Copyright Ted Nissen 2003
1.2 Cutaneous Nerves-Head 1 (31)
1.3 Cutaneous Nerves-Head 2 (32)
1.4 Cutaneous Nerves-Arms (33)
1.5 Cutaneous Nerves-Hands (34)
1.6 Cutaneous Nerves-Back (36)
1.7 Cutaneous Nerves-Front of Chest
(36)
1.8 Cutaneous Nerves-Foot (35)
1.9 Cutaneous Nerves-Legs (35)
2.18 ANSA CERVICALIS (ANSA HYPOGLOSSI)
2.20 RECTUS CAPITIS LATERALIS N.
2.21 RECTUS CAPITIS ANTERIOR N.
2.33 THORACODORSAL N. (MIDDLE
SUBSCAPULAR N.)
3.4 MEDIAL BRACHIAL CUT
N.(FLASH;MEDIAL CUT)(GRAY;LESSER INTERNAL CUT,N. OF WRISBERG)
3.7 MED ANTEBRACHIAL CUT
N.(FLASH;MEDIAL CUTANEOUS N. OF
FOREARM),(GRAY; INTERNAL CUT N.)
5.1 12TH THORACIC INTERCOSTAL (SUB
COSTAL) 35.01
5.2 Lumbar Plexus (Spinal Segments
& Nerves) (61)
5.4 Lumbar Plexus (Muscular Branches
and Relationships) (63)
5.5 Nerves from Ventral Rami of
Lumbar Plexus (64)
5.6 Iliohypogastric Nerve (65)
(Blank)
5.8 Ilio-Inquinal Nerve (66) (Blank)
5.10 Genitofemoral Nerve (67) (Blank)
5.12 Nerves from Ventral Division of
Ventral Rami Lumbar Plexus (68)
5.13 Obturator Nerve (69) (Blank)
5.15 Accessory Obturator Nerve (70)
(Blank)
5.17 Lumbar Plexus (Nerves from Dorsal
Divisions-Ventral Rami (71)
5.18 Lateral Cutaneous Femoral Nerve
(72) (Blank)
5.19 Femoral Nerve (Abdominal Branches)
(73) (Blank)
5.20 Femoral Nerve (Anterior Division)
(74) (Blank)
5.23 Femoral Nerve (Posterior Division)
(75)
5.24 Sacral Plexus (Spinal Segments
& Nerves) (76)
5.25 Sacral Plexus (L4, L5, S1, S2, S3)
(77)
5.26 Sacral Plexus (Nerves from Ventral
Divisions of Ventral Rami) (78)
5.27 Sacral Plexus (Nerves from Dorsal
Divisions of Ventral Rami) (79)
5.28 QUADRATUS FEMORIS N. (80)
5.33 POSTERIOR FEMORAL CUTANEOUS (85)
5.35 Tibial Nerve (Branches Arising
between Gastrocnemius Heads) (87)
5.36 Tibial Nerve (Branches Arising in
the Leg) (88)
5.37 Tibial Nerve (Medial Sural and
Medial Calcanean Cutaneous Branches) (89)
5.38 Medial Plantar (Tibial) (90)
5.39 Lateral Plantar Nerve &
Superficial Branch (Tibial) (91)
5.40 Lateral Plantar Nerve Deep Branch
(Tibial) (92)
5.41 Common Peroneal (Fibular) Nerve
(93)
5.42 Deep Peroneal (Anterior Tibial)
Nerve (Branches Arising in the Leg) (94)
5.43 Deep Peroneal Medial and Lateral
Terminal Branches (95)
5.44 Superficial Peroneal Nerve (96)
5.45 Superficial Peroneal Nerve Medial
and Lateral Terminal Branches (97)
5.46 Perforating Cutaneous Nerve (98)
(Blank)
5.47 Sacral Muscular Branches (4th
Sacral) (99) (Blank)
5.48 Pudendal Nerve: Inferior Rectal
Branch (Inferior Hemeorrhoidal Nerve) (100) (Blank)
5.49 Pudendal Nerve (Perineal Branch)
(101) (Blank)
5.50 Pudendal Nerve (Dorsal Nerve of
Penis or Clitoris) (102) (Blank)
6.7 1ST DORSAL RAMUS(SUBOCCIPITAL N)
6.8 2ND DOR RAMUS(GREATER OCCIPITAL
N)
6.12 LOWR THOR DOR RAM (T7-12)
6.14 UPPER SACRAL DOR RAM (S1-3)
6.15 LWR SAC&COC DR R(ANOCOCCYGEAL
N) (S4,5,C01)
1 Cutaneous Nerves
All
1.1 Index
1.1.1 http://www.anatomyfacts.com/Muscle/cutaneousnerves.htm
1.2 Cutaneous
Nerves-Head 1 (31)
1.2.1 http://www.anatomyfacts.com/Muscle/Illustrations.htm#CNH1
1.3 Cutaneous
Nerves-Head 2 (32)
1.3.1 http://www.anatomyfacts.com/Muscle/Illustrations.htm#CNH2
1.4 Cutaneous
Nerves-Arms (33)
1.4.1 http://www.anatomyfacts.com/Muscle/Illustrations.htm#CNA
1.5 Cutaneous
Nerves-Hands (34)
1.5.1 http://www.anatomyfacts.com/Muscle/Illustrations.htm#CNH
1.6 Cutaneous
Nerves-Back (36)
1.6.1 http://www.anatomyfacts.com/Muscle/Illustrations.htm#CNB
1.7 Cutaneous
Nerves-Front of Chest (36)
1.7.1 http://www.anatomyfacts.com/Muscle/Illustrations.htm#CNFC
1.8 Cutaneous
Nerves-Foot (35)
1.8.1 http://www.anatomyfacts.com/Muscle/Illustrations.htm#CNF
1.9 Cutaneous
Nerves-Legs (35)
1.9.1 http://www.anatomyfacts.com/Muscle/Illustrations.htm#CNL
2 HEAD & NECK
2.1 OLFACTORY
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Table of Contents References
2.1.1 DESCRIPTION # 1:
PATH, FUNCTION
2.1.1.1
SMELL
2.1.2 ROOTS
2.1.2.1
CN 1
2.2
OPTIC
2.2.1 DESCRIPTION # 1: PATH,
FUNCTION
2.2.1.1
VISION
2.2.2 ROOTS
2.2.2.1
CN 2
2.3 OCULOMOTOR
2.3.1 DESCRIPTION # 1:
PATH, FUNCTION
2.3.1.1
EYE MOVEMENTS; MOVEMENT OF EYE BALL, EYELID, CONSTRICTION OF
LENS FOR NEAR VISION
2.3.2 MUSCULAR
BRANCHES(OCCULO)
2.3.2.1
SUPERIOR RECTUS
2.3.2.2
INFERIOR RECTUS
2.3.2.3
MEDIAL RECTUS
2.3.2.4
INFERIOR OBLIQUE
2.3.2.5
LEVATOR PALPEBRAE SUPERIORIS
2.3.3 ROOTS
2.3.3.1
CN 3
2.4 TROCHELEAR
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Table of Contents References
2.4.1 DESCRIPTION # 1:
PATH, FUNCTION
2.4.1.1
EYE MOVEMENTS; EYE BALL MEVEMENT
2.4.2 MUSCULAR BRANCHES(TROCH)
2.4.2.1
SUPERIOR OBLIQUE
2.4.3 ROOTS
2.4.3.1
CN4
2.5 TRIGEMINAL
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Table of Contents References
2.5.1 DESCRIPTION # 1:
PATH, FUNCTION
2.5.1.1
SENSATION TO FACE, CHEWING. SUPRFICIAL SEN=PONS VAROLII,
DEEP SEN= LONG TRACT OF MEDULLA,LWR SEN=SUBSTANIA GELATINOSA ROLANDO,
SEMILUNAR(GASSERIAN) GANGLION=LODGED IN AN OSTEO-FIBROUS SPACE THE CAVUM
MECKELII NEAR THE APEX OF THE PETROUS PORTION OF THE TEMPORAL BONE.
2.5.2 Illustration
2.5.2.1
Reference Number
2.5.2.1.1 31.01
2.5.2.2
Illustration Link
2.5.2.2.1 Trigeminal
2.5.3 NEUROLOGICAL
BRANCHES
2.5.3.1
OPHTHALMIC (TRI)
2.5.3.1.1
DESCRIPTION # 1: PATH, FUNCTION
2.5.3.1.1.1
PASSES
FORWARD ALONG OUTER WALL OF CAVERNOUS SINUS AND JUST BEFORE ENTERING THE ORBIT
THR T SPHENOIDAL FISSURE DIVIDES IN THRE BRANCHES LACHRYMAL, FRONTAL &
NASAL. IT THEN PASSES THRU SUP ORBITAL FISSURE
2.5.3.1.2
DESCRIPTION # 2: CUTANEOUS AREA, ADDITIONAL
COMMENTS
2.5.3.1.2.1
U
EYELID,MUCOUS LINING OF THE EYE,SKIN OF EYEBROW,EYEBALL,LACRIMAL GL,NAS CAVITY,
SIDE OF NOSE, FOREHEAD,A 1/2 OF SCLP.
2.5.3.1.3
Reference
Number
2.5.3.1.3.1 31.011
2.5.3.1.4 Illustration Link
2.5.3.1.4.1 Ophthalmic
2.5.3.2
MAXILLARY (TRI)
2.5.3.2.1
DESCRIPTION # 1: PATH, FUNCTION
2.5.3.2.1.1
FORAMEN
ROTUNDUM
2.5.3.2.2
DESCRIPTION # 2: CUTANEOUS AREA, ADDITIONAL
COMMENTS
2.5.3.2.2.1
MUCOSA
OF NOSE, PALATE, PHARYNX, U TEETH, U LIPL EYELID.
2.5.3.2.3
Reference
Number
2.5.3.2.3.1 31.012
2.5.3.2.4 Illustration Link
2.5.3.2.4.1 Maxillary
2.5.3.3
MANDIBULAR (TRI)
2.5.3.3.1
DESCRIPTION # 1: PATH, FUNCTION
2.5.3.3.1.1
FORAMEN
OVALE
2.5.3.3.2
DESCRIPTION # 2: CUTANEOUS AREA, ADDITIONAL
COMMENTS
2.5.3.3.2.1
A
2/3 TOUGUE L TEETH, SKIN O MANDIBLE,CHECK & MUCOSA,SIDE O HEAD IN F OF EAR,
2.5.3.3.3
Reference
Number
2.5.3.3.3.1 31.011
2.5.3.3.4 Illustration Link
2.5.3.3.4.1 Mandibular
2.5.4 MUSCULAR BRANCHES
(MANDIBULAR)
2.5.4.1
MASSETER
2.5.4.2
TEMPORALIS
2.5.4.3
MEDIAL PTERYGOID
2.5.4.4
LATERAL PTERYGOID
2.5.4.5
TENSOR VELI PALATINI
2.5.4.6
DIGASTRIC (ANTERIOR BELLY)
2.5.4.7
MYLOHYOID
2.5.5 ROOTS
2.5.5.1
CN 5
2.6 ABDUCENS
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Table of Contents References
2.6.1 DESCRIPTION # 1:
PATH, FUNCTION
EYE MOVEMENTS; EYE BALL MEVEMENT
2.6.2 MUSCULAR
BRANCHES(ABDUCENS)
2.6.2.1
LATERAL RECTUS
2.6.3 ROOTS
2.6.3.1
CN 6
2.7 FACIAL
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Table of Contents References
2.7.1 DESCRIPTION # 1:
PATH, FUNCTION
FACIAL EXPRESSION, TASTE,SALIVA SECRETION, TEARS.
