Peripheral Nervous System (Cranial Nerves, Spinal Nerves, Nerve Plexus) Flashcards

1
Q

What is the peripheral nervous system (PNS)?

A

collection of nerve fibers and ganglia

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2
Q

What are ganglia?

A

aggregations of neuronal cell bodies

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3
Q

What are the components of the PNS?

A
  • 12 pairs of cranial nerves
  • 31 pairs of spinal nerves
  • autonomic (visceral) nerve fibers
  • associated sensory and autonomic ganglia
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4
Q

Cranial Nerves

What are the first 2 pairs of cranial nerves?

A

extensions of the cerebrum

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5
Q

Cranial Nerves

What are the last 10 pairs of cranial nerves?

A

their nuclei are within the brainstem

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6
Q

Cranial Nerves

What type of nuclei are in the last 10 pairs of the cranial nerves?

A
  • sensory
  • motor
  • autonomic (parasympathetic)
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7
Q

Cranial Nerves

What is the sensory nuclei of the cranial nerves equivalent to in the spinal cord?

A

posterior horn

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8
Q

Cranial Nerves

What is the motor nuclei of the cranial nerves equivalent to in the spinal cord?

A

anterior horn

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9
Q

Cranial Nerves

What is the parasympathetic nuclei of the cranial nerves comparable to in the spinal cord?

A

lateral horn in S2-S4 segments

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10
Q

Cranial Nerves

What are the sensory ganglia of the cranial nerves similar to in the spinal nerves?

A

similar to dorsal root ganglia of spinal nerves

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11
Q

Cranial Nerves

Where do cranial nerves pass through?

A

different openings at the base of the neurocranium

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12
Q

Cranial Nerves

Where are all the cranial nerves?

A

distributed in the head and neck

EXCEPT: CN X (vagus), which distributes in the thorax and abdomen too

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13
Q

CN I

  • name
  • components
  • function
  • opening of skull
A

Name: olfactory

Components: sensory

Function: olfaction

Opening of the Skull: cribriform plate of ethmoid bone

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14
Q

CN II

  • name
  • components
  • function
  • opening of skull
A

Name: optic

Components: sensory

Function: vision

Opening of the Skull: optic canal

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15
Q

CN III

  • name
  • components
  • function
  • opening of skull
A

Name: oculomotor

Components: motor and autonomic

Function: 5 of the extra ocular muscles, ciliary muscle, and sphincter pupil

Opening of the Skull: superior orbital fissure

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16
Q

CN IV

  • name
  • components
  • function
  • opening of skull
A

Name: trochlear

Components: motor

Function: one of the extra ocular muscles

Opening of the Skull: superior orbital fissure

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17
Q

CN V: Trigeminal - first division

  • name
  • components
  • function
  • opening of skull
A

Name: opthalmic division

Components: sensory

Function: mainly cornea, skin of anterior scalp, upper eyelids, and nose

Opening of the Skull: superior orbital fissure

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18
Q

CN V: Trigeminal - second division

  • name
  • components
  • function
  • opening of skull
A

Name: maxillary division

Components: sensory

Function: mainly skin of face between lower eyelid and upper lip, nasal cavity, nasopharynx, upper teeth, and palates

Opening of the Skull: foramen rotundum

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19
Q

CN V: Trigeminal - third division

  • name
  • components
  • function
  • opening of skull
A

Name: mandibular division

Components: sensory and motor

Function: mainly skin covering the mandible and lateral scalp, lower teeth, oral cavity (except palates), and muscles of mastication

Opening of the Skull: foramen ovale

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20
Q

CN VI

  • name
  • components
  • function
  • opening of skull
A

Name: abducent

Components: motor

Function: one of the extra ocular muscles

Opening of the Skull: superior orbital fissure

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21
Q

CN VII

  • name
  • components
  • function
  • opening of skull
A

Name: facial

Components: sensory, motor, and autonomic

Function: tase of the anterior 2/3’s of the tongue, muscles of facial expression, submandibular, sublingual, and lacrimal glands

