Question

Case scenario

Mr. C, 50 years old, is an amateur soccer player who regularly plays with his friends over weekend. He has chronic anterior right hip pain and weakness over his groin region for 5 years. One day, when he was playing soccer, he was injured by another player who crushed on him from lateral side of his left leg. Then, he fell down on the grassland after twisting his left knee and ankle due to the crush. He started to feel pain and weakness over his left leg from knee to ankle. He could not move his left leg to stand up. When he fell down, he fell on the leg of that player which caused pain, swelling, numbness and weakness over the posterior side of his own left leg. Then, he was send to the emergency room of a nearby hospital. The doctor of the emergency room of the hospital assessed his legs and arranged X-ray check for him. Your supervisor asked you to identify all key anatomical structures in the initial assessment that are related to his hip, knee and ankle discomfort according to the above information. You need to provide clear rationale to support your answers when you report to your supervisor. Please answer according to the following guidance:

1. What nerve (nerves) can be involved in his hip, knee and ankle problems? Please list out accordingly and support with corresponding reasons.

2. What artery (arteries) and vein (veins) are involved in his problems mentioned above? Please list out accordingly and support with corresponding reasons.

3. What lower limb functional movements that can be affected according to his leg conditions? Why?

Answer 1

1. What nerve (nerves) can be involved in his hip, knee and ankle problems? Please list out accordingly and support with corresponding reasons.

Nerves of lowe limbs are sciatic, common fibular and tibial nerve. Sciatic nerve run through the hips, buttocks and down the leg and end just after the knee. Tibial nerve run along the tibia bone.The femoral nerve is located in the pelvis and runs through the front leg. It performs hip movement and straightening of leg. Thigh region connects the hipand the lower limb. Any injury or trauma to these area is sensed by these nerve endinds and damage to these nerve affect the motor nerves of lower limb and ability to walk.

What artery (arteries) and vein (veins) are involved in his problems mentioned above? Please list out accordingly and support with corresponding reasons.

Superficial circumflex iliac, peronial, anterior tibial, posterior tibial, dorsalis pedis are major arteries and veins of lower limb. Femoral artery is the largesta rtey of the lower limb which branches off to popliteal artery to supply blood to the knee and terminates at the anterior and posterior tibial arteries. Swelling and numbness is due to the inflammation due to the injury.

3. What lower limb functional movements that can be affected according to his leg conditions? Why?

Sprains is the most common injury of lower leg often occur in lateral ligaments of the ankle.The functional movements of this are incude abduction, adduction, flextion and extensions might be affected in this condition.