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Questions and Answers

What is a common complication of intramuscular injections in the gluteal region?

  • Improved venous absorption
  • Enhanced nerve function
  • Hematoma (correct)
  • Increased muscle size

    • Which clinical feature indicates injury to the superior gluteal nerve when a person stands on one leg?

  • Foot drop
  • Increased hip extension
  • Weak knee flexion
  • Pelvic tilt on unsupported side (correct)

    • What type of injury can occur from penetrating wounds and bad intramuscular injections?

  • Sciatic nerve injury (correct)
  • Obturator nerve injury
  • Superior gluteal nerve injury
  • Deep fibular nerve entrapment

    • Which of the following muscles may still function despite a sciatic nerve injury?

    <p>Gracilis (A), Sartorius (C)</p> Signup and view all the answers

    Which nerve injury is characterized by paralysis of the hamstring muscles?

    <p>Sciatic nerve injury (D)</p> Signup and view all the answers

    In deep fibular nerve entrapment, which region is primarily affected?

    <p>Anterior aspect of the leg (C)</p> Signup and view all the answers

    Damage to which nerve would likely result in loss of adductor function in the thigh?

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

    What is a significant consequence of injury to the tibial nerve?

    <p>Weak plantar flexion of the foot (B)</p> Signup and view all the answers

    What is a common consequence of a sciatic nerve injury?

    <p>Development of trophic ulcers (C)</p> Signup and view all the answers

    Which of the following is NOT a cause of common fibular nerve injury?

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

    Deep fibular nerve entrapment is commonly referred to as which condition?

    <p>Ski boot syndrome (C)</p> Signup and view all the answers

    Which symptom is primarily associated with injury to the common fibular nerve?

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

    What type of paralysis results from damage to the common fibular nerve?

    <p>Flaccid paralysis of the anterior and lateral compartments (B)</p> Signup and view all the answers

    What feature indicates deep fibular nerve entrapment?

    <p>Dorsal foot pain radiating to the web space (D)</p> Signup and view all the answers

    Which nerve is responsible for sensation in the medial side of the lower leg and the medial border of the foot?

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

    What is a common clinical feature of sciatica?

    <p>Pain radiating from the lower back to the legs (B)</p> Signup and view all the answers

    Flashcards

    Superior Gluteal Nerve Injury

    Damage to the superior gluteal nerve, leading to weakened hip abduction, and a positive Trendelenburg test.

    Trendelenburg Test

    A clinical test used to diagnose superior gluteal nerve injury, showing pelvis tilting to the unsupported side when a leg is lifted.

    Sciatic Nerve Injury

    Damage to the sciatic nerve causing paralysis in hamstring muscles, and muscles below the knee, resulting in foot drop.

    Foot Drop

    Paralysis of muscles controlling foot movement, causing the foot to drop downwards.

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    Intramuscular Injection in Gluteal Region

    Injection of medication into the gluteus muscle. Should be done carefully to avoid nerve injuries.

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    Gluteus medius/minimus

    Hip abduction muscles. Important for stability during single leg stance.

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    Hip Replacement Surgery

    Surgical procedure to replace the hip joint.

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    Complication of Intramuscular Injection

    Potential issues after an intramuscular injection that could include nerve injury, hematoma (blood clot), or abscess formation.

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    Sciatica Pain

    Pain in the lower back that spreads to the hip, buttocks, and leg; worsened by sitting, coughing, or sneezing, accompanied by tingling and numbness along the posterior and lateral sides of the leg and lateral foot.

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    Sciatica Causes

    Intervertebral disc prolapse pressing on lower lumbar and sacral spinal nerves, spondylolisthesis, or pressure on the sciatic nerve by an intra-pelvic tumor.

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    Common Fibular Nerve Injury

    Damage to the common fibular nerve, often due to fractures of the fibular neck or knee dislocation, leading to foot drop and loss of ankle dorsiflexion, and foot eversion.

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    Deep Fibular Nerve Entrapment

    Nerve compression often from tight-fitting ski boots or excessive muscle use, leading to pain in the foot's dorsum (top) and web space between toes.

