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PowerPoint® Lecture Slides presented by Dr. Peter Reonisto, Moorpark College, California PERIPHERAL NERVOUS SYSTEM REVIEW (Spinal Nerve Review) Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Spinal Nerves Dorsal root – contains sensory fibers Cell bodies – located in the dorsal root ganglion Ventral root – contains motor fibers arising from anterior gray column Branch into dorsal ramus and ventral ramus Dorsal and ventral rami contain sensory and motor fibers Rami communicantes connect to the base of the ventral ramus Lead to the sympathetic chain ganglia Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.7a Innervation of the Back A B C D E H DORSAL ROOT DORSAL ROOT GANGLION VENTRAL ROOT SPINAL NERVE DORSAL RAMI VENTRAL RAMI RAMI COMMUNICANTES SYMPATHETIC TRUNK GANGLION F G Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.7b Introduction to Nerve Plexuses Nerve plexus – network of nerves Ventral rami Branch and join with one another Form nerve plexuses In cervical, brachial, lumbar, and sacral regions Primarily serve the limbs Which spinal nerves do not contribute to Nerve plexuses? T2 – T12 Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Cervical Plexus Buried deep in the neck Under the sternocleidomastoid muscle ? Formed by ventral rami of first four cervical nerves ( C1 – 4) Some innervate muscles of the anterior neck ? nerve – the most important nerve of the Phrenic cervical plexus Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Cervical Plexus Buried deep in the neck Under the sternocleidomastoid muscle Formed by ventral rami of first four cervical nerves ( C1 – 4) Some innervate muscles of the anterior neck Phrenic nerve – the most important nerve of the cervical plexus Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Brachial Plexus and Innervation of the Upper Limb Brachial plexus lies in the neck and axilla Formed by ventral rami of C5 – C8 Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.9d The Brachial Plexus and Innervation of the Upper Limb What Cervical Root gives rise to the middle trunk of the brachial plexus? Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.9d The Brachial Plexus and Innervation of the Upper Limb What Cervical Root gives rise to the middle trunk of the brachial plexus? Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.9d The Brachial Plexus and Innervation of the Upper Limb What Cord from the Brachial plexus gives rise to the Median nerve? Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.9d The Brachial Plexus and Innervation of the Upper Limb What Cord from the Brachial plexus gives rise to the Median nerve? Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.9d The Brachial Plexus and Innervation of the Upper Limb This nerve is a continuation of the posterior cord? Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.9d The Brachial Plexus and Innervation of the Upper Limb This nerve is a continuation of the posterior cord? Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.9d The Brachial Plexus and Innervation of the Upper Limb The Ulnar nerve branches from what cord? Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.9d The Brachial Plexus and Innervation of the Upper Limb What is the main branch of the Lateral cord from the Brachial plexus? Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.9d The Brachial Plexus Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.9a Posterior Cord extension - Axillary and Radial Nerves Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.11 The Lumbar Plexus and Innervation of the Lower Limb Lumbar plexus Arises from L1– L4 Smaller branches innervate the posterior abdominal wall and psoas muscle Main branches innervate the anterior thigh Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Lumbar Plexus Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.12a, b The Sacral Plexus Arises from spinal nerves L4–S4 Caudal to the lumbar plexus Often considered with the lumbar plexus Lumbosacral plexus Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Innervation of the Lower Limb Sciatic nerve – the largest nerve of the sacral plexus Actually two nerves in one sheath ? Tibial nerve – innervates most of the posterior lower limb Common fibular (peroneal) nerve – innervates ? muscles of the anterolateral leg Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Innervation of the Lower Limb Sciatic nerve – the largest nerve of the sacral plexus Actually two nerves in one sheath Tibial nerve – innervates most of the posterior lower limb Common fibular (peroneal) nerve – innervates muscles of the anterolateral leg Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Innervation of the Lower Limb Superior and inferior gluteal nerves Innervate the gluteal muscles Pudendal nerve Innervates muscles of the perineum Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Sacral Plexus ? ? Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.13 The Sacral Plexus Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.13 Innervation of the Skin: Dermatomes Dermatome – an area of skin Innervated by cutaneous branches of a single spinal nerve Upper limb Skin is supplied by nerves of the brachial plexus Lower limb Lumbar nerves – anterior surface Sacral nerves – posterior surface Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Map of Dermatomes – Anterior View Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.14a Map of Dermatomes – Posterior View Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.14b Map of Dermatomes – Anterior View Which spinal nerve cutaneous branch is damaged when a person loses sensation at the Digits 1 and 2 (right hand)? Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.14a Map of Dermatomes – Anterior View Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.14a PowerPoint® Lecture Slides presented by Dr. Peter Reonisto, Moorpark College, California PERIPHERAL NERVOUS SYSTEM REVIEW (Cranial Nerve) Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Cranial Nerves Attach to the brain and pass through foramina of the skull Numbered from I–XII Which Cranial nerves are attached to the forebrain? CN I and II All others attach to the brain stem Which Cranial nerves are attached to the Midbrain? CN III and IV at the Pons? CN V and VII at the Medulla?CN VIII and XII Primarily serve head and neck structures Which of Cranial nerve extends into the abdomen? Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings CN X The 12 Pairs of Cranial Nerves CN I CN II CN III CN IV CN V CN VI CN VII CN VIII CN IX CN X CN XI CN XII K L G J I A B C H D F E Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.5 Olfactory Nerves Sensory nerves of smell Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Limbic lobe Piriform lobe Table 14.3 (1 of 12) Optic Nerve Sensory nerve of vision Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Table 14.3 (2 of 12) Oculomotor Nerve (EOM) Innervates four of the extrinsic eye muscles Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Table 14.3 (3 of 12) Oculomotor Nerve (Pupillary Constriction) Innervates four of the extrinsic eye muscles Pupillary constriction Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Table 14.3 (3 of 12) Trochlear Nerve Innervates the superior oblique muscle (an extrinsic eye muscle) Superior midbrain Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Table 14.3 (4 of 12) Abducens Nerve Abducts the eyeball – innervates lateral rectus muscle Inferior Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Table 14.3 (6 of 12) EXTRAOCULAR MUSCLS Medial Rectus Superior Rectus Inferior Rectus Inferior Oblique (Levator Palpebrae) Superior Oblique CN III CN IV LASOT Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Lateral Rectus CN VI Trigeminal Nerve Provides sensory innervation to the face Motor innervation to chewing muscles (THROUGH THE MANDIBULAR DIVISION) Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Trigeminal Nerve OPTHALMIC Pons Trigeminal n. Trigeminal gang. Sup. Orbital fissure Supraorbital foramen MAXILLARY Pons Trigeminal n. Trigeminal gang. Foramen rotundum Infraorbital foramen Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings MAXILLARY Pons Trigeminal n. Trigeminal gang. Foramen ovale Mandibular foramen Mental foramen foramen Table 14.3 (5 of 12) Facial Nerve Innervates muscles of facial expression Pons Internal Acoustic Meatus 1) Chorda tympani to taste Anterior 2/3 tongue 2) Somatic motor to facial Muscles 3) Parasympathetic to Pterygopalatine (lacrimal) and Submandibular (salivary) ganglion - Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Table 14.3 (7 of 12) Vestibulocochlear Nerve Sensory nerve of hearing and balance Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Table 14.3 (8 of 12) Glossopharyngeal Nerve Innervates structures of the tongue and pharynx Medulla CN IX Superior gang. Inferior gang. Jugular foramen 1) Parasymp. to parotid gland via Otic gang. 2) Carotid sinus 3) Tongue 4) Pharynx and throat Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Table 14.3 (9 of 12) Vagus Nerve A mixed sensory and motor nerve “Wanders” into thorax and abdomen Parasympathetic innervation of organs Medulla Jugular foramen Thorax and Abdomen Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Table 14.3 (10 of 12) Accessory Nerve An accessory part of the vagus nerve Innervates trapezius muscle Cranial + Spinal root from medulla Jugular foramen 1) Cranial root goes w/ Vagus n. 2) Spinal