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M.

Shuja Tahir
Faisalabad, Pakistan IR-038
Clinical Skills
EXAMINATION OF COMMON
PERONEAL NERVE
Anatomy CLINICAL ASSESSMENT
The root value of lateral popliteal LOOK
nerve is lumbar 4,5 - sacral1,2. It is Look for abnormalities;
lateral branch of sciatic nerve at
superior angle of popliteal fossa. It Foot drop is seen.
winds around the fibular neck Equino varus deformity is seen.
where it is susceptible to injury. It
gives following branches; Check gait;
! Communicating sural nerve. It is slapping and excess pressure is
! Lateral cutaneous nerve of the seen on outer side of the foot. The
calf. toe of shoe is scuffed.
! Extensors and abductors of leg.
! Evertors of foot. FEEL
! Skin over peroneal and Check sensations;
extensor compartment of the fine touch, pin prick and
leg temperature sensations are
! Knee joint and superior tibio checked.
fibular joint.
There is loss of sensations over the
It is injured due to injury just below lateral and anterior aspect of leg
the knee joint. It is associated with along with medial aspect of the
fracture neck of fibula or in tight dorsum of the foot.
fitting plasters.
MOVE
It may also be injured accidently Check for eversion of foot against
during surgery for varicose veins. resistance;
Its injury leads to loss of function of
muscles of anterior and lateral Failure to do so is due to paralysis of
compartments of the leg below everters such as;
knee and short extensor muscles of
the toes. Peroneus longus and peroneus
brevis
SPECIAL INTERVIEW
Questions should be asked to find Examine extension / dorsiflexion at
out difficulty in walking and history the ankle and other joints of the foot
of injury or plaster application. and toes.

Failure to do so is due to paralysis of

115 April to June, 2010 INDEPENDENT REVIEWS


the muscles of extensor performed and its record is kept for
compartment. future reference and comparison.

REFLEXES Motor function grading is described


Ankle jerk is absent on the affected as below ;
side. Grade Power
Testing fine touch sensation
0 No contraction
GRADING 1 Flicker or trace of contraction
2 Active movement in a plane perpendicular to
Sensory, motor and vasomotor gravity
changes are examined to have 3 Active movement against gravity
adequate assessment of the 4 Active movement against gravity and resistance
(weaker than normal)
neuronal injury. The grading of
5 Normal power
muscle power (motor function) is

CHECK LIST
SPECIAL INTERVIEW
LOOK
for Foot drop
Equinovarus deformity
High stepping gait
Ankle jerk
FEEL
Sensation at lateral and anterior aspect
of leg with medial part of dorsum of foot

MOVE
Eversion of foot
Dorsiflexion of toes and ankle
Ankle reflex

The author :
Muhammad Shuja Tahir
FRCS (Ed), FCPS (Hon)
is professor and head of the
department of Surgery at
Independent Medical
College Faisalabad.
shuja@iu-hospital.com

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