2.7.2 MUSCULAR BRANCHES
(FACIAL)
2.7.2.1
FRONTALIS (EPICRANIUS 1)
2.7.2.2
OCCIPITALIS (EPICRANIUS 2)
2.7.2.3
ORBICULARIS ORIS
2.7.2.4
ZYGOMATICUS MAJOR
2.7.2.5
LEVATOR LABIL SUPERIORIS
2.7.2.6
DEPRESSOR LABII INFERIORIS
2.7.2.7
BUCCINATOR
2.7.2.8
MENTALIS
2.7.2.9
PLATYSMA
2.7.2.10
RISORIUS
2.7.2.11
ORBICULARIS OCULI
2.7.2.12
CORRUGATOR SUPERCILLI
2.7.2.13
STYLOHYOID
2.7.2.14
DIAGASTRIC (POSTERIOR BELLY)
2.7.2.15
STAPEDIUS
2.7.3 CUTANEOUS (FACIAL)
2.7.3.1
DESCRIPTION # 1: PATH, FUNCTION
TASTE IN ANTERIOR TWO-THIRDS OF TONGUE. SENSATION TO SOFT PALATE. INNERVATION OF SALIVARY GLANDS.
2.7.4 ROOTS
2.7.4.1
CN 7
2.8 ACOUSTIC
2.8.1 DESCRIPTION # 1:
PATH, FUNCTION
HEARING, EQUILIBRIUM
2.8.2 ROOTS
2.8.2.1
CN 8
2.9 GLOSSOPHARYNGEAL
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Table of Contents References
2.9.1 DESCRIPTION # 1:
PATH, FUNCTION
TASTE, SPEECH
2.9.2 MUSCULAR
BRANCHES(GLOSSO)
2.9.2.1
STYLOPHARYNGEUS
2.9.3 CUTANEOUS(GLOSSO)
TASTE IN POSTERIOR 2/3 RDS OF TONGUE. SENSATION TO FAUCES, TONSILS, PHARYNX, AND SOFT PALATE.
2.9.4 ROOTS
2.9.4.1
CN 9
2.10 VAGUS
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Table of Contents References
2.10.1
DESCRIPTION # 1: PATH, FUNCTION
PARASYMPATHETIC, VISERAL MUSCLE MOVEMENT, SENSATION FROM ORGANS
2.10.2
CUTANEOUS(VAGUS)
SENSORY FIBERS TO SKIN IN BACK OF AURICLE, POSTERIOR PORTION OF EXTERNAL ACOUSTIC MEATUS, PHARYNX, LARYNX, THORACIC AND ABDOMINAL VISCERA.
2.10.3
RECURRENT LARYNGEAL(VAGUS)
2.10.3.1
MUSCULAR BRANCHES(RECURR LARG)
2.10.3.1.1
POSTERIOR
CRICOARYTENOID
2.10.3.1.2
LATERAL
CRICOARYTENOID
2.10.3.1.3
ARYTENOID
2.10.3.1.4
THYROARYTENOID
2.10.4
EXTERNAL LARYNGEAL(VAGUS)
2.10.4.1
MUSCULAR BRANCHES(EXTER LARG)
2.10.4.1.1
CRICOTHYROID
2.10.5
PHARYNGEAL BRANCH(VAGUS)
2.10.5.1
MUSCULAR BRANCHES(PHARYN)
2.10.5.1.1
INFERIOR
CONSTRICTOR
ADDITIONAL INNERVATION: WITH FILIMENTS FROM SPINAL ACCESSARY NERVE WHICH TRAVELS THRU PHARYNGEAL PLEXUS.
2.10.5.1.2
MIDDLE
CONSTRICTOR
ADDITIONAL INNERVATION: WITH FILIMENTS FROM SPINAL ACCESSARY NERVE WHICH TRAVELS THRU PHARYNGEAL PLEXUS.
2.10.5.1.3
SUPERIOR
CONSTRICTOR
ADDITIONAL INNERVATION: WITH FILIMENTS FROM SPINAL ACCESSARY NERVE WHICH TRAVELS THRU PHARYNGEAL PLEXUS.
2.10.5.1.4
PALATOGLOSSUS
ADDITIONAL INNERVATION: WITH FILIMENTS FROM SPINAL ACCESSARY NERVE WHICH TRAVELS THRU PHARYNGEAL PLEXUS.
2.10.5.1.5
SALPINGOPHARYNGEUS
ADDITIONAL INNERVATION: WITH FILIMENTS FROM SPINAL ACCESSARY NERVE WHICH TRAVELS THRU PHARYNGEAL PLEXUS.
2.10.5.1.6
PALATOPHARYNGEUS
ADDITIONAL INNERVATION: WITH FILIMENTS FROM SPINAL ACCESSARY NERVE WHICH TRAVELS THRU PHARYNGEAL PLEXUS.
2.10.5.1.7
LEVATOR
VELI PALATINI
ADDITIONAL INNERVATION: WITH FILIMENTS FROM SPINAL ACCESSARY NERVE WHICH TRAVELS THRU PHARYNGEAL PLEXUS.
2.10.5.1.8
MUSCULUS
UVULAE
ADDITIONAL INNERVATION: WITH FILIMENTS FROM SPINAL ACCESSARY NERVE WHICH TRAVELS THRU PHARYNGEAL PLEXUS.
2.10.5.1.9
PALATOGLOSSUS
ADDITIONAL INNERVATION: WITH FILIMENTS FROM SPINAL ACCESSARY NERVE WHICH TRAVELS THRU PHARYNGEAL PLEXUS.
2.10.5.1.10
PALATOPHARYNGEUS
ADDITIONAL INNERVATION: WITH FILIMENTS FROM SPINAL ACCESSARY NERVE WHICH TRAVELS THRU PHARYNGEAL PLEXUS.
2.10.6
ROOTS
2.10.6.1
CN 10
2.10.7
References
2.10.7.1
2.11 SPINAL ACCESSORY
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Table of Contents References
2.11.1
DESCRIPTION # 1: PATH, FUNCTION
SWALLOWING, MOVEMENT OF HEAD
2.11.2
ROOTS
2.11.2.1
CN11
2.11.3
MUSCULAR BRANCHES(SPINL ACCES)
2.11.3.1
STERNOCLEIDOMASTOID
2.11.3.1.1
CARD=
21
2.11.3.1.2
INNERVATION
2.11.3.1.2.1
(XI(C1-5)
MOTOR)
2.11.3.2
TRAPEZIUS
2.11.3.2.1
CARD=
22
2.11.3.2.2
INNERVATION
2.11.3.2.2.1
(XI(C1-5)
MOTOR)
2.12 HYPOGLOSSAL
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Table of Contents References
2.12.1
DESCRIPTION # 1: PATH, FUNCTION
MOVEMENT OF TONGUE DURNING SPEECH AND SWALLOWING.
2.12.2
ROOTS
2.12.2.1
CN12
2.12.3
MUSCULAR BRANCHES(HYPO)
2.12.3.1
GENIOGLOSSUS
2.12.3.2
STYLOGLOSSUS
2.12.3.3
HYOGLOSSUS
2.12.3.4
STYLOHYOID
2.12.3.5
MYHLOHYOID
2.12.3.6
OMOHYOID(INFERIOR BELLY)
2.12.3.7
THYROHYOID(DECENDING HYPOGLOSSAL)
2.12.3.8
GENIOHYOID
2.12.3.9
INTRINSIC MUS OF TONGUE
2.13 LESSER OCCIPITAL
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Table of Contents References
2.13.1
DESCRIPTION # 1: PATH, FUNCTION-LESIONS
A FOCAL LESION WILL RESULT IN PARESTHESIA OR LACK OF SENSATION TO THE SKIN DESCRIBED IN THE CUTANEOUS SECTION OF THIS NERVE.
2.13.2
DESCRIPTION # 2: CUTANEOUS AREA, ADDITIONAL COMMENTS
MID NECK ALONG THE P BORDER OF SCM &PRT O MASTOID PRO A T SCALP BEH T LWAR & UPPER MEDIAN PRT O AURICLE.
2.13.3
ROOTS
2.13.3.1
C2-C3
2.13.3.2
SPINAL NERVE
2.13.3.3
VENTRAL
2.13.4
NUMBER
2.13.4.1
32.01
2.13.5
CARD
2.13.5.1
9
2.14 GREATER AURICULAR
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Table of Contents References
2.14.1
DESCRIPTION: PATH,
FUNCTION, LESIONS, CUTANEOUS AREA, AND ADDITIONAL COMMENTS
2.14.1.1
.
2.14.2
NUMBER
2.14.2.1
35
2.14.3
REFERENCE
2.14.3.1
2.14.4
ROOTS
2.14.4.1
2.14.4.2
Lumbar Plexus
2.14.4.3
VENTRAL
2.14.5
DIVISION
2.14.5.1
Dorsal Ventral
2.14.5.2
2.14.6
CUTANEOUS BRANCHES
2.14.6.1
2.14.6.1.1
2.14.6.2
2.14.6.2.1
.
2.14.7
ARTICULAR BRANCHES
2.14.7.1
2.14.7.1.1
2.14.8
MUSCULAR BRANCHES
2.14.8.1
2.14.8.2
2.14.8.3
2.14.8.4
2.14.8.5
2.14.8.6
2.15 TRANSVERSE (ANT)
CUT
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Table of Contents References
2.15.1
DESCRIPTION: PATH, FUNCTION,
LESIONS, CUTANEOUS AREA, AND ADDITIONAL COMMENTS
2.15.1.1
.
2.15.2
NUMBER
2.15.2.1
35
2.15.3
REFERENCE
2.15.3.1
2.15.4
ROOTS
2.15.4.1
2.15.4.2
Lumbar Plexus
2.15.4.3
VENTRAL
2.15.5
DIVISION
2.15.5.1
Dorsal Ventral
2.15.5.2
2.15.6
CUTANEOUS BRANCHES
2.15.6.1
2.15.6.1.1
2.15.6.2
2.15.6.2.1
.
2.15.7
ARTICULAR BRANCHES
2.15.7.1
2.15.7.1.1
2.15.8
MUSCULAR BRANCHES
2.15.8.1
2.15.8.2
2.15.8.3
2.15.8.4
2.15.8.5
2.15.8.6
2.16 SUPRACLAVICULAR
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Table of Contents References
2.16.1
DESCRIPTION: PATH,
FUNCTION, LESIONS, CUTANEOUS AREA, AND ADDITIONAL COMMENTS
2.16.1.1
.
