheral neuropathy</p> Signup and view all the answers

    What are the common causes of peripheral neuropathy?

    <p>Multiple sclerosis and chronic inflammatory demyelinating polyradiculopathy</p> Signup and view all the answers

    What is the differential diagnosis of foot drop?

    <p>L5 and S1 nerve root impingement</p> Signup and view all the answers

    What are the landmarks for lumbar puncture?

    <p>L1 and L2</p> Signup and view all the answers

    What are the symptoms of cauda equina syndrome?

    <p>More severe pain and bilateral sensory disturbance</p> Signup and view all the answers

    What are the symptoms of conus medullaris syndrome?

    <p>Perineum, thighs, and legs pain</p> Signup and view all the answers

    What are the causes of compressive peripheral neuropathy?

    <p>Disc herniation and epidural abscess</p> Signup and view all the answers

    What are the causes of non-compressive peripheral neuropathy?

    <p>Multiple sclerosis and chronic inflammatory demyelinating polyradiculopathy</p> Signup and view all the answers

    What nerve root is usually impinged in sciatica?

    <p>L5</p> Signup and view all the answers

    What is the main focus of the lecture?

    <p>Lower limb nerve injuries</p> Signup and view all the answers

    What is the purpose of discussing foot drop in the lecture?

    <p>To discuss a common presentation of lower limb nerve injuries</p> Signup and view all the answers

    Where does the majority of people's spinal cord end?

    <p>L1</p> Signup and view all the answers

    What are the learning objectives of the lecture?

    <p>To understand the pathology of compartment syndrome</p> Signup and view all the answers

    Which nerve root is predominantly responsible for ankle jerk reflex?

    <p>S1</p> Signup and view all the answers

    Which nerve is responsible for knee flexion?

    <p>Sciatic nerve</p> Signup and view all the answers

    Which nerve is responsible for ankle dorsiflexion?

    <p>Peroneal nerve</p> Signup and view all the answers

    Which nerve root is predominantly responsible for knee extension?

    <p>L3</p> Signup and view all the answers

    Which nerve is responsible for hip flexion?

    <p>Femoral nerve</p> Signup and view all the answers

    What is the common cause of femoral nerve damage?

    <p>Fractures of the pubic ramus</p> Signup and view all the answers

    Which nerve is responsible for knee extension?

    <p>Sciatic nerve</p> Signup and view all the answers

    What is the main cause of sciatic nerve injuries?

    <p>Major trauma</p> Signup and view all the answers

    Which nerve is responsible for supplying sensation to the lateral border of the foot?

    <p>Common peroneal nerve</p> Signup and view all the answers

    Which nerve is vulnerable to fractures of the tibia and cysts and hemorrhages behind the knee?

    <p>Sciatic nerve</p> Signup and view all the answers

    Which nerve is commonly compressed when crossing the legs, leading to difficulty in walking and foot numbness?

    <p>Common peroneal nerve</p> Signup and view all the answers

    What is the easiest and safest nerve to biopsy for nerve biopsy procedures?

    <p>Common peroneal nerve</p> Signup and view all the answers

    What is the most common cause of compressive lesions at the level of the conus medullaris?

    <p>Disc herniation</p> Signup and view all the answers

    Which inflammatory condition specifically affects the peripheral nerves and can also involve the spinal cord?

    <p>Chronic inflammatory demyelinating polyneuropathy</p> Signup and view all the answers

    What is the main symptom experienced by individuals with entrapment of the L5 or S1 nerve roots?

    <p>Sciatica</p> Signup and view all the answers

    Which nerve root is more likely to be affected in compressive lesions at the level of the conus medullaris?

    <p>S1</p> Signup and view all the answers

    Which of the following is a potential cause of foot drop?

    <p>A lesion in the motor cortex</p> Signup and view all the answers

    What would be the presentation of a foot drop caused by a lesion in the motor cortex?

    <p>Weakness of the entire foot</p> Signup and view all the answers

    What type of lesion could potentially cause a foot drop?

    <p>A focal spinal cord lesion</p> Signup and view all the answers

    What would be the presentation of a foot drop caused by a focal spinal cord lesion?

    <p>Weakness of the entire foot</p> Signup and view all the answers

    Which nerve roots could be involved in lower limb nerve injuries causing foot drop?

    <p>L4-L5</p> Signup and view all the answers

    Which muscles are commonly affected in acute anterior compartment syndrome of the leg?

    <p>Ankle dorsiflexors</p> Signup and view all the answers

    What is the main difference in pain presentation between quarter and CONUS lesions?

    <p>Quarter lesions tend to have more ridiculous shooting electrical pain, while CONUS lesions tend to have less pain</p> Signup and view all the answers

    What is the difference in sensory disturbance between quarter and CONUS lesions?

