The peripheral nervous system
, is part of the nervous system
, and consists of the nerves
that reside or extend outside the central nervous system
--to serve the limbs and organs, for example. The peripheral nervous system is further divided into the somatomotoric nervous system and the autonomic nervous system
- Cranial nerves originate from the brainstem, and mainly control the functions of the anatomic structures of the head.
- Spinal nerves take their origins from the spinal cord. They control the functions of the rest of the body. In humans, there are 31 pairs of spinal nerves: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral and 1 coccygeal. The naming convention for spinal nerves is to name it after the vertebra immediately above it. Thus the fourth thoracic nerve originates just below the fourth thoracic vertebra. This convention breaks down in the cervical spine. The first spinal nerve originates above the first cervical vertebra and is called C1. This continues down to the last cervical spinal nerve, C8. There are only 7 cervical vertabra and 8 cervical spinal nerves.
- The first 4 cervical spinal nerves, C1 through C4, split and recombine to produce a variety of nerves that subserve the neck and back of head.
- The last 4 cervical spinal nerves, C5 through C8, and the first thoracic spinal nerve, T1,combine to form the brachial plexus, a tangled array of nerves, splitting, combining and recombining, to form the nerves that subserve the arm and upper back. Although the brachial plexus may appear tangled, it is highly organized and predictable, with little variation between people. See brachial plexus injuries[?].
- The first nerve off the brachial plexus is the dorsal scapular nerve[?], arising from C5 nerve root, and innervating the rhomboids[?] and the levator scapulae[?] muscles.
- The long thoracic nerve[?] arises from C5, C6 and C7 to innervate the serratus anterior[?].
- The brachial plexus first forms three trunks, the superior trunk, composed of the C5 and C6 nerve roots, the middle trunk, made of the C7 nerve root, and the inferior trunk, made of the C8 and T1 nerve roots. The suprascapular nerve[?] is an early branch of the superior trunk. It innervates the suprascapular and infrascapular muscles, part of the rotator cuff. See rotator cuff for rotator cuff injuries
- The trunks reshuffle as they traverse towards the arm into cords. There are three of them. The lateral cord is made up of fibers from the anterior and middle trunk. The posterior cord is made up of fibers from all three trunks. The medial cord is composed of fibers solely from the medial trunk.
- The lateral cord gives rise to the following nerves
- The posterior cord gives rise to the following nerves
- The upper subscapular nerve[?], C7 and C8, to the subscapularis[?] muscle of the rotator cuff.
- The lower subscapular nerve[?], C5 and C6, to the teres major[?] also of the rotator cuff.
- The thoracodorsal nerve[?], C6, C7 and C8, to the latissimus dorsi muscle.
- The axillary nerve, which supplies sensation to the shoulder and motor to the deltoid[?] muscle and the teres minor[?] muscle.
- The radial nerve, which innervates the triceps brachii[?] muscle, the brachioradialis muscle, the extensor muscles of the fingers and wrist(extensor carpi radialis[?] muscle), and the externsor and abductor muscles of the thumb. See radial nerve injuries[?]
- The medial cord gives rise to the following nerves:
- The median pectoral nerve[?], C8 and T1, to the pectoralis muscle
- The medial brachial cutaneous nerve[?], T1
- The medial antebrachial cutaneous nerve[?], C8 and T1
- The median nerve, partly. The other part comes from the lateral cord. C7, C8 and T1 nerve roots. The first branch of the median nerve is to the pronator teres[?] muscle, then the flexor carpi radialis, the palmaris longus[?] and the flexor digitorum superficialis. The median nerve provides sensation to the anterior palm, the anterior thumb, index finger[?] and middle finger[?]. It is the nerve compressed in carpel tunnel syndrome[?].
- The ulnar nerve originates in nerve roots C7, C8 and T1. It provides sensation to the ring and pinky fingers. It innervates the flexor carpi ulnaris[?] muscle, the flexor digitorum profundi[?] muscle to the ring and pinky fingers, and the intrinsic muscles of the hand (the interosseous muscle[?], the lumbrical muscles[?] and the flexor pollicus brevis[?] muscle. This nerve traverses a groove on the elbow called the cubital tunnel[?], also known as the funny bone. Striking the nerve at this point produces an unpleasant sensation in the ring and pinky fingers.
- The remainder of the thoracic spinal nerves, T3 through T12, do little recombining. The form the intercostal nerves[?], so named because the run between the [rib]s, inter(between)-costal(ribs). For points of reference, the 7th intercostal nerve terminates at the lower end of the sternum[?], also known as the xyphoid. The 10th intercostal nerve terminates at the umbilicus, aka the belly button.
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