0:00

On this image, we, uh, see the, uh, uh, nerves,

0:05

the, the muscles innovated by the mul, uh,

0:08

plantar nerve in yellow

0:09

and the lateral plantar nerve in, uh, red.

0:13

At, in this location the mule

0:15

and lateral plantar nerves are still close to each other,

0:17

but the, quite, quite quickly.

0:19

The lateral, uh, plantar nerve will give off a branch.

0:22

The Baxter nerve, which will make a 90 degree turn

0:26

and, uh, will, uh, go innerate the, uh,

0:29

abductor digi MiniMe muscle.

0:32

Uh, here at the, uh, midfoot on this coronal image,

0:37

now we are more distal.

0:39

So the meal and lateral plantar nerves have clearly

0:42

separated and they're separated

0:43

by this flexor digger brevis muscle.

0:46

And in that location,

0:48

the meal plantar nerve can become entrapped by the, uh,

0:51

cross the anatomic crossover

0:53

between the flexor holis longus, uh,

0:56

and the flexor de degener, uh, uh, longest tendons.

1:00

And this, uh, is also called jogger's foot.

1:03

And the patient pre, uh, present with arch pain

1:06

and numbness at the medial plantar aspect of the foot.

1:10

This is a patient who had 10 synovitis at this master knot,

1:14

Henry at the crossover between the two tendons

1:17

and had some denervation, uh, edema in the abductor lysis

1:22

and flexor digitorum brevis muscles.

1:24

So in the territory of the medial plantar nerve,

1:29

if there is entrapment more distally, then there's only two

1:32

or remaining muscles that are innervated by the, uh,

1:36

medial plantar nerve.

1:38

We have the, uh, flexor lysis previs,

1:41

and the first lumbar call Baxter's neuropathy is something

1:45

that we see quite frequently.

1:47

And so this happens when the, uh, inferior calcaneal nerve

1:52

or baxter's nerve makes a, a sharp,

1:54

90 degree turn towards the abductor Gigi MiniMe,

1:57

and it can become entrapped.

1:59

If there's a prominent G canal spur

2:01

or there's a, uh, fasciitis, it can irritate the nerve

2:06

and cause ation changes in the, uh, muscle.

2:10

Like you can see here, there's a little bit

2:12

of fatty atrophy.

2:14

The sal nerve is a, uh, per purely sensory, uh, nerve

2:19

formed, uh, from a branch, branch by the, the temporal nerve

2:22

and the common penal nerve.

2:25

It'll, uh, co in the calf, uh, lateral

2:28

to the achilles tendon

2:29

as you can usually find it quite easily, uh, posterior

2:33

to the peral tendons

2:34

and more distally it'll be inferior to the perineal tendons.

2:38

So this will supply sensation to the lateral aspect

2:42

of the ankle and foot in a narrow band.

2:44

Uh, usually it can be, uh,

2:48

it can be entrapped if there's significant, uh,

2:51

achilles tendinopathy, peral tendon, uh,

2:54

peral tendon pathology, uh, or um, injuries

2:58

To the fifth metatarsal.

3:01

So in summary, uh, we looked at, uh, the, uh,

3:06

three major motor nerves, uh, of the lower extremity,

3:10

the femoral nerve, uh, which supplies the ilio SOAs, uh,

3:15

muscle proximally

3:16

and the quap sartorius muscle more distally.

3:20

The opterator nerve, uh,

3:23

which supplies the adductor musculature

3:25

and the gracilis, uh, musculature

3:28

more approximately also supplies the adductor brevis

3:31

and the opterator ex sternness muscles.

3:34

The sciatic nerve, which will supply, uh,

3:37

all the hamstring muscles and will supply motor

3:42

and sensation below the, the knee except for, um,

3:47

sensation to the medial lower leg, which is supplied

3:50

by the ous nerve branch of the femoral nerve at the ankle.

3:55

We can, uh, see here the tibial nerve,

3:57

which will enter the tarsal tunnel

3:59

where it's susceptible to being entrapped.

4:02

It will, uh, trifurcate into medial

4:05

and lateral plantar nerves

4:06

and medial calcaneal branch, the saphenous nerve,

4:09

which is subcutaneous

4:11

and, uh, sensory branch from the femoral nerve.

4:16

The deep perennial nerve,

4:17

which can be entrapped at the interoral tunnel

4:20

and will supply sensation to the dorsal first web space

4:24

and, uh, mortar, uh, to the, uh, motor ov

4:27

to the extensor dig arm.

4:29

Brevis, uh, muscle, the superficial perineal nerve, uh,

4:33

which supply the perineal longus

4:36

and brevis muscle more approximately

4:38

but distally when it, uh, it becomes superficial

4:42

and is only sensory to the dorsal aspect of the foot.

4:46

And, uh, finally the sural nerve

4:48

that co courses in close proximity to the achilles tendon

4:53

and also, uh, very close to the peral tendons, more distally

4:57

and can be affected by pathologies of these tendons.

5:01

So this is the end of my, uh, talk

5:05

and thank you for your attention.