A spinal nerve is a mixed
nerve
A nerve is an enclosed, cable-like bundle of nerve fibers (called axons) in the peripheral nervous system.
A nerve transmits electrical impulses. It is the basic unit of the peripheral nervous system. A nerve provides a common pathway for the e ...
, which carries motor, sensory, and autonomic signals between the
spinal cord
The spinal cord is a long, thin, tubular structure made up of nervous tissue, which extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (backbone). The backbone encloses the central canal of the spi ...
and the body. In the
human body
The human body is the structure of a Human, human being. It is composed of many different types of Cell (biology), cells that together create Tissue (biology), tissues and subsequently organ systems. They ensure homeostasis and the life, viabi ...
there are 31 pairs of spinal nerves, one on each side of the
vertebral column
The vertebral column, also known as the backbone or spine, is part of the axial skeleton. The vertebral column is the defining characteristic of a vertebrate in which the notochord (a flexible rod of uniform composition) found in all chordata, ...
. These are grouped into the corresponding
cervical
In anatomy, cervical is an adjective that has two meanings:
# of or pertaining to any neck.
# of or pertaining to the female cervix: i.e., the ''neck'' of the uterus.
*Commonly used medical phrases involving the neck are
**cervical collar
**cerv ...
,
thoracic
The thorax or chest is a part of the anatomy of humans, mammals, and other tetrapod animals located between the neck and the abdomen. In insects, crustaceans, and the extinct trilobites, the thorax is one of the three main divisions of the crea ...
,
lumbar
In tetrapod anatomy, lumbar is an adjective that means ''of or pertaining to the abdominal segment of the torso, between the diaphragm and the sacrum.''
The lumbar region is sometimes referred to as the lower spine, or as an area of the back i ...
,
sacral
Sacral may refer to:
*Sacred
Sacred describes something that is dedicated or set apart for the service or worship of a deity; is considered worthy of spiritual respect or devotion; or inspires awe or reverence among believers. The property ...
and
coccygeal
The coccyx ( : coccyges or coccyxes), commonly referred to as the tailbone, is the final segment of the vertebral column in all apes, and analogous structures in certain other mammals such as horses. In tailless primates (e.g. humans and other ...
regions of the spine. There are eight pairs of cervical nerves, twelve pairs of thoracic nerves, five pairs of lumbar nerves, five pairs of sacral nerves, and one pair of coccygeal nerves. The spinal nerves are part of the
peripheral nervous system
The peripheral nervous system (PNS) is one of two components that make up the nervous system of bilateral animals, with the other part being the central nervous system (CNS). The PNS consists of nerves and ganglia, which lie outside the brain ...
.
Structure
![Cervical vertebra english](https://upload.wikimedia.org/wikipedia/commons/d/d9/Cervical_vertebra_english.png)
Each spinal nerve is a mixed nerve, formed from the combination of
nerve fibers
A nerve is an enclosed, cable-like bundle of nerve fibers (called axons) in the peripheral nervous system.
A nerve transmits electrical impulses. It is the basic unit of the peripheral nervous system. A nerve provides a common pathway for the e ...
from its
dorsal
Dorsal (from Latin ''dorsum'' ‘back’) may refer to:
* Dorsal (anatomy), an anatomical term of location referring to the back or upper side of an organism or parts of an organism
* Dorsal, positioned on top of an aircraft's fuselage
* Dorsal c ...
and
ventral roots
In anatomy and neurology, the ventral root of spinal nerve, anterior root, or motor root is the efferent motor root of a spinal nerve.
At its distal end, the ventral root joins with the dorsal root
The dorsal root of spinal nerve (or posterior ...
. The dorsal root is the
afferent sensory root and carries sensory information to the brain. The ventral root is the
efferent motor root and carries motor information from the brain. The spinal nerve emerges from the spinal column through an opening (
intervertebral foramen
The intervertebral foramen (also called neural foramen, and often abbreviated as IV foramen or IVF) is a foramen between two spinal vertebrae. Cervical, thoracic, and lumbar vertebrae all have intervertebral foramina.
The foramina, or opening ...
) between adjacent vertebrae. This is true for all spinal nerves except for the first spinal nerve pair (C1), which emerges between the
occipital bone
The occipital bone () is a neurocranium, cranial dermal bone and the main bone of the occiput (back and lower part of the skull). It is trapezoidal in shape and curved on itself like a shallow dish. The occipital bone overlies the occipital lobe ...
and the
atlas
An atlas is a collection of maps; it is typically a bundle of maps of Earth or of a region of Earth.
