Practice Paper 4: Answers
Anthony B. Starr, Hiruni Jayasena, David Capewell, Saran Shantikumar in Get ahead! Medicine, 2016
The saphenous nerve can be damaged during surgery on the long saphenous vein, particularly when the vein is stripped below the knee, resulting in loss of sensation to the medial aspect of the calf. The sural nerve is a cutaneous sensory branch of the tibial nerve, and can be damaged during surgery on the short saphenous vein. Lesions of the sural nerve result in a loss of sensation to the lateral side of the foot and little toe. The obturator nerve can be damaged in obstetric procedures and pelvic disease. Features of obturator nerve palsy include loss of hip adduction and loss of sensation to the upper inner thigh. Superior gluteal nerve lesions result in loss of hip abduction and a pelvic dip on walking (Trendelenburg gait). Inferior gluteal nerve lesions lead to loss of hip extension and to buttock wasting.
Diseases of the Peripheral Nerve and Mononeuropathies
Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw in Hankey's Clinical Neurology, 2020
Course of the inferior gluteal nerve: Arises from the L5, S1, and S2 nerve roots.Descends through the infrapiriform foramen, dorsolateral to the sciatic nerve.Innervates the gluteus maximus muscle.
Successful restoration of knee extension after transferring of the anterior branch of the obturator nerve: a case study
Published in International Journal of Neuroscience, 2022
Mohammadreza Emamhadi, Iraj Aghaei, Sama Noroozi Guilandehi, Roxana Emamhadi, Mohammad Shabani
In one study, Campbell et al. (2010) transferred the main trunk of obturator nerve to entire femoral nerve in a retroperitoneal schwannoma. Although the patient has regained 4/5 muscle strength in knee extension and almost normal gait, loss of adductor muscle function occurred [13]. Since the cooptation was performed on the entire femoral nerve, including the sensory branch, some motor fiber might have been lost. In our case study, adductor function preserved. We chosed the anterior obturator nerve as the donor nerve in order to preserve the potential adductor muscle function, that contribute to thigh adduction such as inferior fibers of gluteus Maximus (inferior gluteal nerve), quadratus femoris (sacral plexus) in addition to those served exclusively by the obturator nerve [10]. So that sacrificing anterior branch of obturator nerve (that innervates gracile and adductor longus muscles) should not lead to complete loss of adduction due to preserved adductor function of several other leg adductors.
Related Knowledge Centers
- Coccygeal Plexus
- Lumbar Nerves
- Lumbosacral Trunk
- Motor Neuron
- Spinal Nerve
- Pelvis
- Gluteus Maximus
- Ventral Ramus of Spinal Nerve
- Sacral Spinal Nerve 1
- Sacral Spinal Nerve 2