Video: Main nerves of the lower extremity
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Hey everyone! This is Nicole from Kenhub, and in today's tutorial, we're going to be talking about the main nerves of the lower extremity. As this is a basics tutorial, before going on to talk abou... Read more
Hey everyone! This is Nicole from Kenhub, and in today's tutorial, we're going to be talking about the main nerves of the lower extremity. As this is a basics tutorial, before going on to talk about the main nerves of the lower extremity, we're first going to take a few minutes to define the nervous system, the nerves and the lower extremity. So as you may know already, the nervous system is made up of two parts and I'll just begin with the central nervous system which is otherwise known as the CNS.
And the central nervous system is the part of the nervous system which consists of the brain and the spinal cord. Of course, you're probably asking yourself if you have a nervous system then what is a nerve and so a nerve is a bundle of delicate fibers enclosed within a fibrous sheath carrying information from the brain and the spinal cord to the organs in the periphery or from the periphery to the brain and the spinal cord. And in this image of the spinal cord you can see the spinal nerve in the blue circle just here. And of course, nerves make up the peripheral nervous system that is the part of the nervous system that does not include the brain or the spinal cord. So in this image that we have of our lady in the anatomical position, you can see that the peripheral nervous system is highlighted in green throughout the body that is all the nerves, and we mentioned before that the nerves carry information from the spinal cord to the body and vice versa.
And so the nerves that transmit information from the spinal cord to the body are called motor nerves and you can see the direction of the flow of information of the motor nerves as indicated by the blue arrows. Nerves transmitting information from the body to the spinal cord are called sensory nerves and you can see the direction of the flow of information of the sensory nerves as indicated by the arrows. And although usually one type of fiber dominates the nerve, most nerves contain both types of fibers.
The next question we want to ask ourselves is what is the lower extremity? Now the lower extremity is the entire human leg running from the hip to the toes and the lower extremity includes the hip, the thigh, the knee, the leg, the ankle and the foot. And notice that while in everyday life we may use the term leg to refer to the whole lower extremity, in anatomy, the same term applies only to the region between the knee and the ankle.
In this tutorial, however, we'll be focusing on four main regions within the lower extremity and these nerves are the nerves of the hip, the nerves of the thigh, the nerves of the leg and the nerves of the foot. And we've ordered these obviously in the direction of most proximal to distal and you'll be able to follow this as we go through the nerves.
As you can probably guess, there are many nerves in the region of the hip and many of these nerves provide innervation to local muscles, the skin of the hip or the genitals while others travel further down the leg. In this section, however, we're going to contain our discussion to the nerves within the region of the hip and these nerves include the superior gluteal nerve, the inferior gluteal nerve, the pudendal nerve and the sciatic nerve. Let's of course start with the superior gluteal nerve.
So, first of all, we're looking at a posterior view of the pelvis and the femur with some muscles and some nerves that are relevant to that area, and the superior gluteal nerve otherwise known as the upper nerve of the hip is one of the principal nerves of the hip, and you can see the superior gluteal nerve highlighted in green. The superior gluteal nerve arises in the sacral plexus from the roots of L4, L5 and S1. The superior gluteal nerve is accompanied by the superior gluteal artery which is visible in red just beside the nerve and I'm pointing it out with my arrow just here.
As you can see, the superior gluteal nerve is distributed across the surface of a wide muscle known as the gluteus medius which I've drawn for you in green just here, and the gluteus medius is one of the muscles that contribute to thigh abduction. The superior gluteal nerve is a motor nerve innervating the thigh abductor muscles which includes the gluteus minimus – we can see outlined in green – in addition to the tensor fascia which is involved in the stabilization of the hip and thigh extension – we can see the tensor fascia lata outlined in green as it arises from the anterior iliac crest of the pelvis. Therefore, the superior gluteal nerve is a nerve that controls the muscles that abduct the thigh which is the lateral movement of the thigh and also stabilize the hip in thigh extension which is movement of the thigh backwards.
The inferior gluteal nerve otherwise known as the lower nerve of the hip is also an important nerve of the hip. And the inferior gluteal nerve arises from the posterior division of the sacral plexus from the roots of L5, S1 and S2 and it exits the pelvis by emerging beneath the lowest surface of the piriformis muscle which you can see here on this image. Do note, however, that in spite of this close structure relationship the lower gluteal nerve does not innervate the piriformis muscle. Like the superior gluteal nerve, the inferior gluteal nerve is a motor nerve and it innervates the gluteus maximus muscle which you can see outlined in green on the right, and the gluteus maximus muscle is responsible for hip extension. So you saw hip extension on the last section of the superior gluteal muscle but the gluteus maximus which we've highlighted in green on this lateral view of the leg is usually activated during squatting or climbing the stairs. And so we've got a little image for you here and here she goes making her way up the staircase. And of course the gluteus maximus is activated during this movement.
