Head and neck: Cervical plexus, nerves, symp. supply Flashcards
types of fibres: main
- motor
- sensory
- autonomic
fibre types: list (7)
- GSA
- GSE
- GVA
- GVE
- SVA
- SVE
- SSA
CNS div: somatic part
- body
- innervate skin and skeletal mm
- derived from somites in embryo
- receiving and responding to info from ext env.
CNS div: visceral part
- organs
- innervates organs, smooth mm, glands
- receives and responds to info from internal env.
spinal nerve: features
- part of PNS
- mixed: sensory, motor, autonomic
- transmit signals from spinal cord to end organ and back
- modulated by CNS
flow of spinal nerve from smallest:
rootlets - root - spinal nerve - plexus
spinal nerve: how many pairs
- 31
spinal n: detail of pairs
- 8 cervical
- 12 thoracic
- 5 lumbar
- 5 sacral
- 1 coccygeal
spinal nerve: emerges from
- intervertebral foramen
- btw pedicles of adjacent vertebra
rootlets unite to form nerve roots: called
- anterior root
- post root
anterior root: which from ant horn
- motor efferent fibres (from ant horn to effector organ)
anterior root: which from lateral horn
- autonomic from lateral horns
posterior root: which from post horn
- sensory afferent fibres from sensory receptors
dermatome:
- area of skin innervated by spinal n
myotome:
- area of mm innervated by spinal n
define plexus:
- branching network of intersecting spinal nerves
which spinal n do not create plexus:
T1 - T12
list spinal n plexuses:
- cervical
- brachial
- lumbar
- sacral
- coccygeal
nerves incl in: cervical plexus
C1-C4
nerves incl in: brachial plexus
C5-T1
nerves incl in: lumbar plexus
L1-4
nerves incl in: sacral plexus
ranging from L4 to S4
cervical plexus: features
- 8 paired cervical n
- 1st four: inn head and neck region
- ventral rami of C1 to C4
cervical plexus: supply
- skin of head and neck
- skin of sup part of shoulders and chest
- infrahyoid mm
brachial plexus inn:
shoulder and arm
location: ventral rami of C1-4
- anterolateral to levator scapulae, middle scalene
- deep to SCM
ventral rami of C1-4 consist of:
- cutaneous/ superficial branches
- muscular/ deep branches
cervical plexus: list superficial branches
- lesser occipital n
- greater auricular n
- transverse cervical n
- supraclavicular
cervical plexus: list deep branches
- ansa cervicalis
- phrenic n
cervical plexus: superficial branches- emerge from
- post border of SCM
- nerve point of neck
- star shape
cervical plexus: superficial branches- lesser occipital n supplies
- C2
- supplies skin of neck and scalp post to ear
cervical plexus: superficial branches- greater auricular n
- C2, 3
- skin over parotid region, ear, mastoid
cervical plexus: superficial branches- transverse cervical n
- C2, 3
- skin over lateral and ant part of neck
cervical plexus: superficial branches- supraclavicular nerves
- C3, 4
- skin over clavicle, shoulder, inf to rib 2
cervical plexus: deep muscular branches- ansa cervicalis from
- ant rami of C1-3
cervical plexus: deep muscular branches- ansa cervicalis features
- sup root -> geniohyoid, thyrohyoid, from C1 via hypoglossal n
- inf root -> infrahyoid mm
cervical plexus: deep muscular branches- segmental branches
- inn ant and middle scalene mm
cervical plexus: deep muscular branches- phrenic n
- C3-5
- supplies diaphragm w sensory and motor fibres
- forms superolateral border of ant scalene at level of sup border of thyroid cartilage
visceral part of nervous system: visceral motor
- autonomic div
- divided into para/ sympathetic parts
visceral part of nervous system: visceral motor sympathetic
- nerves in thoracic and lumbar spinal cord
visceral part of nervous system: visceral motor parasympathetic
- nerves in brainstem and sacral spinal cord
visceral part of nervous system: sensory
- from neural crest cells
- chemoreception
- mechanoreception
- stretch reception
visceral part of nervous system: sympathetic trunk- features
- from base of skull: paravertebral trunks
- converge ant to coccyx as ganglion impar
visceral part of nervous system: sympathetic trunk- define ganglion
- collection of neuronal cell bodies outside CNS
visceral part of nervous system: sympathetic trunk- white rami communicantes
- myelinated fibres
- preganglionic fibres from ant rami T1-L2 -> trunk
visceral part of nervous system: sympathetic trunk- grey rami communicantes
- non-myelinated
- postganglionic
- connect ganglion to spinal n
cervical ganglia: list
- superior
- middle
- inferior
cervical ganglia: sup
- lies C1-2 vertebra
cervical ganglia: middle
- C4
cervical ganglia: inf
- if + first thoracic = stellate ganglion
- lies ant to neck of first rib,
TVP of C7 vertebrate
cervical plexus: sympathetic nervous system features
- only sym chain ganglia and sympathetic n cells in thoracic spine
- communicate btw cervical plexus and sym chain to deliver info to head/ neck
- sym fibres carried by nerves of cervical plexus to inn structures of head/ neck region
cervical plexus: sympathetic nervous system - branches of sup cervical ganglion
- form plexus around int carotid aa
- travel through C1-4
cervical plexus: sympathetic nervous system - sup cervical ganglion inn
- pharynx
- heart
- sup cardicac n
cervical plexus: sympathetic nervous system- middle cervical ganglion
- travel through C5-6
- inn heart via middle cardiac n
cervical plexus: sympathetic nervous system- inf cervical ganglion
- C7 -T1
- help form plexus around vertebral aa and innervates it
- inn heart vn
eg. lesions to cervical sympathetic trunk:
- damage to symp trunk = Horner syndrome
- contraction of pupil, due to paralysis dilator pupillar
– ptosis: paralysis of smooth muscle intermingled w levator - sinking in of eye
- vasodilation and absenceof sweating and face/neck
(lack of sym supply to blood vesels and sweat glands
cervical plexus: parasympathetic system- cranio-sacral system includes
- cranial n
- S2-4
cervical plexus: parasympathetic system- cranial n involved
- CN III (occulomotor)
- CN VII (facial)
- CN IX (glossopharyngeal)
- CN X (vagus)
cervical plexus: parasympathetic system- S2-4 supply
- abdominal and pelvic viscera
cervical plexus: parasympathetic system- parasym ganglia features
- ganglia in parasym system mainly found within end organ
- except CN -> para ganglia found outside organ
cervical plexus: parasympathetic system- list para ganglia of CN
- ciliary
- pterygopalatine
- submandibular
- otic ganglia
eg. brain freeze
- somatic sensory receptors in palate pick up cold temp, AP sent along CN V2 afferents to brain
- reflex vasodilation of cranial blood v (attempt to heat brain)
= sharp headache