A medical student is reviewing maternal lower extremity neuropathies that can occur as complications of labor, operative positioning, or fetal descent. Match each classic postpartum clinical presentation with the specific compromised nerve.
- A patient develops weakness in knee extension, an absent patellar reflex, and numbness over the anterior thigh after a 3-hour second stage of labor in a hyperflexed lithotomy position.Femoral nerve neuropathy
- A patient exhibits a noticeable foot drop and sensory loss over the lateral lower leg and dorsum of the foot following prolonged compression of the lateral knee against hard stirrups.Common fibular (peroneal) nerve neuropathy
- A patient complains of weakness in leg adduction and numbness isolated to the medial aspect of the thigh following prolonged descent of a macrosomic fetus through the maternal pelvis.Obturator nerve neuropathy
- A patient experiences fecal incontinence and severe perineal numbness despite an intact anal sphincter complex on examination, following a difficult forceps-assisted delivery.Pudendal nerve neuropathy
Cevap
1 matches with Femoral nerve neuropathy, 2 matches with Common fibular (peroneal) nerve neuropathy, 3 matches with Obturator nerve neuropathy, and 4 matches with Pudendal nerve neuropathy.
Each neuropathy is correctly identified by combining its specific neuroanatomical distribution (motor and sensory deficits) with its classic intrapartum risk factor (e.g., hyperflexed hips compressing the femoral nerve, hard stirrups compressing the common fibular nerve, fetal head compressing the obturator nerve, and operative stretching of the pudendal nerve).
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Anahtar Kavram
Maternal obstetric neuropathies result from distinct mechanisms of nerve compression or stretch during labor and delivery, with each compromised nerve presenting with a classic and predictable pattern of motor and sensory deficits.