A young patients presented with loss of sensation in sloe of foot with paralysis of medial side of plantar muscles of the foot, Most likely nerve involvement is
## **Core Concept**
The question involves identifying a nerve responsible for sensory and motor functions in the foot. The **sural nerve** primarily provides sensation to the lateral side of the foot and lower leg, while the **tibial nerve** and its branches (including the **medial plantar nerve**) are responsible for the sensation and motor innervation of the medial and plantar aspects of the foot.
## **Why the Correct Answer is Right**
The **medial plantar nerve**, a branch of the **tibial nerve**, provides sensation to the medial sole of the foot and motor innervation to the muscles of the medial side of the plantar aspect of the foot, including the **abductor hallucis**, **flexor digitorum brevis**, and **opponens digiti minimi** (or **flexor digiti minimi brevis** in some contexts). The symptoms described—loss of sensation in the sole of the foot and paralysis of the medial side of the plantar muscles—align with the distribution of the **medial plantar nerve**. This nerve's involvement would lead to both sensory and motor deficits as described.
## **Why Each Wrong Option is Incorrect**
- **Option A:** The **sural nerve** primarily provides sensory innervation to the lateral side of the foot and lower leg. It does not innervate the muscles of the foot; hence, it cannot cause paralysis of the medial side of the plantar muscles.
- **Option B:** While the **tibial nerve** itself does give rise to the medial plantar nerve and is involved in foot sensation and motor function, the specific distribution mentioned points more directly to a branch like the **medial plantar nerve** rather than the **tibial nerve** as a whole.
- **Option D:** The **lateral plantar nerve**, another branch of the **tibial nerve**, primarily supplies sensation to the lateral sole of the foot and motor innervation to the muscles of the lateral plantar aspect, which does not match the described distribution.
## **Clinical Pearl / High-Yield Fact**
A key point to remember is that the **tibial nerve** divides into the **medial and lateral plantar nerves**, which are crucial for the sensation and motor function of the foot's plantar surface. The **medial plantar nerve** specifically supplies the muscles of the medial plantar aspect and sensation to the medial sole, making it a likely candidate for the symptoms described.
## **Correct Answer:** B. medial plantar nerve.