![Anterior cervical cutaneous[Transverse cervical
nerve ] (C2,3)
Crosses SCM horizontally forward
Supplies skin & subcutaneous tissues of the cylinder of the
neck, so it transmits sensory information from the skin of
the anterior and lateral aspects of the neck.](https://image.slidesharecdn.com/cervicalplexus-171003233500/85/Cervical-plexus-18-320.jpg)
Cervical plexus
- 2. The Nervous System The nervous system can be defined as the network of nerve cells and fibers that sends messages for controlling movement and feeling between the brain and the other parts of the body. This nervous system is divided into two main parts, the central nervous system (CNS), which consists of the brain and spinal cord , and the peripheral nervous system (PNS) , which consists of 12 pairs of cranial nerves and 31 pairs of spinal nerves and their associated ganglia. Functionally, the nervous system can be further divided into the somatic nervous system, which controls voluntary activities, and the autonomic nervous system, which controls involuntary activities.
- 3. functions of the nervous system The three basic functions of the nervous system: Motor output: Respond via muscle or glandular action Sensory input: Receive sensations from inside and outside the body Integration: Process and interpret sensations and make decisions The nervous system, together with the endocrine system, controls and integrates the activities od the different parts of the body.
- 4. Nervous system Central nervous system Brain Spinal cord Peripheral nervous system Cranial nerves Spinal nerves plexuses
- 5. Nerve plexus plexus /pleksəs/ noun a network of nerves, blood vessels or lymphatics. A nerve plexus is a system of connected nerve fibers that link spinal nerves with specific areas of the body. Fibers in a plexus connect the spinal cord and the body by grouping themselves into one larger nerve. The human body consists of several nerve plexuses, including the brachial plexus, the cervical plexus, the coccygeal plexus, the lumbar plexus, the sacral plexus, and the solar plexus. A plexus is like an electrical junction box, which distributes wires to different parts of a house. In a plexus, nerve fibers from different spinal nerves (which connect the spinal cord to the rest of the body) are sorted. The fibers are recombined so that all fibers going to a specific body part are put together one nerve. Damage to nerves in the major plexuses causes problems in the arms or legs that these nerves supply.
- 6. NERVE PLEXUS ANATOMY The nerve plexus is actually made up of a multitude of nerve branches. These branches come from the spinal nerves, except for the thoracic spinal nerves 2 through 12. The remaining nerves donate their anterior rami, which branch off from the spinal nerves only to adjoin with each other . A nerve plexus is composed of afferent and efferent fibers that arise from the merging of the anterior rami of spinal nerves and blood vessels.
- 7. NERVE PLEXUS STRUCTURE Once they connect, they break off again and develop the network of nerve fibers known as the nerve plexus. There are actually 4 of these nerve plexuses in the human body, the brachial plexus, cervical plexus, the sacral plexus and the lumbar plexus. At the root of the limbs, the anterior rami join one another to form complicated nerve plexus. The cervical and brachial plexuses are found at the root of the upper limbs, and the lumbar and sacral plexuses are found at the root of the lower limbs. The nerves which come out of the various plexus are typically named either for the specific area which they innervate or the basic course which can be traced along the way.
- 8. The main function of a nerve plexus The main function of a nerve plexus is to ensure that all areas of the body are innervated, thereby equipping each region with the ability to send and receive messages from the peripheral nervous system. The different plexuses are charged with innervating different portions of the body and help to control the functions unique to each portion. A nerve plexus is formed during development, when disparate muscles of the skeleton fuse together and result in large muscles requiring innervation . The nerves that arise from the plexuses have both sensory and motor functions. These functions include muscle contraction, the maintenance of body coordination and control, and the reaction to sensations such as heat, cold, pain and pressure.
- 9. Nerve plexus Spinal plexuses Cervical plexus Brachial plexus Lumbar plexus Sacral plexus Coccygeal plexus Autonomic plexuses Auerbach’s plexus Meissner’s plexus Celiac plexus
- 10. 1. Spinal plexus At each vertebral level, paired spinal nerves leave the spinal cord via the intervertebral foramina of the vertebral column. There are five spinal nerve plexuses
- 11. 1.a. Cervical plexus The cervical nerve plexus is a junction of small nerve fiber network that transports sensory information to the shoulder, neck and the head. It continues until pharynx and is enclosed deep within the neck. It extends further up to the pharynx. The cervical plexus is an important part of the peripheral nervous system (PNS) which is a part of nervous system located outside the spinal cord and brain. Cervical Plexus—Serves the Head, Neck and Shoulders The cervical plexus is formed by the ventral rami of the upper four cervical nerves and the upper part of fifth cervical ventral ramus. The network of rami is located deep within the neck.
