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Sacral Plexus Flashcards

1
Q

The sacral plexus is formed by what rami?

A

Anterior primary rami of L4, L5, S1-S3 and part of S4

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2
Q

Contributions of L4 and L5 are from the _____ trunk

A

Lumbosacral

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3
Q

The sacral plexus forms of the anterior surface of what muscle?

A

Piriformis

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4
Q

The sacral plexus divides into anterior and posterior divisions after exiting the ____?

A

IVF/sacral foremen

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5
Q

What nerve roots supply the nerve to the quadratic femoris and gemellus inferior?

A

L4, L5, S1

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6
Q

The nerve to the quadratus femoris and gemellus inferior leaves the pelvis through what?

A

Greater sciatic foramen

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7
Q

The nerve to the quadratus femoris and gemellus inferior supply muscles that have what two actions?

A

Lateral rotation and addiction of the thigh

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8
Q

What nerve roots form the nerve to the obturator inter us and gemellus superior?

A

L5, S1 and S2

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9
Q

What opening does the nerve to the obturator internus and gemellus superior leave the pelvis through?

A

Greater sciatic foramen

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10
Q

After the nerve to the obturator internus and gemellus superior leave the pelvis through the sciatic foramen, it gives off branches to what?

A

The gemellus superior

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11
Q

The nerve to the obturator internus and gemellus superior re-enters the pelvis through what to supply what?

A

Lesser sciatic foramen

Obturator internus

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12
Q

The nerve to the obturator internus and gemellus superior supply muscles that have what two actions?

A

Lateral rotation and abduction of the thigh

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13
Q

The pudendal nerve contains fibers from?

A

S2, S3, S4

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14
Q

The pudendal nerve exits the pelvic cavity through the ____ _____ _____ and arches around the ______ _______ and into the perineum via the _____ ____ ______

A

Greater sciatic foramen
Ischial spine
Lesser sciatic foramen

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15
Q

After the pudendal nerve re-enters through the lesser sciatic foramen, it travels in the _______ _______ inferior to the pubic symphysis to reach the dorsal side of the _____ (males) or _____ (females)

A

Pudendal canal
Penis
Clitoris

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16
Q

Do some branches come off the pudendal nerve within the pudendal canal?

A

Yes

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17
Q

What are the names of the branches that come off the pudendal nerve within the pudendal canal?

A

Inferior rectal nerves
Perineal nerve
Dorsal nerve of the penis/clitoris (terminal nerve of the pudendal nerve)

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18
Q

What is the terminal nerve of the pudendal nerve?

A

Dorsal nerve of the penis/clitoris

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19
Q

The inferior rectal nerves carry _______ information from what two areas?

A

Sensory

  1. Skin around the anus
  2. Inferior 2/3 of the anal canal
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20
Q

What nerve carries sensory information from the skin around the anus and the inferior 2/3 of the anal canal?

A

Inferior rectal nerves

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21
Q

The inferior rectal nerve has motor supply to what?

A

External anal sphincter

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22
Q

What nerve contains motor supply to the external anal sphincter

A

Inferior rectal nerves

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23
Q

The _______ nerve is a branch of the pudendal nerve and splits into deep and superficial branches

A

Perineal nerve

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24
Q

The deep branch of the perineal nerve have motor supply to what 4 muscles?

A
  1. External anal sphincter
  2. Bulbospongiosus
  3. Ischiocavernosus
  4. Superficial transverse perineus
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25
Q

What nerve has motor supply to the following muscles: external anal sphincter, bulbospongiosus, ischiocavernosus, and superficial transferee perineus?

A

Deep branch of the perineal N.

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26
Q

Superficial branches of the perineal N carry sensory fibers from what in males and females?

A

Males: posterior scrotum, urethral mucosa, and bulb of the penis
Females: labium majus, external urethral orifice, vestibule

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27
Q

What nerve carries sensory fibers from the posterior scrotum, urethral mucosa, and bulb of the penis in males and labium majus, external urethral orifice, and vestibule in females?

A

Superficial branches of perineal N.

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28
Q

What muscles does the terminal branch of the pudendal N, the dorsal nerve of the penis/clitoris, supply?

A

Deep transverse perineus

Urethral sphincter muscles

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29
Q

What nerve supplies the deep transverse perineus and the urethral sphincter muscles?

A

Dorsal nerve of the penis/clitoris

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30
Q

The dorsal nerve of the penis/clitoris carries sensory fibers from what in males and females?

A

Males: corpus cavernosum, glans penis, and skin covering penis
Females: corpus cavernosum, clitoris

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31
Q

What nerve carries sensory fibers from the corpus cavernosum, glans penis, and skin covering the penis in males and corpus cavernosum, and the clitoris in females?