2.16.2
NUMBER
2.16.2.1
35
2.16.3
REFERENCE
2.16.3.1
2.16.4
ROOTS
2.16.4.1
2.16.4.2
Lumbar Plexus
2.16.4.3
VENTRAL
2.16.5
DIVISION
2.16.5.1
Dorsal Ventral
2.16.5.2
2.16.6
CUTANEOUS BRANCHES
2.16.6.1
2.16.6.1.1
2.16.6.2
2.16.6.2.1
.
2.16.7
ARTICULAR BRANCHES
2.16.7.1
2.16.7.1.1
2.16.8
MUSCULAR BRANCHES
2.16.8.1
2.16.8.2
2.16.8.3
2.16.8.4
2.16.8.5
2.16.8.6
2.17 SUPRASCAPULAR
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Table of Contents References
2.17.1
DESCRIPTION: PATH,
FUNCTION, LESIONS, CUTANEOUS AREA, AND ADDITIONAL COMMENTS
2.17.1.1
.
2.17.2
NUMBER
2.17.2.1
35
2.17.3
REFERENCE
2.17.3.1
2.17.4
ROOTS
2.17.4.1
2.17.4.2
Lumbar Plexus
2.17.4.3
VENTRAL
2.17.5
DIVISION
2.17.5.1
Dorsal Ventral
2.17.5.2
2.17.6
CUTANEOUS BRANCHES
2.17.6.1
2.17.6.1.1
2.17.6.2
2.17.6.2.1
.
2.17.7
ARTICULAR BRANCHES
2.17.7.1
2.17.7.1.1
2.17.8
MUSCULAR BRANCHES
2.17.8.1
2.17.8.2
2.17.8.3
2.17.8.4
2.17.8.5
2.17.8.6
2.18
ANSA CERVICALIS (ANSA
HYPOGLOSSI)
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Table of Contents References
2.18.1
DESCRIPTION: PATH,
FUNCTION, LESIONS, CUTANEOUS AREA, AND ADDITIONAL COMMENTS
2.18.1.1
.
2.18.2
NUMBER
2.18.2.1
35
2.18.3
REFERENCE
2.18.3.1
2.18.4
ROOTS
2.18.4.1
2.18.4.2
Lumbar Plexus
2.18.4.3
VENTRAL
2.18.5
DIVISION
2.18.5.1
Dorsal Ventral
2.18.5.2
2.18.6
CUTANEOUS BRANCHES
2.18.6.1
2.18.6.1.1
2.18.6.2
2.18.6.2.1
.
2.18.7
ARTICULAR BRANCHES
2.18.7.1
2.18.7.1.1
2.18.8
MUSCULAR BRANCHES
2.18.8.1
2.18.8.2
2.18.8.3
2.18.8.4
2.18.8.5
2.18.8.6
2.19
PHRENIC (phrenic19)
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Table of Contents References
2.19.1
Spinal Roots C3, C4, & C5
2.19.1.1
.
2.19.2
Cutaneous Branches
2.19.2.1
None
2.19.3
Sensory Branches
2.19.3.1
The anterior, anterolateral and posterior branches supply
Proprioceptive endings in the diaphragm, parietal peritoneum of the diaphragm,
and diaphragmatic pleura related to the central tendon and musculature.
2.19.4
Muscular Branches-To the Diaphragm divided into three branches
2.19.4.1 A=Anterior (sternal) branches
2.19.4.1.1
Supply
the muscular fibers anterior to the central tendon.
2.19.4.2 B=Anterolateral branches
2.19.4.2.1
Supply
the muscular fibers anterior to the lateral leaf of the central tendon
2.19.4.3 C=Posterior branches
2.19.4.3.1
Supply
the muscular fibers posterior to the central tendon, including the crural
fibers.
2.19.5
Articular Branches
2.19.5.1
None
2.19.6
Lesions
2.19.6.1
Complete section of the phrenic nerve will produce paralysis
and atrophy of corresponding part of the diaphragm. Unilateral lesion: few or
no symptoms may be exhibited. Bilateral lesion: usually from damage to the
cervical spinal cords. Presents as severe dyspnea (difficult or laboured
respiration-shortness of breath) upon slightest exertion, over activity of
accessory respiratory muscles, difficulty in coughing and sneezing and atrophy
of diaphragm. If an accessory phrenic nerve exists and escapes damage the
paralysis will be incomplete.
2.19.7
Note
2.19.7.1
An accessory phrenic nerve would branch from the nerve to
the subclavius or ansa cervicalis.
2.19.8
Path Description
2.19.8.1
The Phrenic Nerve (n. phrenicus; internal respiratory nerve
of Bell) contains motor and sensory fibers in the proportion of about two to
one. It arises chiefly from the fourth cervical nerve, but receives a branch
from the third and another from the fifth; (the fibers from the fifth
occasionally come through the nerve to the Subclavius.) It descends to the root
of the neck, running obliquely across the front of the Scalenus anterior, and
beneath the Sternocleidomastoideus, the inferior belly of the Omohyoideus, and
the transverse cervical and transverse scapular vessels. It next passes in
front of the first part of the subclavian artery, between it and the subclavian
vein, and, as it enters the thorax, crosses the internal mammary artery near
its origin. Within the thorax, it descends nearly vertically in front of the
root of the lung, and then between the pericardium and the mediastinal pleura,
to the diaphragm, where it divides into branches, which pierce that muscle, and
are distributed to its under surface. In the thorax it is accompanied by the
pericardiacophrenic branch of the internal mammary artery.
2.19.8.2
The two phrenic
nerves differ in their length, and also in their relations at the upper part of
the thorax. 22
2.19.8.3
The right nerve is
situated more deeply, and is shorter and more vertical in direction than the
left; it lies lateral to the right innominate vein and superior vena cava. 23
2.19.8.4
The left nerve is
rather longer than the right, from the inclination of the heart to the left
side, and from the diaphragm being lower on this than on the right side. At the
root of the neck it is crossed by the thoracic duct; in the superior
mediastinal cavity it lies between the left common carotid and left subclavian
arteries, and crosses superficial to the vagus on the left side of the arch of
the aorta.
2.19.8.1
Each nerve supplies filaments to the pericardium
and pleura, and
at the root of the neck is joined by a filament from the sympathetic, and,
occasionally, by one from the ansa hypoglossi. Branches have been described as
passing to the peritoneum.
2.19.8.2
From the right
nerve, one or two filaments pass to join in a small phrenic ganglion with
phrenic branches of the celiac plexus; and branches from this ganglion are
distributed to the falciform and coronary ligaments of the liver, the
suprarenal gland, inferior vena cava, and right atrium. From the left nerve,
filaments pass to join the phrenic branches of the celiac plexus, but without
any ganglionic enlargement; and a twig is distributed to the left adrenal
gland (suprarenal gland).
2.19.8.3
The phrenic nerve arises from the
third, fourth, and fifth cervical spinal nerves (C3-C5). It provides motor innervation to the diaphragm and is thus responsible for
the act of breathing. In addition, it provides sensory innervation for many
components of the mediastinum and pleura,
as well as the upper abdomen, especially the liver
and gall bladder. Pain arising from structures served by the phrenic
nerve is often "referred" to other somatic regions served by spinal
nerves C3-C5. For instance, angina pectoris classically is felt both in
the chest and in the left arm. Likewise, a liver abscess close to the diaphragm
will be felt in the right shoulder.
2.19.8.4
Both phrenic nerves run from C3, C4 and C5 along the anterior scalene muscle deep to the carotid sheath. The right phrenic nerve passes over the right brachiocephalic artery, the subclavian vein, and the superior vena cava and then crosses the
root of the right lung and then leaves the thorax
by passing through the vena cava hiatus opening in the diaphragm at the level
of T10. The right phrenic nerve passes over the right atrium. The left phrenic
nerve passes over the left ventricle and pierces the diaphragm separately.
2.19.8.5
Both these nerves supply motor fibres to the diaphragm and
sensory fibres to the fibrous pericardium, mediastinal pleura and diaphragmatic peritoneum.
2.19.8.6
Irritation of the phrenic nerve leads to the Hiccup Reflex,
which is due to spasms of the diaphram pushing air that hits the closed folds
of the glottis.
2.19.1
Functional Anatomy
2.19.1.1
The Phrenic Nerve contains twice as many motor nerve fibers
as sensory fibers. The Phrenic Nerve arises mostly from fourth cervical nerve
(C4), but receives a branch from the third (C3) and another from the fifth
(C5). The phrenic nerve http://en.wikipedia.org/wiki/Phrenic_nerve
forms
from both the cervical http://www.bartleby.com/107/illus804.html
and Brachial Plexus http://www.bartleby.com/107/illus807.html. The motor fibers send nerve impulses from the
brain (efferent) to the diaphragm muscle, which then tightens. When the
diaphragm muscle contracts it increases the volume of the cavity in which the
lungs are contained. This expands the lungs and allows you to take a deep
breath, cough, or sneeze. If the phrenic nerve is completely cut (Complete
section) it becomes very difficult to breathe (Dyspnea (difficult or laboured
respiration)). The afferent sensory fibers of the Phrenic Nerve
send impulses to the spinal cord from the following structures; to the hearts pericardium and
pleura of the lungs, Mediastinum (non-delineated group of structures in the
thorax (chest)), inferior vena cava, and right atrium, peritoneum (smooth
transparent serous membrane that lines the cavity of the abdomen), falciform
and coronary ligaments of the liver, and adrenal gland (suprarenal gland). Some
references indicate phrenic sensory
nerve connections to the gall bladder (although one references
mentions=no specifics are given http://en.wikipedia.org/wiki/Phrenic_nerve), capsule of the
liver, and pancreas (As he stated in his article). I will then assume that
these do not exist until otherwise informed. The phrenic nerve sensory fibers
will refer pain from the aforementioned structures it supplies to other somatic
regions also supplied by the nerve roots that form the phrenic nerve (C3-5).
Dermatomal, sclerotomal and or proprioceptive pain referral is possible. For
example heart disease (angina pectoris) may be felt in the chest and or down
the left arm. Liver or Gall bladder problems near the diaphragm may be felt in
the right shoulder. Pain in the shoulder or down the arm from irritated
visceral structures does not constitute prima facie evidence for phrenic nerve
transmission of psychological stress nor does it necessarily imply a role in
more complex Orthopedic, muscular and or skeletal problems.
