Chapter 13 continued - PowerPoint Presentation

Chapter 13 continued Fill in the information for the items marked with a * © 2013 Pearson Education, Inc.

© 2013 Pearson Education, Inc. C. Spinal Nerves 1. General Information * Number : all mixed nerves b) Naming: Most exit inferior to vertebra Cervical: #1-8 C1 exits superior to vertebra #1 * Thoracic : * Lumbar : * Sacral : Coccygeal: 1= C 0 c) * Exit Spinal Column via:

Spinal Nerves Cervical nerves C 1 – C 8 Thoracic nerves T 1 – T 12 Lumbar nerves L 1 – L 5 Sacral nerves S 1 – S 5 Coccygeal nerve Co 1 Cervical plexus Intercostal nerves Cervical enlargement Lumbar enlargement Cauda equina Brachial plexus Lumbar plexus Sacral plexus

Spinal Nerves … d) Spinal Nerves Roots * Formation of Spinal Nerves by fusion of: *Length of Spinal Nerves: Dorsal root ganglion Ventral root Dorsal root Dorsal and ventral rootlets of spinal nerve Ventral ramus of spinal nerve Spinal nerve Rami communicantes

2. Branches of Spinal Nerves: Dorsal ramus Ventral ramus Spinal nerve Rami communicantes Rami * Dorsal ramus: * Ventral ramus: form plexuses in all but T 2 -T 12 Rami Communicates

Figure 13.7 (b) Dorsal ramus Ventral ramus Intercostal nerve Spinal nerve Rami communicantes Dorsal root ganglion Dorsal root Ventral root Sympathetic trunk ganglion Sternum (b) Cross section of thorax showing the main roots and branches of a spinal nerve. Branches of intercostal nerve • Lateral cutaneous • Anterior cutaneous

© 2013 Pearson Education, Inc. 3. *Plexuses = * Formed from :b ) Not all Ventral Rami do this: T2-T11c) Number of Plexuses: d ) Final Product = Mixed Systemic Nerves: Function :*most carry somatic sensory and autonomic to and from skin Brachial Plexus

© 2013 Pearson Education, Inc. Phrenic 4) Cervical Plexus a ) * Ventral rami of : b ) * Body Location: c) Sytemic Nerves Phrenic nerveServes:)

© 2013 Pearson Education, Inc. 5) Brachial Plexus and Upper Limb a ) *Ventral Rami: b) *Body Locations: c) Major branches of this plexus: Roots—five ventral rami (C5 –T1), which formTrunks —upper, middle, and lower, which formDivisions—2 anterior & 3 posterior, which form Cords —lateral, medial, and posterior C4 T1 Lateral Posterior Medial Posterior * Divisions Anterior Divisions * Cords Trunks M shape

© 2013 Pearson Education, Inc. Anterior divisions Roots (ventral rami): Posterior divisions Trunks Roots Dorsal scapular Nerve to subclavius Suprascapular Posterior divisions Lateral Posterior Medial Axillary Musculo- cutaneous Radial Median Ulnar Upper Middle Lower Long thoracic Medial pectoral Lateral pectoral Upper subscapular Lower subscapular Thoracodorsal Medial cutaneous nerves of the arm and forearm C 4 C 5 C 6 C 7 C 8 T 1 Trunks Roots (rami C 5 –T 1 ), trunks, divisions, and cords Cords Figure 13.10a The brachial plexus.

© 2013 Pearson Education, Inc. 5) Brachial Plexus … d) Systemic Nerves of Brachial Plexusi) 3 Nerves form a “M” shape: They are more anterior and superficial and come off the Lateral and Medial cords. * Musculocutaneous: Muscels innervated = Median: to lateral forearm to innervate hand flexorsUlnar: to medial forearm to innervate medial hand flexors Cadaver photo Musculocutaneous nerve Axillary nerve Radial nerve Median nerve Ulnar nerve Lateral cord Posterior cord Medial cord

© 2013 Pearson Education, Inc. Humerus Axillary nerve Radial nerve Musculocutaneous nerve Ulna Radius Ulnar nerve Median nerve Radial nerve (superficial branch) Dorsal branch of ulnar nerve Superficial branch of ulnar nerve Digital branch of ulnar nerve Muscular branch Digital branch Median nerve

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© 2013 Pearson Education, Inc. ii) Nerves branch off Posterior Cord and move posteriorly and deep just below head of humerus *Radial: Muscles innervated =wrist drop Axillary—to armpit: Serves: deltoid, teres minor muscles Cadaver photo Musculocutaneous nerve Axillary nerve Radial nerve Median nerve Ulnar nerve Lateral cord Posterior cord Medial cord

© 2013 Pearson Education, Inc.