Opening of the Skull: internal acoustic (auditory) meatus

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22
Q

CN VIII

  • name
  • components
  • function
  • opening of skull
A

Name: vestibulocochlear

Components: sensory

Function: hearing and balance

Opening of the Skull: internal acoustic (auditory) meatus

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23
Q

CN IX

  • name
  • components
  • function
  • opening of skull
A

Name: glossopharyngeal

Components: sensory, motor, and autonomic

Function:

  • taste and general sensation of the posterior 1/3 of the tongue, stylopharyngeus msucle
  • general sensation of the oropharynx, carotid sinus, and carotid body

Opening of the Skull: jugular foramen

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24
Q

CN X

  • name
  • components
  • function
  • opening of skull
A

Name: vagus

Components: sensory, motor, and autonomic

Function:

  • general sensation of larynx, laryngopharynx, and trachea, pharyngeal muscles (except stylopharyngeus),
  • parasympathetic innervation of lungs, heaart, and parts of gastrointestinal tract

Opening of the Skull: jugular foramen

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25
Q

CN XI

  • name
  • components
  • function
  • opening of skull
A

Name: accessory

Components: motor

Function: sternocleidomastoid and trapezius

Opening of the Skull: jugular foramen

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26
Q

CN XII

  • name
  • components
  • function
  • opening of skull
A

Name: hypoglossal

Components: motor

Function: muscles of the tongue (except palatoglossus)

Opening of the Skull: hypoglossal canal

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27
Q

Spinal Nerves

Where do spinal nerves leave the vertebral canal?

A

through the corresponding foramina

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28
Q

Spinal Nerves

What are spinal nerves associated with?

A

segments of the spinal cord

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29
Q

Spinal Nerves

How is each spinal nerve connected to the spinal cord?

A

by ventral (anterior) root and dorsal (posterior) root

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30
Q

Spinal Nerves

What do ventral roots arise from?

What do they carry?

A

ventral horn of spinal cord

carries motor (efferent) fibers

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31
Q

Spinal Nerves

What do dorsal roots arise from?

What do they carry?

A

dorsal horn of spinal cord

carries sensory (afferent) fibers

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32
Q

Spinal Nerves

What type of nerve is the spinal nerve? Why?

A

mixed (motor and sensory) nerve

it is formed by the union of the motor (ventral) and sensory (dorsal) roots

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33
Q

Spinal Nerves

When do spinal nerves split?

What do they split into?

A

immediately after emerging from the vertebral canal

splits into ventral (anterior) and dorsal (dorsal) ramus/branch

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34
Q

Spinal Nerves

What are somatic nerve plexuses?

A

present in cervical, lumbar, and sacral regions

formed by ventral (anterior) rami

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35
Q

Spinal Nerves

Are ventral or dorsal rami thicker?

A

ventral

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36
Q

Spinal Nerves

What are the intercostal nerves?

A

ventral rami of thoracic spinal nerves T1-T11

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37
Q

Spinal Nerves

What is the subcostal nerve?

A

ventral ramus of thoracic spinal nerve T12

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38
Q

Spinal Nerves

Do intercostal nerves form a distinct nerve plexus?

A

no

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39
Q

Spinal Nerves

What do dorsal rami supply?

A

paravertebral musculature and the overlying skin

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40
Q

Spinal Nerves

Where does the spinal cord end?

A

at the level of vertebra LI-LII

since the spinal cord ends there, ventral and dorsal roots of the lumbar, sacral, and coccygeal spinal nerves descend to the respective foramina before emerging from the vertebral canal

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41
Q

Spinal Nerves

What is the cauda equina (horse’s tail)?

A

bundle of roots

since the spinal cord ends at the level of vertebra LI-LII, ventral and dorsal roots of the lumbar, sacral, and coccygeal spinal nerves descend to the respective foramina before emerging from the vertebral canal

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42
Q

Spinal Nerves

How are spinal nerves named?

