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PowerPoint ® Lecture Slides prepared by Janice Meeking, Mount Royal College C H A P T E R Copyright © 2010 Pearson Education, Inc. 13 The Peripheral Nervous System and Reflex Activity: Part C
Copyright © 2010 Pearson Education, Inc. Spinal Nerves 31 pairs of mixed nerves named according to their point of issue from the spinal cord 8 cervical (C 1 –C 8 ) 12 thoracic (T 1 –T 12 ) 5 Lumbar (L 1 –L 5 ) 5 Sacral (S 1 –S 5 ) 1 Coccygeal (C 0 )
Copyright © 2010 Pearson Education, Inc. Figure 13.6 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
Copyright © 2010 Pearson Education, Inc. Spinal Nerves: Roots Each spinal nerve connects to the spinal cord via two roots Ventral roots Contain motor (efferent) fibers from the ventral horn motor neurons Fibers innervate skeletal muscles)
Copyright © 2010 Pearson Education, Inc. Spinal Nerves: Roots Dorsal roots Contain sensory (afferent) fibers from sensory neurons in the dorsal root ganglia Conduct impulses from peripheral receptors Dorsal and ventral roots unite to form spinal nerves, which then emerge from the vertebral column via the intervertebral foramina
Copyright © 2010 Pearson Education, Inc. Figure 13.7 (a) Dorsal root ganglion Gray matter White matter Ventral root Dorsal root Dorsal and ventral rootlets of spinal nerve Dorsal ramus of spinal nerve Ventral ramus of spinal nerve Sympathetic trunk ganglion Spinal nerve Rami communicantes Anterior view showing spinal cord, associated nerves, and vertebrae. The dorsal and ventral roots arise medially as rootlets and join laterally to form the spinal nerve.
Copyright © 2010 Pearson Education, Inc. Spinal Nerves: Rami Each spinal nerve branches into mixed rami Dorsal ramus Larger ventral ramus Meningeal branch Rami communicantes (autonomic pathways) join to the ventral rami in the thoracic region
Copyright © 2010 Pearson Education, Inc. Spinal Nerves: Rami All ventral rami except T 2 –T 12 form interlacing nerve networks called plexuses (cervical, brachial, lumbar, and sacral) The back is innervated by dorsal rami via several branches Ventral rami of T 2 –T 12 as intercostal nerves supply muscles of the ribs, anterolateral thorax, and abdominal wall
Copyright © 2010 Pearson Education, Inc. 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
Copyright © 2010 Pearson Education, Inc. Cervical Plexus Formed by ventral rami of C 1 –C 4 Innervates skin and muscles of the neck, ear, back of head, and shoulders Phrenic nerve Major motor and sensory nerve of the diaphragm (receives fibers from C 3 –C 5 )
Copyright © 2010 Pearson Education, Inc. Figure 13.8 Hypoglossal nerve (XII) C1C1 C2C2 C3C3 C4C4 C5C5 Segmental branches Lesser occipital nerve Greater auricular nerve Ansa cervicalis Phrenic nerve Supraclavicular nerves Accessory nerve (XI) Transverse cervical nerve Ventral rami: Ventral rami
Copyright © 2010 Pearson Education, Inc. Table 13.3
Copyright © 2010 Pearson Education, Inc. Brachial Plexus Formed by ventral rami of C 5 –C 8 and T 1 (and often C 4 and T 2 ) It gives rise to the nerves that innervate the upper limb Major branches of this plexus: Roots—five ventral rami (C 5 –T 1 ) Trunks—upper, middle, and lower Divisions—anterior and posterior Cords—lateral, medial, and posterior
Copyright © 2010 Pearson Education, Inc. Figure 13.9 (a) Upper Middle Trunks Lower Roots (ventral rami): Upper subscapular Lower subscapular Thoracodorsal Medial cutaneous nerves of the arm and forearm Long thoracic Medial pectoral Lateral pectoral Nerve to subclavius Suprascapular Dorsal scapular Posterior divisions Anterior divisions Lateral Posterior Cords Medial Axillary Musculo- cutaneous Radial Median Ulnar Posterior divisions Trunks Roots C4C4 C5C5 C6C6 C7C7 C8C8 T1T1 (a) Roots (rami C 5 – T 1 ), trunks, divisions, and cords
Copyright © 2010 Pearson Education, Inc. Figure 13.9 (d) Anterior divisions (d) Flowchart summarizing relationships within the brachial plexus Major terminal branches (peripheral nerves) CordsDivisionsTrunks Roots (ventral rami) Musculocutaneous Median Ulnar Radial Axillary Anterior Posterior Anterior Posterior Anterior Upper Middle Lower Lateral Medial Posterior divisions TrunksRoots C5C5 C6C6 C7C7 C8C8 T1T1
