意大利整骨Pathophysiology 3.1.ppt

Pathophysiology through clinical cases- Leg and Foot -CLINICAL CASE 1;Patient Presentation A 38-year-old male complains of numbness on the dorsum of his right foot and difficulty lifting the front part of the foot History The previous day he was stuck by a car No serious injuries, but subsequently: Numbness over the dorsum of his right foot Having to make a “high step” to avoid dragging his toes when he walks Progressive loss of the ability to raise his toes;Clinical Case;Clinical Reasoning This patient presents with signs and symptoms indicating a clinical condition of foot drop Clinical Problems to Consider Anterior compartment syndrome Common fibular nerve trauma;Relevant Anatomy Skeletal elements that contribute to the lateral aspect of knee region: Lateral condyle of the femur Lateral condyle of the tibia Proximal end of the fibula, articulated with lateral condyle of the tibia and providing distal attachment for the tendon of biceps femoris and the lateral collateral ligament of the knee;Relevant Anatomy Common fibular nerve (L4-S2) palpable on the neck of the fibula No sensory distribution It innervates the short head of biceps femoris The subcutaneous position of the common fibular nerve on the fibular neck makes it vulnerable with trauma to the lateral knee region On the neck of the fibula common fibular nerve divides into terminal branches;Relevant Anatomy On the neck of the fibula common fibular nerve divides into terminal branches: Superficial fibular nerve (L4-S1) It supplies sensory innervation from the distal anterolateral leg and most of the dorsum of the foot It innervates the muscles of the lateral compartment of the leg (fibularis longus and brevis);Relevant Anatomy On the neck of the fibula common fibular nerve divides into terminal branches: Deep fibular nerve (L4-L5) It supplies sensory innervation from the adjacent sides of toes 1 and 2 It innervates the muscles of the anterior compartment of the leg (tibialis anterior, extensor longus dig