root to a) Sternocleidomastoid b) Trapezius Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Table 14.3 (11 of 12) Hypoglossal Nerve Runs inferior to the tongue Innervates the tongue muscles Medulla Hypoglossal canal Tongue (movement) Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Table 14.3 (12 of 12) PowerPoint® Lecture Slides presented by Dr. Peter Reonisto, Moorpark College, California PERIPHERAL NERVOUS SYSTEM REVIEW (Autonomic Nervous System Review)) Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Peripheral Nervous System Autonomic nervous system (ANS) General visceral motor part of the PNS ANS has two divisions Parasympathetic Sympathetic Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Functional Organization of the PNS Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.1 Basic Anatomical Scheme of the PNS in the Region of a Spinal Nerve Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 14.2 MOTOR NEURONS ANS includes a chain of 2 motor neurons: 1) Pre-ganglionic neuron – cell body lies within the spinal cord or brain. a) Preganglionic axon- synapses with the ganglionic neuron 2) Ganglionic neuron- cell body lies in the peripheral location. a) Postganglionic axon- extends to the visceral organs Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings DIVISIONS OF THE ANS Sympathetic- “fight, flight, or fright response” Parasympathetic- body at rest, conserving body energy; directs vital “housekeeping activities” (digestion , urination); “rest and digest” Both divisions have chains of motor neurons that mostly innervate the same visceral organ, but they cause opposite effects. 1) 2) Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Anatomical and biochemical difference: SYMPATHETIC originate at the thoracolumbar region of the spinal cord. Long postganglionic fibers. Sympathetic fibers branch profusely. Neurotransmitter released at postganglionic axons are Norepinephrine mostly. PARASYMPATHETIC originate from the cranial (brain) and sacral (spinal cord) outflow Short postganglionic fibers Parasympathetic fibers not profusely branched. Neurotransmitter released are Acetylcholine The preganglionic axon terminals of both divisions release acetylcholine Refer to Table 15.1, page 434 Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings PARASYMPATHETIC NERVOUS SYSTEM CRANIAL OUTFLOW - comes from the brain. - Innervate the head, neck, thorax, and most of the abdomen. - Preganglionic fibers come from CNIII, VII, IX, X. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings SACRAL OUTFLOW - comes from the sacral sinal cord - Supplies the rest of abdominal organs and the pelvic organs Cranial outflow Sacral outflow Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings SUMMARY OF NEURONS CONNECTED TO THE SPINAL CORD Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings SUMMARY OF ANS FUNCTIONS EFFECTOR ORGAN HEART SA NODE SYMPATHETIC STIMULI Rate Contractility Increase Decrease Increase Decrease Increase Decrease Increase ------ Relaxation smooth Muscle B2 Contraction smooth Muscle A1 Constriction(direct A1) Dilation(circ Epi at B2) Both dilation (circ AcH at M2) (minor) Constriction (direct A1) ------ Conduction velocity AV NODE Conduction velocity VENTRICLES Conduction velocity LUNGS Bronchial smooth muscle ARTERIOLES Skin, resistance vessels Skin surface vessels Mucosa PARASYMPATHEITIC STIMULI Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings SUMMARY OF ANS FUNCTIONS EFFECTOR ORGAN ARTERIOLES SYMPATHETIC STIMULI Abdominal viscera PARASYMPATHEITIC STIMULI Constriction (direct A1) ------ Dilation (circ Epi at B2) Dilation (circ AcH at M2) Dilation (circ Epi at B2) Dilation (circ AcH at M2) Constriction (direct at A1) Dilation (circ AcH at M2) Constriction (direct at A1) ------ Decrease Increased Contraction Relaxation Skeletal muscles Coronary Glands VEINS (SYSTEMIC) GIT Motility and tone Sphincter contraction Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings SUMMARY OF ANS FUNCTIONS EFFECTOR ORGAN SKIN SYMPATHETIC STIMULI PARASYMPATHEITIC STIMULI Pilomotor muscle Piloerection ------ Secretion ------ Contraction ------ Contraction (mydriasis) ------ ------ Contraction (miosis) Relaxation (far vision) Contraction (near vision) Inhibition of secretion Secretion Sweat glands SPLEEN CAPSULE EYE Radial muscle of iris Sphincter muscle of th iris Ciliary muscle GLANDS Gastrointestinal Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings SUMMARY OF ANS FUNCTIONS EFFECTOR ORGAN GLANDS SYMPATHETIC STIMULI PARASYMPATHEITIC STIMULI Lacrimal ------ Secretion ------- Secretion Inhibition of secretion Secretion Thick secretion Thin secretion Nasopharyngeal Respiratory Salivary Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings
