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Spine > Sacral plexus > Flashcards

Sacral plexus Flashcards

1
Q

Where is the sacral plexus located?

A

posterior pelvic wall, anterior to piriformis muscles (pelvic surface of sacrum to greater trochanter of femur - L5-S1)

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2
Q

What does the sacral plexus supply?

A

skin and muscles of the pelvis + lower limb

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3
Q

What is the sacral plexus formed by?

A

anterior compartment of Sacral spinal nerves (S1-S4), receives contribution from L4, L5 lumbar roots (forms lumbosacral trunk - joins lumbar to sacral plexus as sacral roots emerge from spinal cord)

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4
Q

what are the main nerves in the sacral plexus?

A
  1. superior gluteal nerve
  2. inferior gluteal nerve
  3. sciatic nerve
  4. posterior femoral cutaneous
  5. pudendal nerve
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5
Q

where do the main nerves of the sacral plexus travel through?

A

descend down the posterior pelvic wall

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6
Q

what are the 2 main destinations of the sacral plexus?

A
  1. leave pelvis via greater foramen

2. remain in the pelvis

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7
Q

what happens to the sacral nerves which remain in the pelvis?

A

innervate the pelvic muscles, organs and perineum (between anus and scrotum (M) / vulva (F))

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8
Q

what happens to the nerves which leave the pelvis via the greater sciatic foramen (opening a back of pelvis)?

A

enters gluteal region (bottom) of lower limb, innervating structures there

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9
Q

superior gluteal nerve:
where does it leave pelvis?
where does it enter?
what are the accompanying nerves and arteries?

A

SGN leaves pelvis via greater sciatic foramen
enters gluteal region superiorly to piriformis muscle
accompanied by superior gluteal artery and vein

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10
Q

Superior gluteal nerve:

root, motor, sensory

A

Roots: L5, L5, S1
Motor: gluteus minimus, gluteal medius, tensor fascia latae
Sensory: none

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11
Q

inferior gluteal nerve:

where does it leave and enter?

A

leaves pelvis via greater sciatic foramen

enters gluteal region inferior to piriformis muscle

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12
Q

Inferior gluteal nerve:

Roots, motor, sensory

A

Roots: L5, S1, S2
Motor: gluteus maximus
Sensory: none

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13
Q

Sciatic nerve roots

A

Roots: L4, L5, S1, S2, S3

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14
Q

Sciatic nerve motor innervation (tibial portion)

A

TIBIAL portion: all muscles posterior thigh, hamstring portion of adductor magnus, posterior leg and all muscles of foot
posterior thigh exceptions: short head of biceps femoris

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15
Q

What are the 2 portions of the sciatic nerve motor innervation?

A

tibial and common fibular portion

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16
Q

sciatic nerve motor (common fibular portion)

A

short head of biceps femoris
muscles of anterior and lateral compartments of the leg
extensor digitorum brevis

17
Q

sciatic nerve sensory (tibial + common fibular)

A

tibial portion: skin on posterolateral + medial surfaces of foot + sole of foot

common fibular portion: skin on anterolateral suface of leg + dorsal aspect of foot

18
Q

posterior femoral cutaneous (of thigh)

where it leaves and enter from sacral plexus?

A

leaves pelvis via greater sciatic foramen, enter gluteal region inferior to piriformis muscle
descends deep into gluteus maximus, runs down back of thigh to knee

19
Q

Posterior femoral cutaneous

Roots, motor, sensory

A

Roots: S1, S2, S3
Motor: none
Sensory: skin on posterior surface of thigh + leg + skin of perineum (pelvic floor)

20
Q

Pudendal nerve

exit and insert?

A

leaves pelvis via greater sciatic foramen, re-enters via lesser sciatic foramen
moves anterosuperiorly along lateral wall of ischiorectal fossa, terminates by dividing into several branches

21
Q

Pudendal nerve

roots, motor, sensory

A

Roots: S2, S3, S4
Motor: innervates skeletal muscles in perineum, external urethral sphincter, external anal sphincter, levator ani
Sensory: innervates penis + clitoris + most of skin of perineum

S2, S3, S4 keeps the poo off the floor!

22
Q

perforating cutaneous nerve (minor branch of sacral plexus)

A

sensory: skin over inferior gluteal region

23
Q

pelvic splanchnic nerve (minor branch of sacral plexus)

A

innervate abdominal viscera

24
Q

Name other minor branches of the sacral plexus

A

nerve to piriformis
nerve to Obturator internus
Nerve to Quadrator femoris

25
Q

Lumbosacral plexopathy (disorder + symptoms)

A

Disorder affecting either lumbar / sacral plexus of nerves, damage to nerve bundles
Symptoms: neuropathic pains, numbness / weakness + wasting of muscles

26
Q

Causes of lumbosacral plexus

A

Diabetic amyotrophy: high blood sugar damages nerves
idiopathic plexopathy
Tumours + other local invasions: compression of plexus

27
Q

Treatment of lumbosacral plexopathy

A

removal of tumours / space occupying lesions

high dose corticosteroids for diabetic / idiopathic

28
Q

Mnemonic for remembering sacral plexus

A 
Some Irish Sailor Pesters Polly
Superior gluteal
Inferior gluteal
Sciatic
Posterior cutaneous nerve of thigh
Pudendal

Spine (7 decks)

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