Peripheral Nervous System
- 1. Nervous 2Peripheral Nervous SystemMcKinley and O’LaughlinChapter 15&16
- 3. Cranial NervesWhat openings in the skull transmit the first cranial nerve?Foramina of the cribriform plate of the ethmoid bone
- 5. What openings in the skull transmit the second cranial nerve?Optic foramen (or optic canal)
- 6. Oculomotor (CN III)What is the function of the third cranial nerve?Somatic motor: 4 extrinsic eye muscles and levator palpebrae superiorisParasympathetic motor: pupil (iris) and ciliary muscle
- 7. Which cranial nerves innervate eye muscles?
- 9. Superior view showing action of superior oblique muscle (down & out)
- 11. TrigeminalWhat are the functions of the fifth cranial nerve?Sensory:Ophthalmic: cornea, nose, forehead, anterior scalpMaxillary: nasal mucosa, palate, gums, cheek, upper teethMandibular: anterior 2/3 of tongue, skin of chin, lower jaw and teeth, part of auricleSomatic motor: muscles of mastication and others of lower face
- 12. Cranial NervesWhat openings in the skull transmit the fifth cranial nerve?Ophthalmic: superior orbital fissureMaxillary: foramen rotundumMandibular: foramen ovale
- 14. Cranial NervesWhat is the function of the seventh cranial nerve?Sensory: anterior 2/3 tongueSomatic motor: muscles of facial expression and others (e.g. digastric and stapedius)Parasympathetic motor: submandibular and sublingual glands and lacrimal gland
- 15. Cranial NervesWhat openings in the skull transmit the seventh cranial nerve?Internal auditory canal (internal acoustic meatus). It takes a tortuous course to finally exit the:Stylomastoid foramen
- 17. CN VII (Facial)Passes through the parotid gland. Does it innervate it??
- 18. Tell me about vestibulocochlear nerve
- 19. Cranial Nerve IXWhat is the name of the ninth cranial nerve?What are its functions?Sensory: posterior 1/3 of tongue, carotid sinus (blood pressure and chemistry)Somatic motor: a muscle of the pharynxParasympathetic motor: parotid glandWhat opening in the skull transmits this nerve?
- 20. Note the carotid sinus. . . Remember Master Long?
- 21. CN XLet’s talk about the vagabond.
- 22. Cranial NervesWhat is the function of the tenth cranial nerve?Sensory: pharynx, larynx, thoracic and abdominal viscera, external auditory canal, tympanumSomatic motor: pharyngeal and laryngeal musclesParasympathetic motor: myocardium, smooth muscle and glands of viscera
- 23. Cranial NervesWhat is the function of the eleventh cranial nerve?Somatic motor:Cranial root: pharynx (with vagus nerve)Spinal root: trapezius and sternocleidomastoid muscles
- 25. Cranial NervesWhat is the function of the twelfth cranial nerve?Somatic motor: intrinsic and extrinsic tongue muscles
- 27. Spinal Cord and NervesWhat are the 2 functions of the spinal cord?Pathway for motor impulsesReflexes
- 28. Spinal Cord Gross AnatomyWhat is the general shape of the spinal cord in cross-section?Dorsoventrally compressed cylinder
- 29. Spinal Cord Gross AnatomyWhat depressions lie on the anterior and posterior surfaces of the spinal cord?Anterior median fissure (wider)Posterior median sulcus
- 30. Spinal Cord Gross AnatomyWhere does the spinal cord end in an adult?Extends from foramen magnum to L1Spine grows more than cord
- 31. Gross AnatomyList the regions of the spinal cord.CervicalThoracicLumbarSacralCoccygeal
- 32. Spinal Cord Gross AnatomyWhat is the cauda equina?“Horse’s tail”Spinal nerves extending from end of the spinal cord travel through vertebral canal and exit at each of the lower levels
- 34. Spinal Cord Gross AnatomyHow many pairs of spinal nerves are there?31List regions and associated spinal nerves.C1-C8T1-T12L1-L5S1-S5Co1
- 35. Spinal Cord MeningesFrom superficial to deep list the spaces and structures surrounding the spinal cord.
- 38. Spinal Cord Sectional AnatomyWithin the spinal cord, where is the gray matter located and how is it shaped?
