Peripheral nerve innervation of lower extremity

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  1. Sensory
    1. lateral cutaneous nerve of the thigh (L23)
      1. nerve travels beneath the inguinal ligament where it can be compressed causing meralgia paresthetica
      2. afftects the lateral aspect of the upper thigh
      3. treatment: conservative with steroids or physical therapy or cut lateral cutaneous nerve
    2. obturator nerve (L23)
      1. nerve runs along anterior portion of pelvis and exits medial to the femoral vein
      2. innervates proximal inner portion of thigh
    3. femoral nerve (L234)
      1. innervates distal 1/3 of the anteromedial aspect of the thigh
      2. also innervates the medial aspect of the lower leg via the saphenous nerve
    4. sciatic nerve (L45S123)
      1. comprised of two main nerves – common peroneal (L45S12) and tibial (L45S123)
        1. peroneal most commonly injured
          1. peroneal has two divisions: superficial and deep; if the superficial branch is involved then there will be hypalgesia on the anterolateral aspect of the foot
          2. if the deep division is affected there will be weakness in dorsiflexion and inversion of the foot with a sensory loss between the web area of the first two toes
        2. tibial nerve
          1. innervates the flexors of the foot and plantar flexion of the ankle; lesions affect plantar flexion of ankle and flexion of toes
  2. Motor
    1. iliopsoas; L23; femoral nerve; hip flexion
    2. quadriceps femoris; L34; femoral nerve; knee extension
    3. adductor longus; L3; obturator nerve
    4. gluteus medius/minimus (thigh abduction and medial rotation); L5; superior gluteal nerve
    5. gluteus maximum (thigh abduction with patient prone);S1; inferior gluteal nerve Remember: inferior gluteal nerve comes out underneath piriformis muscle while superior gluteal nerve comes out above the piriformis muscle
    6. biceps femoris; S1; sciatic nerve; hip extension
    7. tibialis anterior (dorsiflexion and inversion); L4; deep peroneal nerve
    8. extensor hallicus longus; L5; deep peroneal
    9. peroneus longus and brevis; (plantar flexion and eversion); L5; superficial peroneal nerve Remember: superficial peroneal nerve is lateral to deep peroneal nerve and tibial nerve is posterior to both
    10. posterior tibialis (plantar flexion and inversion); L4; tibial nerve
    11. gastrocnemius; S1; tibial nerve; plantar flexion
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