FEMORAL NERVE INJURYFEMORAL NERVE INJURY ((AA ) )MotorMotor

11.. Wasting of the Wasting of the quadriceps femorisquadriceps femoris..

22.. Loss of knee Loss of knee extensionextension..This can be compensated This can be compensated

by the adductors in by the adductors in walkingwalking..

33.. Some loss of hip Some loss of hip flexionflexion ( iliacus & pectineus)( iliacus & pectineus)..

FEMORAL NERVE INJURYFEMORAL NERVE INJURY

((BB ) )Sensory Loss Sensory Loss OverOver::

11.. The The frontfront and and medial medial side of the side of the thigh (anterior and thigh (anterior and medial cutaneous medial cutaneous nerves of the nerves of the thigh)thigh)..

FEMORAL NERVEFEMORAL NERVE

22.. The medial side The medial side of the lower part of of the lower part of the legthe leg..

33.. The medial The medial border of the foot border of the foot as far as the ball of as far as the ball of the big toe the big toe (Saphenous nerve)(Saphenous nerve)..

OBTURATOR NERVE INJURYOBTURATOR NERVE INJURY

CausesCauses: : Pressure of the fetal Pressure of the fetal

head during labourhead during labour..Pelvic wall malignancyPelvic wall malignancy..

MotorMotor: : IncompleteIncomplete loss of loss of

adduction ( ischial part adduction ( ischial part of adductor magnus is of adductor magnus is functioning)functioning)..

OBTURATOR NERVE INJURYOBTURATOR NERVE INJURY

Sensory lossSensory loss: : Minimal over the Minimal over the

middle of the medial middle of the medial thighthigh..

SCIATIC NERVE INJURYSCIATIC NERVE INJURY

CausesCauses: : 11.. Badly placed Badly placed

intramuscular intramuscular injectioninjection..

SCIATIC NERVE INJURYSCIATIC NERVE INJURY

22.. Posterior Posterior dislocation of the dislocation of the hip jointhip joint..

33.. Fracture of the Fracture of the pelvispelvis..

SCIATIC NERVE INJURYSCIATIC NERVE INJURY

MotorMotor: : 11.. Marked Marked wastingwasting of the of the

muscles below the kneemuscles below the knee..22.. Weak flexionWeak flexion of the of the

knee ( sartorius & gracilis knee ( sartorius & gracilis are functioning)are functioning)..

33.. The foot assumes the The foot assumes the position of position of foot dropfoot drop (planter flexed position) by (planter flexed position) by its weightits weight..

SCIATIC NERVE INJURYSCIATIC NERVE INJURY

Sensory lossSensory loss: : Below the kneeBelow the knee..

EXCEPTEXCEPT: : The area supplied The area supplied

by the by the SaphenousSaphenous nervenerve..

TrophicTrophic ulcers in ulcers in the solethe sole..

SCIATICASCIATICA

It is pain in the leg It is pain in the leg extending from the extending from the buttock towards the heelbuttock towards the heel..

CausesCauses: : Pressure on the sciatic Pressure on the sciatic

nerve or its roots by nerve or its roots by prolapsed intervertebral prolapsed intervertebral disc (L4-5) or cancer disc (L4-5) or cancer deposits adjacent to the deposits adjacent to the nervenerve..

SCIATICASCIATICA

DiagnosisDiagnosis: : 11.. Straight leg raising Straight leg raising

is diminished by the is diminished by the pain of sciaticapain of sciatica..

22.. Sensory loss over Sensory loss over the lateral side of the the lateral side of the legleg. .

33.. Loss of ankle Loss of ankle reflexreflex..

COMMON PRONEAL NERVE COMMON PRONEAL NERVE INJURYINJURY

It is the most liable nerve It is the most liable nerve to be injured in the to be injured in the lower limb. Because of lower limb. Because of its superficial positionits superficial position . .

The nerve may be The nerve may be severed during fracture severed during fracture of the neck of fibula or of the neck of fibula or when the knee joint is when the knee joint is injured or dislocatedinjured or dislocated . .

COMMON PRONEAL NERVE COMMON PRONEAL NERVE INJURYINJURY

MotorMotorLoss ofLoss of::

11 . .DorsiflexionDorsiflexion (extensor muscles) (extensor muscles) 2. 2. EversionEversion ( peronei)( peronei) . .

The The foot – dropsfoot – drops..And becomes And becomes

invertedinverted..

COMMON PRONEAL NERVE COMMON PRONEAL NERVE INJURYINJURY

The toes The toes dragdrag on the on the floor in walkingfloor in walking..

The patient has to The patient has to raise his foot high to raise his foot high to keep the toes from keep the toes from hitting the groundhitting the ground..

The foot comes down The foot comes down suddenlysuddenly . .

COMMON PRONEAL NERVE COMMON PRONEAL NERVE INJURYINJURY

Sensory loss Sensory loss overover::

11.. Lateral and Lateral and anterior sides of anterior sides of the legthe leg..

22.. Dorsum of the Dorsum of the foot and toesfoot and toes..

33.. Medial side of Medial side of the big toethe big toe . .

DEEP PERONEAL NERVE DEEP PERONEAL NERVE INJURYINJURY

MotorMotor: : Loss of Loss of dorsiflexiondorsiflexion of of

the foot and toes. The the foot and toes. The foot becomes foot becomes planter planter flexedflexed and and inverted inverted because of the because of the unopposed action of unopposed action of Tibialis posteriorTibialis posterior..

An attitude referred to An attitude referred to as as EquinovarusEquinovarus..

DEEP PERONEAL NERVE DEEP PERONEAL NERVE INJURYINJURY

Sensory LossSensory Loss: : Between the first Between the first

and second toesand second toes..

SUPERFICIAL PERONEAL SUPERFICIAL PERONEAL NERVE INJURYNERVE INJURY

MotorMotor: : EvertionEvertion by the by the

peroni is lostperoni is lost..The foot becomes The foot becomes

invertedinverted..

SUPERFICIAL PERONEAL SUPERFICIAL PERONEAL NERVE INJURYNERVE INJURY

Sensory LossSensory Loss: : 11.. Lateral side of Lateral side of

the legthe leg..22.. Dorsum of the Dorsum of the

foot and toesfoot and toes..33.. Medial side of Medial side of

the big toethe big toe . .

TIBIAL NERVE INJURYTIBIAL NERVE INJURY

MotorMotor: : All the muscles in the All the muscles in the

back of the leg and back of the leg and sole of the foot are sole of the foot are paralysedparalysed..

The foot is The foot is dorsiflexeddorsiflexed and and evertedeverted..

An attitude referred to An attitude referred to as as CalcaneovalgusCalcaneovalgus..

TIBIAL NERVE INJURYTIBIAL NERVE INJURY

Sensory loss Sensory loss overover: :

11 . .Lateral side of Lateral side of the leg and footthe leg and foot..

22 . .Trophic ulcers in Trophic ulcers in the solethe sole..

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