A

after the spinal cord segments that give rise to them

43
Q

Spinal Nerves

cervical spinal nerves

A

C1-C8

  • emerge from vertebral canal above the corresponding cervical vertebrae
  • C8 passes between vertebra CVII and TI
  • ventral rami of these nerves form either cervical (C1-C4) or brachial (C5-T1) plexuses
44
Q

Spinal Nerves

thoracic spinal nerves

A

T1-T12

  • exit from vertebral canal below the corresponding thoracic vertebrae
  • intercostal nerves (the ventral rami of thoracic spinal nerves) travel in intercostal and abdominal muscles, and the skin of the ventral aspect of the trunk
  • ventral ramus of spinal nerve T1 contributes in brachial plexus
45
Q

Spinal Nerves

lumbar spinal nerves

A

L1-L5

  • exit from vertebral canal below the corresponding lumbar vertebrae
  • ventral rami of these nerves form lumbar plexus (L1-L4) and contribute in sacral plexus
46
Q

Spinal Nerves

sacral spinal nerves

A

S1-S5

  • emerge from vertebral canal through the corresponding sacral foramina
  • ventral rami of these nerves form the sacral plexus (L4-S4) and contribute in coccygeal plexus
47
Q

Spinal Nerves

coccygeal spinal nerves

A

Co

  • pair of spinal nerves
  • ventral rami forms coccygeal plexus with contribution from sacral nerves S4 and S5
48
Q

Spinal Nerves

What is the dermatome?

A

area of the skin that is innervated by a single spinal nerve or spinal cord segment

49
Q

Spinal Nerves

What is the myotome?

A

part of the skeletal muscle that is innervated by a single spinal nerve or spinal cord segment

50
Q

Nerve Plexuses

What are nerve plexuses?

A

intertwined network of nerve fibers

51
Q

Nerve Plexuses

What are the somatic plexuses formed by?

A

ventral rami of the spinal nerves (except T2-T11 nerves)

52
Q

Nerve Plexuses

What are the visceral (autonomic) plexuses formed by?

A

autonomic nerve fibers

53
Q

Nerve Plexuses

What do ventral rami in somatic plexuses do?

A

communicate with each other and redistribute their fibers

  • each branch of the somatic plexus carries fibers from several spinal nerves
  • fibers from each ventral ramus distributes via several different branches
54
Q

Nerve Plexuses - Cervical

Where is the cervical plexus?

A

deep to the sternocleidomastoid muscle

55
Q

Nerve Plexuses - Cervical

What is the cervical plexus composed of?

A

nerve loops formed by the ventral rami of the spinal nerves C1-C4

56
Q

Nerve Plexuses - Cervical

What are the 2 branches of the cervical plexus?

A

cutaneous

motor

57
Q

Nerve Plexuses - Cervical

Cutaneous Branch

  • name
  • distribution
A

Name: -

Distribution: posterior scalp, auricle, ventral and lateral aspects of the neck

58
Q

Nerve Plexuses - Cervical

Motor Branch (2)

  • name
  • distribution
A

Name: ansa cervicalis

Distribution: most of the infrahyoid muscles

Name: phrenic

Distribution: diaphragm

59
Q

Nerve Plexuses - Brachial

What is the brachial plexus?

A

major network that supplies the upper limb

60
Q

Nerve Plexuses - Brachial

What is the brachial plexus formed by?

A

union of ventral rami of spinal nerves C5-T1, which are considered as the roots of the plexus

61
Q

Nerve Plexuses - Brachial

What do the roots of the plexus join to form?

A

upper (superior), middle, and lower (inferior) trunks

62
Q

Nerve Plexuses - Brachial

Describe the upper (superior), middle, and lower (inferior) trunks.

