TIBIAL NERVE SYNDROME3

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TIBIAL NERVE SYNDROME : 

TIBIAL NERVE SYNDROME Chaman Lal Physiotherapist College of Physiotherapy JPMC Karachi. +92-333-3256772 sunnykoool_1@yahoo.com

TIBIAL NERVE ANATOMY : 

TIBIAL NERVE ANATOMY The tibial nerve arises from anterior division of L4-S3 root.

PHOTO OF TIBIAL NERVE MUSCLES : 

PHOTO OF TIBIAL NERVE MUSCLES

TIBIAL NERVE SYNDROME : 

TIBIAL NERVE SYNDROME Tibial nerve dysfunction is a loss of movement or sensation in the lower leg, caused by damage to the Tibial nerve. FUNCTION The tibial nerve supplies movement and sensation to the calf and foot muscles.

CAUSES : 

CAUSES The usual causes are direct trauma, prolonged pressure on the nerve, and compression of the nerve from nearby body structures. Entrapment involves pressure on the nerve where it passes through a narrow structure.(tarsal tunnel)

CAUSES : 

CAUSES The tibial nerve is commonly injured by fractures or other injury to the back of the knee or the lower leg. DIABETES MELLITUS POLYARTHERITIS

CLINICAL SYMPTOMS : 

CLINICAL SYMPTOMS Sensation changes on the bottom of the foot Numbness, tingling, or other abnormal sensations. Burning sensation Pain Weakness of the knee or foot, difficulty with walking.

RECORDING TECHNIQUES FOR POST TIBIAL : 

RECORDING TECHNIQUES FOR POST TIBIAL It is recorded from the abductor hallucis muscle. It is stimulated from the ankle and knee. The normative values are 5.8msec for distal latencies, 41msec for the conduction velocity, 5uV for the amplitudes and 58msec for the F-wave latencies.

TARSAL TUNNEL SYNDROME : 

TARSAL TUNNEL SYNDROME The tibial nerve passes through the tunnel called tarsal made up of tissues called flexor retinaculum like median in CTS. Tibial nerve in tarsal tunnel is compressed due to excess pressure.

RECORDING TECHNIQUES FOR MEDIAL AND LATERAL PLANTER : 

RECORDING TECHNIQUES FOR MEDIAL AND LATERAL PLANTER MIXED NERVE Active electrode on AH muscle and stimulate the medial site of foot to get the medial planter. Same placement with stimulation on lateral side of foot will give us lateral planter nerve.

CONTD. : 

CONTD. SENSORY NERVE Place the ring electrode on the greater finger that is the thumb and stimulate the tarsal tunnel side to get the medial planter nerve. Lateral planter is obtained by placing ring electrodes on the last finger.

CONTD. : 

CONTD. MOTOR NERVE To record the medial planter motor nerve we would have to do the same as we do in post tibial nerve at ankle. For lateral planter we will have to place our active electrode at (adductor hallucis, adductor digiti minimi and stimulate the same side.

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