© 2013 Pearson Education, Inc. Humerus Axillary nerve Radial nerve Musculocutaneous nerve Ulna Radius Ulnar nerve Median nerve Radial nerve (superficial branch) Dorsal branch of ulnar nerve Superficial branch of ulnar nerve Digital branch of ulnar nerve Muscular branch Digital branch Median nerve

© 2013 Pearson Education, Inc. Suprascapular Long thoracic pectoral subscapular Thoracodorsal iii ) Nerves that can be seen at muscles they innervate (or as they go there) Long Thoracic – is long, innervates Serratus Anterior * Pectoral Nerves (medial and lateral ): Suprascapular : travels at top of shoulder to supraspinatus. Also infraspinatus. Comes off before Trunks superiorly, right before lateral cord * Subscapular (Upper and Lower ): Comes off Posterior Cord above where radial nerve beginsThoracodorsal– to Latissamus Dorsi

© 2013 Pearson Education, Inc. 6) Lumbosacral Plexus: = lumbar and sacral plexuses overlap, so often combined. Serves mainly lower limba) Lumbar PlexusArises from L1–L4 (L5)*Femoral nerve—Comes through Groin area with veins/arteries; Muscles = Saphenous nerve– * hip and knee joints, skinBranch of Femoral nerve*Obturator nerve— travels to medial thigh to innervate = Femoral Saphenous Obturator

© 2013 Pearson Education, Inc. Figure 13.11 The lumbar plexus. Ventral rami Iliohypogastric Ilioinguinal Genitofemoral Lateral femoral cutaneous Obturator Femoral Lumbosacral trunk Iliohypogastric Ilioinguinal Femoral Lateral femoral cutaneous Obturator Anterior femoral cutaneous Saphenous Ventral rami: Ventral rami and major branches of the lumbar plexus Distribution of the major nerves from the lumbar plexus to the lower limb L 1 L 2 L 3 L 4 L 5

© 2013 Pearson Education, Inc. Table 13.5 Branches of the Lumbar Plexus

© 2013 Pearson Education, Inc. b) Sacral Plexus i ) Arises from L4–S4ii) Serves: mainly posterior thigh & leg, but also buttock, pelvic structures, and perineumiii) Sciatic nerveL4 – S3Longest and thickest nerve of body*Serves: prior to branching, serves muscles = -- *Proximal to Knee, Sciatic branches into what two nerves? Sciatica : Sciatic Nerve Common fibular Tibial

© 2013 Pearson Education, Inc. Ventral rami Ventral rami and major branches of the sacral plexus Superior gluteal Lumbosacral trunk Inferior gluteal Common fibular Tibial Posterior femoral cutaneous Pudendal Sciatic Ventral rami: L 4 L 5 S 1 S 2 S 3 S 4 S 5 Co 1 Figure 13.12a The sacral plexus.

© 2013 Pearson Education, Inc. Piriformis Inferior gluteal nerve Common fibular nerve Tibial nerve Pudendal nerve Posterior femoral cutaneous nerve Sciatic nerve Figure 13.12c The sacral plexus. Gluteus maximus Cadaver photo

iv) Tibial Nerve: on Tibia side ( medial)*Serves: posterior thigh and leg muscles = It eventually branches into the plantar nerves, medial and lateral© 2013 Pearson Education, Inc. Sciatic Posterior femoral cutaneous Common fibular Tibial Deep fibular Superficial fibular Plantar branches

Common Fibular Nerve : on fibula side Before Branch it Serves: biceps femoris *Branches into what two nerves:Branches Serve: Externsor Digitorum Longus and Tibialis anterior © 2013 Pearson Education, Inc. Sciatic Common fibular Tibial Deep fibular Superficial fibular Plantar branches

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