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    Sensory Loss in Saphenous Nerve

    Reduced or lost sensation below the knee, except for a small area along the medial side of the lower leg and foot.

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    Trophic Ulcers

    Skin sores that develop due to a lack of sensation in the sole of the foot.

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    Sciatic Nerve Repair Outcomes

    Operative repair of sciatic nerve injuries often results in incomplete recovery.

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    Study Notes

    Nerve Injuries of Lower Limb

    • Intramuscular Injection Sites: The gluteal region is a common intramuscular injection site due to the thick, large muscles, which provide a wide area for drug absorption.
    • Safe Injection Quadrant: Injections into the buttock are safest within the supero-lateral quadrant.
    • Injection Complications: Improper injection technique can lead to nerve injury, hematoma, and abscess formation.
    • Superior Gluteal Nerve Injury: Injury to the superior gluteal nerve (L4, L5, S1) can result from hip replacement surgery.
    • Clinical Presentation (Superior Gluteal Nerve): Weakened abduction of the hip joint due to gluteus medius and minimus muscle impairment is a key clinical feature. Weakness is observed when the patient stands on one leg, and the unsupported side's pelvis tilts. The Trendelenburg test is used to diagnose this clinically.
    • Sciatic Nerve Injury (L4, L5, S1, 2, 3): Located midway between the posterior superior iliac spine and ischial tuberosity, then midway between the greater trochanter and ischial tuberosity.
    • Sciatic Nerve Injury Causes: Possible causes include penetrating wounds, pelvic fractures, hip dislocations, and poorly placed intramuscular injections.
    • Sciatic Nerve Injury Clinical Presentation: Pain originates in the buttock and travels down the leg, potentially reaching the feet and toes. Weakness or paralysis of the knee is possible as well.
    • Common Fibular Nerve Injury (Foot Drop): This nerve winds around the fibular neck, making it susceptible to direct trauma.
    • Common Fibular Nerve Injury Causes: Causes include fibular neck fractures and knee dislocations.
    • Common Fibular Nerve Injury Clinical Features (Sensory): Loss of sensation in the lateral aspect of the leg, and the dorsum of the foot.
    • Common Fibular Nerve Injury Clinical Features (Motor): Results in paralysis of all muscles in the anterior and lateral compartments of the leg. A key sign is foot drop and loss of eversion of the foot.
    • Deep Fibular Nerve Entrapment (Ski Boot Syndrome): This condition results from excessive use of the deep fibular nerve-supplied muscles, such as during sporting activities (e.g., skiing, running). It can also be caused by compression from tight-fitting ski boots, occurring where the nerve passes deep to the inferior extensor retinaculum.
    • Deep Fibular Nerve Entrapment Clinical Presentation: Pain commonly presents on the dorsum of the foot, spreading towards the web space between the first and second toes.
    • Tibial Nerve Injury (L4, L5, S1, 2, 3): Uncommon, as it is situated in the popliteal fossa.
    • Tibial Nerve Injury Causes: Deep lacerations within the popliteal fossa and posterior knee dislocations.
    • Tibial Nerve Injury Clinical Presentation: Pain occurs on the dorsum of the foot and spreads toward the web space between the first and second toes.
    • Obturator Nerve Injury (L2, L3, L4): Rarely injured.
    • Obturator Nerve Injury Causes: Penetrating wounds, anterior hip dislocations, and pressure from the fetal head during labor.
    • Obturator Nerve Injury Clinical Features (Motor): Paralysis of all adductor muscles except the hamstring portion of adductor magnus, supplied by the sciatic nerve, and pectineus (by femoral nerve).
    • Obturator Nerve Injury Clinical Features (Sensory): Minimal cutaneous sensory loss on the medial aspect of the thigh.

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    Nerve Injuries of Lower Limb PDF

    Description

    This quiz focuses on various nerve injuries occurring in the lower limb, particularly related to intramuscular injections in the gluteal region. It covers complications, safe injection techniques, and the clinical presentation of superior gluteal and sciatic nerve injuries. Test your knowledge on these critical topics and enhance your understanding of nerve injury implications.

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