The pudendal nerve derives its name from the Latin word "pudendum" which literally means "the shameful place", and you can see this highlighted in green with this extreme close-up view of the posterior aspect of the pelvis. The pudendal nerve arises from the ventral rami of the sacral plexus from the roots of S2 to S4, and note that the pudendal nerve does not exit the pelvis, rather its branches are distributed in the peroneal area. The pudendal nerve innervates the skin of the external genital organs, the skin of the perineum and the skin around the anus. It also innervates many muscles in the perineum including the urethral and anal constrictor muscles which are commonly known as sphincters.
Let's move on now to the sciatic nerve, and the sciatic nerve derives its name from the word "ischium" which is an ancient Greek word for the lower and back portion of the pelvic bone. The sciatic nerve arises in the sacral plexus from the anterior rami of L4 to S3 and it leaves the pelvis passing just below the piriformis which you can see drawn in green here on the right. It gives off some minor articular branches to the hip joint before continuing on down the posterior thigh. The sciatic nerve is the biggest nerve and although it doesn’t look like it in the image, the sheath of the sciatic nerve encloses two nerves – the common peroneal nerve and the tibial nerve. And in this ventral image of the hip and the thigh region of our anatomically-positioned female, you can see more clearly how the sciatic nerve divides into the tibial nerve on our left in orange and the common peroneal nerve on our right in purple.
In terms of its innervation, the sciatic nerve innervates the hip joint and the hamstring muscles on the posterior aspect of the thigh and of course the hamstring muscles help extend the hip or flex the lower limb on the joint of the knee and antagonize the knee extensors of the front thigh. And of course you've already seen the extension of the hip in our previous slides so in this image we'll just show you the flexion of the knee, and you can see the hamstrings outlined in green.
So let's now take a look at the nerves of the thigh. Unlike the nerves of the hip which originate in the pelvis within the sacral plexus, the nerves of the thigh originate in the lumbar plexus. And there are two major nerves of the thigh that we'll be discussing today – the femoral nerve and the saphenous nerve. Let's start with the femoral nerve.
So the femoral nerve is a very important nerve of the thigh which contains both sensory and motor fibers and its significance is reflected in its naming as the word femur is the Latin word for thigh. But of course remember that despite its etymology, the femoral nerve is not the only nerve in the thigh. There are plenty of nerves at the thigh which we are going to talk about over the next couple of minutes. But first let's talk about where the femoral nerve arises from, and the femoral nerve arises from the L2 to L4 roots of the lumbar plexus and then enters the thigh below the inguinal ligament. And in this close-up ventral view of the anterior aspect of the right pelvis, the inguinal ligament and the anterior muscles of the thigh, you can see the highlighted femoral nerve in green as it passes beneath the inguinal ligament on our right here and I've also outlined the inguinal ligament for you in green.
As the femoral nerve passes beneath the inguinal ligament, it travels with two major vessels – the femoral vein in blue and the femoral artery in red – and these relationships are of course very important as they are particularly useful for palpating the femoral pulse and catheterizing the femoral artery so do take note of these structures. And of course with everything medical, we always have a popular mnemonic to remember our structures and in this case, the mnemonic is the word VAN which stands for the terms Vein, Artery and Nerve, and the way to remember this is that the vein is the most medial structure as it’s positioned first in the mnemonic and with the femoral nerve being the last and the most lateral. So vein is the most medial, arteries in between the two, and the nerve is the most lateral – VAN.
So now that we've talked about some of these anatomical relations, let's move on to talk a little bit about the innervation that the femoral nerve supplies, and the motor subdivision of the femoral nerve innervates the knee extensor muscles which in this image is the quadriceps muscle – highlighted in green for you – and of course these knee extensor muscles are involved in extending the leg from the knee joint. And the femoral nerve also provides motor supply to the hip flexor muscles – that is, the iliopsoas, the sartorius muscle and the pectineus which assists with flexing the thigh towards the hip. And while we're at it, let's just illustrate these movements with some images – so the quadriceps extending the knee and over here we have the hip flexors flexing the hip.