2.19.2
Theory WARNING LABEL; I am not a neurologist and THIS IS A
THEORY. When I’m not sure about something I will mark it with a (?=not sure)
2.19.2.1
The sensory fibers of the phrenic nerve supply structures,
which are related to increased exertion e.g. the heart, membranes in the chest
(Mediastinum), abdominal membranes attached to the diaphragm (?), ligaments which
are attached to the diaphragm (?), and endocrine glands, which give us the
energy for exertion. The phrenic nerve forms a reflex arc with its motor nerves
in the spinal cord (?). It does not need to be connected to the higher brain to
function properly and therefore does not serve as a conduit to disperse the
stress of negative thinking. The primary function of the phrenic nerves
Proprioceptive sensory fibers is to tell its motor nerves when we are exerting
ourselves; running walking fighting ect so as to give more juice to the
diaphragm (to increase O2 delivery). If the heart is pumping away because we
are on the last 100 yards of a killer marathon this feedback loop is just what
the doctor ordered. Its very much like an automatic pilot that instantly
without your conscious thought initiates a reflex arc with the motor fibers in
the spinal cord (?) to increase contraction of the diaphragm muscle during
heavy exertion. The function of the phrenic nerve as primarily a motor nerve is
evident in its neuroanatomy with twice as many motor fibers as sensory fibers.
None of its motor or sensory fibers are connected with rotator cuff, capsule of
the shoulder, ligaments or muscles of the neck ect. Because the phrenic nerve
forms from the cervical and brachial plexus (A plexus looks like macramé done
by someone with severe ADHD) and I am not intimately familiar with the
neuroanatomy of these structures so it is not clear to me if some connection
exists to the accessory nerve (Cranial Nerve). I will assume there is no
connection until otherwise informed. Therefore there is no mind body connection
with the phrenic nerve serving as a conduit displacing psychological stress.
Further because the motor portion of the phrenic doesn’t innervate any of the
sacs and tubes mentioned by Dr Alexander in his article [1] there
can be no cringing of sacs & shortening of tubes. The motor portion of the
phrenic nerve only innervates to the diaphragm muscle at least according to all
of the anatomical books I’ve looked at. I realize it feels that way when you
are anxious. Perhaps there are other explanations but the phrenic circuit is
not one of them. Perhaps though there are other connections, which I do not
have the neuroanatomical knowledge to explore. I believe (?) the shoulder joint
capsule both its tendons and perhaps connective tissue are innervated
dermatomally, sclerotomally (area of bone innervated by a single spinal
segment), and perhaps proprioceptivly (sensory nerves embedded with connective
tissue/muscle to provide joint positional information) by the C5 nerve. I don’t
think this should affect the simple reflex arc between the motor and sensory
fibers of the phrenic nerve whose primary purpose is to increase contraction of
the diaphragm during heavy exertion. I will assume it does not unless otherwise
informed.
2.19.3
Hypothesis
2.19.3.1
Complete section of the sensory fibers of the phrenic nerve
will significantly decrease aerobic capacity during heavy exertion.
2.19.4
Literature Review
2.19.4.1
I’m thinking a literature review rather than an experiment
simply because nobody I know would raise their hand to volunteer to have the
sensory fibers of their phrenic nerve cut. I am quite sure no one would
volunteer his or her pet hamster, dog, or cat for this experiment either. So a
review of the scientific literature is in order to determine the aerobic
capacity of people or animals that have a damaged phrenic sensory nerve.
2.19.5
Gray’s Anatomy and other references
2.19.5.1
Discussion
2.19.5.1.1
Cervical
Nerves
2.19.5.1.1.1
http://www.bartleby.com/107/210.html
2.19.5.1.2
Brachial
Plexus
2.19.5.1.2.1
http://www.bartleby.com/107/210.html#i807
2.19.5.1.3
Diaphragm
2.19.5.1.3.1
http://www.bartleby.com/107/illus391.html
2.19.5.1.3.2
Diaphragm
2.19.5.2
Illustrations
2.19.5.2.1
Thoracic
Cavity (or chest cavity)
2.19.5.2.1.1
http://www.bartleby.com/107/illus806.html
2.19.5.2.2
Cervical
Plexus
2.19.5.2.2.1
http://www.bartleby.com/107/illus804.html
2.19.5.2.3
Brachial
Plexus
2.19.5.2.3.1
http://www.bartleby.com/107/illus807.html
2.19.5.2.4
Vagus
Nerve
2.19.5.2.4.1
http://www.bartleby.com/107/205.html
2.19.5.2.5
Sympathetic
Nervous System
2.19.5.2.5.1
http://www.bartleby.com/107/214.html
2.19.5.2.6
Diaphragm
2.19.5.2.6.1
http://www.bartleby.com/107/illus391.html
2.19.6
Number
2.19.6.1
32.05
2.19.7
Reference
2.19.7.1
19
2.19.8
Illustration
2.19.8.1 
2.1 RECTUS CAPITIS
LATERALIS N.
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Table of Contents References
2.1.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
2.1.1.1
.
2.1.2 NUMBER
2.1.2.1
35
2.1.3 REFERENCE
2.1.3.1
2.1.4 ROOTS
2.1.4.1
2.1.4.2
Lumbar Plexus
2.1.4.3
VENTRAL
2.1.5 DIVISION
2.1.5.1
Dorsal Ventral
2.1.5.2
2.1.6 CUTANEOUS BRANCHES
2.1.6.1
2.1.6.1.1
2.1.6.2
2.1.6.2.1
.
2.1.7 ARTICULAR BRANCHES
2.1.7.1
2.1.7.1.1
2.1.8 MUSCULAR BRANCHES
2.1.8.1
2.1.8.2
2.1.8.3
2.1.8.4
2.1.8.5
2.1.8.6
2.2 RECTUS CAPITIS
ANTERIOR N.
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2.2.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
2.2.1.1
.
2.2.2 NUMBER
2.2.2.1
35
2.2.3 REFERENCE
2.2.3.1
2.2.4 ROOTS
2.2.4.1
2.2.4.2
Lumbar Plexus
2.2.4.3
VENTRAL
2.2.5 DIVISION
2.2.5.1
Dorsal Ventral
2.2.5.2
2.2.6 CUTANEOUS BRANCHES
2.2.6.1
2.2.6.1.1
2.2.6.2
2.2.6.2.1
.
2.2.7 ARTICULAR BRANCHES
2.2.7.1
2.2.7.1.1
2.2.8 MUSCULAR BRANCHES
2.2.8.1
2.2.8.2
2.2.8.3
2.2.8.4
2.2.8.5
2.2.8.6
2.3 LONGUS CAPITIS N
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2.3.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
2.3.1.1
.
2.3.2 NUMBER
2.3.2.1
35
2.3.3 REFERENCE
2.3.3.1
2.3.4 ROOTS
2.3.4.1
2.3.4.2
Lumbar Plexus
2.3.4.3
VENTRAL
2.3.5 DIVISION
2.3.5.1
Dorsal Ventral
2.3.5.2
2.3.6 CUTANEOUS BRANCHES
2.3.6.1
2.3.6.1.1
2.3.6.2
2.3.6.2.1
.
2.3.7 ARTICULAR BRANCHES
2.3.7.1
2.3.7.1.1
2.3.8 MUSCULAR BRANCHES
2.3.8.1
2.3.8.2
2.3.8.3
2.3.8.4
2.3.8.5
2.3.8.6
2.4 LONGUS COLI N.
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2.4.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
2.4.1.1
.
2.4.2 NUMBER
2.4.2.1
35
2.4.3 REFERENCE
2.4.3.1
2.4.4 ROOTS
2.4.4.1
2.4.4.2
Lumbar Plexus
2.4.4.3
VENTRAL
2.4.5 DIVISION
2.4.5.1
Dorsal Ventral
2.4.5.2
2.4.6 CUTANEOUS BRANCHES
2.4.6.1
2.4.6.1.1
2.4.6.2
2.4.6.2.1
.
2.4.7 ARTICULAR BRANCHES
2.4.7.1
2.4.7.1.1
2.4.8 MUSCULAR BRANCHES
2.4.8.1
2.4.8.2
2.4.8.3
2.4.8.4
2.4.8.5
2.4.8.6
2.5 STERNOCLEIDOMASTOID
N.
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2.5.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
2.5.1.1
.
2.5.2 NUMBER
2.5.2.1
35
2.5.3 REFERENCE
2.5.3.1
2.5.4 ROOTS
2.5.4.1
2.5.4.2
Lumbar Plexus
2.5.4.3
VENTRAL
2.5.5 DIVISION
2.5.5.1
Dorsal Ventral
2.5.5.2
2.5.6 CUTANEOUS BRANCHES
2.5.6.1
2.5.6.1.1
2.5.6.2
2.5.6.2.1
.
2.5.7 ARTICULAR BRANCHES
2.5.7.1
2.5.7.1.1
2.5.8 MUSCULAR BRANCHES
2.5.8.1
2.5.8.2
2.5.8.3
2.5.8.4
2.5.8.5
2.5.8.6
2.6 TRAPEZIUS N.
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2.6.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
2.6.1.1
.
2.6.2 NUMBER
2.6.2.1
35
2.6.3 REFERENCE
2.6.3.1
2.6.4 ROOTS
2.6.4.1
2.6.4.2
Lumbar Plexus
2.6.4.3
VENTRAL
2.6.5 DIVISION
2.6.5.1
Dorsal Ventral
2.6.5.2
2.6.6 CUTANEOUS BRANCHES
2.6.6.1
2.6.6.1.1
2.6.6.2
2.6.6.2.1
.
2.6.7 ARTICULAR BRANCHES
2.6.7.1
2.6.7.1.1
2.6.8 MUSCULAR BRANCHES
2.6.8.1
2.6.8.2
2.6.8.3
2.6.8.4
2.6.8.5
2.6.8.6
2.7 LEVATOR SCAPULAE
N.
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2.7.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
2.7.1.1
.
2.7.2 NUMBER
2.7.2.1
35
2.7.3 REFERENCE
2.7.3.1
2.7.4 ROOTS
2.7.4.1
2.7.4.2
Lumbar Plexus
2.7.4.3
VENTRAL
2.7.5 DIVISION
2.7.5.1
Dorsal Ventral
2.7.5.2
2.7.6 CUTANEOUS BRANCHES
2.7.6.1
2.7.6.1.1
2.7.6.2
2.7.6.2.1
.
2.7.7 ARTICULAR BRANCHES
2.7.7.1
2.7.7.1.1
2.7.8 MUSCULAR BRANCHES
2.7.8.1
2.7.8.2
2.7.8.3
2.7.8.4
2.7.8.5
2.7.8.6
2.8 SCALENUS NERVES.
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2.8.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
2.8.1.1
.
2.8.2 NUMBER
2.8.2.1
35
2.8.3 REFERENCE
2.8.3.1
2.8.4 ROOTS
2.8.4.1
2.8.4.2
Lumbar Plexus
2.8.4.3
VENTRAL
2.8.5 DIVISION
2.8.5.1
Dorsal Ventral
2.8.5.2
2.8.6 CUTANEOUS BRANCHES
2.8.6.1
2.8.6.1.1
2.8.6.2
2.8.6.2.1
.
2.8.7 ARTICULAR BRANCHES
2.8.7.1
2.8.7.1.1
2.8.8 MUSCULAR BRANCHES
2.8.8.1
2.8.8.2
2.8.8.3
2.8.8.4
2.8.8.5
2.8.8.6
2.9 BRACHIAL PLEXUS
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2.9.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
2.9.1.1
.