A

Dorsal nerve of the penis/clitoris

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32
Q

Individual muscular branches off the sacral plexus contain fibers from ____ and supply the _____ _______ and ______ muscles

A

S4
Lavatory ani
Coccygeus

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33
Q

The pelvic splanchnic nerves contain fibers from?

A

S2, S3, S4

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34
Q

What nerves are branches of the posterior division of the sacral plexus?

A
  1. Nerve to piriformis
  2. Superior gluteal N
  3. Inferior gluteal N.
  4. Perforating cutaneous N
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35
Q

Nerve to the piriformis what fibers to the piriformis?

A

S1 and S2

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36
Q

The superior gluteal N. Is made of what fibers?

A

L4, L5, S1

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37
Q

The superior gluteal N. Leaves the pelvis through _________, superior/inferior to the piriformis and splits into superior and inferior branches

A

Greater sciatic foramen, SUPERIOR

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38
Q

What does the superior branch of the superior gluteal N. Supply?

A

Gluteus mediums and minimus

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39
Q

What does the inferior branch of the superior gluteal N supply?

A

Gluteus mediums, gluteus minimus and the tensor fascia lata

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40
Q

The inferior gluteal nerve carries fibers from?

A

L5, S1, and S2

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41
Q

The inferior gluteal nerve leaves the pelvis through the ______ superior/inferior to the piriformis and innervates what?

A

Greater sciatic foramen, SUPERIOR

Gluteus Maximus

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42
Q

What nerve supplies the gluteus Maximus?

A

Inferior gluteal N

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43
Q

The perforating cutaneous nerve is made up of what fibers?

A

S2 and S3

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44
Q

The perforating cutaneous nerves travels through what structure and then ultimately reaches what structure?

A

Sacrotuberous ligament

Lower medial aspect of the buttocks

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45
Q

The perforating cutaneous nerve may instead be formed by a branch off the ______ nerve or may even be ______

A

Pudendal

Absent

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46
Q

What nerve may also be formed from the pudendal nerve or be absent?

A

Perforating cutaneous nerve

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47
Q

What two nerves are formed by branches of both the anterior and posterior division of the sacral plexus?

A
  1. Posterior cutaneous nerve of the thigh

2. Sciatic N

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48
Q

what fibers form the posterior cutaneous nerve of the thigh?

A

S2 and S3 from the anterior division

S1 and S2 fro the posterior division

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49
Q

What nerve is formed by S2 and S3 from the anterior division and S1 and S2 from the posterior divisions?

A

Posterior cutaneous nerve of the thigh

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50
Q

The posterior cutaneous nerve of the thigh leaves the pelvis through the __________ and ascends/descends through the posterior thigh and inferior leg to where it ultimately communicates with the ______ nerve

A

Greater sciatic foramen
Descends
Sural

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51
Q

What does the posterior cutaneous nerve of the thigh supply?

A

Skin on the posterior and medial thigh

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52
Q

What nerve supplied the skin of the posterior and medial thigh?

A

Posterior cutaneous nerve of the thigh

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53
Q

What is the largest nerve in the human body?

A

Sciatic nerve

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54
Q

What is the diameter of the sciatic nerve?

A

2cm

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55
Q

The sciatic nerve is a combination of what two nerves?

A

Tibial and common fibular N.

56
Q

What fibers make up the tibial nerve?

A

L4-S3 from the anterior division

57
Q

What fibers make up the common fibular nerve?

A

L4-S2 from the posterior division

58
Q

The sciatic nerve leaves the pelvis through _______ within a _______ ______ above/below the piriformis muscle?

A

Greater sciatic foramen
Common sheath
BELOW!

59
Q

What nerve exits the pelvis through the greater sciatic foramen BELOW the piriformis muscle?

60
Q

After the sciatic nerve exits the greater sciatic foramen below the piriformis, it continues inferior on the posterior aspect of what muscle?

A

Adductor magnus

61
Q

2/3 of the way to the knee, what happens to the sciatic nerve?

A

It splits into the common fibular and tibial nerves.

62
Q

Is the point where the sciatic nerve splits into the common fibular and tibial nerve variable?

63
Q

The common fibular nerve gives off branches to what muscle in the thigh before separating from the tibial nerve?

A

Biceps femoris (short head)

64
Q

After separating from the tibial nerve, the common fibular nerve courses around the _____ aspect of the fibula. Upon reaching the anterior-lateral aspect of the leg it gives off an _______ branch to the ____ _____.

A

Lateral

Articular, knee joint

65
Q

What two branches are given off the common fibular nerve along the lateral aspect of the popliteal fossa?

A
  1. Lateral sural cutaneous nerve

2. Fibular communicating branch

66
Q

Where are the lateral sural cutaneous nerve and the fibular communicating branches given off the common fibular N?

A

Along the lateral aspect of the popliteal fossa

67
Q

What does the lateral sural cutaneous nerve supply?

