Lower Extremity

Nerve
Roots
Pain Distribution Causative lesions Reflex Arc Tests Notes
Obturator L2-L3-L4 Medial
thigh
Sensory Medial surface
of thigh
Motor Obturator
Externus
Pectineus
Adductors
Gracilis
Pelvic neoplasm
Pregnancy
Pelvic surgery
Adductor jerk (L3) Hip adductors (L2,
L3) adductors
Pectineus may be innervated
by obturator or femoral nerves
Femoral L2-L3-L4 Ant thigh
Med leg to
ankle
Sensory Anterior
aspect of thigh & medial
aspect of leg down to
medial malleolus
Motor Quads
Pectineus
Iliacus

Diabetes
Femoral hernia
Retroperitoneal
haematoma
Femoral art.
Aneurysm
Post. Abdomen
Neoplasm
Psoas abscess
Knee jerk L3-L4 Knee extension L3-
L4
Fem n. lesion will affect both
knee ext & hip Flex. (psoas not
affected tho)
NB: Reflex arc conveyed
purely in L4.

Diabetic Amyotrophy mm
wasting in front of thigh w/
weakness & wastage due to
vasc changes supplying n
Lateral
cutaneus nerve
of the thigh
L2-L3 Sensory anterolateral
aspect of thigh

Sciatic Fibular

L4-L5-S1 Often only
dorsum of
foot
Sensory Anterolateral
leg dorsum of ankle & foot
up to distal
interphalangeal joints
Deep branch 1
st

interdigital cleft
Motor Short head
biceps femoris
Fibularis Longus
& Brevis (Sup Fibular
nerve)
Tibialis anterior,
EDL, EHL. P tertius (Deep
Pressure palsy at
fibula neck
Hip fracture /
dislocation
Penetrating trauma
to buttock
Piriformis syndrome
Lateral hamstring
jerk (S1)
Foot dorsiflexion L4-
L5 Tibialis anterior
Big toe ext L5 - EHL
Ext of toes (L5, S1)
EDL
Foot eversion L5-S1
Fib longus &
brev5s

Medial hamstring jerk Medial
reflex is carried in the tibial div
Cause foot drop
x6 more likely to be damaged
than tibial div
fibular nerve)
Sciatic Tibial L4-L5-S1-
S2
Often
painless

uncommon
Sensory Sole and lat
border of foot, around nail
beds
Motor Hamstrings (not
short head biceps fem)
plantaris, popliteus
TP, Gastroc,
soleus, FDL, FHL and
small foot muscles
Rarely injured even
in buttock
Misplaced injections!
Piriformis syndrome
Ankle jerk S1
Medial hamstring
jerk S1
Knee flexion L5-S1
hamstrings
Plantarflexion S1
Gastrocnemius
Foot inversion L4,
L5 tibialis Post.

Medial hamstring jerk Medial
reflex is carried in the tibial div
Posterior
cutaneus nerve
of the thigh


S1-S2-S3 Sensory central
posterior thigh

Superior gluteal
nerve
L4-L5-S1 Gluteus minimus
Gluteus medius
Tensor fascia lata

Inferior gluteal
nerve
L5-S1-S2 Gluteus Maximus