Atlases have traditionally been bound into book form, but today many atlases are in multimedia formats. In addition to presenting geographic ...
(the first vertebra). Thus the cervical nerves are numbered by the vertebra below, except spinal nerve C8, which exists below vertebra C7 and above vertebra T1. The thoracic, lumbar, and sacral nerves are then numbered by the vertebra above. In the case of a
lumbarized S1 vertebra (aka L6) or a
sacralized L5 vertebra, the nerves are typically still counted to L5 and the next nerve is S1.
![Gray799](https://upload.wikimedia.org/wikipedia/commons/e/ee/Gray799.svg)
Outside the vertebral column, the nerve divides into branches. The
dorsal ramus
The dorsal ramus of spinal nerve (or posterior ramus of spinal nerve, or posterior primary division) is the posterior division of a spinal nerve. The dorsal ramus (Latin for branch, plural ''rami'' ) is the dorsal branch of a spinal nerve that form ...
contains nerves that serve the posterior portions of the trunk carrying visceral motor, somatic motor, and somatic sensory information to and from the skin and
muscles of the back (
epaxial muscles
In adult vertebrates, trunk muscles can be broadly divided into hypaxial muscles, which lie ventral to the horizontal septum of the vertebrae and epaxial muscles, which lie dorsal to the septum. Hypaxial muscles include some vertebral muscles, the ...
). The
ventral ramus
The ventral ramus (pl. ''rami'') (Latin for ''branch'') is the anterior division of a spinal nerve. The ventral rami supply the antero-lateral parts of the trunk and the limbs. They are mainly larger than the dorsal rami.
Shortly after a spinal n ...
contains nerves that serve the remaining anterior parts of the trunk and the upper and lower limbs (
hypaxial muscles
In adult vertebrates, trunk muscles can be broadly divided into hypaxial muscles, which lie ventral to the horizontal septum of the vertebrae and epaxial muscles, which lie dorsal to the septum. Hypaxial muscles include some vertebral muscles, th ...
) carrying visceral motor, somatic motor, and sensory information to and from the ventrolateral body surface, structures in the body wall, and the limbs. The
meningeal branches (recurrent meningeal or sinuvertebral nerves) branch from the spinal nerve and re-enter the intervertebral foramen to serve the ligaments, dura, blood vessels, intervertebral discs, facet joints, and periosteum of the vertebrae. The
rami communicantes
Ramus communicans (plural rami communicantes) is the Latin term used for a nerve which connects two other nerves, and can be translated as "communicating branch".
Structure
When used without further definition, it almost always refers to a commu ...
contain autonomic nerves that serve visceral functions carrying visceral motor and sensory information to and from the visceral organs.
Some anterior rami merge with adjacent anterior rami to form a
nerve plexus
A nerve plexus is a plexus (branching network) of intersecting nerves. 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. There are five spinal nerve ple ...
, a network of interconnecting nerves. Nerves emerging from a plexus contain fibers from various spinal nerves, which are now carried together to some target location. Major plexuses include the
cervical
In anatomy, cervical is an adjective that has two meanings:
# of or pertaining to any neck.
# of or pertaining to the female cervix: i.e., the ''neck'' of the uterus.
*Commonly used medical phrases involving the neck are
**cervical collar
**cerv ...
,
brachial,
lumbar
In tetrapod anatomy, lumbar is an adjective that means ''of or pertaining to the abdominal segment of the torso, between the diaphragm and the sacrum.''
The lumbar region is sometimes referred to as the lower spine, or as an area of the back i ...
, and
sacral
Sacral may refer to:
*Sacred
Sacred describes something that is dedicated or set apart for the service or worship of a deity; is considered worthy of spiritual respect or devotion; or inspires awe or reverence among believers. The property ...
plexuses.
Regional nerves
Cervical nerves
![Gray795](https://upload.wikimedia.org/wikipedia/commons/e/e6/Gray795.png)
The cervical nerves are the spinal nerves from the cervical vertebrae in the
cervical segment
The spinal cord is a long, thin, tubular structure made up of nervous tissue, which extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (backbone). The backbone encloses the central canal of the spinal ...
of the spinal cord. Although there are seven cervical vertebrae (C1–C7), there are eight cervical nerves
C1–
C8. C1–C7 emerge above their corresponding vertebrae, while C8 emerges below the C7 vertebra. Everywhere else in the spine, the nerve emerges below the vertebra with the same name.
