Материал: Атлас Ханц фениш

342

Spinal nerves

1

LUMBAR NERVES. Nn. lumbales (lumbares). 18

Ilioinguinal nerve. N. ilioinguinalis. Nerve aris-

1

Five lumbar spinal nerves each emerging below

ing from L1, possibly also T12. It appears at the

its respective lumbar vertebra.

lateral margin of the psoas and courses between

2

2

Posterior branches. Rami posteriores. They

the kidney and quadratus lumborum, then be-

supply the autochthonous back muscles and

tween the transversus abdominis and internal

abdominal oblique (muscular branches) to enter

3

the skin overlying them. C

the inguinal canal. C

branch in the lumbar region. C

19

Anterior scrotal nerves. Nn. scrotales anteri-

4

4

Lateral branch. Ramus lateralis. Predominantly

ores. Sensory branches to the anterior skin of the

scrotum, mons pubis and adjacent skin of the

sensory. C

5

thigh. C

5

Superior clunial (gluteal) branches. Rami

20

Anterior labial nerves. Nn. labiales anteriores.

clunium (gluteales) superiores. Lateral rami of

Sensory rami to the labium majus, mons pubis

6

L1−3 supplying the skin up to the greater tro-

and adjacent skin of the thigh. C

chanter (buttock region). B

21 Genitofemoral nerve. N. genitofemoralis. Nerve

7

6

Anterior branches. Rami anteriores. Ventral

that arises from L1−2, penetrates the psoas

branches forming the lumbar plexus. C

major and courses on top of it. C

coccygeal nerve.

courses through the inguinal canal and supplies

9

8

Posterior branches. Rami posteriores. Sensory

the cremaster muscle, skin of scrotum (labium

majus) and adjacent skin of the thigh. C

and motor rami emerging from the posterior

23

Femoral branch. Ramus femoralis. Branch that

10

sacral foramina. A B

9

Medial branch. Ramus medialis. It supplies the

passes through the vascular lacuna (between

femoral artery and iliopectineal arch), then

multifidus and the skin over the sacrum and

11

through the saphenous hiatus to supply the skin

coccyx. A B

10 Lateral branch. Ramus lateralis. Sensory branch

located there. C

12

24 Lateral femoral cutaneous nerve. N. cutaneus

for the skin over the coccyx formed by the union

femoris lateralis. Nerve that arises from L2−3. It

of sensory fibers from the posterior rami of S1−3.

appears at the lateral margin of the psoas and

13

A B

courses beneath the iliac fascia and through the

11

Medial

clunial

(gluteal)

nerves. Rami

lateral part of the muscular lacuna into the thigh,

clunium (gluteales) mediales. Sensory nerves

14

where it proceeds below or above the sartorius

from S1−3. They penetrate the gluteus maximus

to the lateral skin of the thigh. C

and supply the skin of the medial, upper gluteal

25

Obturator nerve. N. obturatorius. Nerve that

15

region. B

12

Anterior branches. Rami anteriores. They pass

arises from L2−4. It passes beneath the psoas, be-

hind the internal iliac artery and lateral to the

16

through the anterior sacral foramina and form

ureter, then through the obturator canal to the

the sacral plexus. A C

adductor group and to the medial skin of the

13

LUMBOSACRAL PLEXUS. Plexus lumbosacralis.

thigh. C

17

Collective term for the combined lumbar and

26 Anterior branch. Ramus anterior. Nerve that

sacral plexuses joined together by fibers from L4

courses on top of the adductor brevis and obtura-

18

and mutually supplying the lower limb. C

tor externus muscles and beneath the adductor

14

LUMBAR PLEXUS. Plexus lumbalis (lumbaris).

longus and pectineus muscles. It supplies these

Nerve network formed by spinal nerves L1−4

and the gracilis muscles. C

19

which lie at the anterior side of the leg.

27

Cutaneous branch. Ramus cutaneus. Variable

15

Iliohypogastric nerve. N.

iliohypogastricus.

20

terminal branch which appears between the ad-

Nerve that contains sensory and motor fibers

ductor longus and gracilis muscles and supplies

from T12 and L1 for the abdominal muscles. It

the distal 2/3 of the skin of the thigh. C

21

traverses the psoas major, then courses between

28

Posterior branch. Ramus posterior. It pierces

the transversus abdominis and internal abdomi-

nal muscles and pierces the latter medial to the

the obturator externus and supplies it and the

22

anterior superior iliac spine. C

adductor magnus and brevis. Via a sensory

16

Lateral

cutaneous

branch. Ramus cutaneus

branch it extends as far as the posterior wall of

the knee joint. C

23

lateralis. It can reach as far as the lateral gluteal

29

Muscular branches. Rami musculares. Branches

region. C

24

17

Anterior cutaneous branch. Ramus cutaneus

supplying the previously named muscles. C

30

Accessory obturator nerve. N. obturatorius ac-

anterior. It frequently penetrates the aponeuro-

sis of the external oblique just above the superfi-

cessorius. It frequently arises as an additional

25

cial inguinal ring and supplies the skin in this

obturator nerve from L3−4 to supply the pec-

area. C

tineus and hip joint.