A

Skin no the lateral aspect of the leg

68
Q

the fibular communicating branch forms the _____ nerve after combining with the _____ ______ _____ nerve

A

Sural

Medial sural cutaneous nerve

69
Q

What two nerves does the common fibular nerve split into after giving off branches in the lateral popliteal fossa?

A
  1. Superficial fibular nerve

2. Deep fibular nerve

70
Q

The superficial fibular nerve travels inferior between the ____ _____ and the _____ down to the dorsum of the foot.

A

Fibular is longus and fibula

71
Q

What nerve travels inferior between the fibularis longus and the fibula to the dorsum to supply the fibularis longus/brevis?

A

Superficial fibular nerve

72
Q

What two muscles does the superficial fibular nerve supply?

A
  1. Fibularis longus

2. Fibularis brevis

73
Q

After the superficial fibular nerve branches to supply the fibularis longus and brevis it splits into what two additional nerves?

A
  1. Medial dorsal cutaneous nerve

2. Intermediate dorsal cutaneous nerve

74
Q

What do the medial and intermediate dorsal cutaneous nerves supply together?

A

Skin over the dorsum of the foot

(Except for the skin between the first two toes)

75
Q

What two nerves supply the skin over the dorsum of the foot (except for the skin between the first two toes)?

A

Medial and intermediate dorsal cutaneous nerves

76
Q

The deep fibular nerves runs inferiorly along the _____ _____ to reach the dorsum of the foot to supply the extensor muscles of the foot and toes

A

Tibialis anterior

77
Q

What 7 muscles/areas does the deep fibular nerve supply?

A 
1. Tibialis anterior
2/3. Extensor digitorum longus/brevis
4/5. Extensor hallucinate longus/brevis
6. Fibularis tertius
7. Sensory- skin between the first two toes (terminal branch of the deep fibular nerve)
78
Q

What nerve supplies the tibialis anterior?

A

Deep fibular N

79
Q

What nerve supplies the extensor digitorum longus/brevis?

A

Deep fibular N

80
Q

What nerve supplies the extensor hallucis longus/brevis?

A

Deep fibular N

81
Q

What nerve supplies the fibularis tertius?

A

Deep fibular N

82
Q

What nerve supplies the skin between the first and second toes?

A

Deep fibular nerve

83
Q

What clinical finding might you see if there was damage to the common fibular nerve?

A

Steppage gait

84
Q

What fibers make up the tibial nerve?

85
Q

Is the common fibular or tibial nerve larger?

86
Q

while still combined with the common fibular nerve, tibial nerve fibers are sent to what 4 muscles?

A
  1. Biceps femoris (long head)
  2. Semitendinosus
  3. Semimembranosus
  4. Adductor magnus
87
Q

What types of branches does the tibial nerve give off in the popliteal fossa?

A

Articular branch
muscular branch
Popliteal branch
Medial sural cutaneous nerve

88
Q

The articular branch that is given off by the tibial nerve in the popliteal fossa supplies what?

A

The knee joint

89
Q

The muscular branches that the tibial nerve gives off in the popliteal fossa supply what?

A
  1. Popliteus
  2. Gastrocnemius
  3. Soles
  4. Plantaris
90
Q

What nerve/branch supply the following muscles: popliteus, gastrocnemius, soleus, plantaris?

A

The muscular branch of the tibial nerve

91
Q

The popliteal branch travels inferior to give rise to the _____ ____ __ __ _____

A

Interosseous nerve of the leg

92
Q

The interosseous nerve of the leg travels along the posterior surface of the _______ ______ and carries _______ informations from the _______ ________, _______, ________?

A

Interosseous membrane
Sensory
Tibial periosteum, ankle and tibiofibular joints

93
Q

What nerve carries information from the tibial periosteum, ankle and tibiofibular joints?

A

The interosseous nerve of the leg

94
Q

In the leg the tibial nerve gives rise to both _____ and ______ sensory branches.

A

Muscular and sensory

95
Q

The muscular branches of the tibial nerve in the leg supply what 3 muscles?

A

Tibialis posterior
Flexor digitorum longus
Flexor hallucis longus

96
Q

What nerve/branch supply the tibialis posterior, flexor digitorum longus and hallucis longus muscles?

A

Muscular branch of the tibial nerve (in the leg)

97
Q

What is the name for the sensory branches of the tibial nerve in the leg?

A

The medial calcaneal branches

98
Q

The medial calcaneal branches supply what?

A

The skin over the medial heel

99
Q

What branches supply the skin over the medial heel?

A

The medial calcaneal branches (of the tibial nerve)

100
Q

The tibial nerve travels around the _____ _____ to the plantar surface of the food and divide into two terminal branches: _____ _____ nerve, and ______ ______ nerve.

A

Medial malleolus

Medial plantar nerve and lateral plantar nerve

101
Q

What are the two terminal branches of the tibial nerve on the plantar surface of the foot?

