The causes of<unk> , as for all causes of neurological lesions, should be approached using a localization-focused approach before etiologies are considered. Most of the time,<unk>  is the result of neurological disorder; only rarely is the muscle diseased or nonfunctional. The source for the neurological impairment can be central (spinal cord or brain) or peripheral (nerves located connecting from the spinal cord to an end-site muscle or sensory receptor).<unk>  is rarely the result of a pathology involving the muscles or bones that make up the lower leg. The anterior tibialis is the muscle that picks up the foot. Although the anterior tibialis plays a major role in dorsiflexion, it is assisted by the fibularis tertius, extensor digitorum longus and the extensor hallucis longus. If the drop foot is caused by neurological disorder all of these muscles could be affected because they are all innervated by the deep fibular (peroneal) nerve, which branches from the sciatic nerve. The sciatic nerve exits the lumbar plexus with its root arising from the fifth lumbar nerve space. Occasionally, spasticity in the muscles opposite the anterior tibialis, the gastrocnemius and soleus, exists in the presence of<unk> , making the pathology much more complex than<unk> . Isolated<unk>  is usually a flaccid condition. There are gradations of weakness that can be seen with<unk> , as follows according to MRC: * 0 = complete paralysis, * 1 = flicker of contraction, * 2 = contraction with gravity eliminated alone, * 3 = contraction against gravity alone, * 4 = contraction against gravity and some resistance, and * 5 = contraction against powerful resistance (normal power).<unk>  is different from foot slap, which is the audible slapping of the foot to the floor with each step that occurs when the foot first hits the floor on each step, although they often are concurrent. Treated systematically, possible lesion sites causing<unk>  include (going from peripheral to central): # Neuromuscular disease; # Peroneal nerve (common, i.e., frequent) —chemical, mechanical, disease; # Sciatic nerve—direct trauma, iatrogenic; # Lumbosacral plexus; # L5 nerve root (common, especially in association with pain in back radiating down leg); # Cauda equina syndrome, which is caused by impingement of the nerve roots within the spinal canal distal to the end of the spinal cord; # Spinal cord (rarely causes isolated<unk>  —poliomyelitis, tumor; # Brain (uncommon, but often overlooked) —stroke, TIA, tumor; # Genetic (as in Charcot-Marie-Tooth Disease and hereditary neuropathy with liability to pressure palsies); # Nonorganic causes, e.g. as part of a functional neurological symptom disorder. If the L5 nerve root is involved, the most common cause is a herniated disc. Other causes of<unk>  are diabetes (due to generalized peripheral neuropathy), trauma, motor neuron disease (MND), adverse reaction to a drug or alcohol, and multiple sclerosis. Gait cycle Drop foot and<unk>  are interchangeable terms that describe an abnormal neuromuscular disorder that affects the patient's ability to raise their foot at the ankle. Drop foot is further characterized by an inability to point the toes toward the body (dorsiflexion) or move the foot at the ankle inward or outward. Therefore, the normal gait cycle is affected by the drop foot syndrome. The normal gait cycle is as follows: * Swing phase (SW): The period of time when the foot is not in contact with the ground. In those cases where the foot never leaves the ground (foot drag), it can be defined as the phase when all portions of the foot are in forward motion. * Initial contact (IC): The point in the gait cycle when the foot initially makes contact with the ground; this represents the beginning of the stance phase. It is suggested that heel strike not be a term used in clinical gait analysis as in many circumstances initial contact is not made with the heel. Suggestion: Should use foot strike. * Terminal contact (TC): The point in the gait cycle when the foot leaves the ground: this represents the end of the stance phase or beginning of the swing phase. Also referred to as foot off. Toe-off should not be used in situations where the toe is not the last part of the foot to leave the ground. The drop foot gait cycle requires more exaggerated phases. * Drop foot SW: If the foot in motion happens to be the affected foot, there will be greater flexion at the knee to accommodate the inability to dorsiflex. This increase in knee flexion will cause a stair-climbing movement. * Drop foot IC: Initial contact of the foot that is in motion will not have normal heel-toe foot strike. Instead, the foot may either slap the ground or the entire foot may be planted on the ground all at once. * Drop foot TC: Terminal contact that is observed in patients that have drop foot is quite different. Since patients tend to have weakness in the affected foot, they may not have the ability to support their body weight. Often, a walker or cane will be used to assist in this aspect. Drop Foot is the inability to dorsiflex, evert, or invert the foot. So when looking at the Gait cycle, the part of the gait cycle that involves most dorsiflexion action would be Heel Contact of the foot at 10% of Gait Cycle, and the entire swing phase, or 60-100% of the Gait Cycle. This is also known as Gait Abnormalities.
Foot drop
Wrist drop
Pegleg
Jersey finger
Freckle
Rocker bottom foot
Jammed finger
Habit-tic deformity