The posterior distribution includes the
suboccipital nerve
The suboccipital nerve (first cervical dorsal ramus) is the dorsal primary ramus of the first cervical nerve (C1). It exits the spinal cord between the skull and the first cervical vertebra, the atlas.
It lies within the suboccipital triangle ...
(C1), the
greater occipital nerve
The greater occipital nerve is a nerve of the head. It is a spinal nerve, specifically the medial branch of the dorsal primary ramus of cervical spinal nerve 2. It arises from between the first and second cervical vertebrae, ascends, and then p ...
(C2) and the
third occipital nerve
While under the Trapezius
The trapezius is a large paired trapezoid-shaped surface muscle that extends longitudinally from the occipital bone to the lower thoracic vertebrae of the spine and laterally to the spine of the scapula. It moves ...
(C3). The anterior distribution includes the
cervical plexus
The cervical plexus is a plexus of the anterior rami of the first four cervical spinal nerves which arise from C1 to C4 cervical segment in the neck. They are located laterally to the transverse processes between prevertebral muscles from the medi ...
(C1–C4) and
brachial plexus
The brachial plexus is a network () of nerves formed by the anterior rami of the lower four cervical nerves and first thoracic nerve ( C5, C6, C7, C8, and T1). This plexus extends from the spinal cord, through the cervicoaxillary canal in th ...
(C5–T1).
The cervical nerves innervate the
sternohyoid
The sternohyoid muscle is a thin, narrow muscle attaching the hyoid bone to the sternum. It is one of the paired strap muscles of the infrahyoid muscles. It is supplied by the ansa cervicalis. It depresses the hyoid bone.
Structure
The sternoh ...
,
sternothyroid and
omohyoid muscle
The omohyoid muscle is a muscle that depresses the hyoid. It is located in the front of the neck, and consists of two bellies separated by an intermediate tendon. The omohyoid muscle is proximally attached to the scapula and distally attached to th ...
s.
A loop of nerves called
ansa cervicalis
The ansa cervicalis (or ansa hypoglossi in older literature) is a loop of nerves that are part of the cervical plexus. It lies superficial to the internal jugular vein in the carotid triangle. Its name means "handle of the neck" in Latin.
Branc ...
is part of the cervical plexus.
Thoracic nerves
The thoracic nerves are the twelve spinal nerves emerging from the thoracic vertebrae. Each thoracic nerve T1–T12 originates from below each corresponding
thoracic vertebra
In vertebrates, thoracic vertebrae compose the middle segment of the vertebral column, between the cervical vertebrae and the lumbar vertebrae. In humans, there are twelve thoracic vertebrae and they are intermediate in size between the cervical ...
. Branches also exit the spine and go directly to the
paravertebral ganglia
The sympathetic ganglia, or paravertebral ganglia are autonomic ganglia, of the sympathetic nervous system. Ganglia are 20,000 to 30,000 afferent and efferent nerve cell bodies that run along on either side of the spinal cord. Afferent nerve cel ...
of the
autonomic nervous system
The autonomic nervous system (ANS), formerly referred to as the vegetative nervous system, is a division of the peripheral nervous system that supplies viscera, internal organs, smooth muscle and glands. The autonomic nervous system is a control ...
where they are involved in the functions of organs and glands in the head, neck, thorax and abdomen.
Anterior divisions
The
intercostal nerves
The intercostal nerves are part of the somatic nervous system, and arise from the anterior rami of the thoracic spinal nerves from T1 to T11. The intercostal nerves are distributed chiefly to the thoracic pleura and abdominal peritoneum, and diffe ...
come from thoracic nerves T1–T11, and run between the ribs. At T2 and T3, further branches form the
intercostobrachial nerve
The intercostobrachial nerves are cutaneous branches of the intercostal nerves.
Second intercostal nerve
The lateral cutaneous branch of the second intercostal nerve does not divide, like the others, into an anterior and a posterior branch; it is ...
. The
subcostal nerve
The subcostal nerve (anterior division of the twelfth thoracic nerve) is larger than the others. It runs along the lower border of the twelfth rib, often gives a communicating branch to the first lumbar nerve, and passes under the lateral lumbocost ...
comes from nerve T12, and runs below the twelfth rib.
