The femoral nerve originates from the lumbar plexus and innervates muscles in the anterior compartment of the thigh. Causes of femoral neuropathy include pelvic or femoral fractures, hip dislocations, spinal issues, and diabetes. Symptoms include sensory loss and weakness of the quadriceps and hip flexors. Special tests like the slump test and prone knee bending test isolate compression of the femoral nerve. Electromyography can help evaluate the severity and location of nerve damage. Treatment involves addressing the underlying cause, physical therapy, bracing, and surgery in severe cases.

1. FEMORAL
NEUROPATHY
P/B :- DR NIYATI PATEL 1

2. P/B :- DR NIYATI PATEL 2

3. ANATOMY
It is the nerve of anterior compartment of thigh
Its cutaneous branch, the saphenous nerve
extend to the medial side of leg and medial
border of foot till the ball of great big toe
ROOT VALUE – L2,L3,L4
Arising from dorsal division of the ventral
primary rami of lumbar plexus
MOTOR SUPPLY
oAnterior division
•Sartorius
•Pectineus
oPosterior division
•Vastus medialis
•Vastus intermedius
•Vastus lateralis
•Rectus femoris
P/B :- DR NIYATI PATEL 3

4. P/B :- DR NIYATI PATEL 4

5. CAUSES
• Psoas abscess
• Pelvic neoplasm
• Fracture of the pelvis or femur
• Hip dislocation
• Inguinal hernia
• Complication of spinal anesthesia
• Prolapse intervertebral disc
• Lumbar spondylosis or stenosis
• Neuropathy secondary to diabetes mellitus known as diabetic
Amyotrophy
• Neurapraxia after hysterectomy or gynecological surgery
• Penetrating wounds of lower abdomen.
P/B :- DR NIYATI PATEL 5

6. SIGN & SYMPTOMS
Sensory
There is loss of sensation over the following areas:
a. Anterior division - anterior and medial aspect of the thigh
b. Posterior division – Continuous as the saphenous nerve involving the
medial aspect of the leg and foot right up to the ball of the great toe.
Motor
The muscles which are paralyzed due to the lesion of the anterior
division are Sartorius and pectineus.
The muscles which are paralyzed due to the lesion to the posterior
division are rectus femoris, vastus medialis, vastus lateralis and vastus
intermedius.
P/B :- DR NIYATI PATEL 6

7. Reflexes
Quadriceps jerk is lost.
Deformity
Genu recurvatum is seen because as
the quadriceps is paralyzed the
patient will try to lock the knee into
hyperextension to get the center of
gravity well in front of the knee joint
to keep it stable.
P/B :- DR NIYATI PATEL 7

8. SPECIAL TESTS
oSLUMP TEST
oPRONE KNEE BENDING TEST
oFEMORAL NERVE TRACTION TEST
P/B :- DR NIYATI PATEL 8

9. INVESTIGATION
RADIOGRAPH :- shows whether there is presence of fracture
MRI :- To delineate complete avulsion of nerve roots
SD CURVE:- abnormality in conduction can be verified. Sharp curve, long
chronaxie, low rheobase and the absence of contraction with repetitive
stimuli indicates denervation. If it is done 2-3 weeks after injury, it
shows the sign of denervation and to find out whether it is moderate or
severe injury
NCV:- To find out the severance of nerve fibers with wallerian
degeneration.
EMG:- it will help to find out reversible and irreversible nerve damage
and will help map out whether it pre ganglionic/ post ganglionic lesion
P/B :- DR NIYATI PATEL 9

10. TYPES OF INJURIES
In Neuropraxia  pain, numbness, muscle weakness,
minimal muscle wasting is present. Recovery occurs within
minutes to days
In Axonotmesis  there is pain, evident muscle wasting,
complete loss of motor, sensory and sympathetic functions.
Recovery time– months (axon regeneration at 1-1.5
mm/day)
In Neurotmesis  no pain, complete loss of motor, sensory
and sympathetic functions. Recovery time – months and
only with surgery
P/B :- DR NIYATI PATEL 10

11. TREATMENTS
• Underlying cause must be deal with the specific surgeries
• IG stimulation to the paralyzed muscles
• Passive movements
• Orthosis to correct genu recurvatum. Either anterior knee guard or
above knee ankle orthosis
P/B :- DR NIYATI PATEL 11

12. MERALGIA PARESTHETICA
P/B :- DR NIYATI PATEL 12

13. P/B :- DR NIYATI PATEL 13

14. It is also known as ‘’lateral femoral cutaneous
nerve entrapment”
Causes:-
•Tight clothing, such as belts, corsets and tight pants
•Obesity or weight gain
•Wearing a heavy tool belt
•Pregnancy
•Fluid accumulation in the abdomen causing increased
abdominal pressure
•Scar tissue near the inguinal ligament due to injury or past
surgery
P/B :- DR NIYATI PATEL 14

15. Sign and symptoms:-
•Tingling, numbness and burning pain in your lateral
aspect of thigh
•Decreased sensation
•Increased sensitivity and pain to even a light touch
P/B :- DR NIYATI PATEL 15

16. SLUMP TEST
P/B :- DR NIYATI PATEL 16

17. P/B :- DR NIYATI PATEL 17

18. P/B :- DR NIYATI PATEL 18

19. SLUMP1
P/B :- DR NIYATI PATEL 19

20. SLUMP2
P/B :- DR NIYATI PATEL 20

21. SLUMP3
P/B :- DR NIYATI PATEL 21

22. SLUMP4
P/B :- DR NIYATI PATEL 22

23. PRONE KNEE
BENDING
P/B :- DR NIYATI PATEL 23

24. P/B :- DR NIYATI PATEL 24

25. PKB1
P/B :- DR NIYATI PATEL 25

26. PKB2
P/B :- DR NIYATI PATEL 26

27. PKExtension
P/B :- DR NIYATI PATEL 27

28. FEMORAL NERVE TRACTION TEST/
CROSSED FEMORAL STRETCHING
TEST
P/B :- DR NIYATI PATEL 28