Coming back to our ventral image of the femoral triangle, we'll just talk briefly about the sensory division of the femoral nerve, and the sensory subdivision of the femoral nerve innervates the skin of the front of the upper thigh and the inner leg, and the largest of these branches is the saphenous nerve which innervates the inner leg and what we'll talk about later on the next slide.
So let's take some time to talk about the saphenous nerve which is a very important nerve of the lower extremity as the saphenous nerve is the largest cutaneous branch of the femoral nerve as well as its continuation. And as you can see, it arises within the femoral triangle which is bounded superiorly by the inguinal ligament – as you can see on our ventral view of the pelvis. It's also bordered by the muscles of the thigh and the bones of the leg – and you can see how I've drawn the femoral triangle in green on the right. The structure highlighted in green is of course the saphenous nerve with the femoral nerve running laterally alongside it in yellow.
After branching off, the saphenous nerve enters a tunnel formed by the muscles of the front thigh known as the adductor canal, and the adductor canal is quite an important canal as it also contains the femoral vessels as well as the nerve to the vastus medialis and you can see it outlined in green on this image. The saphenous nerve then crosses to the medial surface of the thigh and then continues subcutaneously down the medial aspect of the leg which of course is not visible in this image. In the lower third of the leg, it divides into a tibial branch that terminates at the ankle while the other branch passes along the anterior aspect of the medial malleolus to terminate in the foot. And of course let's talk a little bit about its nerve supply, and the saphenous nerve is an entirely sensory nerve supplying the anteromedial surfaces of the leg and the foot.
Now that we finished talking about nerves at the thigh, let’s talk about the nerves of the leg. And the nerves of the leg are named in relation to the tibia and fibula which is sometimes given the descriptor, peroneal. So it follows that the nerves of the leg consist of the tibial nerve, the common peroneal nerve, the superficial peroneal nerve and the deep peroneal nerve. And let's of course begin with the tibial nerve.
So the tibial nerve takes its name from the Latin word "tibia" which means shin bone, and is the terminal branch of the sciatic nerve as well as its largest branch. The tibial nerve arises at the bifurcation of the sciatic nerve in the back of the thigh and around about the lower third of the thigh, and in this posterior view of the femur, the tibia and the fibula at the knee, you can see the bifurcation of the sciatic nerve just here in my green circle as it splits into the tibial nerve in green and the common peroneal nerve in yellow.
And on this next image of the posterior aspect of the right knee, you can see the sciatic nerve bifurcating into the tibial nerve in green and the common peroneal nerve in purple. The tibial nerve as you can see is the larger and more medial nerve of the two which makes the side on the left here – the medial side of the right knee – and this side on the right is the lateral side of the right knee.
So shortly after the bifurcation of the sciatic nerve, the tibial nerve enters the popliteal fossa, a diamond-shaped depression which is found on the posterior aspect of the knee running from its superior apex to its inferior apex. And you can see it drawn on green on the right. And let's just briefly pause to chat a little about the popliteal fossa. So the popliteal fossa is superficially bounded by muscles including the gastrocnemius down here in green but actually the popliteal fossa runs quite deep.
And, in addition to the popliteal nerve, there are a couple of other important neurovascular structures that run with it namely the popliteal vein and artery seen here in blue and red, however, the popliteal nerve is the most superficial of the three. A few more things about the popliteal fossa – within the popliteal fossa, the tibial nerve gives off the medial sural cutaneous nerve which is this nerve in purple that I've drawn for you just here. And if you can imagine, the sural communicating branch coming off the common peroneal nerve in orange, you can imagine the sural nerve which I've drawn for you in brown, forming out of these two nerves which supplies the leg and the ankle.
The tibial nerve also gives off the nerve to the gastrocnemius, which you can see here highlighted in purple and of course you remember our gastrocnemius over here while our popliteus is over here in green.
Let's move on to an image where we can see the posterior aspect of the leg and the foot, and in this image we’re still in the right leg but we're looking at the tibial nerve as it travels towards the foot with the calcaneus or the heel bone of the foot circled in green. So as you can see after the tibial nerve leaves the popliteal fossa, it travels down the posterior aspect of the leg where it divides at the level of the foot into the lateral and medial plantar nerves which we’ll talk a little bit more about later in the tutorial.
