A young patients presented with loss of sensation in sole of foot with paralysis of medial side of plantar muscles of the foot, Most likely nerve involvement is
Correct Answer: Tibial nerve
Description: TIBIAL NERVE:- Root value:ventral division of ventral rami of L4,L5,S1,S2,S3 segments of spinal cord.Beginning: largest subdivision of sciatic nerve.Course: descends veically in popliteal fossa. It continues in back of leg as the neurovascular bundle with posterior tibial vessels. Lastly passes deep to flexor retinaculum of ankle joint.Branches:Muscular branches to gastrocnemius,soleus, popliteus, plantaris, FHL, FDL and Tibialis posterior.Aicular branches to superior,middle and inferior genicular .Cutaneous and vascular branch: sural nerve ,medial calcaneal branch and branch to posterior tibial aery.Terminates by dividing into medial and lateral plantar nerves.MEDIAL PLANTAR NERVE:-Muscular branches: Abductor hallucis, flexor digitorum brevis, flexor hallucis brevis and first lumbrical.Cutaneous branch: skin of medial pa of sole and medial three and a half toes.LATERAL PLANTAR NERVE:-Main trunk: flexor digitorum accessorius and abductor digiti minimi and skin of sole. Ends by dividing into superficial and deep branches.Superficial branch: lateral and medial branch Lateral branch:flexor digiti minimi brevis ,3rd plantar, 4th interossei and skin on lateral side of little toe.Medial branch: 4th interdigital cleft. Deep branch:2nd,3rd,4th lumbricals1st,2nd,3rd dorsal interossei 1st,2nd plantar interossei andAdductor hallucis. COMMON PERONEAL:-Branch of sciatic nerve Root value:L4,L5,S1,S2 Branches:Muscular branch: sho head of biceps Cutaneous:lateral cutaneous nerve of calf.Aicular: superior lateral,inferior lateral and recurrent genicular .Terminal branches: superficial and deep peroneal. SUPERFICIAL PERONEAL:-Muscular branches: peroneus longus and brevis Cutaneous branches:Digital branches to medial side of big toe,adjacent sides of 2nd and 3rd, 3rd and 4th ,and 4th and 5th toes. DEEP PERONEAL:-Muscular branches to muscles of anterior compament of leg:Tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus teius.Extensor digitorum brevis Cutaneous: dorsal digital nerves for adjacent sides of big toe and second toe.Aicular branches:Ankle joint, tarsal joints, tarsometatarsal joints and metatarsophalangeal joint of big toe. {Reference:BDC 6E vol2 pg 79}
Category:
Anatomy
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