FEMORAL NERVE INJURY A Motor n 1 Wasting

FEMORAL NERVE INJURY (A) Motor n 1. Wasting of the n quadriceps femoris. 2. Loss of knee n extension. This can be compensated by the adductors in walking. 3. Some loss of hip n flexion ( iliacus & pectineus). n

FEMORAL NERVE INJURY (B) Sensory Loss Over: 1. The front and n medial side of the thigh (anterior and medial cutaneous nerves of the thigh). n

FEMORAL NERVE 2. The medial side n of the lower part of the leg. 3. The medial n border of the foot as far as the ball of the big toe (Saphenous nerve).

OBTURATOR NERVE INJURY Causes : n Pressure of the fetal n head during labour. Pelvic wall malignancy. Motor : n Incomplete loss of n adduction ( ischial part of adductor magnus is functioning). n

OBTURATOR NERVE INJURY Sensory loss : n Minimal over the n middle of the medial thigh.

SCIATIC NERVE INJURY Causes : n 1. Badly placed intramuscular injection. n

SCIATIC NERVE INJURY 2. Posterior n dislocation of the hip joint. 3. Fracture of the pelvis. n

SCIATIC NERVE INJURY Motor : n 1. Marked wasting of the muscles below the knee. 2. Weak flexion of the n knee ( sartorius & gracilis are functioning). 3. The foot assumes the n position of foot drop (planter flexed position) by its weight. n

SCIATIC NERVE INJURY Sensory loss : n Below the knee. n EXCEPT : n The area supplied n by the Saphenous nerve. Trophic ulcers in n the sole.

SCIATICA It is pain in the leg n extending from the buttock towards the heel. Causes : n Pressure on the sciatic n nerve or its roots by prolapsed intervertebral disc (L 4 -5) or cancer deposits adjacent to the nerve.

SCIATICA Diagnosis : n 1. Straight leg raising n is diminished by the pain of sciatica. 2. Sensory loss over n the lateral side of the leg. 3. Loss of ankle n reflex.

COMMON PRONEAL NERVE INJURY It is the most liable n nerve to be injured in the lower limb. Because of its superficial position. The nerve may be n severed during fracture of the neck of fibula or when the knee joint is injured or dislocated.

COMMON PRONEAL NERVE INJURY Motor n Loss of: n 1. Dorsiflexion n (extensor muscles) 2. Eversion ( peronei). The foot – drops. n And becomes n inverted.

COMMON PRONEAL NERVE INJURY The toes drag on the floor in walking. The patient has to n raise his foot high to keep the toes from hitting the ground. The foot comes down suddenly. n n

COMMON PRONEAL NERVE INJURY Sensory loss n over: 1. Lateral and n anterior sides of the leg. 2. Dorsum of the foot and toes. 3. Medial side of the big toe. n n

DEEP PERONEAL NERVE INJURY Motor : n 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. n n

DEEP PERONEAL NERVE INJURY Sensory Loss : Between the first and second toes. n n

SUPERFICIAL PERONEAL NERVE INJURY Motor : n Evertion by the n peroni is lost. The foot becomes n inverted.

SUPERFICIAL PERONEAL NERVE INJURY Sensory Loss : n 1. Lateral side of n the leg. 2. Dorsum of the n foot and toes. 3. Medial side of n the big toe.

TIBIAL NERVE INJURY Motor : n All the muscles in the back of the leg and sole of the foot are paralysed. The foot is n dorsiflexed and everted. An attitude referred to as Calcaneovalgus. n n

TIBIAL NERVE INJURY Sensory loss over : 1. Lateral side of n the leg and foot. 2. Trophic ulcers in the sole. n n

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