A
  • each trunk divides into anterior and posterior division

- these divisions unite to form lateral, medial, and posterior cords of the brachial plexus

63
Q

Nerve Plexuses - Brachial

Where are the roots and trunks of the brachial plexus?

A

in neck region

64
Q

Nerve Plexuses - Brachial

Where are the divisions and cords of the brachial plexus?

A

mainly contained within axilla

65
Q

Nerve Plexuses - Brachial

What are the main branches (nerves) of the brachial plexus? (15)

A
  • long thoracic
  • dorsal scapular
  • suprascapular
  • lateral pectoral
  • musculocutaneous
  • median
  • medial pectoral
  • medial cutaneous nerve of arm
  • medial cutaneous nerve of forearm
  • ulnar
  • upper subscapular
  • thoracodorsal
  • lower subscapular
  • axillary
  • radial
66
Q

Nerve Plexuses - Brachial

Long Thoracic Nerve

  • origin
  • course
  • distribution
A

Origin: roots (C5-C7)

Course: runs on lateral aspect of thoracic wall

Distribution: serratus anterior muscle

67
Q

Nerve Plexuses - Brachial

Dorsal Scapular Nerve

  • origin
  • course
  • distribution
A

Origin: root C5

Course: descends on the medial border of scapula

Distribution: rhomboids and levator scapula muscles

68
Q

(don’t need to know)

Nerve Plexuses - Brachial

Suprascapular Nerve

  • origin
  • course
  • distribution
A

Origin: superior trunk

Course: enters supraspinous fossa and passes to infraspinous fossa

Distribution: supraspinatus and infraspinatus muscles

69
Q

(don’t need to know)

Nerve Plexuses - Brachial

Lateral Pectoral Nerve

  • origin
  • course
  • distribution
A

Origin: lateral cord

Course: pierces pectoralis minor muscle and enters pectoralis major muscle

Distribution: pectoralis major and minor muscles

70
Q

Nerve Plexuses - Brachial

Musculocutaneous Nerve

  • origin
  • course
  • distribution
A

Origin: lateral cord

Course: penetrates coracobrachialis muscle and descends in anterior arm

Distribution:

  • muscles of anterior compartment of arm
  • skin of lateral aspect of forearm
71
Q

Nerve Plexuses - Brachial

Median Nerve

  • origin
  • course
  • distribution
A

Origin: medial and lateral cords

Course: passes the anterior arm, cubital fossa, anterior forearm, and through carpal tunnel to enter hand

Distribution:

  • all muscles of anterior compartment of forearm (except 1 1⁄2 muscles), thenar muscles, and first and second lumbricals
  • skin of lateral 2/3’s of palm of hand, and most of lateral 3 1⁄2 fingers
72
Q

(don’t need to know)

Nerve Plexuses - Brachial

Medial Pectoral Nerve

  • origin
  • course
  • distribution
A

Origin: medial cord

Course: pierces pectoralis minor muscle and enters pectoralis major muscle

Distribution: pectoralis major and minor muscles

73
Q

(don’t need to know)

Nerve Plexuses - Brachial

Medial Cutaneous Nerve of Arm

  • origin
  • course
  • distribution
A

Origin: medial cord

Course: runs along medial side of arm

Distribution: most of skin of medial side of arm

74
Q

(don’t need to know)

Nerve Plexuses - Brachial

Medial Cutaneous Nerve of Forearm

  • origin
  • course
  • distribution
A

Origin: medial cord

Course: descends on medial side of forearm

Distribution: skin of medial side of forearm

75
Q

Nerve Plexuses - Brachial

Ulnar Nerve

  • origin
  • course
  • distribution
A

Origin: medial cord

Course: travels on medial side
of arm, passes behind
medial epicondyle, descends on medial side of forearm, passes in front of carpal tunnel and enters hand

Distribution:

  • 1 1⁄2 muscles in anterior forearm, hypothenar and interosseous muscles, the third and fourth lumbricals
  • skin of medial 1/3 of palmar and dorsal aspects of hand, medial 1 1⁄2 fingers
76
Q