2.9.2 NUMBER
2.9.2.1
35
2.9.3 REFERENCE
2.9.3.1
2.9.4 ROOTS
2.9.4.1
2.9.4.2
Lumbar Plexus
2.9.4.3
VENTRAL
2.9.5 DIVISION
2.9.5.1
Dorsal Ventral
2.9.5.2
2.9.6 CUTANEOUS BRANCHES
2.9.6.1
2.9.6.1.1
2.9.6.2
2.9.6.2.1
.
2.9.7 ARTICULAR BRANCHES
2.9.7.1
2.9.7.1.1
2.9.8 MUSCULAR BRANCHES
2.9.8.1
2.9.8.2
2.9.8.3
2.9.8.4
2.9.8.5
2.9.8.6
2.10 DORSAL SCAPULAR N.
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2.10.1
DESCRIPTION: PATH,
FUNCTION, LESIONS, CUTANEOUS AREA, AND ADDITIONAL COMMENTS
2.10.1.1
.
2.10.2
NUMBER
2.10.2.1
35
2.10.3
REFERENCE
2.10.3.1
2.10.4
ROOTS
2.10.4.1
2.10.4.2
Lumbar Plexus
2.10.4.3
VENTRAL
2.10.5
DIVISION
2.10.5.1
Dorsal Ventral
2.10.5.2
2.10.6
CUTANEOUS BRANCHES
2.10.6.1
2.10.6.1.1
2.10.6.2
2.10.6.2.1
.
2.10.7
ARTICULAR BRANCHES
2.10.7.1
2.10.7.1.1
2.10.8
MUSCULAR BRANCHES
2.10.8.1
2.10.8.2
2.10.8.3
2.10.8.4
2.10.8.5
2.10.8.6
2.11 LONG THORACIC
NERVE
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2.11.1
DESCRIPTION: PATH,
FUNCTION, LESIONS, CUTANEOUS AREA, AND ADDITIONAL COMMENTS
2.11.1.1
.
2.11.2
NUMBER
2.11.2.1
35
2.11.3
REFERENCE
2.11.3.1
2.11.4
ROOTS
2.11.4.1
2.11.4.2
Lumbar Plexus
2.11.4.3
VENTRAL
2.11.5
DIVISION
2.11.5.1
Dorsal Ventral
2.11.5.2
2.11.6
CUTANEOUS BRANCHES
2.11.6.1
2.11.6.1.1
2.11.6.2
2.11.6.2.1
.
2.11.7
ARTICULAR BRANCHES
2.11.7.1
2.11.7.1.1
2.11.8
MUSCULAR BRANCHES
2.11.8.1
2.11.8.2
2.11.8.3
2.11.8.4
2.11.8.5
2.11.8.6
2.12 SUBCLAVIUS N.
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2.12.1
DESCRIPTION: PATH, FUNCTION,
LESIONS, CUTANEOUS AREA, AND ADDITIONAL COMMENTS
2.12.1.1
.
2.12.2
NUMBER
2.12.2.1
35
2.12.3
REFERENCE
2.12.3.1
2.12.4
ROOTS
2.12.4.1
2.12.4.2
Lumbar Plexus
2.12.4.3
VENTRAL
2.12.5
DIVISION
2.12.5.1
Dorsal Ventral
2.12.5.2
2.12.6
CUTANEOUS BRANCHES
2.12.6.1
2.12.6.1.1
2.12.6.2
2.12.6.2.1
.
2.12.7
ARTICULAR BRANCHES
2.12.7.1
2.12.7.1.1
2.12.8
MUSCULAR BRANCHES
2.12.8.1
2.12.8.2
2.12.8.3
2.12.8.4
2.12.8.5
2.12.8.6
2.13 UPPER SUBSCAPULAR
N.
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2.13.1
DESCRIPTION: PATH,
FUNCTION, LESIONS, CUTANEOUS AREA, AND ADDITIONAL COMMENTS
2.13.1.1
.
2.13.2
NUMBER
2.13.2.1
35
2.13.3
REFERENCE
2.13.3.1
2.13.4
ROOTS
2.13.4.1
2.13.4.2
Lumbar Plexus
2.13.4.3
VENTRAL
2.13.5
DIVISION
2.13.5.1
Dorsal Ventral
2.13.5.2
2.13.6
CUTANEOUS BRANCHES
2.13.6.1
2.13.6.1.1
2.13.6.2
2.13.6.2.1
.
2.13.7
ARTICULAR BRANCHES
2.13.7.1
2.13.7.1.1
2.13.8
MUSCULAR BRANCHES
2.13.8.1
2.13.8.2
2.13.8.3
2.13.8.4
2.13.8.5
2.13.8.6
2.14 THORACODORSAL N.
(MIDDLE SUBSCAPULAR N.)
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Table of Contents References
2.14.1
DESCRIPTION: PATH,
FUNCTION, LESIONS, CUTANEOUS AREA, AND ADDITIONAL COMMENTS
2.14.1.1
.
2.14.2
NUMBER
2.14.2.1
35
2.14.3
REFERENCE
2.14.3.1
2.14.4
ROOTS
2.14.4.1
2.14.4.2
Lumbar Plexus
2.14.4.3
VENTRAL
2.14.5
DIVISION
2.14.5.1
Dorsal Ventral
2.14.5.2
2.14.6
CUTANEOUS BRANCHES
2.14.6.1
2.14.6.1.1
2.14.6.2
2.14.6.2.1
.
2.14.7
ARTICULAR BRANCHES
2.14.7.1
2.14.7.1.1
2.14.8
MUSCULAR BRANCHES
2.14.8.1
2.14.8.2
2.14.8.3
2.14.8.4
2.14.8.5
2.14.8.6
2.15 LOWER SUBSCAPULAR
N.
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Table of Contents References
2.15.1
DESCRIPTION: PATH,
FUNCTION, LESIONS, CUTANEOUS AREA, AND ADDITIONAL COMMENTS
2.15.1.1
.
2.15.2
NUMBER
2.15.2.1
35
2.15.3
REFERENCE
2.15.3.1
2.15.4
ROOTS
2.15.4.1
2.15.4.2
Lumbar Plexus
2.15.4.3
VENTRAL
2.15.5
DIVISION
2.15.5.1
Dorsal Ventral
2.15.5.2
2.15.6
CUTANEOUS BRANCHES
2.15.6.1
2.15.6.1.1
2.15.6.2
2.15.6.2.1
.
2.15.7
ARTICULAR BRANCHES
2.15.7.1
2.15.7.1.1
2.15.8
MUSCULAR BRANCHES
2.15.8.1
2.15.8.2
2.15.8.3
2.15.8.4
2.15.8.5
2.15.8.6
1 Arms
1.1 SUPRACLAVICULAR
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Table of Contents References
1.1.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
1.1.1.1
.
1.1.2 NUMBER
1.1.2.1
35
1.1.3 REFERENCE
1.1.3.1
1.1.4 ROOTS
1.1.4.1
1.1.4.2
Lumbar Plexus
1.1.4.3
VENTRAL
1.1.5 DIVISION
1.1.5.1
Dorsal Ventral
1.1.5.2
1.1.6 CUTANEOUS BRANCHES
1.1.6.1
1.1.6.1.1
1.1.6.2
1.1.6.2.1
.
1.1.7 ARTICULAR BRANCHES
1.1.7.1
1.1.7.1.1
1.1.8 MUSCULAR BRANCHES
1.1.8.1
1.1.8.2
1.1.8.3
1.1.8.4
1.1.8.5
1.1.8.6
1.2 AXILLARY (U LAT
CUT N)
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Table of Contents References
1.2.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
1.2.1.1
.
1.2.2 NUMBER
1.2.2.1
35
1.2.3 REFERENCE
1.2.3.1
1.2.4 ROOTS
1.2.4.1
1.2.4.2
Lumbar Plexus
1.2.4.3
VENTRAL
1.2.5 DIVISION
1.2.5.1
Dorsal Ventral
1.2.5.2
1.2.6 CUTANEOUS BRANCHES
1.2.6.1
1.2.6.1.1
1.2.6.2
1.2.6.2.1
.
1.2.7 ARTICULAR BRANCHES
1.2.7.1
1.2.7.1.1
1.2.8 MUSCULAR BRANCHES
1.2.8.1
1.2.8.2
1.2.8.3
1.2.8.4
1.2.8.5
1.2.8.6
1.3 2ND THOR INTERCSL
N
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Table of Contents References
1.3.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
1.3.1.1
.
1.3.2 NUMBER
1.3.2.1
35
1.3.3 REFERENCE
1.3.3.1
1.3.4 ROOTS
1.3.4.1
1.3.4.2
Lumbar Plexus
1.3.4.3
VENTRAL
1.3.5 DIVISION
1.3.5.1
Dorsal Ventral
1.3.5.2
1.3.6 CUTANEOUS BRANCHES
1.3.6.1
1.3.6.1.1
1.3.6.2
1.3.6.2.1
.
1.3.7 ARTICULAR BRANCHES
1.3.7.1
1.3.7.1.1
1.3.8 MUSCULAR BRANCHES
1.3.8.1
1.3.8.2
1.3.8.3
1.3.8.4
1.3.8.5
1.3.8.6
1.4 MEDIAL BRACHIAL
CUT N.(FLASH;MEDIAL CUT)(GRAY;LESSER INTERNAL CUT,N. OF WRISBERG)
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Table of Contents References
1.4.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
1.4.1.1
.
1.4.2 NUMBER
1.4.2.1
35
1.4.3 REFERENCE
1.4.3.1
1.4.4 ROOTS
1.4.4.1
1.4.4.2
Lumbar Plexus
1.4.4.3
VENTRAL
1.4.5 DIVISION
1.4.5.1
Dorsal Ventral
1.4.5.2
1.4.6 CUTANEOUS BRANCHES
1.4.6.1
1.4.6.1.1
1.4.6.2
1.4.6.2.1
.
1.4.7 ARTICULAR BRANCHES
1.4.7.1
1.4.7.1.1
1.4.8 MUSCULAR BRANCHES
1.4.8.1
1.4.8.2
1.4.8.3
1.4.8.4
1.4.8.5
1.4.8.6
1.5 RADIAL
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Table of Contents References
1.5.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
1.5.1.1
.
1.5.2 NUMBER
1.5.2.1
35
1.5.3 REFERENCE
1.5.3.1
1.5.4 ROOTS
1.5.4.1
1.5.4.2
Lumbar Plexus
1.5.4.3
VENTRAL
1.5.5 DIVISION
1.5.5.1
Dorsal Ventral
1.5.5.2
1.5.6 CUTANEOUS BRANCHES
1.5.6.1
1.5.6.1.1
1.5.6.2
1.5.6.2.1
.
1.5.7 ARTICULAR BRANCHES
1.5.7.1
1.5.7.1.1
1.5.8 MUSCULAR BRANCHES
1.5.8.1
1.5.8.2
1.5.8.3
1.5.8.4
1.5.8.5
1.5.8.6
1.6 MUSCULOCUTANEOUS
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Table of Contents References
1.6.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
1.6.1.1
.