- 40. Spinal Cord Sectional AnatomyWithin the spinal cord, what are the anterior masses of gray matter that contain the cell bodies of somatic motor neurons?Within the spinal cord, from T1-T12, what structures contain the cell bodies of ofautonomic motor neurons?Within the spinal cord, what are the posterior masses of gray matter that contain the axons of sensory neurons and the cell bodies of interneurons?
- 42. Spinal Cord Sectional AnatomyWhat horizontal bar of gray matter surrounds the central canal within the spinal cord?Gray commissure“commissure” just means a place where two parts join (the corners of your mouth are commissures)What fills the central canal of the spinal cord?CSF
- 44. Spinal Cord Sectional AnatomyWithin the regions of the spinal cord’s gray matter what are the various functional groups of neuron cell bodies?NucleiSensorySomatic motorAutonomic motor
- 46. Spinal Cord Sectional AnatomyWhere does the white matter of the spinal cord lie in relation to the gray matter?The white matter of the spinal cord is organized/partitioned into three regions. What is each called?Funiculus (means a “slender rope” or “cord” and is referring to a bundle of nerve fibers)Posterior, lateral, and anteriorAscending and descending
- 48. Spinal NervesAnteriorly and posteriorly what are the small attachments of a spinal nerve to the spinal cord?The numerous small attachments of a spinal nerve to the spinal cord converge to form what structures?
- 50. Spinal NervesThe cell bodies of sensory neurons associated with the spinal cord are in what structures?The cell bodies of motor neurons within the spinal cord are found in what structures?
- 52. Spinal NervesWhat are the 2 main branches of a spinal nerve?Anterior and posterior ramiWhich is larger?What branches of a spinal nerve are associated with the autonomic nervous system?Communicating rami (rami communicantes)
- 54. Spinal NervesWhat is a specific segment of skin supplied by a single spinal nerve?Dermatome
- 55. Note faceWhich areas are innervated by cauda equina nerves?
- 56. Intercostal NervesThe anterior rami of T1-T11 travel in intercostal spaces. What are these nerves called?Intercostal nervesWhat term is used to refer to T12 because it lies below the ribs (T12) rather than between them?Subcostal nerve
- 57. Intercostal NervesIn general, what do intercostal nerves innervate?Intercostal musclesAbdominal musclesAssociated skin area
- 59. A “plexus” is a combined set of spinal nerves that are going to the same areaWhat is a network of interweaving anterior rami of spinal nerves?Nerve plexusThe cervical plexus arises from what spinal nerves?C1-C4Where is the cervical plexus located?Deep on each side of the neck
- 60. Cervical PlexusWhat regions of the body does the cervical plexus innervate?Anterior neck musclesSkin of neck, parts of face and headWhat branch of the cervical plexus innervates the diaphragm?PhrenicC3-C5 (primarily C4)Don’t damage your spinal cord above this
- 63. Brachial PlexusWhat regions of the body does the brachial plexus innervate?Pectoral girdleUpper limbs
- 64. Brachial PlexusThe brachial plexus arises from what spinal nerves?C5-T1Where is the brachial plexus located?Superior to 1st rib (subclavicular)Axilla
- 67. Brachial PlexusList the 5 (major) nerves that innervate the upper extremity.Axillary nerveMedian nerveMusculocutaneous nerveRadial nerveUlnar nerveI’m asking that you know the general innervation but be able to list at least 1 specific muscle for each nerve
- 69. Brachial Plexus: Axillary NerveWhat is the motor innervation of the axillary nerve?DeltoidTeres minorWhat is the cutaneous innervation of the axillary nerve?Superolateral arm (deltoid region)
- 71. Brachial Plexus: Median NerveWhat is the motor innervation of the median nerve?Most anterior antebrachial muscles (flexors/pronators)Thenar musclesLateral 2 lumbricalsWhat is the cutaneous innervation of the median nerve?Palmar aspects & dorsal tips of lateral 3.5digits
- 73. Median nerve & carpal tunnel
- 74. Brachial Plexus: MusculocutaneousWhat is the motor innervation of the musculocutaneous nerve?Anterior brachial muscles (coracobrachialis, biceps brachii, brachialis)What is the cutaneous innervation of the musculocutaneous nerve?Lateral antebrachium
- 76. Brachial Plexus: Radial NerveWhat is the motor innervation of the radial nerve?Posterior brachial muscles (triceps brachii, anconeus)Posterior antebrachial muscles (supinator, extensors, brachioradialis)
- 77. Brachial Plexus: Radial NerveWhat is the cutaneous innervation of the radial nerve?Posterior brachiumPosterior antebrachiumDorsal portion of lateral 3.5 digits
- 79. Wrist DropThe radial nerve can be damaged if the humerus (the bone of the arm) is broken, because it runs through the radial groove on the lateral border of this boneCan also be caused by lead poisoning
- 80. Brachial Plexus: Ulnar NerveWhat is the motor innervation of the ulnar nerve?Anterior antebrachial muscles (1/2 flexor digitorum profundus, flexor carpi ulnaris)Hypothenar musclesMost intrinsic muscles of the hand (interossei, adductor pollicis, medial 2 lumbricals)
- 81. Brachial Plexus: Ulnar NerveWhat is the cutaneous innervation of the ulnar nerve?All of medial 1.5 digits and associate hand (dorsal and palmar)
- 83. Remember your “funny bone?”
