Test 1 question

[Katie Fish]

. As you observe a patient entering your outpatient clinic, you note decreased left foot clearance during swing phase of gait and absent heel strike at initial contact. Formal strength testing supports your hypothesis that ankle dorsiflexor weakness is contributing to these gait deviations, as all other muscle groups received manual muscle test grades of 4/5 or greater. A lesion to any of the following sites could contribute to this presentation EXCEPT:
a. Common peroneal nerve
b. Deep peroneal nerve
c. Sciatic nerve
d. Tibial nerve

In this question, a sciatic nerve lesion would make all the muscles below weak not just ankle dorsiflexion. However I understand why the tibial nerve would not make ankle DF weak, is this a trick question? Are there 2 answers?

[Chrissy Durrough Lugge]

Another good question! Sciatic nerve injuries can present as isolated foot drop (https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/sciatic-nerve-injury). The more important test taking strategy takeaway from this question is to know that the tibial nerve would not result in foot drop, so that must be the best answer.

Chrissy

[Katie Fish]

ahh, makes sense. Thank you.

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