1.6.2 NUMBER
1.6.2.1
35
1.6.3 REFERENCE
1.6.3.1
1.6.4 ROOTS
1.6.4.1
1.6.4.2
Lumbar Plexus
1.6.4.3
VENTRAL
1.6.5 DIVISION
1.6.5.1
Dorsal Ventral
1.6.5.2
1.6.6 CUTANEOUS BRANCHES
1.6.6.1
1.6.6.1.1
1.6.6.2
1.6.6.2.1
.
1.6.7 ARTICULAR BRANCHES
1.6.7.1
1.6.7.1.1
1.6.8 MUSCULAR BRANCHES
1.6.8.1
1.6.8.2
1.6.8.3
1.6.8.4
1.6.8.5
1.6.8.6
1.7 MED ANTEBRACHIAL
CUT N.(FLASH;MEDIAL CUTANEOUS N. OF
FOREARM),(GRAY; INTERNAL CUT N.)
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Table of Contents References
1.7.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
1.7.1.1
.
1.7.2 NUMBER
1.7.2.1
35
1.7.3 REFERENCE
1.7.3.1
1.7.4 ROOTS
1.7.4.1
1.7.4.2
Lumbar Plexus
1.7.4.3
VENTRAL
1.7.5 DIVISION
1.7.5.1
Dorsal Ventral
1.7.5.2
1.7.6 CUTANEOUS BRANCHES
1.7.6.1
1.7.6.1.1
1.7.6.2
1.7.6.2.1
.
1.7.7 ARTICULAR BRANCHES
1.7.7.1
1.7.7.1.1
1.7.8 MUSCULAR BRANCHES
1.7.8.1
1.7.8.2
1.7.8.3
1.7.8.4
1.7.8.5
1.7.8.6
2 Hands
2.1 ULNAR
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Table of Contents References
2.1.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
2.1.1.1
.
2.1.2 NUMBER
2.1.2.1
35
2.1.3 REFERENCE
2.1.3.1
2.1.4 ROOTS
2.1.4.1
2.1.4.2
Lumbar Plexus
2.1.4.3
VENTRAL
2.1.5 DIVISION
2.1.5.1
Dorsal Ventral
2.1.5.2
2.1.6 CUTANEOUS BRANCHES
2.1.6.1
2.1.6.1.1
2.1.6.2
2.1.6.2.1
.
2.1.7 ARTICULAR BRANCHES
2.1.7.1
2.1.7.1.1
2.1.8 MUSCULAR BRANCHES
2.1.8.1
2.1.8.2
2.1.8.3
2.1.8.4
2.1.8.5
2.1.8.6
2.2 RADIAL
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Table of Contents References
2.2.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
2.2.1.1
.
2.2.2 NUMBER
2.2.2.1
35
2.2.3 REFERENCE
2.2.3.1
2.2.4 ROOTS
2.2.4.1
2.2.4.2
Lumbar Plexus
2.2.4.3
VENTRAL
2.2.5 DIVISION
2.2.5.1
Dorsal Ventral
2.2.5.2
2.2.6 CUTANEOUS BRANCHES
2.2.6.1
2.2.6.1.1
2.2.6.2
2.2.6.2.1
.
2.2.7 ARTICULAR BRANCHES
2.2.7.1
2.2.7.1.1
2.2.8 MUSCULAR BRANCHES
2.2.8.1
2.2.8.2
2.2.8.3
2.2.8.4
2.2.8.5
2.2.8.6
2.3 MEDIAN NERVE
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Table of Contents References
2.3.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
2.3.1.1
.
2.3.2 NUMBER
2.3.2.1
35
2.3.3 REFERENCE
2.3.3.1
2.3.4 ROOTS
2.3.4.1
2.3.4.2
Lumbar Plexus
2.3.4.3
VENTRAL
2.3.5 DIVISION
2.3.5.1
Dorsal Ventral
2.3.5.2
2.3.6 CUTANEOUS BRANCHES
2.3.6.1
2.3.6.1.1
2.3.6.2
2.3.6.2.1
.
2.3.7 ARTICULAR BRANCHES
2.3.7.1
2.3.7.1.1
2.3.8 MUSCULAR BRANCHES
2.3.8.1
2.3.8.2
2.3.8.3
2.3.8.4
2.3.8.5
2.3.8.6
2.4
2.5
3 HIP AND LEGS
3.1 12TH THORACIC
INTERCOSTAL (SUB COSTAL) 35.01
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Table of Contents References
3.1.1 DESCRIPTION # 1:
PATH, FUNCTION-LESIONS
3.1.1.1
A FOCAL LESION TO THE SUBCOSTAL NERVE WOULD NOT
SIGNIFICANTLY WEAKEN THE QUADRATUS LUMBORUM BUT WOULD PARALYZE THE PYRAMIDALIS
AND WEAKEN THE LOWER ABDOMINAL MUSCLES PRESENTING "BEAVOR'S SIGN".
THIS COULD ALSO PRESENT A BULGING OF THE LOWER ABDOMEN.
3.1.2 DESCRIPTION # 2:
CUTANEOUS AREA, ADDITIONAL COMMENTS
3.1.2.1
T12 IS OFTEN CONSIDERED PART OF THE LUMBAR PLEXUS.
3.1.3 CUTANEOUS BRANCHES
(12TH THOR)
3.1.3.1
LATERAL CUTANEOUS (CUT B) 35.011
3.1.3.1.1
ANTEROLATERAL
GLUTEAL SKIN SOME FILAMENTS REACHING THE SKIN OVER THE GREATER TROCHANTER
3.1.3.2
ANTERIOR CUTANEOUS(CUT BR) 35.012
3.1.3.2.1
SKIN
OF SUPRAPUBIC AREA.
3.1.4 Articular Branches
3.1.4.1
ARTICULAR(12 THOR)
3.1.4.1.1
12TH
COSTOVERTEBRAL(ART)
3.1.5 ROOTS
3.1.5.1
T12
3.1.5.2
SPINAL NERVE
3.1.5.3
VENTRAL
3.1.6 MUSCULAR BRANCHES
(12TH THORACIC)
3.1.6.1 QUADRATUS
LUMBORUM T12-L3,(L4)
3.1.6.2 TRANSVERSE
ABDOMINAL T7-L1
3.1.6.3 INTERNAL OBLIQUE
ABDOMINAL T7-L1
3.1.6.4 EXTERNAL OBLIQUE
ABDOMINAL T5-T12
3.1.6.4.1
T12
LATERAL CUTANEOUS BRANCH SUPPLIES THE LOWER SLIP
3.1.6.5 RECTUS ABDOMINAL
(T5),T6-T12
3.1.6.6 PYRAMIDALIS T12
3.1.7 NUMBER
3.1.7.1
35.01
3.1.8 REFERANCE
3.1.8.1
50
3.2 Lumbar Plexus
(Spinal Segments & Nerves) (61)
3.2.1 Spinal Segments
3.2.1.1
3.2.2 Nerves
3.2.2.1
3.2.3 Reference
3.2.3.1
61
3.3 Lumbar Plexus (62)
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Table of Contents References
3.3.1 Spinal Roots
3.3.1.1
L 1, L2, L3, L4 ventral rami with a
ramus from T12
3.3.1.1.1
They descend laterally into the psoas
major. The first three and most of the fourth form the lumbar plexus. The rest
of L4 splits to join L5 forming the Lumbosacral trunk
3.3.2 Named Branches
3.3.2.1 A=Muscular branches / T12,
L 1-L4.
3.3.2.2 B=Iliohypogastric
nerve /
T12, L 1.
3.3.2.3 C=llio-inguinal
nerve / L 1.
3.3.2.4
D=Genitofemoral
nerve /
L 1, L2.
3.3.3 From Ventral
Divisions
3.3.3.1 E=Obturator nerve / L2-L4.
3.3.3.2
F=Accessory
Obturator nerve / L3,
L4
3.3.4 From Dorsal
Divisions
3.3.4.1 G=Lateral femoral cutaneous nerve / L4,
L5.
3.3.4.2 H=Femoral nerve / L2-L4.
3.3.4.3
I=Lumbosacral
trunk to sacral plexus / L4, L5.
3.3.5 Cutaneous Branches
3.3.5.1
The areas of cutaneous innervation
are designated by the letters as described above
3.3.6 Lesions
3.3.6.1
Injury to the lumbar roots or the
cauda equina related to L 1, L2, L3 can result from neurofibromas, meningiomas
or other malignant disease. Disc herniations, although less common, can produce
focal lesions of the lumbar roots. Injury
to L1 results in weakness of abdominal musculature and
paresthesias to the skin region of the greater trochanter and upper groin. Injury to L2
produces weak hip flexion, due to deficits in psoas major and iliacus, and
paresthesias to skin of anterior thigh. Injury to L3 results in weak adduction of
leg and reduced knee jerk reflex and paresthesias to skin of anterior thigh
(femoral nerve), anteromedial knee, leg and foot (saphenous nerve). Injury to L4 is
the most common lesion of the lumbar plexus and typically results from a
herniated intervertebral disc between L4 and L5 or degenerative arthritis
(spondylosis) in the spine. Deficits resemble those of L3 except that cutaneous
fibers for the anterior thigh (via the femoral nerve) survive. Deficits to
tibialis anterior and posterior will result in a "foot drop" via L4
lumbosacral trunk deficit.
3.3.7 Path Description
3.3.7.1
The lumbar plexus is formed by the loops of communication
between the anterior divisions of the first three and the greater part of the
fourth lumbar nerves; the first lumbar often receives a branch from the last
thoracic nerve. It is situated in the posterior part of the Psoas major, in front
of the transverse processes of the lumbar vertebra. The mode in which the
plexus is arranged varies in different subjects. It differs from the brachial
plexus in not forming an intricate interlacement, but the several nerves of
distribution arise from one or more of the spinal nerves, in the
following manner: the first lumbar nerve, frequently supplemented by a twig
from the last thoracic, splits into an upper and lower branch; the upper and
larger branch divides into the Iliohypogastric and ilioinguinal nerves; the
lower and smaller branch unites with a branch of the second lumbar to form the
Genitofemoral nerve. The remainder of the second nerve, and the third and
fourth nerves, divide into ventral and dorsal divisions. The ventral division
of the second unites with the ventral divisions of the third and fourth nerves
to form the Obturator nerve. The dorsal divisions of the second and third
nerves divide into two branches, a smaller branch from each uniting to form the
lateral femoral cutaneous nerve, and a larger branch from each joining with the
dorsal division of the fourth nerve to form the femoral nerve. The accessory
Obturator, when it exists, is formed by the union of two small branches given
off from the third and fourth nerves.
3.3.8 Gray’s Anatomy
3.3.8.1
http://www.bartleby.com/107/212.html
3.3.8.2
Illustrations
3.3.8.2.1
http://www.bartleby.com/107/illus822.html
3.3.8.2.2
http://www.bartleby.com/107/illus823.html
3.3.8.2.3
http://www.bartleby.com/107/illus824.html
3.3.9 Number
3.3.9.1
3.3.10
Reference
3.3.10.1
62
3.3.11
Illustration
3.3.11.1
3.4 Lumbar Plexus
(Muscular Branches and Relationships) (63)
3.4.1 Spinal Roots
3.4.1.1
T12, L 1, L2, L3, L4 Ventral rami
3.4.2 Named Branches
3.4.2.1
None
3.4.3 Muscular Branches
3.4.3.1 A=Quadratus lumborum / T12,
L 1-L3.