- 15. The cervical plexus is an arrangement of sensory and motor fibers, formed from the ventral rami of spinal nerves C1 to C4. The cutaneous branches of cervical plexus are: Lesser occipital nerve innervate the skin of the occipital region Great auricular nerve innervate outer ear & ear canal Transverse cervical nerve innervate the anterior aspect of the neck Supraclavicular nerves innervate the shoulder and the upper thorax
- 16. Lesser occipital (C2): Along the posterior border of SCM Supplies skin & subcutaneous tissue at the insertion of the muscle
- 17. Great auricular (C2,3): Ascends in the direction of the auricle Supplies the auricle (except the upper ½ of lateral surface) & skin over the angle of mandible
- 18. Anterior cervical cutaneous[Transverse cervical nerve ] (C2,3) Crosses SCM horizontally forward Supplies skin & subcutaneous tissues of the cylinder of the neck, so it transmits sensory information from the skin of the anterior and lateral aspects of the neck.
- 19. Supraclavicular nerves The supraclavicular nerves are three groups of nerves that arise from the third and the fourth cervical nerves, via the cervical plexus, to provide sensory innervation of the skin above and below the clavicle. Once They pass through the platysma, the multiple fibers become arranged into three groups termed medial, intermediate, and lateral according to their position. As well as the skin, the medial supraclavicular nerve innervates part of the sternoclavicular joint. The three groups and their innervation are: 1. Medial; skin over manubrium sterni 2. Intermediate; skin over the pectoral region down to the sternal angle 3. Lateral; skin over deltoid as far as the distal 1/2 of muscle
- 20. Muscular (motor) branches of cervical plexus are: Ansa cervicalis innervate various hyoid attaching muscles Phrenic nerve innervate diaphragm & pericardium Segmental branches that innervate anterior and middle scalenes
- 21. Superior root of Ansa cervicalis Branches of the cervical spinal nerves 1(C1) and 2 (C2) travel in the hypoglossal nerve. These nerves separate in the carotid triangle to form the superior root of the Ansa cervicalis. The superior root travels around the occipital artery and then descends on the carotid sheath. Branches of the superior root then travel to the superior belly of the omohyoid muscle and the upper parts of the sternothyroid and sternohyoid muscles. It is then joined by the inferior root, creating a loop.
- 22. Inferior root of Ansa cervicalis The inferior root of the Ansa cervicalis (also known as the descendens cervicalis) is formed by fibers from the cervical spinal nerves C2 and C3. The inferior root of the Ansa cervicalis then branches off to the inferior belly of the omohyoid muscle, and the lower parts of the sternothyroid and sternohyoid muscles.
- 23. Phrenic nerve The phrenic nerve arises from the ventral primary rami of spinal nerves of the cervical plexus (C3-C5). It supplies the skeletal muscles of the respiratory diaphragm and provides cutaneous innervation to the diaphragmatic pleura. A few fibers are distributed to the pericardium as well as the surrounding mediastinal and costal pleurae.
- 24. Greater occipital nerve The greater occipital nerve is a branch of the posterior ramus of the 2nd cervical nerve. The 1st cervical nerve has no cutaneous branch. The skin of the front and sides of the neck is supplied by anterior rami of cervical nerves 2 to 4 through branches of the cervical plexus. The branches emerge from beneath the posterior border of the sternocleidomastoid muscle. The greater occipital nerve is the medial branch of the dorsal primary ramus of the second cervical nerve. It supplies the muscles of the posterior neck, the semispinalis capitis muscle, the multifidus cervicis muscle and the skin on the posterior scalp. It also provides meningeal branches to the posterior cranial fossa and pain and proprioceptive branches to the first cervical nerve for the suboccipital muscles.
- 25. Suboccipital nerve The suboccipital nerve is the dorsal division of the first cervical spinal nerve. It innervates the rectus capitis posterior major, obliquus capitis superior , and oblique capitis inferior, which together form the boundaries of the suboccipital triangle, as well as the rectus capitis posterior minor. It is so named due to its leaving the spinal cord between the occipital bone of the skull and the first cervical vertebra.
- 27. Notes : The cervical plexus is different from the brachial plexus that it is do not have roots or cords . The cervical plexus is not regular as the brachial plexus. The accessory nerve supplies the sternocleidomastoid and trapezius muscles. The hypoglossal nerve supplies the intrinsic and extrinsic muscles of the tongue, except the palatoglossus muscles. C1 has four branches in the neck are: 1. Meningeal branch 2. Superior ramus of Ansa cervicalis 3. Nerve to thyrohyoid 4. Nerve to geniohyoid These nerves distributed by the hypoglossal nerve