But coming back to our original image of the tibial nerve, let’s briefly discuss what the tibial nerve innervates, and as you can probably guess, the tibial nerve innervates a part of the knee joint as well as part of the skin of the upper leg. The tibial nerve also contains many motor fibers for the muscles of the calf which include as we saw before the gastrocnemius, the soleus, the plantaris and the popliteus, and these muscles which are outlined in our image of the leg help with walking and with plantarflexion of the foot.
The next nerve we’re going to talk about is, of course, the common peroneal nerve and in this image, you can see it bifurcating off the sciatic nerve in green with the tibial nerve in yellow. And as you can see in our text about etymology, the word comes from the ancient Greek name for the fibula or the calf bone, and so since the fibula is on the lateral aspect of the leg so too is the nerve. And like the tibial nerve, the common peroneal nerve arises at the bifurcation of the sciatic nerve.
Moving on to a posterior image of the nerve, you can see it arising from the bifurcation of the sciatic nerve which I’ve circled for you in my green circle just here. And as with the tibial nerve, we’re looking at the posterior aspect of the right knee with the smaller terminal more lateral common peroneal nerve on the lateral side of the leg. After arising from the bifurcation, the nerve travels from the superior apex of the popliteal fossa – so let’s draw our popliteal fossa back in again just here – and you can see it therefore following the border of the biceps femoris and its tendon which itself forms the superolateral of the fossa. And let’s just fade out our popliteal fossa so you can see the biceps femoris and the common peroneal nerve that runs along the border of that.
The common peroneal nerve then emerges from the popliteal fossa at the level of the lateral head of the gastrocnemius and of course this is our full gastrocnemius but the lateral head is this section which is just here outlined in dark grey for you. It then winds around the head of the fibula – so around our invisible fibula just here – and divides into the superficial peroneal nerve and the deep peroneal nerve.
In terms of its innervation, the common peroneal nerve gives off some branches for the sensory innervation of the knee joint as well as the skin mainly via the lateral sural nerve which in this image is this branch otherwise known as the communicating sural nerve. As we mentioned earlier, this medial sural cutaneous nerve joins with the lateral communicating nerve to form the sural nerve and these nerves mediate the sensory information from the overlying skin. The common peroneal nerve has no motor branches before its division so we will be looking at its branches for motor supply.
And speaking of these branches, let’s now have a look at these two branches. And the superficial peroneal nerve arises as a branch of the common peroneal nerve just below the head of the fibula. In this image, you can see the head of the fibula here in my green circle and then the green superficial peroneal nerve branching off that. It then continues down the lateral aspect of the leg to terminate in the foot. The superficial peroneal nerve is the major nerve of the lateral compartment of the leg and it innervates the muscles of this compartment, that is, the fibularis longus and the fibularis brevis, which you can see outlined in this image and these muscles are the muscles that plantarflex and everts the foot. And in this image, we can see the eversion of the foot and the lateral muscles highlighted in green. It also provides sensory supply for the distal anterior surface of the leg and the dorsum of the foot.
The other branch of the common peroneal nerve – the deep peroneal nerve – arises at the bifurcation of the common peroneal nerve just like the superficial peroneal nerve just below the head of the fibula. And it travels down the leg anterior to the interosseous membrane which is this fibrous membrane between the bones of the leg you can see just here. Upon reaching the foot, it divides into two terminal branches – a medial terminal branch and a lateral terminal branch.
The deep peroneal nerve is the nerve of the anterior compartment of the leg and primarily innervates the muscles of the anterior compartment that is the tibialis anterior, the extensor digitorum longus, the extensor hallucis longus and the peroneus tertius, and these muscles flex the foot dorsally at the ankle joint or extend the toes. It also receives sensory information from the ankle joint and the dorsal aspect of the foot.
Now that we’re finished talking about the nerves of the leg, let’s talk about the nerves of the foot. And, of course, as you can see, there are many nerves of the foot mainly the medial plantar nerve, the lateral plantar nerve, the common plantar digital nerve, the proper plantar digital nerve and the dorsal digital nerves. And these are all terminal branches of the nerves of the hip and the thigh.
Let’s of course begin with the medial plantar nerve, and the medial plantar nerve is one of the branches of the tibial nerve which innervates the inner or medial side of the sole of the foot. And just out of interest, let’s of course explain the etymology. Planta is the Latin word for the sole of the foot, so the name medial plantar literally means the nerve of the inner side of the sole of the foot. And again in our image we’re looking at our right foot from its plantar aspect with the calcaneus or the heel bone up here in green. And again our medial aspect is on our left here and our lateral aspect is on our right. And you can see the tibial nerve over here dividing into the medial plantar nerve which is highlighted in green and the lateral plantar nerve which is in yellow with the medial plantar nerve being the more medial nerve.