Copyright © 2010 Pearson Education, Inc. Brachial Plexus: Nerves Axillary—innervates the deltoid, teres minor, and skin and joint capsule of the shoulder Musculocutaneous—innervates the biceps brachii and brachialis and skin of lateral forearm Median—innervates the skin, most flexors and pronators in the forearm, and some intrinsic muscles of the hand Ulnar—supplies the flexor carpi ulnaris, part of the flexor digitorum profundus, most intrinsic muscles of the hand, and skin of medial aspect of hand Radial—innervates essentially all extensor muscles, supinators, and posterior skin of limb
Copyright © 2010 Pearson Education, Inc. Figure 13.9 (c) Median nerve Musculocutaneous nerve Radial nerve Humerus Ulna Ulnar nerve Median nerve Radius Radial nerve (superficial branch) Superficial branch of ulnar nerve Dorsal branch of ulnar nerve Digital branch of ulnar nerve Muscular branch Digital branch (c) The major nerves of the upper limb Axillary nerve Anterior divisions Posterior divisions TrunksRoots
Copyright © 2010 Pearson Education, Inc. Table 13.4
Copyright © 2010 Pearson Education, Inc. Lumbar Plexus Arises from L 1 –L 4 Innervates the thigh, abdominal wall, and psoas muscle Femoral nerve—innervates quadriceps and skin of anterior thigh and medial surface of leg Obturator nerve—passes through obturator foramen to innervate adductor muscles
Copyright © 2010 Pearson Education, Inc. Figure (a) Ventral rami and major branches of the lumbar plexus Iliohypogastric L1L1 L2L2 L3L3 L4L4 L5L5 Ilioinguinal Genitofemoral Lateral femoral cutaneous Obturator Femoral Lumbosacral trunk Lateral femoral cutaneous Anterior femoral cutaneous Saphenous Obturator Iliohypogastric Ilioinguinal Femoral Ventral rami Ventral rami: (b) Distribution of the major nerves from the lumbar plexus to the lower limb
Copyright © 2010 Pearson Education, Inc. Table 13.5
Copyright © 2010 Pearson Education, Inc. Sacral Plexus Arises from L 4 –S 4 Serves the buttock, lower limb, pelvic structures, and perineum Sciatic nerve Longest and thickest nerve of the body Innervates the hamstring muscles, adductor magnus, and most muscles in the leg and foot Composed of two nerves: tibial and common fibular
Copyright © 2010 Pearson Education, Inc. Figure (a) Superior gluteal Lumbosacral trunk Inferior gluteal Common fibular Tibial Posterior femoral cutaneous Pudendal Sciatic Ventral rami and major branches of the sacral plexus L4L4 L5L5 S1S1 S2S2 S3S3 S4S4 S5S5 Co 1 Ventral rami Ventral rami:
Copyright © 2010 Pearson Education, Inc. Figure (b) Superior gluteal Inferior gluteal Common fibular Deep fibular Superficial fibular Plantar branches Tibial Sural (cut) Posterior femoral cutaneous Pudendal Sciatic (b) Distribution of the major nerves from the sacral plexus to the lower limb
Copyright © 2010 Pearson Education, Inc. Table 13.6
Copyright © 2010 Pearson Education, Inc. Innervation of Skin Dermatome: the area of skin innervated by the cutaneous branches of a single spinal nerve All spinal nerves except C 1 participate in dermatomes Most dermatomes overlap, so destruction of a single spinal nerve will not cause complete numbness
Copyright © 2010 Pearson Education, Inc. Figure C2 C3 C4 C5 T1 T2 T3 T4 T5 C6 C8 C7 C6 T6 T7 T8 T9 T10 T11 T12 L1 S2 S3 L1 L2 L3 L4 L5 L2 L3 L4 L5 S1 C5 C6 C8 T2 C5 C6 S1 Anterior view C2 C3 C4 C5 C6 C7 C8 C7 T1 T2 T3 T4 T5 T6 T7 T8 T9 T10 T11 T12 L1 L2 L3 S1 (b) Posterior view L5 S2 S1 S3 S2S1S2 S4 S5 L5 L4 L5 L4 C6 C5 L4 L3 L2 L1 L4
Copyright © 2010 Pearson Education, Inc. Innervation of Joints Hilton’s law: Any nerve serving a muscle that produces movement at a joint also innervates the joint and the skin over the joint
PowerPoint ® Lecture Slides prepared by Janice Meeking, Mount Royal College C H A P T E R Copyright © 2010 Pearson Education, Inc. 13 The Peripheral Nervous.
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