(don’t need to know)

Nerve Plexuses - Brachial

Upper Subscapular Nerve

  • origin
  • course
  • distribution
A

Origin: posterior cord

Course: runs on posterior wall of axilla

Distribution: subscapularis muscle

77
Q

Nerve Plexuses - Brachial

Thoracodorsal Nerve

  • origin
  • course
  • distribution
A

Origin: posterior cord

Course: runs on posterior wall of axilla

Distribution: latissimus dorsi muscle

78
Q

(don’t need to know)

Nerve Plexuses - Brachial

Lower Subscapular Nerve

  • origin
  • course
  • distribution
A

Origin: posterior cord

Course: runs on posterior wall of axilla

Distribution: subscapularis and teres major muscles

79
Q

Nerve Plexuses - Brachial

Axillary Nerve

  • origin
  • course
  • distribution
A

Origin: posterior cord

Course: winds around surgical neck of humerus

Distribution:

  • deltoid and teres minor muscles
  • lower part of skin covering deltoid muscle
80
Q

Nerve Plexuses - Brachial

Radial Nerve

  • origin
  • course
  • distribution
A

Origin: posterior cord

Course: travels through radial groove, enters cubital fossa, divides into a deep (motor) and a superficial (cutaneous) branch

Distribution:

  • muscle of posterior compartments of arm and forearm
  • skin of posterior aspect of arm and forearm, plus lateral 2/3’s of posterior aspect of hand
81
Q

Nerve Plexuses - Lumbar

What is the lumbar plexus formed by? Where?

A

ventral rami of spinal nerves L1-L4 deep to psoas major muscle on the posterior abdominal wall

82
Q

Nerve Plexuses - Lumbar

What do the branches of the lumbar plexus do?

A

contribute in innervation of the muscles and skin of the lower limb

83
Q

Nerve Plexuses - Lumbar

What are the 5 main branches (nerves) of the lumbar plexus?

A
  • iliohypogastric and ilioinguinal
  • genitofemoral
  • lateral femoral cutaneous
  • obturator
  • femoral
84
Q

Nerve Plexuses - Lumbar

Iliohypogastric and Ilioinhuinal Nerve

  • course
  • distribution
A

Course: follows the abdominal wall from posterior to anterior

Distribution:

  • small contribution in innervations of anterolateral abdominal wall muscles
  • skin of pubic and inguinal regions
85
Q

(don’t need to know)

Nerve Plexuses - Lumbar

Genitofemoral Nerve

  • course
  • distribution
A

Course: descends anterior to psoas major muscle

Distribution:

  • cremaster muscle
  • skin of upper anterior aspect of thigh
86
Q

Nerve Plexuses - Lumbar

Lateral Femoral Cutaneous Nerve

  • course
  • distribution
A

Course: passes medial to the anterior superior iliac spine, deep to inguinal ligament, and enters the lateral thigh

Distribution: skin of lateral side of thigh

87
Q

Nerve Plexuses - Lumbar

Obturator Nerve

  • course
  • distribution
A

Course: descends medial to psoas major muscle

Distribution: muscles of medial compartment of thigh, and skin of medial side of thigh

88
Q

Nerve Plexuses - Lumbar

Femoral Nerve

  • course
  • distribution
A

Course: descends lateral to psoas major muscle, deep to inguinal ligament, and enters thigh

Distribution:

  • muscles of anterior compartment of thigh and iliacus muscle
  • skin of anterior and medial aspects of thigh, medial aspects of leg and foot
89
Q

Nerve Plexuses - Sacral

What is the sacral plexus formed by?

A

union of ventral rami of spinal nerves L4-S4 in front of posterior pelvic wall

90
Q

Nerve Plexuses - Sacral

What is the lumbosacral trunk formed by?

A

part of ventral ramus of spinal nerve L4 and entire ventral ramus of spinal nerve L5 unit

91
Q

Nerve Plexuses - Sacral

What does the lumbosacral trunk contribute to?