3.4.3.2 B=Psoas
minor / L 1.
3.4.3.3
C=Psoas
major / L 1-L3
3.4.4 Articular Branches
3.4.4.1
None
3.4.5 Cutaneous Branches
3.4.5.1
None
3.4.6 Lumbar Plexus
Relations
3.4.6.1
The whole lumbar plexus pierces the psoas major,
divides into branches exiting from the:
3.4.6.2
Lateral Border of Psoas
3.4.6.2.1
D=Iliohypogastric nerve.
3.4.6.2.2
E=llio-inguinal nerve.
3.4.6.2.3
F=Lateral
femoral cutaneous nerve.
3.4.6.2.4
G=Femoral
nerve.
3.4.6.3
Anterolateral Border of Psoas
3.4.6.3.1
H=Genitofemoral
nerve
3.4.6.4
Anteromedial Border of Psoas
3.4.6.4.1
I=Obturator nerve.
3.4.6.4.2
J=Accessory Obturator nerve
(if present).
3.4.6.4.3
K=Upper
root of
lumbosacral trunk
3.4.7 Lesions
3.4.7.1
Root lesions to L2, L3 can weaken
the psoas major, however, L2 provides the greatest affect. Presents as weakness
or inability to flex the hip. Paresthesia or loss of sensation to the anterior
proximal thigh (femoral nerve L2) could further specify the root damage as L2
rather than L1.
3.4.8 Gray’s Anatomy
3.4.8.1
http://www.bartleby.com/107/212.html
3.4.9 Number
3.4.9.1
3.4.10
Reference
3.4.10.1
63
3.4.11
Illustration
3.4.11.1
3.5 Nerves from
Ventral Rami of Lumbar Plexus (64)
3.5.1 Illustration A
3.5.1.1
3.5.2 Illustration B
3.5.2.1
3.5.3 Number
3.5.3.1
3.5.4 Reference
3.5.4.1
64
3.6 Iliohypogastric
Nerve (65) (Blank)
3.6.1 Spinal Roots
3.6.1.1
3.6.2 Named Branches
3.6.2.1
3.6.3 Muscular Branches
3.6.3.1
3.6.4 Articular Branches
3.6.4.1
3.6.5 Cutaneous Branches
3.6.5.1
3.6.6 Lesions
3.6.6.1
3.6.7 Gray’s Anatomy
3.6.7.1
http://www.bartleby.com/107/212.html
3.6.8 Number
3.6.8.1
3.6.9 Reference
3.6.9.1
3.6.10
Illustration
3.6.10.1
3.7 ILLIOHYPOGASTRIC
(65)
Back
Table of Contents References
3.7.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
3.7.1.1
. EXITS THROUGH THE LATERAL BORDER OF THE PSOAS MAJOR.
INJURY TO THIS NERVE CAN RESULT FROM AN INCISION FOR AN APPENDECTOMY. PRESENTS
AS A WEAKNESS IN THE ABDOMINAL AREA OF INQUINAL CANL AND PARESTHESIA OF LOSS OF
SENSATION TO THE SKIN DESCRIBED IN THE CUTANEOUS SECTION FOR THIS NERVE. THE ABDONIMAL
WEKNESS MAY RESULT IN THE DEVELOPMENT OF A DIRECT INQUINAL HERNIA.
3.7.2 CUTANEOUS BRANCHES
3.7.2.1
LATERAL CUTANEOUS
3.7.2.1.1
L GLUTEAL SKIN
3.7.2.2
ANTERIOR CUTANEOUS
3.7.2.2.1
.
SUPRAPUBIC SKIN (HYPOGASTRIC REGION)
3.7.3 ARTICULAR BRANCHES
3.7.3.1
NONE
3.7.3.1.1
3.7.4 ROOTS
3.7.4.1
T12-L1
3.7.4.2
Lumbar Plexus
3.7.4.3
VENTRAL
3.7.5 MUSCULAR BRANCHES
3.7.5.1 TRANSVERSE
ABDOMINIS
3.7.5.1.1
SUPPLIED
BY THE VENTRAL RAMI T7-T12 AND THE ILLIOINGUINAL NERVES.
3.7.5.2 INTERNAL ABDOMINAL
OBLIQUE
3.7.5.2.1
SUPPLIED
BY THE VENTRAL RAMI T7-T12 AND THE ILLIOINGUINAL NERVES.
3.7.6 NUMBER
3.7.6.1
. 35 .02
3.7.7 REFERENCE
3.7.7.1
66
3.8 Ilio-Inquinal
Nerve (66) (Blank)
3.8.1 Spinal Roots
3.8.1.1
3.8.2 Named Branches
3.8.2.1
3.8.3 Muscular Branches
3.8.3.1
3.8.4 Articular Branches
3.8.4.1
3.8.5 Cutaneous Branches
3.8.5.1
3.8.6 Lesions
3.8.6.1
3.8.7 Gray’s Anatomy
3.8.7.1
http://www.bartleby.com/107/212.html
3.8.8 Number
3.8.8.1
3.8.9 Reference
3.8.9.1
3.8.10
Illustration
3.8.10.1
3.9 ILLIO-INGUINAL
(66)
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3.9.1 DESCRIPTION: PATH, FUNCTION, LESIONS, CUTANEOUS AREA, AND
ADDITIONAL COMMENTS
3.9.1.1
. EXITS THROUGH THE LATERAL BORDER OF THE PSOAS MAJOR.
INJURY TO THIS NERVE CAN RESULT BY AN INCISION FOR AN APPENDECTOMY AND
HERNIORRHAPHIES, DURNING PLANNENSTIEL'S (HORIZONTAL SUPRAPUBIC) INCISIONS, OR
NEPHRECTOMIES. SOMETIMES NORMAL PREGNACY AND DELIVERY CAN STRETCH THE NERVE.
THE PATIENT USUALLY COMPLAINS OF PARESTHESIA OR LOSS OF S4ENSATION TO THE SKIN
DECRIBED IN THE CUTANEOUS XERCTION FOR THIS NERVE. LIOHYPOGASTRIC,
ILIO-INGUINAL AND GENITOFEMORAL NERVES IN AND OF THEMSELVES MAY NOT BE AS
IMPORTANT AS PARESTHESIAS AND PAIN IN DISTRIBUTION. THIS BEING AN INDICATOR
IDENTIFYING (LOCALIZING) SPINAL NERVE LESIONS. ALSO PAIN FROM DISEASE OF THE
URETER AND RENAL PELVIS MAY REFER HERE.
3.9.2 CUTANEOUS BRANCHES
3.9.2.1
GROIN 35.031
3.9.2.1.1
PROXIMOMEDIAL SKIN OF THE THIGH(GROIN).
3.9.2.2
BASE O PENIS/MONS PUBIS 35.032
3.9.2.2.1
.
IN MALES THE SKIN OVER THE PENILE ROOT AND UPPER PART OF SCROTUM. IN FEMALES,
THE SKIN COVERING THE MONS PUBIS AND THE ADJOINING LABIUM MARORUS.
3.9.3 ARTICULAR BRANCHES
3.9.3.1
NONE
3.9.4 ROOTS
3.9.4.1
L1
3.9.4.2
Lumbar Plexus
3.9.4.3
VENTRAL
3.9.5 MUSCULAR BRANCHES
3.9.5.1 TRANSVERSE
ABDOMINIS
3.9.5.1.1
THIS
NERVE IS SUPPLIED BY THE VENTRAL RAMI T7-T12 AND THE ILLIOHYPOGASTRIC NERVES.
3.9.5.2 INTERNAL ABDOMINAL
OBLIQUE
3.9.5.2.1
THIS
NERVE IS SUPPLIED BY THE VENTRAL RAMI T7-T12 AND THE ILLIOHYPOGASTRIC NERVES.
3.9.6 NUMBER
3.9.6.1
. 35 .03
3.9.7 REFERENCE
3.9.7.1
67
3.10 Genitofemoral
Nerve (67) (Blank)
3.10.1
Spinal Roots
3.10.1.1
3.10.2
Named Branches
3.10.2.1
3.10.3
Muscular Branches
3.10.3.1
3.10.4
Articular Branches
3.10.4.1
3.10.5
Cutaneous Branches
3.10.5.1
3.10.6
Lesions
3.10.6.1
3.10.7
Gray’s Anatomy
3.10.7.1
http://www.bartleby.com/107/212.html
3.10.8
Number
3.10.8.1
3.10.9
Reference
3.10.9.1
3.10.10
Illustration
3.10.10.1
3.11 GENITAL FEMORAL
(67)
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3.11.1
DESCRIPTION: PATH,
FUNCTION, LESIONS, CUTANEOUS AREA, AND ADDITIONAL COMMENTS
3.11.1.1
. SCARRING AND ADHESIONS FROM APPENDECTOMIES CAN CONSTRICT
THE NERVE AND RESULT IN PARALYSIS OF THE CREMASTER MUSCLE. CREMASTERIC ACTIONS
ARE NOT USUALLY VOLUNTARY, RAISING TESTES, ESSENTIAL TO TESTICULAR
THERMOREGULATION. STIMULATION OF MEDIAL FEMORAL SKIN EVODES A REFLEX
CONTRACTION; THIS WOULD BE LOST. HOWEVER, THIS IS NOT CONSIDERED A
RELIABLETEST. PRESENTS AS A PARESTHESIA OR LOSS OF SENSATION TO THE SKIN IN THE
CUTANEOUS DESCRIPTION FOR THIS NERVE.
3.11.2
NUMBER
3.11.2.1
35.04
3.11.3
REFERENCE
3.11.3.1
68
3.11.4
ROOTS
3.11.4.1
L1-L2
3.11.4.2
Lumbar Plexus
3.11.4.3
VENTRAL
3.11.5
CUTANEOUS BRANCHES
3.11.5.1
GENITAL BR 35.041
3.11.5.1.1
SUPPLIES THE SCROTAL SKIN IN MALES AND IN FEMALES THE SKIN
OF THE MONS PUBIS, LABIUM MAJORUS AND PARTS OF VULVA INCLUDING THE CLITORIS,
LABIA MINOR VVAGINA GREATER VESTIBULE(BARTHOLIN) GLANDS, AND BULB OF VESTIBULA.
3.11.5.2
FEMORAL BR 35.042
3.11.5.2.1
.
SKIN OVER THE UPPER PART OF THE FEMORAL TRIANGLE.