    <p>Quarter lesions tend to have asymmetric sensory disturbance, while CONUS lesions tend to have symmetric sensory disturbance</p> Signup and view all the answers

    What is the difference in motor loss between quarter and CONUS lesions?

    <p>Quarter lesions tend to have symmetric motor loss, while CONUS lesions tend to have asymmetric motor loss</p> Signup and view all the answers

    What is the main difference in pain intensity between quarter and CONUS lesions?

    <p>Quarter lesions tend to be more painful, while CONUS lesions tend to be less painful</p> Signup and view all the answers

    Study Notes

    Nerve Functions

    • Hip flexion is primarily controlled by the femoral nerve.
    • Knee extension is facilitated by the femoral nerve.
    • Ankle dorsiflexion is managed by the deep peroneal nerve.
    • Ankle plantar flexion is regulated by the tibial nerve.
    • Ankle inversion is innervated by the tibial nerve.
    • Knee flexion is handled by the sciatic nerve.
    • Hip extension involves the sciatic nerve.
    • Ankle eversion is controlled by the superficial peroneal nerve.

    Sensory Loss and Neuropathy

    • Sensory loss in the thigh is commonly associated with the femoral nerve.
    • Sensory loss over the dorsum of the foot relates to the deep peroneal nerve.
    • Diabetes is commonly known to cause peripheral neuropathy, while Guillain-Barré syndrome is another name for itself.
    • Symptoms of Guillain-Barré syndrome typically include muscle weakness and tingling.
    • The type of peripheral neuropathy that specifically affects neurons is termed axonopathy.

    Compartment Syndrome

    • Compartment syndrome refers to increased pressure within a muscle compartment, often leading to muscle and nerve damage.
    • Common sites for compartment syndrome include the leg, but the scapular region is NOT a typical site.
    • Untreated compartment syndrome can result in permanent muscle and nerve damage.
    • Commonly affected muscles in acute anterior compartment syndrome of the leg include tibialis anterior, extensor hallucis longus, and extensor digitorum longus.
    • Signs of compartment syndrome typically encompass pain, paresthesia, and pulselessness.
    • Management of acute compartment syndrome usually requires surgical intervention, typically fasciotomy.

    Nerve Root and Injury

    • Lumbosacral nerve roots involved in lower limb nerve injuries typically include L4, L5, S1, and S2.
    • The common cause of foot drop is peroneal nerve injury.
    • Causes of peripheral neuropathy are widespread and include systemic diseases, infections, and toxins.
    • Differential diagnosis of foot drop includes peroneal nerve palsy and muscle disorders.

    Spinal and Neurological Context

    • Landmarks for lumbar puncture include the L3-L4 or L4-L5 interspace.
    • Symptoms of cauda equina syndrome reflect severe lower back pain, loss of bowel and bladder control, and saddle anesthesia.
    • Conus medullaris syndrome presents with similar symptoms but may also lead to sudden onset weakness.
    • Compressive causes of peripheral neuropathy often arise from herniated discs or tumors, while non-compressive causes include diabetes and toxins.

    Specific Conditions and Complications

    • The nerve root usually impinged in sciatica is L5.
    • The majority of people's spinal cords end around the level of the L1-L2 vertebrae.
    • Common reasons for femoral nerve damage include hip dislocations and pelvic fractures.
    • The lateral border of the foot is supplied by the sural nerve.
    • The peroneal nerve is susceptible to injury from leg crossing or trauma behind the knee.

    Nerve Biopsy and Peripheral Nerve Conditions

    • The sural nerve is the easiest and safest for nerve biopsy procedures.
    • The most common cause of compressive lesions at the conus medullaris is likely related to herniated discs.
    • Various inflammatory conditions that can affect peripheral nerves include Guillain-Barré syndrome.
    • Individuals with entrapment of the L5 or S1 nerve roots often experience radiating pain down the leg.
    • Foot drop may present variably depending on the site of the lesion, with motor cortex lesions presenting differently than focal spinal cord lesions.

    Presentation Variations

    • Differences in pain between quarter and conus lesions can manifest in varying intensities and distributions of sensory and motor loss.
    • Motor loss in the quarter syndrome may be more pronounced in the distribution of the affected nerve root, while conus lesions may lead to more diffuse weakness.

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    T2 L13. Lower limb nerve injuries and compression syndrome (RC)(2).ppt

    Description

    Test your knowledge on lower limb nerve injuries and compartment syndrome with this quiz. Learn about nerve roots, cauda equina, lumbar and sacral plexus, common patterns of lower limb nerve injury, differential diagnosis of foot drop, common causes of peripheral neuropathy, and diagnosis and management of compartment syndrome. Get ready to expand your understanding of these important topics in neurology.

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