skanuj0026 (162)

L3

L4

L5

S1

Anterior side of thigh, passing obliquely downward from the approximate level of the trochanter to the medial side ofthe knee

© Quadriceps femoris (Adductors)

Posterolatera! thigh, extensor side of knee to anteromedial side of lower leg

© Quadriceps femoris, especiallythevastus medialis

© (Tibialis anterior, adductors)

Posterior side of thigh, lateral side of knee, antero-lateral lower leg, dorsum offoottobigtoe

© Extensor hallucis longus ©Tibialis anterior © Gluteus medius

Lateral surface of thigh and calf, heel to lateral edgeoffoot

© Triceps surae, peronei, thigh flexors © Gluteus maximus

Quadriceps reflex (■ patellar tendon reflex ■ knee-jerk reflex)

Quadriceps reflex (Adductor reflex)

Tibialis posterior reflex

Triceps surae reflex (* Achilles tendon ref\ex ■ ankle-jerk reflex)

C Clinical manifestations of nerve root irritation

•    Pain in the affected dermatome

•    Sensory losses in the affected dermatome

•    Increased pain during coughing, sneezing, or straining

•    Pain fibers morę severely affected than other sensory fibers

•    Motor deficits in the indicator musdes of the segment

•    Refłexes associated with the affected segment are absent or diminished.

3 tor musdes ofthe spinał cord segments be typical indicator musdes for each cord segment.

Indicator musde

Diaphragm Dełtoid Kceps brachii Triceps brachii

Hypothenar musdes, long digital flexors on ulnar side Quadriceps femoris Quadriceps femoris, vastus medialis Extensor hallucis longus, tibialis anterior Triceps surae, peronei, gluteus maximu$