3.11.6
ARTICULAR BRANCHES
3.11.6.1
NONE
3.11.7
MUSCULAR BRANCHES
3.11.7.1.1
CREMASTER
3.12 Nerves from
Ventral Division of Ventral Rami Lumbar Plexus (68)
3.12.1
Illustration A
3.12.1.1
3.12.2
Illustration B
3.12.2.1
3.12.3
Number
3.12.3.1
3.12.4
Reference
3.12.4.1
68
3.13 Obturator Nerve
(69) (Blank)
3.13.1
Spinal Roots
3.13.1.1
3.13.2
Named Branches
3.13.2.1
3.13.3
Muscular Branches
3.13.3.1
3.13.4
Articular Branches
3.13.4.1
3.13.5
Cutaneous Branches
3.13.5.1
3.13.6
Lesions
3.13.6.1
3.13.7
Gray’s Anatomy
3.13.7.1
http://www.bartleby.com/107/212.html
3.13.8
Number
3.13.8.1
3.13.9
Reference
3.13.9.1
3.13.10
Illustration
3.13.10.1
3.14 OBTURATOR (69)
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3.14.1
DESCRIPTION: PATH,
FUNCTION, LESIONS, CUTANEOUS AREA, AND ADDITIONAL COMMENTS
3.14.1.1
. L2-L4 VENTRAL DIVISION OF THE VENTRAL RAMI, EXITING
THROUGH THE MEDIAL BORDER OF THE PSOAS MAJOR. BEFORE PASSING THROUGH THE OBTURATOR
FORAMEN IT BIFURCATES INTO ANTERIOR AND POSTERIOR DIVISIONS.
3.14.1.2
INJURY TO THIS NERVE IS RARE. IT IS VULNERABLE TO SURGICAL
DAMAGE DURING PELVIC INTRUSION TO REMOVE MALIGNANT LYMPH NODES. PRESSURE FROM A
GRAVID UTERUS AND DAMAGE FROM SEVERE LABOUR IS NOT UNCOMMON. IT MAY ALSO BE
IRRITATED BY DISEASE OF AN OVARY.
3.14.1.3
PRESSENTS A WEAKNESS OR INABLIITY TO STABILIZE THE HIP.
PARALYSIS OF ADDUCTORS AND OBTURATOR EXTERNUS WEAKEN BY ADDUCTION AND EXTERNAL
ROTATION OF THE THIGH, MAKING CROSSING OF LEGS DIFFICULT. PARESTHESIA OR LOSS
OF SENSATION TO THE SKIN AREAS DESCRIBED.
3.14.1.4
HIP JOINT DISEASE MAY CAUSE REFERRED PAIN TO THE MEDIAL SIDE
OF THE THIGH. THE NERVE IS SOMETIMES SEVERED TO RELIEVE ADDUCTOR SPASM IN
SPASTIC PARALYSIS, PARAPLEGIA OR MULTIPLE SCLEROSIS. TO DIFFERENTIATE A FOCAL
OBTURATOR NERVE LESION FROM LUMBAR ROOT LESION, TEST THE FEMORAL NERVE, WHICH
IS ALSO DERIVES FROM L2-L4.
3.14.2
NUMBER
3.14.2.1
35.06
3.14.3
REFERENCE
3.14.3.1
85
3.14.4
ROOTS
3.14.4.1
S1-S2 S2-S3
3.14.4.2
Lumbar Plexus
3.14.4.3
VENTRAL
3.14.5
DIVISION
3.14.5.1
Anterior Posterior
3.14.6
ANT DIVISION(OBTURATOR) 35.061
3.14.6.1 MUSCULAR BRANCHES
(Ant Div)
3.14.6.1.1.1
ADDUCTOR
LONGUS L2,L3,L4
3.14.6.1.1.2
GRACILLIS
L2,L3
3.14.6.1.1.3
ADDUCTOR
BREVIS L3,L4
3.14.6.1.1.3.1SOMETIMES FROM POSTERIOR BRANCH OF OBTURATOR NERVE ALSO
3.14.6.1.1.4
PECTINEUS L2,L3
3.14.6.1.1.4.1THIS USUALLY RECEIVES FROM THE FEMORAL NERVE OR SOMETIMES THE ACCESSORY OBTURATOR NERVE WHEN PRESENT
3.14.6.1.1.5
3.14.6.2 ARTICULAR
BRANCHES(ANT DIV)
3.14.6.2.1
HIP
3.14.6.3 CUTANEOUS BRANCHES(ANT DIV)
3.14.6.3.1
TO
THE SKIN ON THE MEDIAL SIDE OF THIGH.
3.14.7
POSTERIOR DIVISION(OBTURATOR)
3.14.7.1
MUSCULAR BRANCHES (Posterior Div)
3.14.7.1.1
OBTURATOR
EXXTERNUS L3,L4
3.14.7.1.2
ABDUCTOR
MAGNUS (PROXIMAL HORIZONTAL) L2,L3,L4
3.14.7.1.2.1
THE
DISTAL (ISCHIOCONDYLAR) MUSCULAR FIBERS ARE SUPPLIED BY TIBIAL DIVISION OF
SCIATIC NERVE.
3.14.7.1.3
ADDUCTOR
BREVIS (SOMETIMES) L3,L4
3.14.7.2
ARTICULAR BRANCHES(POST DIV)
3.14.7.2.1
KNEE
(SOMETIMES ABSENT)
3.15 Accessory
Obturator Nerve (70) (Blank)
3.15.1
Spinal Roots
3.15.1.1
3.15.2
Named Branches
3.15.2.1
3.15.3
Muscular Branches
3.15.3.1
3.15.4
Articular Branches
3.15.4.1
3.15.5
Cutaneous Branches
3.15.5.1
3.15.6
Lesions
3.15.6.1
3.15.7
Gray’s Anatomy
3.15.7.1
http://www.bartleby.com/107/212.html
3.15.8
Number
3.15.8.1
3.15.9
Reference
3.15.9.1
3.15.10
Illustration
3.15.10.1
3.16 ACCESSORY
OBTURATOR (70)
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3.16.1
DESCRIPTION: PATH,
FUNCTION, LESIONS, CUTANEOUS AREA, AND ADDITIONAL COMMENTS
3.16.1.1
. EXITING THROUGH THE MEDIAL BOARDER OF PSOAS MAJOR. THIS
NERVE IS PRESENT ABOUT 30% OF THE TIME WITH VARIATIONS.
3.16.1.2
IF PRESENT AND INJURED IT COULD MINIMALLY WEKEN ADDUCTION
AND FLEXION OF THE HIP JOINT.
3.16.2
NUMBER
3.16.2.1
None
3.16.3
REFERENCE
3.16.3.1
71
3.16.4
ROOTS
3.16.4.1
L3, L4
3.16.4.2
Lumbar Plexus
3.16.4.3
VENTRAL
3.16.5
DIVISION
3.16.5.1
None
3.16.6
CUTANEOUS BRANCHES
3.16.6.1
None
3.16.7
ARTICULAR BRANCHES
3.16.7.1
None
3.16.7.1.1
3.16.8
MUSCULAR BRANCHES
3.16.8.1 PECTINEUS
3.16.8.1.1
THE
PECTINEUS MAY BE DIVIDED INTO ANTERIOR AND POSTERIOR STRATA. THE ACCESSORY
OBTURATOR OR OBTURATOR NERVES SUPPLYING THE POSTERIOR STRATUM; THE FEMORAL NERVE
SUPPLIES THE ANTERIOR STRATUM.
3.16.8.2 ADDUCTOR
LONGUS (SOMETIMES)
3.17 Lumbar Plexus
(Nerves from Dorsal Divisions-Ventral Rami (71)
3.17.1
Illustration # A
3.17.1.1
3.17.2
Illustration # B
3.17.2.1
3.17.3
REFERENCE
3.17.3.1
71
3.18 Lateral Cutaneous
Femoral Nerve (72) (Blank)
3.18.1
Spinal Roots
3.18.1.1
3.18.2
Named Branches
3.18.2.1
3.18.3
Muscular Branches
3.18.3.1
3.18.4
Articular Branches
3.18.4.1
3.18.5
Cutaneous Branches
3.18.5.1
3.18.6
Lesions
3.18.6.1
3.18.7
Gray’s Anatomy
3.18.7.1
http://www.bartleby.com/107/212.html
3.18.8
Number
3.18.8.1
3.18.9
Reference
3.18.9.1
3.18.10
Illustration
3.18.10.1
3.19 Femoral Nerve
(Abdominal Branches) (73) (Blank)
3.19.1
Spinal Roots
3.19.1.1
3.19.2
Named Branches
3.19.2.1
3.19.3
Muscular Branches
3.19.3.1
3.19.4
Articular Branches
3.19.4.1
3.19.5
Cutaneous Branches
3.19.5.1
3.19.6
Lesions
3.19.6.1
3.19.7
Gray’s Anatomy
3.19.7.1
http://www.bartleby.com/107/212.html
3.19.8
Number
3.19.8.1
3.19.9
Reference
3.19.9.1
3.19.10
Illustration
3.19.10.1
3.20 Femoral Nerve
(Anterior Division) (74) (Blank)
3.20.1
Spinal Roots
3.20.1.1
3.20.2
Named Branches
3.20.2.1
3.20.3
Muscular Branches
3.20.3.1
3.20.4
Articular Branches
3.20.4.1
3.20.5
Cutaneous Branches
3.20.5.1
3.20.6
Lesions
3.20.6.1
3.20.7
Gray’s Anatomy
3.20.7.1
http://www.bartleby.com/107/212.html
3.20.8
Number
3.20.8.1
3.20.9
Reference
3.20.9.1
3.20.10
Illustration
3.20.10.1
3.21 LAT FEM CUT (?)
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3.21.1
DESCRIPTION: PATH,
FUNCTION, LESIONS, CUTANEOUS AREA, AND ADDITIONAL COMMENTS
3.21.1.1
. L2-3 DORSAL DIVISION FROM THE VENTRAL RAMI EXITING THROUGH
THE LATYERAL BAORDER OF PSOAS MAJOR.
3.21.1.2
PRESENTS AS PARESTHESIA OR LOSS OF SENSATION TO THE SKIN
AREA DESCRIBED.
3.21.2
NUMBER
3.21.2.1
35.07
3.21.3
REFERENCE
3.21.3.1
73
3.21.4
ROOTS
3.21.4.1
L2, L3
3.21.4.2
Lumbar Plexus
3.21.4.3
VENTRAL
3.21.5
DIVISION
3.21.5.1
Dorsal
3.21.6
CUTANEOUS BRANCHES
3.21.6.1
ANTERIOR 35.071
3.21.6.1.1
SUPPLIES THE SKIN OF THE ANTEROLATERAL THIGH
AS FAR DISTAL AS THE KNEE AND FORMS PART OF PATELLAR PLEXUS.
3.21.6.2
POSTERIOR 35.072
3.21.6.2.1
.
SUPPLIES THE SKIN OF THE LATERAL THIGH FROM THE GREATER TROCHANTER TO ABOUT THE
MID-THIGH: IT MAY ALSO SUPPLY SOME OF THE GLUTEAL SKIN.
3.21.7
ARTICULAR BRANCHES
3.21.7.1
None
3.21.8
MUSCULAR BRANCHES
3.21.8.1 None
3.22 FEMORAL NERVE (?)
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