A

sacral plexus

92
Q

Nerve Plexuses - Sacral

What do the branches of the sacral plexus do?

A

supply majority of the muscles and skin of lower limb

93
Q

Nerve Plexuses - Sacral

What are the 6 main branches (nerves) of the sacral plexus?

A
  • superior gluteal
  • inferior gluteal
  • nerves to deep gluteal muscles
  • posterior femoral cutaneous
  • pudendal
  • sciatic (tibial nerve, common fibular nerve, deep fibular nerve, and superficial fibular nerve)
94
Q

Nerve Plexuses - Sacral

Superior Gluteal Nerve

  • course
  • distribution
A

Course: leaves pelvis through greater sciatic foramen to enter gluteal region

Distribution: gluteus medius, minimus, and tensor fascia lata muscles

95
Q

Nerve Plexuses - Sacral

Inferior Gluteal Nerve

  • course
  • distribution
A

Course: leaves pelvis through greater sciatic foramen to enter gluteal region

Distribution: gluteus maximus muscle

96
Q

(don’t need to know)

Nerve Plexuses - Sacral

Nerves to Deep Gluteal Muscles

  • course
  • distribution
A

Course: leaves pelvis through greater sciatic foramen to enter gluteal region

Distribution: deep gluteal muscles

97
Q

Nerve Plexuses - Sacral

Posterior Femoral Cutaneous Nerve

  • course
  • distribution
A

Course: leaves pelvis through greater sciatic foramen to enter gluteal and posterior thigh regions

Distribution: skin of posterior aspect of thigh

98
Q

Nerve Plexuses - Sacral

Pudendal Nerve

  • course
  • distribution
A

Course: leaves pelvis through greater sciatic foramen, enters gluteal region, and passes into perineum through lesser sciatic foramen

Distribution:

  • muscles of perineum
  • skin of perineum
99
Q

Nerve Plexuses - Sacral

Sciatic Nerve
- course

A

Course: leaves pelvis through greater sciatic foramen, enters gluteal region, descends
in posterior thigh, and splits above popliteal fossa into tibial and common fibular nerves

100
Q

Nerve Plexuses - Sacral

What are the tibial and common fibular nerves that the sciatic nerve splits into? (4)

A
  • tibial nerve
  • common fibular nerve
  • deep fibular nerve
  • superficial fibular nerve
101
Q

Nerve Plexuses - Sacral

Sciatic Nerve - Tibial Nerve

  • course
  • distribution
A

Course: descends through popliteal fossa, posterior leg, behind medial malleolus, and enters sole of foot and divides into medial and lateral plantar nerves

Distribution:

  • hamstring muscles (except short head of biceps femoris), muscles of posterior compartment of leg, muscles of sole of foot
  • most of the skin of posterior aspect of leg and dorsum of foot
102
Q

Nerve Plexuses - Sacral

Sciatic Nerve - Common Fibular Nerve

  • course
  • distribution
A

Course: descends through popliteal fossa, winds around the neck of fibula and divides into deep and superficial fibular nerves

Distribution:

  • muscles of anterior compartment of leg and dorsum of foot
  • skin of the web of big toe
  • muscles of lateral compartment of leg
  • skin of dorsum of foot (except web of big toe)
103
Q

Nerve Plexuses - Sacral

Sciatic Nerve - Deep Fibular Nerve

  • course
  • distribution
A

Course: descends in anterior leg and enters the dorsum of foot

Distribution:

  • muscles of anterior compartment of leg and dorsum of foot
  • skin of the web of big toe
104
Q

Nerve Plexuses - Sacral

Sciatic Nerve - Superficial Fibular Nerve

  • course
  • distribution
A

Course: descends in lateral leg and superficially enters the dorsum of foot

Distribution:

  • muscles of lateral compartment of leg
  • skin of dorsum of foot (except web of big toe)