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Orthopaedic

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Nerve Injuries

Question
45 out of 51
 

40 yr old man lifted something heavy and then he had pain on lateral aspect of Leg and great TOE diagnosis (AIIMS Nov 2011)



A L3 L4 disc prolapsed
B L4 L5 disc prolapse

C L5 S1 disc prolapsed
D L2-L3 disc prolapsed

Ans. B

L4 L5 disc prolapse

Compression level

Symptoms and signs

L4 – Weakness of quadriceps muscle

– Knee (patellar) reflex is depressed or absent

– Medial aspect of knee, leg and ankle –sensory loss

L5 – Wasting of glutei and dorsiflexors of foot

-–weakness of knee flexion and big toe extension

– Knee and ankle jerks are normal. Paradoxically knee (quadriceps) reflex may appear to be increased because of weakness of antagonist (which are supplied by L5)

– Lateral aspect of lower thigh, anterolateral aspect of knee and leg and dorsum of foot and covers big toe and one or more adjacent toes (i.e. 1st web space) but never little toe –sensory loss

S1 – Wasting of glutei, hamstring and calf muscles,

– Weakness of eversion and plantar flexion of foot and toes

– Ankle jerk is reduced or absent

– Lateral border of foot and little toe (never big toe) –sensory loss

Nerve Injuries Flashcard List

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