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Innervation
  • Tibial division
    • motor
      •  semitendinous 
      •  semimembranous 
      •  long head biceps femoris 
      • topic gastrocnemius 
      • topic popliteus 
      •  plantaris 
      •  soleus 
      •  tibialis posterior 
      •  flexor digitorum longus 
      •  flexor hallucis longus 
    • sensory innervation
      • none
  • Peroneal division 
    • motor
      •  abductor hallucis 
      •  flexor digitorum brevis 
      •  flexor hallucis brevis 
      •  foot lumbricals 
      •  quadratus plantae 
      •  flexor digiti minimi 
      •  adductor hallucis 
      •  foot interossei
      •  abductor digiti minimi 
    • sensory 
      • articular branch to knee joint
      • sural nerve branch
        • runs distal with the small saphenous vein
        • anastomoses with a branch from the peroneal nerve
        • continues distal on lateral aspect of the Achilles tendon
        • terminates as the lateral dorsal cutaneous nerve of the foot
  • common peroneal nerve
    • motor
      •  short head of biceps femoris
    • deep peroneal nerve 
      • motor 
        • leg
          •  tibialis anterior  
          •  extensor digitorum longus  
          •  peroneus tertius  
          •  extensor hallucis longus   
        • foot
          • extensor digitorum brevis (lateral terminal branch)
          • extensor hallucis brevis  (lateral terminal branch)
      • sensory  
        • articular branch to the ankle joint    
        • medial terminal branch: 1st dorsal webspace
    • superficial peroneal nerve 
      • motor 
        • lateral compartment of leg
          •  peroneus longus 
          •  peroneus brevis   
      • sensory  
        • majority of skin on the dorsum of foot, excluding webspace between hallux and second digit (deep peroneal nerve)    
        • anterolateral distal 1/3 of leg
Origin
  • The sciatic nerve originates from lumbosacral plexus L4-S3 
    • tibial division
      • orginates from anterior preaxial branches of L4,L5,S1,S2,S3
    • peroneal division
      • originates from from postaxial branches of L4,L5,S1,S2
Course
  • Exits sciatic notch 
    • runs anterior or deep to piriformis
    • runs posterior or superficial to short external rotators (superior gemellus, inferior gemellus, obturator internus)  
  • Posterior leg
    • It then runs down the posterior leg where it breaks into its three main divisions at the level of the mid thigh
  • Terminal branches
    •  common peroneal nerve
    •  tibial nerve
Injury & Clinical Conditions
  • Iatrogenic Injury
    • methods to prevent injury
      • routine visual identification not advised in primary THA
      • palpation recommended
      • visual identification is recommended in revision THA
      • hip extension, knee flexion decreases tension on nerve
 

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