Posterior divisions
The medial branches (ramus medialis) of the posterior branches of the upper six thoracic nerves run between the
semispinalis dorsi
The semispinalis muscles are a group of three muscles belonging to the transversospinales. These are the semispinalis capitis, the semispinalis cervicis and the semispinalis thoracis.
The semispinalis capitis (''complexus'') is situated at the ...
and
multifidus
The multifidus (multifidus spinae : ''pl. multifidi'' ) muscle consists of a number of fleshy and tendinous fasciculi, which fill up the groove on either side of the spinous processes of the vertebrae, from the sacrum to the axis. While very thin ...
, which they supply; they then pierce the
rhomboid
Traditionally, in two-dimensional geometry, a rhomboid is a parallelogram in which adjacent sides are of unequal lengths and angles are non-right angled.
A parallelogram with sides of equal length (equilateral) is a rhombus but not a rhomboi ...
and
trapezius muscle
The trapezius is a large paired trapezoid-shaped surface muscle that extends longitudinally from the occipital bone to the lower thoracic vertebrae of the spine and laterally to the spine of the scapula. It moves the scapula and supports the ...
s, and reach the skin by the sides of the spinous processes. This sensitive branch is called the medial cutaneous ramus.
The medial branches of the lower six are distributed chiefly to the multifidus and
longissimus dorsi
The longissimus ( la, the longest one) is the muscle lateral to the semispinalis muscles. It is the longest subdivision of the erector spinae muscles that extends forward into the transverse processes of the posterior cervical vertebrae.
Structu ...
, occasionally they give off filaments to the skin near the middle line. This sensitive branch is called the posterior cutaneous ramus.
Lumbar nerves
![Gray823](https://upload.wikimedia.org/wikipedia/commons/7/7c/Gray823.png)
The lumbar nerves are the five spinal nerves emerging from the lumbar vertebrae. They are divided into posterior and anterior divisions.
Posterior divisions
The medial branches of the posterior divisions of the lumbar nerves run close to the articular processes of the vertebrae and end in the
multifidus muscle
The multifidus (multifidus spinae : ''pl. multifidi'' ) muscle consists of a number of fleshy and tendinous fasciculi, which fill up the groove on either side of the spinous processes of the vertebrae, from the sacrum to the axis. While very thin ...
.
The laterals supply the
erector spinae muscles
The erector spinae ( ) or spinal erectors is a set of muscles that straighten and rotate the back. The spinal erectors work together with the glutes (gluteus maximus, gluteus medius and gluteus minimus) to maintain stable posture standing or sittin ...
.
The upper three give off cutaneous nerves which pierce the aponeurosis of the
latissimus dorsi
The latissimus dorsi () is a large, flat muscle on the back that stretches to the sides, behind the arm, and is partly covered by the trapezius on the back near the midline. The word latissimus dorsi (plural: ''latissimi dorsorum'') comes from L ...
at the lateral border of the erector spinae muscles, and descend across the posterior part of the
iliac crest
The crest of the ilium (or iliac crest) is the superior border of the wing of ilium and the superiolateral margin of the greater pelvis.
Structure
The iliac crest stretches posteriorly from the anterior superior iliac spine (ASIS) to the posterior ...
to the skin of the
buttock
The buttocks (singular: buttock) are two rounded portions of the exterior anatomy of most mammals, located on the posterior of the pelvic region. In humans, the buttocks are located between the lower back and the perineum. They are composed ...
, some of their twigs running as far as the level of the
greater trochanter
The greater trochanter of the femur is a large, irregular, quadrilateral eminence and a part of the skeletal system.
It is directed lateral and medially and slightly posterior. In the adult it is about 2–4 cm lower than the femoral head.Stan ...
.
Anterior divisions
The anterior divisions of the lumbar nerves (rami anteriores) increase in size from above downward. They are joined, near their origins, by
gray rami communicantes
Each spinal nerve receives a branch called a gray ramus communicans (plural rami communicantes) from the adjacent paravertebral ganglion of the sympathetic trunk. The gray rami communicantes contain postganglionic nerve fibers of the sympathetic ne ...
from the
lumbar ganglia
The lumbar ganglia are paravertebral ganglia located in the inferior portion of the sympathetic trunk. The lumbar portion of the sympathetic trunk typically has 4 lumbar ganglia. The lumbar splanchnic nerves arise from the ganglia here, and contr ...
of the
sympathetic trunk
The sympathetic trunks (sympathetic chain, gangliated cord) are a paired bundle of nerve fibers that run from the base of the skull to the coccyx. They are a major component of the sympathetic nervous system.
