Exam 3- Peripheral Nervous System Flashcards
How many pairs of spinal nerves are there? Individually?
- 31 pairs
2. 62 individuals nerves
How many pairs of cranial nerves are there? Individually?
- 12 pairs
2. 24 individual nerves
Where do cranial nerves arise from?
Directly from the brain
Where do spinal nerves arise from?
From the spinal cord
What parts of the body do ventral rami supply?
- Limbs
- Anterior thorax/abdomen
- Pelvic regions
What gives rise to the nerve plexuses?
ventral rami
What is a nerve plexus?
Braiding or twining together of nervous tissue
What are the four major plexus systems?
- Cervical Plexus
- Brachial Plexus
- Lumbar Plexus
- Sacral Plexus
What is the brachial plexus composed of?
VENTRAL RAMI of cervical and thoracic spinal nerves C5, C6, C7, C8 and T1
What are the cords of the brachial plexus named in relation to?
Axillary Artery
From superior to inferior, name the divisions of the brachial plexus (on the netter plate)
- 5 roots (ventral rami of the spinal nerves)
- 3 Trunks (Superior, Middle and Inferior)
- 3 Anterior and 3 Posterior Divisions
- 3 cords (Lateral, Posterior and Medial)
- Terminal Branches
Generally what does the brachial plexus supply? What is excluded?
- Musculature of the entire upper limb
2. exception of the trapezius muscle (CN XI) and levator scapulae (C3 and C4 spinal nerves)
What does the brachial plexus give cutaneous innervation to?
Majority of the upper limb except for the skin over the upper medial portion of the arm and part of the upper shoulder
What does the axillary never innervate?
- Deltoid
2. Teres Minor
What nerves compromise the terminal branches brachial plexus?
- Musculocutaneous Nerve
- Radial Nerve
- Median Nerve
- Ulnar Nerve
- Axillary Nerve
How many nerves does the brachial plexus give off?
16 nerves on each side of the body/ 32 total
What is the Musculocutaneous nerve derived from?
Lateral cord of the brachial plexus
What does the Musculocutaneous nerve innervate?
Entire Anterior Arm:
- Coracobrachialis
- Biceps Brachii (long and short head)
- Brachialis
What is the Median nerve derived from?
Medial and lateral roots of the brachial plexus which converge together
What muscles does the median nerve innervate?
- 5/8 of the anterior forearm muscles:
- Pronator Teres
- Flexor Carpi Radialis
- Palmaris Longus
- Flexor Digitorum Superficialis
- Flexor Digitorum Profundus (LATERAL half)
- Flexor Pollicis Longus
- Pronator Quadratus
Missing:
- Flexor Digitorum Profundus (MEDIAL half)
- Flexor Carpi Ulnaris
What is the cutaneous innervation of the median nerve?
- Lateral Surfaces of the Palm
2. Distal ends of digits 1, 2, 3 and the LATERAL half of digit 4
What is the ulnar nerve derived from?
Continuation of the Medical Cord of the brachial plexus
Where does the ulnar nerve lie?
Posterior to the medial epicondyle of the humerus (along the groove for the ulnar nerve)
What is the muscular innervation of the ulnar nerve?
Other 1.5 anterior forearm/hand muscles:
- Flexor Digitorum Profundus (Medial half)
- Flexor Carpi Ulnaris
- The majority of hand muscles
What is the cutaneous innervation of the Ulnar nerve?
- Skin on the medial surface of the palm and dorsum of the hand
- Distal end of digit 5 and the MEDIAL half of digit 4
What is the radial nerve derived from?
Posterior Cord of the brachial plexus (after the axillary never is given off)
What is the muscular innervation of the radial nerve?
Entire posterior arm/forearm:
Posterior Arm:
1.Triceps Brachii
Posterior Superficial Forearm:
- Brachioradialis
- Extensor Carpi Radialis Longus
- Extensor Carpi Radialis Brevis
- Extensor Digitorum
- Extensor Digiti Minimi
- Extensor Carpi Ulnaris
- Anconeus
Posterior Deep Forearm:
- Supinator
- Abductor Pollicis Longus
- Extensor Pollicis Brevis
- Extensor Pollicis Longus
- Extensor Indicis
What is the cutaneous innervation of the Radial nerve?
- Skin on the lateral dorsal surface of the hand
2. Lateral palmar surface of the thenar area
What two plexus systems make up the lumbosacral plexus?
- Lumbar Plexus
2. Sacral Plexus
What is the Lumbosacral plexus formed from?
Ventral rami of spinal nerves L1-S4
In General what muscles does the lumbar plexus muscle innervate?
tissue and musculature of the anterior, medial and lateral thigh
What is the lumbar plexus muscle formed from?
Formed from the Ventral Rami of spinal nerves L1, L2, L3 and the upper division of the ventral ramus of L4
What is the femoral nerve derived from?
Lumbar Plexus
Where does the femoral nerve course?
Courses deep to the inguinal ligament
What is the muscular innervation of the femoral nerve?
