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The first 25 slides, exactly as they appear. The full deck has 59 content slides.
Orthopaedics
Lumbosacral Radiculopathy
Built from Pillemer — Physical Signs in Orthopaedics and Neurology
What’s inside
10 sections · 59 slides
Overview
- What you will learn
Understanding radiculopathy
What is going wrong, and why it matters
- Start with the root: what 'radiculopathy' means
- What lumbosacral radiculopathy is
- What squeezes the root
- How worried should you be?
- Red flags: do not miss these
- The cauda equina triad: three signs that mean 'act now'
Segmental innervation
Three jobs every spinal nerve does at its level
- One nerve level, three functions
Sensory function
Dermatomes and autonomous zones
- Dermatome vs autonomous zone
- Dermatomes of the lower limb
- Autonomous zones of the lower limb
- Autonomous zones, level by level
Motor function
Myotomes and Last's segmental rules
- What a myotome is
- Last's rules of segmental supply
- Seeing the rules in action
- Movements beyond simple flex and extend
- Segments driving each lower-limb joint
- The shortcut you can do in your head
Reflex function
Tap, twitch and what it tells you
- One reflex for each root
- When a reflex seems absent: reinforce it
- Reinforcement to bring out a reflex
- When reflexes are too brisk
The 666 method
A repeatable routine for radiculopathy
- Eighteen quick checks, memorised as three sixes
- How the 666 method works
- The 666 grid: what each test maps to
- Testing the knee reflex (L4)
- Testing the medial hamstring reflex (L5)
- Testing the ankle reflex (S1)
- Testing foot inversion (L4)
- Testing big-toe extension (L5)
- Testing foot eversion (S1)
- Sensation over the inner foot (L4)
- Sensation over the top of the foot (L5)
- Sensation over the outer foot (S1)
- What each root shows when it is damaged
The EDB sign
An overlooked pointer to L5
- Wasting of extensor digitorum brevis
- Extensor digitorum brevis on the foot
The lumbosacral plexus
The wiring behind the roots
- How the plexus is built
- The lumbosacral plexus
- The lumbar plexus
- The lumbar plexus
- Lumbar branches and the saphenous nerve
- The sacral plexus and the sciatic nerve
- The sacral plexus
- Other branches of the sacral plexus
Bringing it together
Takeaways and self-test
- Key takeaways
- Weak big-toe extension, numb dorsum of foot, reduced medial hamstring reflex: which root, and what confirms it?
- Sources referenced in this topic
- Physical Signs in Orthopedic and Neurologic Disorders: A Practical Guide