The cervical plexus

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The cervical plexus

  1. 1. The Spinal Nerves
  2. 2. 31 pairs:Cervical 8Thoracic 12Lumbar 5Sacral 5Coccygeal 1
  3. 3. The Cervical Plexus
  4. 4. The cervical plexus is a network of nerves formed bycommunications between the anterior rami of the upper 4 cervical nerves.
  5. 5. It lies posterior to the internal jugular vein and the SCM muscles.
  6. 6. -supplies the back andsides of the head, andfront of the neck;phrenic nerve –supplies thediaphragm.
  7. 7. Branches of theCervical Plexus
  8. 8. Branches of the Cervical Plexus• A. Superficial or Cutaneous Branches• Deep branches or muscular and communicating branches
  9. 9. A. Superficial orCutaneous Branches
  10. 10. 1. Ascending branches a. Lesser occipital nerve b. Great auricular nerve c. Nervus cutaneous colli2. Descending branches a. Medial supraclavicular b. Intermediate supraclavicular c. Lateral supraclavicular
  11. 11. 1. ASCENDING BRANCHES
  12. 12. a. Lesser occipital nerveb. Great auricular nervec. Transverse cervical nerve
  13. 13. A. LESSER OCCIPITAL NERVE
  14. 14. - Comes from the second cervical ventral ramus and sometimes also from the third
  15. 15. - curves around the accessory nerve and ascends along the posterior border of the sternocleidomastoid.
  16. 16. - supplies the skin on the upper third of the medial auricular aspect
  17. 17. -connects with the posterior branch of the great auricular nerve.
  18. 18. B. THE GREAT AURICULAR NERVE
  19. 19. This is the largest ascending branch.
  20. 20. It arises from the second and third cervical rami, encircles the posterior border of the sternocleidomastoid.
  21. 21. supplies the skin over the mastoid process and on the back of the auricle, the lobule and concha. .
  22. 22. communicates with the lesser occipital, the auricularbranch of the vagus and the posterior auricular branch of the facial nerve.
  23. 23. C. TRANSVERSE CUTANEOUS NERVE
  24. 24. This arises from the second and third cervicalrami, curves round the posterior border of the sternocleidomastoid
  25. 25. It perforates the deep cervical fascia, dividing under theplatysma into ascending and descending branches distributed to the anterolateral areas of the neck.
  26. 26. distributed to the skin of the upper anterior areas ofthe neck and anterolaterally to the skin of the neck, as low as the sternum.
  27. 27. 2. DESCENDING BRANCHES
  28. 28. Supra Clavicular Nerves• These arise by a common trunk from the third and fourth cervical ventral rami and emerge from the posterior border of the sternocleidomastoid, to descend under the platysma and the deep cervical fascia;
  29. 29. 3 Branches:1. The medial supraclavicular nerves - supply the skin as far as the midline and as low as the second rib. They supply the sternoclavicular joint.
  30. 30. 2. The intermediate supraclavicular nerves -cross the clavicle to supply the skin over the pectoralis major and deltoid down to the level of the second rib
  31. 31. 3. The lateral supraclavicular nerves - supply the skin of the upper and posterior parts of the shoulder.
  32. 32. Deep branches or Muscular and Communicating Branches
  33. 33. 1. Lateral Branches:a. Muscular branches going to the following: i. SCM ii. Trapezius iii. Levator scapula iv. Scalenius medius v. Scalenius posteriorb. Communicating branches to spinal accessory nerves
  34. 34. Deep Branches—Lateral SeriesMuscular branches Sternocleidomastoid C2, 3, 4 Trapezius C2, (3) Levator scapulae C3, 4 Scalenus medius C3, 4Communicating branches Accessory Nerve C2, 3, 4
  35. 35. 2. Medial branches:a. Muscular branches going to the following muscles: i. Prevertebral muscles ii. Infrahyoid muscles thru the ansa hypoglossi iii. Diaphragm thru the phrenic nerve b. Communicating branches to the vagus, hypoglossaland sympathetic nerves c. Phrenic nerve is the most important branch because itsupplies the diaphragm which is the chief muscle forrespiration. It is derived from cervical nerves 3, 4, and 5.
  36. 36. Communicating and Muscular Branches (Medial Series)Communicating branches with Hypoglossal C1, 2 Vagus C1–2 Sympathetic C1, 2
  37. 37. Muscular branches to Rectus capitis lateralis C1 Rectus capitis anterior C1, 2 Longus capitis C1–4 Longus colli C2–4 Inferior root of ansa cervicalis C2, 3 Phrenic nerve C3–5
  38. 38. THE ANSA HYPOGLOSSI
  39. 39. Formed by spinal nerves C1, C2, and C3.• 3 parts:1. Superior root C1 - innervates the superior belly of omohyoid2. Inferior root C2, C33. Loop of ansa cervicalis - innervates the sternothyroid, sternohyoid, inferior belly of omohyoid
  40. 40. THE PHRENIC NERVE
  41. 41. • Arises from the converging APR of spinal nerves C3, C4, and C5.• This is the sole motor supply to the diaphragm, and also contains widespread sensory fibres.

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