With regards to its course, the tibial nerve bifurcates within a tunnel formed by the underlying bone and an overlying ligament and this tunnel is known as the tarsal tunnel, and the tarsal tunnel is formed by the flexor retinaculum which is drawn for you here in orange and the medial surfaces of the calcaneus, the tarsus and the tibia – so it’s this little tunnel just here outlined in green. The nerve then runs down the medial aspect of the dorsum of the foot towards the big toe. And the medial plantar nerve is the larger of the two plantar nerves and innervates the muscles on the medial aspect of the foot. And these muscles include the abductor hallucis, the flexor digitorum brevis, the flexor hallucis brevis and the first lumbrical. And all of these muscles here are involved in abduction of the big toe and the lateral four digits, so if you look at our image of the big toe and we’re just drawing a line down the middle which indicates the central line of the foot, you can see the abduction of the big toe and the lateral four digits. And the medial plantar nerve also innervates the skin on the medial side of the foot as well as the skin on the medial aspect of the first three digits of the foot.
The other branch of the tibial nerve is the lateral plantar nerve and therefore has the same origin point as the medial plantar nerve – that is the bifurcation of the tibial nerve – and as it’s the lateral plantar nerve it runs along the lateral aspect of the plantar aspect of the foot. The lateral plantar nerve divides into a superficial branch and a deep branch, and in this image, the branch over here on our left is the deep branch highlighted in dark purple and the branch over here on our light is our superficial branch highlighted in light purple. And before the plantar nerve divides, it runs by the quadratus plantae muscle which you can see over here and the flexor digitorum brevis muscle which you can see over here. It then divides into the superficial and deep branches though the superficial branch merely divides again into the proper plantar digital nerves and a common digital plantar nerve which we’ll talk about a little bit later in the tutorial whereas the deep branch innervates the second to fourth lumbricals, the adductor hallucis and all the interossei except between the metatarsals 4 and 5 which is innervated by the superficial branch, though in this image note that we’ve only drawn the plantar interossei that are those between metatarsals 4 and 5. The lateral plantar nerve also innervates the skin of the fifth toe and the outer lower half of the fourth toe.
Let’s move on now to the common plantar digital nerves and looking briefly at the etymology we can see that digital refers to the digits of the foot, i.e. the toes. So those common plantar digital nerves are the nerves exclusively for the toes. And since they’re plantar, they only innervate the plantar surfaces of the toes – that is, the side of the sole of the foot. The common plantar digital nerves arises branches of the medial and the lateral plantar nerves. So if you remember our medial plantar nerve, let’s trace it onto our image in dark purple and here on our right, the lateral plantar nerve we’ve drawn in a lighter purple. And as you can see, three of these common plantar digital nerves are derived from the medial plantar nerve while one of these nerves is derived from the lateral plantar nerve.
The common plantar digital nerves travel along the length of the metatarsals before they divide into the proper plantar digital nerves from the medial plantar and the proper plantar digital nerves from the lateral plantar nerves. And of course in terms of its innervation, the first common plantar digital nerve innervates the first lumbrical. And if you remember our little outline of the first lumbrical, you can see how the common plantar digital nerve would innervate that.
Let’s now talk about the proper plantar digital nerves. And the proper plantar digital nerves as we just mentioned arise from the common plantar digital nerves and the most medial three and half nerves arise from the medial plantar nerves which we just said while the most lateral one and a half nerves arise from the lateral plantar nerve.
Now let’s talk a little bit about how they divide up in terms of innervation. So the proper plantar digital branches of the medial plantar nerve innervates the first four toes and they innervate the lowest side of the first three toes in the inner or medial side of the fourth toe and of course the distribution of these branches is similar to that of the median nerve of the hand. But of course they’re innervating different things. They’re innervating the medial three and a half toes as opposed to the medial three and a half fingers, but it’s a useful thing to remember. And in addition to the medial three and a half toes, the proper plantar medial digital nerves of the medial plantar nerve also innervates the plantar skin and the nail beds of the digital phalanges.
The lateral side of the fourth toe and the fifth toe are innervated by the proper digital branches of the lateral plantar nerve and the proper digital branches of the lateral plantar nerve also innervate the flexor digiti minimi brevis which you can see on the right here and it also innervates the dorsal and plantar interossei muscles between the fourth and fifth metatarsals but again we’ll just draw in the plantar interossei muscles.