All anterior thigh muscles, and pectineus:
Anterior Thigh Muscles: 1.Iliopsoas 2.Sartorius Quadriceps Femoris 3.Rectus Femoris 4.Vastus Lateralis 5.Vastus Medialis 6.Vastus Intermedius
Medial Thigh Muscles:
7.Pectineus
Where does the obturator nerve course?
Transverses the Obturator Foramen
What is the muscular innervation of the Obturator Nerve?
All medial thigh muscles except pectineus and extensor part of the adductor magnus:
Anterior Thigh Muscles:
- Gracilis
- Adductor Longus
- Adductor Brevis
- Adductor part of Adductor Magnus
In general what does the the sacral plexus supply?
The sacral plexus supplies tissues and musculature of the 1. 1. Pelvis
- Gluteal region
- Posterior thigh
- The entire leg
- All the foot
What is the obturator nerve derived from?
Lumbar Plexus
What nerves make up the Lumbar Plexus?
- Femoral Nerve
2. Obturator Nerve
What nerves make up the sacral Plexus?
- Superior Gluteal Nerve
- Inferior Gluteal Nerve
- Sciatic Nerve
- Tibial Nerve
1. Medial Plantar Nerve
2. Lateral Plantar Nerve - Common Fibular (Peroneal) Nerve
1. Superficial Fibular (Peroneal) Nerve
2. Deep Fibular (Peroneal) Nerve
- Tibial Nerve
What is the sacral plexus derived from?
Lower division of the ventral ramus of L4 and the ventral rami of L5, S1, S2, S3 and S4
Where does the superior gluteal nerve originate from?
Sacral Plexus
What is the muscular innervation of the superior gluteal nerve?
All gluteal muscles except gluteus Maximus:
- Gluteus Medius
- Gluteus Minimus
- Tensor Fasciae Latae
Where does the inferior gluteal nerve originate from?
Sacral Plexus
What is the muscular innervation of the inferior gluteal nerve?
Gluteus Maximus
What is the largest nerve in the body?
Sciatic Nerve
Where does the sciatic nerve course through?
Greater Sciatic Notch and enters the gluteal region inferior to the piriformis muscle
What is the muscular innervation of the sciatic nerve?
Entire posterior thigh & the Extensor Part of Adductor Magnus
Medial Thigh:
1. Extensor Part of Adductor Magnus
Posterior Thigh:
- Semitendinosus
- Semimembranosus
- Long Head of the Biceps Femoris
- Head of the Biceps Femoris
Where does the sciatic nerve originate from?
Sacral Plexus
What are the two nerves that combine to make the sciatic nerve? How do these nerves course?
- Tibial Nerve
- Common Fibular (Peroneal) Nerve
- Course as separate bundles of axons within the sciatic nerve
How are the tibial and Common Fibular (Peroneal) Nerve enclosed in the sciatic nerve?
Enveloped in a Common Epineurium (a connective tissue surrounding the individual nerves)
Where does the sciatic nerve terminate and bifurcate into the tibial and fibular nerve?
Proximal to the popliteal fossa
What is the muscular innervation of the tibial nerve?
Entire posterior leg (superficial and deep):
Superficial Posterior Leg:
- Gastrocnemius
- Soleus
- Plantaris
Deep Posterior Leg:
- Tibialis Posterior
- Flexor Hallucis Longus
- Flexor Digitorum Longus
Where does the tibial nerve originate from?
Sciatic Nevre
Where does the tibial nerve course into?
Medial to the ankle and passes deep to the flexor retinaculum
What is the flexor retinaculum?
a specialized connective tissue spanning between the medial malleolus and the calcaneus
What does the tibial nerve do once it passes the flexor retinaculum?
Once through the flexor retinaculum, the Tibial Nerve divides into the Medial and Lateral Plantar Nerves
What do the Medial and Lateral Plantar Nerves supply?
Musculature on the plantar surface of the foot
How can you tell which is the medical plantar nerve?
Closer to big toe
How can you tell which is the lateral plantar nerve?
Closer to small toe
Where are the medial and lateral planter nerves derived from?
Tibial Nerve
What is the Common Fibular (Peroneal) Nerve derived from?
Sciatic Nerve
Where does the Common Fibular (Peroneal) Nerve bifurcate into its two separate branches?
It courses superficial to the lateral head of gastrocnemius and BIFURCATES AT THE NECK OF THE FIBULA into its two terminal branches
What two nerves does the Common Fibular (Peroneal) Nerve bifurcate into?
- Superficial Fibular (Peroneal) Nerve
2. Deep Fibular (Peroneal) Nerve
Where does the Deep Fibular (Peroneal) Nerve originate from?
Common Fibular (Peroneal) Nerve
What is the muscular innervation of the Deep Fibular (Peroneal) Nerve?
Entire Anterior Leg Muscles:
- Tibialis Anterior
- Extensor Hallucis Longus
- Extensor Digitorum Longus
- Peroneus Tertius
What is the muscular innervation of the Superficial Fibular (Peroneal) Nerve?
Entire Lateral Leg Muscles:
- Fibularis longus
- Fibularis brevis
Where do the cranial nerves enter and exit the brain?
Through foramina of the cranial base
What type of fibers can cranial nerves contain?
