FEMORAL NERVE INJURY - PowerPoint PPT Presentation

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FEMORAL NERVE INJURY
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FEMORAL NERVE INJURY

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

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

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

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

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

  6. SCIATIC NERVE INJURY • Causes : • 1. Badly placed intramuscular injection.

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

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

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

  10. SCIATICA • It is pain in the leg extending from the buttock towards the heel. • Causes : • Pressure on the sciatic nerve or its roots by prolapsed intervertebral disc (L4-5) or cancer deposits adjacent to the nerve.

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

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

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

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

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

  16. DEEP PERONEAL NERVE INJURY • Motor : • 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.

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

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

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

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

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

  22. THANK YOU BEST WISHES