And now finally we’re going to move on to talk about the dorsal digital nerves. And of course looking quickly at our etymology, the word dorsal is derived from the word “dorsum” which means the back, so of course dorsal means of the back meaning the upper surface of the foot. And the dorsal digital nerves are branches arising either from the superficial peroneal nerve, the deep peroneal nerve or the sural nerves. Let’s take a couple of minutes to break some of these down.
So the branches of the superficial peroneal nerve innervates the dorsal skin of all the toes except for the lateral side of the fifth toe which is supplied by the sural nerve which as you remember is highlighted in a medium purple here. As you can see, it travels down the lateral or outer side of the toe. The superficial peroneal nerve also neglects to innervate the adjoining sides of the big and second toe which is supplied by the deep peroneal nerve – and you can see this pattern if you look closely at the image. And also note that the deep peroneal nerve in light purple and it divides into the dorsal digital nerves that are distributed on the adjoining sides of the big toe and the second toe.
Now we’re finished talking about all the major nerves of the lower extremities so now of course it’s time to talk about our clinical correlations. And of course the major clinical correlations that we have for the nerves of the lower extremity are lesions at various levels of the lower extremity; so most of the conditions that we’ll be looking today will be lesions of particular nerves. So the first lesion we’ll look at is a lesion of the superior gluteal nerve, and if you recall from our section of the superior gluteal nerve, the superior gluteal nerve innervates the thigh abductor muscles. These are our gluteus medius, the gluteus minimus and the tensor fascia lata and of course the gluteus maximus is a thigh abductor too but it’s not innervated by the superior gluteal nerve. It’s innervated by our inferior gluteal nerve. If we come back to our image of our lady in the anatomical position, we can see that these muscles help support the body so a lesion in this nerve will make it impossible to stand on the leg on that side of the lesion, and this is normally referred to as a waddling gait.
Lesions in the inferior gluteal nerve sometimes occur during hip replacement surgery and people with these kinds of injuries cannot extend their hip so they usually move their upper bodies backwards to compensate. So again if we have a look at our image of our anatomical woman this time looking at her from the dorsolateral side we can see that she probably moved backwards as she walks off the page.
The last clinical lesion we want to talk about is the sciatic nerve, and the sciatic nerve is susceptible to musculoskeletal injuries. Such injuries present with shooting pain down the backside, in the entire lower limb in combination with foot drop and a high stepping gait. So, on the right, you can see an image illustrating foot drop and as you can see, the muscles of the anterior compartment can’t hold up the foot or dorsally flex the foot properly leading to a kind of gait which is where the foot flops about when you walk and the heel is picked up very high.
Of course now that we’re at the end of our tutorial, let’s briefly summarize everything we’ve seen today. And as we mentioned starting at the most proximal part of our lower extremity, we began with the nerves of the hip and the nerves of the hip include the superior gluteal nerve which is a major nerve of the hip, the inferior gluteal nerve which innervates the gluteus maximus, the pudendal nerve which doesn’t exit the pelvis, the sciatic nerve which is also a major nerve and is one of the largest nerves of the lower extremity. Then we also looked at the nerves of the thigh and of course the nerves of the thigh include the femoral nerve which is a major nerve of the leg and passes and through the femoral triangle with the femoral artery and the femoral vein as well as the saphenous nerve which is the largest branch of the femoral nerve which brings us to the nerves of the leg which include the tibial nerve which is the nerve that’s on the medial side of the body, the common peroneal nerve which is the nerve on the lateral aspect of the leg, the superficial peroneal nerve which as you can see runs lateral to the fibula, the deep peroneal nerve which as you can see runs across the interosseous membrane. And that brings us to the nerves of the foot which include the medial plantar nerve which supplies the medial side of the foot, the lateral plantar nerve which supplies the lateral side of the foot, the common plantar digital nerve which runs along the metatarsals and divides into the proper plantar digital nerves which supply the distal phalanges on the plantar aspect of the foot and of course we also have the dorsal digital nerves which supply the phalanges on the dorsal aspect of the foot.
And just briefly going back over our clinical notes, let’s just mention the superior gluteal nerve which if there’s a lesion in this results in a waddling gait, the inferior gluteal nerve which with a lesion results in the gluteus maximus lurch so someone who’s leaning backwards as they walk, and of course finally the sciatic nerve where if we have a lesion with this we get a lot of pain as well as some foot drop.
So thanks for sticking with me throughout this tutorial. Hope to see you next time.
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