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3 Cards in this Set
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- Back
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Tibial nerve injury - motor loss |
Tibial nerve Posterior Compartment of the leg: [Superficial] - Gastrocnemius, Soleus, Plantaris [Deep] - Popliteus, Flexor hallucis longus, flexordigitorum longus, & Tibialis posterior *Loss of: plantarflexion, foot inversion; Partial loss of flexion of phalanges (NOTE: complete loss due to injury to M+L Plantar nerves) Medial plantar nerve Abductorhallucis, flexor digitorum brevis, medial lumbrical (x1), flexor hallucisbrevis *Loss of: flexion of toes, abduction of great toe Lateral plantar nerve Abductor digiti minimi, quadratusplantae, adductor hallucis, flexor digiti minimi brevis, lateral 3 lumbricals, dorsal& plantar interossei mm. *Loss of: flexion, abduction, & adduction of digits 2-5 |
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Tibial nerve injury - sensory loss |
Medial sural cutaneous nerve - smallstrip of posterior leg Medial calcaneal branches of tibial nerve - calcaneal/heel area Medial plantar nerve - supplies plantar aspect of medial foot and 3½ digits,plus sides and distal dorsal aspects of those digits Lateral plantar nerve - supplies skin on plantaraspect lateral to a line splitting 4th digit, as well asdistal dorsal aspect of lateral 1½ toes |
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Tibial nerve injury - gait dysfunction |
Loss of plantar flexion translatesto being unable to push-off from the forefoot, Pre-swing phase. ·When there is weak push-off (often called anapropulsive gait), the stride length will be reduced, and gait velocity falls ·Gastrocsoleus weakness results in loss of ankle dorsiflexioncontrol. *Heel off will be delayed and the push off phasewill be decreased. This results in a lag of forward movement of the pelvis onthe unaffected side at the time of heelstrike and on the affected side during pushoff. *There will be a shortening of the stride on the unaffectedside due to the delay of forward movement of the ipsilateral hip. Alteredground reactive forces lead to a flexion moment behind the knee, which canresult in knee buckling Loss of proprioception of the soleof the foot can lead to a sensory gait (stomping gait), where patient willstomp hard on the ground to be able to sense where their feet/foot lands. Loss of innervation to theintrinsic foot muscles & tibialis posterior will cause the foot to flatten,via losing muscular support of the arches Loss of innervation to tibialisposterior m. results in loss of inversion, leading to a valgul deformity of thefoot/ankle due to dominance of eversion via properly functioning tibialisanterior ·Valgus deformity is a condition in which a boneor joint is twisted outward from the center of the body |