A

Medial and lateral plantar nerves

102
Q

The medial plantar nerve sends motor fibers to?

A
  1. Abductor hallucis
  2. Flexor digitorum brevis
  3. Flexor digitorum longus
103
Q

What nerve supplies the abductor hallucis, flexor digitorum brevis, flexor hallucis brevis?

A

Medial plantar nerve (terminal branch of the tibial nerve)

104
Q

After the medial plantar nerve supplies the abductor hallucis, flexor digitorum brevis and flexor hallucis brevis, the medial plantar nerve divides into ____ ____ _____ nerves

A

Common plantar digital

105
Q

The common plantar digital nerves have motor supply to what?

A

1st lumbrical

106
Q

The common plantar digital nerves have sensory supply to where?

A

Skin between the toes by way of the proper plantar digital nerves

107
Q

Sensory supply to the skin between the toes from the tibial nerve is supplied by what nerves?

A

Proper plantar digital nerves

108
Q

What does the proper plantar digital nerves supply?

A

Skin between the toes

109
Q

The lateral plantar nerve divides into what?

A

Superficial and deep branches

110
Q

The superficial branch off the lateral plantar nerve supplies what?

A

Skin around the 5th digit

111
Q

What supplies the skin around the fifth digit?

A

The superficial branch of the lateral plantar nerve (a branch of the tibial nerve)

112
Q

The deep branch of the lateral plantar nerve supplies motor fibers to what 6 muscles?

A
  1. Adductor hallucis
  2. Flexor digiti minimi brevis
  3. Abductor digiti minimi
  4. Quadratus plantae
  5. Lateral lumbricals
  6. Interossei muscles
113
Q

What branch/nerve supply the following: adductor hallucis, flexor digiti minimi brevis, abductor digiti minimi, quadratus plantae, lateral lumbricals, and the interossei muscles?

A

Deep branch of the lateral plantar nerve (branch of the tibial nerve)

114
Q

What are some clinical considerations regarding damage to the tibial nerve?

A
  1. Flexor paralysis
  2. Hammer toes (distal phalanx of metatarsal joint abnormally flexed, while other joints are in extension)
  3. Claw foot (tarsal tunnel syndrome)
115
Q

Where is the tarsal tunnel located?

A

Medial/posterior malleolus

116
Q

How many sacral spinal nerves are there?

117
Q

The sacral spinal nerves descend inside _____, and form much of the ___ _____

A 
Dura
Cauda equina (~L2)
118
Q

Each sacral nerve divides into an ____ and ______ ____ _____

A

Anterior and posterior primary ramus

119
Q

The posterior primary rami of s1-s4 travel through the four ____ _____. S5 travels through the _____ ____

A

Sacral foramina

Sacral hiatus

120
Q

What sacral rami travel through the sacral foramina?

A

Posterior primary rami of s1-s4

121
Q

What sacral rami travel through the sacral hiatus

A

Posterior primary rami of s5

122
Q

The posterior primary rami of ______ divide into ____ and ____ branches

A

S1-s3

Medial and lateral

123
Q

The medial branches of posterior primary rami of s1-s3 supply what?

A

The adjacent multifidi

124
Q

The lateral branches of the posterior primary ramus of s1-s3 supply what? (Also L4/l5)

A

Skin over buttock?

125
Q

What supply the skin of the multifidi in the sacrum>

A

Medial branch of posterior primary rami of s1-s3

126
Q

What supply the skin to the buttock?

A

Lateral branches of posterior primary rami of s1-s3 and L4/l5

127
Q

The posterior primary rami of _______ unite with the ______ ______ rami to supply the skin over the coccyx

A

S4-s5

Coccygeal posterior rami

128
Q

What supply the skin over the coccyx?

A

The posterior primary rami of s4-s5 and the coccygeal posterior rami

129
Q

The anterior primary rami of s1-s4 travel through the four _____ _____ ____ while the s5 travels through the _____ _____

A

Anterior sacral foramina

Sacral hiatus

130
Q

The anterior primary rami of s1-s4 contribute to what?

A

Sacral plexus

131
Q

The anterior primary rami of s4/s5 contribute to what?

A

Coccygeal pleaxus

132
Q

What are the two communications with the sympathetic trunk to the sacral nerves?

A
  1. 3-4 sacral sympathetic ganglia

2. Anterior primary ramus each have postganglionic sympathetic fibers via gray ramus communicans

133
Q

What forms the coccygeal plexus?

A

S4, s5, Co1

134
Q

The s4, s5, co1 nerves combine and give rise to _________nerves that carry sensory information from where?

A

Anococcygeal nerves

Skin adjacent to the coccyx and anus

135
Q

What supply the skin adjacent to the coccyx and anus?

A

Anococcygeal nerves

PNS (8 decks)

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