Structure
The sympathetic trunk lies j ...
. These rami consist of long, slender branches which accompany the
lumbar arteries
The lumbar arteries are arteries located in the lower back or lumbar region. The lumbar arteries are in parallel with the intercostals.
They are usually four in number on either side, and arise from the back of the aorta, opposite the bodies of ...
around the sides of the vertebral bodies, beneath the
psoas major
The psoas major ( or ; from grc, ψόᾱ, psóā, muscles of the loins) is a long fusiform muscle located in the lateral lumbar region between the vertebral column and the brim of the lesser pelvis. It joins the iliacus muscle to form the iliop ...
. Their arrangement is somewhat irregular: one ganglion may give rami to two lumbar nerves, or one lumbar nerve may receive rami from two
ganglia
A ganglion is a group of neuron cell bodies in the peripheral nervous system. In the somatic nervous system this includes dorsal root ganglia and trigeminal ganglia among a few others. In the autonomic nervous system there are both sympatheti ...
.
The first and second, and sometimes the third and fourth lumbar nerves are each connected with the lumbar part of the sympathetic trunk by a
white ramus communicans
The white ramus communicans (plural: rami communicantes) from Latin ramus (branch) and communicans (communicating) is the preganglionic sympathetic outflow nerve tract from the spinal cord.
Each of the thoracic, and the first and second lumbar ner ...
.
The nerves pass obliquely outward behind the psoas major, or between its
fasciculi
Fascicle or ''fasciculus'' may refer to:
Anatomy and histology
* Muscle fascicle, a bundle of skeletal muscle fibers
* Nerve fascicle, a bundle of axons (nerve fibers)
** Superior longitudinal fasciculus
*** Arcuate fasciculus
** Gracile fas ...
, distributing filaments to it and the
quadratus lumborum
The quadratus lumborum muscle, informally called the ''QL'', is a paired muscle of the left and right posterior abdominal wall. It is the deepest abdominal muscle, and commonly referred to as a back muscle. Each is irregular and quadrilateral in sh ...
.
The first three and the greater part of the fourth are connected together in this situation by anastomotic loops, and form the
lumbar plexus
The lumbar plexus is a web of nerves (a nervous plexus) in the lumbar region of the body which forms part of the larger lumbosacral plexus. It is formed by the Ventral ramus of spinal nerve, divisions of the first four lumbar nerves (L1-L4) and ...
.
The smaller part of the fourth joins with the fifth to form the
lumbosacral trunk
The lumbosacral trunk is nervous tissue that connects the lumbar plexus with the sacral plexus.
Structure
The lumbosacral trunk comprises the whole of the ventral rami of L5 and a part of L4. It appears at the medial margin of the psoas major a ...
, which assists in the formation of the
sacral plexus
In human anatomy, the sacral plexus is a nerve plexus which provides motor and sensory nerves for the posterior thigh, most of the lower leg and foot, and part of the pelvis. It is part of the lumbosacral plexus and emerges from the lumbar vertebr ...
. The fourth nerve is named the
furcal nerve
The furcal nerve (forked nerve) links the lumbar plexus and the sacral plexus. It has its own dorsal and ventral branches with fibres that branch out to become part of the femoral and obturator nerves. The furcal nerve is found in the lumbosacral ...
, from the fact that it is subdivided between the two plexuses.
Sacral nerves
![Gray828](https://upload.wikimedia.org/wikipedia/commons/1/1a/Gray828.png)
The sacral nerves are the five pairs of spinal nerves which exit the
sacrum
The sacrum (plural: ''sacra'' or ''sacrums''), in human anatomy, is a large, triangular bone at the base of the spine that forms by the fusing of the sacral vertebrae (S1S5) between ages 18 and 30.
The sacrum situates at the upper, back part ...
at the lower end of the
vertebral column
The vertebral column, also known as the backbone or spine, is part of the axial skeleton. The vertebral column is the defining characteristic of a vertebrate in which the notochord (a flexible rod of uniform composition) found in all chordata, ...
. The roots of these nerves begin inside the vertebral column at the level of the
L1 vertebra
The lumbar vertebrae are, in human anatomy, the five vertebrae between the rib cage and the pelvis. They are the largest segments of the vertebral column and are characterized by the absence of the foramen transversarium within the transverse p ...