- Sensory (afferent)
- Motor (efferent)
- Both
What are sensory (afferent) responsible for?
Carrying nerve fibers from sensory receptors to the brain
What are Motor (efferent) responsible for?
Carrying nerve fibers from the brain to effector tissues (muscles)
CN I
- Name
- Motor, Sensory or Both
- General Function
- Cranial Exit
- Olfactory Nerve
- Sensory (afferent)
- Smell
- Foramina of the cribriform plate
CN II
- Name
- Motor, Sensory or Both
- General Function
- Cranial Exit
- Optic Nerve
- Sensory (afferent)
- Vision/Interpretation of sense of light
- Optic Canal
CN III
- Name
- Motor, Sensory or Both
- General Function
- Cranial Exit
- Oculomotor Nerve
- Motor (efferent)
- Intrinsic and extrinsic muscles of eye movement
- Superior Orbital Fissure
What are the intrinsic muscles of the eye involved in?
Involved with dilation and contraction of the iris
What are the extrinsic muscles of the eye involved in?
Move the eye
CN IV
- Name
- Motor, Sensory or Both
- General Function
- Cranial Exit
- Trochlear Nerve
- Motor (efferent)
- Extrinsic muscle of eye movement (Superior oblique)
- Superior Orbital Fissure
CN V
- Name
- Motor, Sensory or Both
- General Function
- What are the 3 branches?
- Trigeminal Nerve
- Both
- Innervation of the muscles of mastication and cutaneous innervation to the face and head
- Branches:
V1: Ophthalmic nerve
V2: Maxillary Nerve
V3: Mandibular Nerve
CN V1
- Name
- General Function
- Cranial Exit
- Ophthalmic nerve
- General Function:
- Supply the lacrimal glands
- Cutaneous innervation to the skin of the forehead, nose and upper eyelids
- Superior Orbital Fissure
CN V2
- Name
- General Function
- Cranial Exit
- Maxillary Nerve
- General Function:
- Superior dental plexus
- Lateral scalp
- Cheek
- Lower eyelid
- Lateral nose
- Upper lip
- Foramen Rotundum
CN V3
- Name
- General Function
- Cranial Exit
- Mandibular Nerve
- General Function:
- Sensation to the skin and mucosa of the cheek
- The anterior 2/3 of the tongue (for general sensation)
- Muscles of mastication
- Gives off the inferior alveolar nerve which supplies the: Inferior dental plexus
- Foramen Ovale
What nerve does CN V3 give off and what does it supply?
- Inferior alveolar nerve
2. Inferior Dental Plexus
CN VI
- Name
- Motor, Sensory or Both
- General Function
- Cranial Exit
- Abducent Nerve
- Motor (efferent)
- ABDUCTION OF THE EYE (extrinsic muscle of eye movement) (Lateral rectus)
- Superior Orbital Fissure
What eye muscle is responsible for abduction of the eye, and what cranial nerve innervates this muscle?
- Lateral Rectus
2. CN VI (Abducent Nerve)
CN VII
- Name
- Motor, Sensory or Both
- General Function
- Cranial Exit
- Facial Nerve
- Both
- General Function:
- Sensory: anterior 2/3 of the tongue for taste
- Motor: Muscles of facial expression
- Internal acoustic meatus (courses through the temporal bone and ultimately exits through the stylomastoid foramen)
CN VIII
- Name
- Motor, Sensory or Both
- General Function
- Cranial Exit
- Vestibulocochlear nerve
- Sensory (afferent)
- Two Parts:
1. The Vestibular branch: Balance
2. The Cochlear branch: Hearing - Internal acoustic meatus
CN IX
- Name
- Motor, Sensory or Both
- General Function
- Cranial Exit
- Glossopharyngeal nerve
- Both
- Two Parts:
1. Sensory: Posterior 1/3 of the tongue for taste and general sensation
2. Motor: Supplies muscles of the pharynx - Jugular foramen
CN X
- Name
- Motor, Sensory or Both
- General Function
- Cranial Exit
- Vagus Nerve
- Both
- Two Parts:
- Sensory:
1. Parasympathetic innervation to the heart (slows down the heart rate)
2. Innervates the major viscera of the abdomen - Motor: Supplies muscles of the pharynx and larynx
- Sensory:
- Jugular foramen
CN XI
- Name
- Motor, Sensory or Both
- General Function
- Cranial Exit
- Accessory nerve
- Motor (efferent)
- Trapezius and Sternocleidomastoid Muscles
- Jugular foramen
CN XII
- Name
- Motor, Sensory or Both
- General Function
- Cranial Exit
- Hypoglossal nerve
- Motor (efferent)
- Muscles of tongue movement
- Hypoglossal canal
What are the muscles of facial expression?
- Orbicularis Oculi
- Zygomaticus Major
- Zygomaticus Minor
- Orbicularis Oris
- Procerus
- Risorius
- Buccinator
What are the muscles of mastication?
- Temporalis
- Masseter
- Medial Pterygoid
- Lateral Pterygoid
What nerve supplies the DORSUM of the foot with cutaneous and muscular innervation?
Deep Fibular Nerve