- 84. Lumbar PlexusThe lumbar plexus arises from the anterior rami of what spinal nerves?L1-L4We will learn two of the nerves that branch off the lumbar plexus (there are others we won’t learn)
- 86. Lumbar Plexus: Femoral NerveWhat is the main nerve of the posterior division of the lumbar plexus?Femoral nerveWhat is the motor innervation of the femoral nerve?Anterior thigh muscles (quads, iliopsoas, sartorius)Pectineus
- 88. Lumbar Plexus: Femoral NerveWhat is the cutaneous innervation of the femoral nerve?Anterior thighInferomedial thighMedial legMedial footBasically the pathway of the great saphenous vein
- 90. Lumbar Plexus: Obturator nerveWhat is the main nerve of the anterior division of the lumbar plexus?Obturator nerve
- 91. Lumbar Plexus: Obturator NerveWhat is the motor innervation of the obturator nerve?Medial thigh muscles (adductors, gracilis, pectineus*) *femoral, obturator, or bothObturator externusWhat is the cutaneous innervation of the obturator nerve?Superomedial thigh
- 93. Lumbar Plexus: Other BranchesWhat other regions of the body do small branches of the lumbar plexus innervate?Abdominal wallScrotum/LabiaInferior portions of abdominal muscles (also innervated by intercostal nerves)
- 94. Sacral PlexusThe anterior rami of what spinal nerves form the sacral plexus?L4-S4Nerves emerging from the sacral plexus innervate what portions of the body?Gluteal regionPelvisPerineumPosterior thighLeg and Foot
- 97. Sacral PlexusWhat are the 2 main divisions of the sacral plexus?Anterior and posterior divisionsNerves of the sacral plexus arising from the anterior division tend to innervate what muscles?Muscles that flex and plantar flex Hamstrings and hamstring portion of adductor magnusPosterior crural musclesPlantar foot muscles
- 98. Sacral PlexusNerves of the sacral plexus arising from the posterior division tend to innervate what muscles?Muscles that extend and dorsiflex We’ll discuss these for each branch of the posterior division
- 99. Sacral Plexus: Sciatic Nerve-anteriorWhat is the largest and longest nerve in the body?Sciatic nerveWhat nerve is formed from the anterior divisions of the sciatic nerve?Tibial nerve
- 100. Sacral Plexus: Sciatic Nerve: TibialWhat division of what nerve innervates the hamstrings?Tibial division of the sciatic nerveWithin the leg what nerve innervates the plantar flexors of the foot and the flexors of the toes?Tibial nerve
- 102. Sacral Plexus: Sciatic Nerve: FibularWhat nerve is formed from the posterior division of the sciatic nerve?Common fibular nerveWhat division of what nerve innervates the short head of the biceps femoris?Common fibular division of the sciatic nerve
- 103. Sacral PlexusWhat are the 2 main divisions of the common fibular nerve?Deep fibular nerveSuperficial fibular nerve
- 104. Sacral Plexus: Sciatic: Deep FibularWhat is the motor innervation of the deep fibular nerve?Anterior leg muscles (tibialis anterior, extensors)Dorsal muscles of foot (extensor brevia muscles)What is the cutaneous innervation of the deep fibular nerve?Dorsally between digits I and II
- 106. Sacral Plexus: Sciatic: Superficial FibularWhat is the motor innervation of the superficial fibular nerve?Lateral leg muscles (Fibularis brevis and longus)What is the cutaneous innervation of the superficial fibular nerve?Anteroinferior legDorsum of foot
- 108. Wow! That’s the End!Now on to Autonomic Nervous System!