, where the
cauda equina
The cauda equina () is a bundle of spinal nerves and spinal nerve rootlets, consisting of the second through fifth lumbar nerve pairs, the first through fifth sacral nerve pairs, and the coccygeal nerve, all of which arise from the lumbar enlargeme ...
begins, and then descend into the sacrum.
There are five paired sacral nerves, half of them arising through the sacrum on the left side and the other half on the right side. Each nerve emerges in two divisions: one division through the
anterior sacral foramina
The sacrum (plural: ''sacra'' or ''sacrums''), in human anatomy, is a large, triangular bone at the base of the spine that forms by the fusing of the sacral vertebrae (S1S5) between ages 18 and 30.
The sacrum situates at the upper, back part o ...
and the other division through the
posterior sacral foramina
The sacrum (plural: ''sacra'' or ''sacrums''), in human anatomy, is a large, triangular bone at the base of the spine that forms by the fusing of the sacral vertebrae (S1S5) between ages 18 and 30.
The sacrum situates at the upper, back part o ...
.
The nerves divide into branches and the branches from different nerves join with one another, some of them also joining with lumbar or coccygeal nerve branches. These anastomoses of nerves form the
sacral plexus
In human anatomy, the sacral plexus is a nerve plexus which provides motor and sensory nerves for the posterior thigh, most of the lower leg and foot, and part of the pelvis. It is part of the lumbosacral plexus and emerges from the lumbar vertebr ...
and the
lumbosacral plexus
The anterior divisions of the lumbar nerves, sacral nerves, and coccygeal nerve form the lumbosacral plexus, the first lumbar nerve being frequently joined by a branch from the twelfth thoracic. For descriptive purposes this plexus is usually divi ...
. The branches of these plexus give rise to nerves that supply much of the
hip
In vertebrate anatomy, hip (or "coxa"Latin ''coxa'' was used by Celsus in the sense "hip", but by Pliny the Elder in the sense "hip bone" (Diab, p 77) in medical terminology) refers to either an anatomical region or a joint.
The hip region is ...
,
thigh
In human anatomy, the thigh is the area between the hip (pelvis) and the knee. Anatomically, it is part of the lower limb.
The single bone in the thigh is called the femur. This bone is very thick and strong (due to the high proportion of bone ...
,
leg
A leg is a weight-bearing and locomotive anatomical structure, usually having a columnar shape. During locomotion, legs function as "extensible struts". The combination of movements at all joints can be modeled as a single, linear element ca ...
and
foot
The foot ( : feet) is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is a separate organ at the terminal part of the leg made ...
.
The sacral nerves have both
afferent and
efferent fibers
Efferent nerve fibers refer to axonal projections that ''exit'' a particular region; as opposed to afferent projections that ''arrive'' at the region. These terms have a slightly different meaning in the context of the peripheral nervous syste ...
, thus they are responsible for part of the
sensory perception
Perception () is the organization, identification, and interpretation of sensory information in order to represent and understand the presented information or environment. All perception involves signals that go through the nervous system ...
and the movements of the lower extremities of the human body. From the S2, S3 and S4 arise the pudendal nerve and parasympathetic fibers whose electrical potential supply the
descending colon
In the anatomy of humans and homologous primates, the descending colon is the part of the colon extending from the left colic flexure to the level of the iliac crest (whereupon it transitions into the sigmoid colon). The function of the descendin ...
and
rectum
The rectum is the final straight portion of the large intestine in humans and some other mammals, and the Gastrointestinal tract, gut in others. The adult human rectum is about long, and begins at the rectosigmoid junction (the end of the s ...
,
urinary bladder
The urinary bladder, or simply bladder, is a hollow organ in humans and other vertebrates that stores urine from the kidneys before disposal by urination. In humans the bladder is a distensible organ that sits on the pelvic floor. Urine enters ...
and
genital organs
A sex organ (or reproductive organ) is any part of an animal or plant that is involved in sexual reproduction. The reproductive organs together constitute the reproductive system. In animals, the testis in the male, and the ovary in the female, a ...
. These pathways have both afferent and efferent fibers and, this way, they are responsible for conduction of sensory information from these pelvic organs to the
central nervous system
The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all par ...
(CNS) and motor impulses from the CNS to the pelvis that control the movements of these pelvic organs.