Spinal nerves

343

12

1

5

2

L III

3

4

8

5

8

6

9

10

11

9

7

Exit of a sacral nerve

3

4

8

10

2

9

B

Middle and superior

6

10

21

clunial nerves

15

11

15

18

18

12

21

346

Spinal nerves

Tibial nerve. N. tibialis. Nerve arising from L4−

14

Common plantar digital nerves. Nn. digitales

1

1

S3. It is the second terminal branch of the sci-

plantares communes. Two branches, one pass-

atic nerve. It passes through the popliteal fossa,

ing to the little toe and giving off a branch to the

2

disappears beneath the tendinous arch of the

flexor digiti minimi brevis, the other proceed-

soleus muscle and proceeds, accompanied by

ing to the interval between the 4th and 5th toes.

3

the posterior tibial artery, around the medial

A

malleolus to the sole of the foot. A

15

Proper plantar digital nerves. Nn. digitales

4

2

Muscular branches. Rami musculares. Rami to

plantares proprii. They pass to the fibular and

the gastrocnemius, plantaris, soleus and the

tibial sides of the little toe as well as to the fibu-

deep flexors at the lower leg. A

lar side of the 4th toe. A

5

3

Interosseous nerve of leg. N. interosseus

16

Deep branch. Ramus profundus. Muscular

cruris. It is accompanied by the anterior tibial

branch passing in company with the plantar

6

artery and contains fibers for the bones and ti-

arch to the interossei, adductor hallucis and the

biofibular joint. A

lateral three lumbrical muscles. A

7

4

Medial sural cutaneous nerve. N. cutaneus

17

Pudendal nerve. N. pudendus. Arising from

surae medialis. Nerve that arises from the tibial

S2−4, it passes through the greater sciatic fora-

nerve in the popliteal fossa, then descends sub-

men below the piriformis [[”infrapiriform fora-

8

fascially lateral to the small saphenous vein and

men”]] to the ischioanal fossa. C

joins the communicating branch of the com-

18

Inferior rectal nerves. Nn. rectales (anales) in-

9

mon fibular nerve to form the sural nerve. A B

feriores. Fibers from S3−4 for the external anal

5

Sural nerve. N. suralis. Continuation of the

sphincter and the anal skin. C

10

medial sural cutaneous nerve after its union

19

Perineal nerves. Nn. perineales. Collective

with the communicating branch of the com-

term for the nerves of the perineum.

11

mon fibular nerve. B

20

Posterior scrotal (labial) nerves. Nn.

6

Lateral dorsal cutaneous nerve. N. cutaneus

scrotales/libiales posteriores. They reach the

dorsalis lateralis. It passes to the lateral aspect

scrotum (labium majus) from behind. C

12

of the dorsum of the foot and anastomoses with

21

Muscular

branches. Rami musculares. They

the intermediate dorsal cutaneous nerve. B

supply the muscles of the perineum.

7 Lateral calcaneal branches. Rami calcanei later-

13

22

Dorsal nerve

of

penis. N. dorsalis penis.

ales. Lateral branches to the calcaneus. B

Paired nerves lying on the dorsum of the penis

14

8

Medial calcaneal branches. Rami calcanei

with branches

also

to the underside of the

mediales. Branches arising directly from the ti-

penis. C

15

bial nerve. They pass to the medial aspect of the

23

Dorsal nerve of clitoris. N. dorsalis clitoridis.

calcaneus. B

Smaller nerve corresponding to the dorsal

9

Medial plantar nerve. N. plantaris medialis.

nerve of the penis. C

16

The larger terminal branch of the tibial nerve. It

24

Coccygeal

nerve. N. coccygeus. Last spinal

proceeds beneath the flexor retinaculum and

nerve. It

emerges

between the coccyx and

17

the abductor hallucis to the sole of the foot

sacrum and anastomoses with S4−5 nerves. C

which it supplies, as well as the skin and the

25

Coccygeal plexus. Plexus coccygeus. Nerve

flexor hallucis brevis and flexor digitorum

18

brevis. A

plexus formed by fibers from a part of S4, all of

S5 and the coccygeal nerve. It supplies the skin

10

Common plantar digital nerves. Nn. digitales

over the coccyx. C

19

plantares communes. They course in the inter-

26

Anococcygeal nerves. Nn. anococcygei. Several

val between toes 1−4 and divide to form the

proper plantar digital nerves. A

fine nerves from the coccygeal plexus. They

20

pierce the anococcygeal ligament and supply

11

Proper plantar digital nerves. Nn. digitales plan-

the skin lying over it. C

tares proprii. Cutaneous nerves passing on the