[3. Human Neuroanatomy. Carpenter, Malcolm B. Baltimore : Williams & Wilkins Co., 1976 (7th ed)]
Coccygeal nerve
The bilateral coccygeal nerves, Co, are the 31st pair of spinal nerves. It arises from the conus medullaris, and its ventral ramus helps form the
coccygeal plexus
The coccygeal plexus is a nerve plexus near the coccyx bone.
Structure
This plexus is formed by the ventral rami
The ventral ramus (pl. ''rami'') (Latin for ''branch'') is the anterior division of a spinal nerve. The ventral rami supply the ant ...
. It does not divide into a medial and lateral branch. Its fibers are distributed to the skin superficial and posterior to the
coccyx
The coccyx ( : coccyges or coccyxes), commonly referred to as the tailbone, is the final segment of the vertebral column in all apes, and analogous structures in certain other mammals such as horses. In tailless primates (e.g. humans and othe ...
bone via the
anococcygeal nerve
The anococcygeal nerve is a nerve in the pelvis which provides sensory innervation to the skin over the coccyx. The number of anococcygeal nerves vary between one and three.
Structure
The anococcygeal nerve arises from the coccygeal plexus. It ...
of the coccygeal nerve plexus.
Function
Clinical significance
The muscles that one particular spinal root supplies are that nerve's
myotome
A myotome is the group of muscles that a single spinal nerve innervates. Similarly a dermatome is an area of skin that a single nerve innervates with sensory fibers. Myotomes are separated by myosepta (singular: myoseptum). In vertebrate embryoni ...
, and the
dermatomes are the areas of sensory innervation on the skin for each spinal nerve. Lesions of one or more nerve roots result in typical patterns of neurologic defects (
muscle weakness
Muscle weakness is a lack of muscle strength. Its causes are many and can be divided into conditions that have either true or perceived muscle weakness. True muscle weakness is a primary symptom of a variety of skeletal muscle diseases, includi ...
, abnormal sensation, changes in reflexes) that allow localization of the responsible lesion.
There are several procedures used in
sacral nerve stimulation
Sacral nerve stimulation, also termed sacral neuromodulation, is a type of medical electrical stimulation therapy.
It typically involves the implantation of a programmable stimulator subcutaneously, which delivers low amplitude electrical sti ...
for the treatment of various related disorders.
Sciatica
Sciatica is pain going down the leg from the lower back. This pain may go down the back, outside, or front of the leg. Onset is often sudden following activities like heavy lifting, though gradual onset may also occur. The pain is often described ...
is generally caused by the compression of lumbar nerves L4, or L5 or sacral nerves S1, S2, or S3, or by compression of the sciatic nerve itself
Additional Images
File:Gray796.png, A portion of the spinal cord, showing its right lateral surface. The dura is opened and arranged to show the nerve roots.
File:Gray797.png, Distribution of the cutaneous nerves. Ventral aspect.
File:Gray798.png, Distribution of the cutaneous nerves. Dorsal aspect.
File:Sobo 1909 611.png, The spinal cord with dura cut open, showing the exits of the spinal nerves.
File:Sobo 1909 613.png, The spinal cord showing how the anterior and posterior roots join in the spinal nerves.
File:Sobo 1909 614.png, A longer view of the spinal cord.
File:Sobo 1909 615.png, Projections of the spinal cord into the nerves (red motor, blue sensory).
File:Sobo 1909 616.png, Projections of the spinal cord into the nerves (red motor, blue sensory).
File:Cervical plexus.gif, Schematic diagram of cervical plexus.
File:Slide2PIT.JPG, Cerebrum. Inferior view. Deep dissection.
File:Slide3PIT.JPG, Cerebrum. Inferior view. Deep dissection.
File:Slide2VAS.JPG, Spinal nerves. Spinal cord and vertebral canal. Deep dissection.
See also
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Cranial nerves
Cranial nerves are the nerves that emerge directly from the brain (including the brainstem), of which there are conventionally considered twelve pairs. Cranial nerves relay information between the brain and parts of the body, primarily to and f ...
References
* Blumenfeld H. 'Neuroanatomy Through Clinical Cases'. Sunderland, Mass: Sinauer Associates; 2002.
* Drake RL, Vogl W, Mitchell AWM. 'Gray's Anatomy for Students'. New York: Elsevier; 2005:69-70.
* Ropper AH, Samuels MA. 'Adams and Victor's Principles of Neurology'. Ninth Edition. New York: McGraw Hill; 2009.
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Peripheral nervous system
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