The document provides information about the sacral plexus:
- The sacral plexus is a network of nerves that supplies the lower limb and pelvis. It is formed from the sacral and lumbar spinal nerves.
- The sacral plexus has five major peripheral nerves (superior gluteal, inferior gluteal, sciatic, posterior cutaneous thigh, pudendal) and provides motor and sensory functions.
- Damage to the sacral plexus can cause lumbosacral plexopathy, with symptoms like weakness, numbness, and pain. Causes include tumors, diabetes, and sometimes the cause is unknown. Treatment depends on the underlying cause.
The document provides information about the sacral plexus:
- The sacral plexus is a network of nerves that supplies the lower limb and pelvis. It is formed from the sacral and lumbar spinal nerves.
- The sacral plexus has five major peripheral nerves (superior gluteal, inferior gluteal, sciatic, posterior cutaneous thigh, pudendal) and provides motor and sensory functions.
- Damage to the sacral plexus can cause lumbosacral plexopathy, with symptoms like weakness, numbness, and pain. Causes include tumors, diabetes, and sometimes the cause is unknown. Treatment depends on the underlying cause.
The document provides information about the sacral plexus:
- The sacral plexus is a network of nerves that supplies the lower limb and pelvis. It is formed from the sacral and lumbar spinal nerves.
- The sacral plexus has five major peripheral nerves (superior gluteal, inferior gluteal, sciatic, posterior cutaneous thigh, pudendal) and provides motor and sensory functions.
- Damage to the sacral plexus can cause lumbosacral plexopathy, with symptoms like weakness, numbness, and pain. Causes include tumors, diabetes, and sometimes the cause is unknown. Treatment depends on the underlying cause.
The document provides information about the sacral plexus:
- The sacral plexus is a network of nerves that supplies the lower limb and pelvis. It is formed from the sacral and lumbar spinal nerves.
- The sacral plexus has five major peripheral nerves (superior gluteal, inferior gluteal, sciatic, posterior cutaneous thigh, pudendal) and provides motor and sensory functions.
- Damage to the sacral plexus can cause lumbosacral plexopathy, with symptoms like weakness, numbness, and pain. Causes include tumors, diabetes, and sometimes the cause is unknown. Treatment depends on the underlying cause.
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Course code: A2A811
Course Name: Anatomy 2
Sacral Plexus
Learning outcomes: *Nerves *Branches *Motor and sensory functions Dr Mehreen Jabbar,PT SACRAL PLEXUS
The sacral plexus is a network of nerve fibres
that supplies the skin and muscles of the pelvis and lower limb. It is located on the surface of the posterior
pelvic wall, anterior to the piriformis muscle.
The plexus is formed by the anterior
rami (divisions) of the sacral spinal nerves S1,
S2, S3 and S4. It also receives contributions from the lumbar spinal nerves L4 and L5. BRANCHES
The anterior rami of the S1-S4 spinal roots (and
the lumbosacral trunk) divide into several cords. These cords then combine together to form the five major peripheral nerves of the sacral plexus. Lumbosacral trunk is formed by part of anterior
ramus of fourth lumber nerve emerges from
medial border of psoas muscle and joins the anterior ramus of L5. trunk enters the pelvis by passing down in front of SI and joins the sacral plexus. Cont.. These nerves then descend down the posterior pelvic wall. They have two main destinations:
Leave the pelvis via the greater sciatic foramen – these nerves enter the gluteal region of the lower limb, innervating the structures there are Sciatic nerve, superior and inferior gluteal nerve, nerve to quadratus femoris, nerve to Obturator internus muscle and posterior cutaneous nerve of thigh
Remain in the pelvis – these nerves innervate the pelvic
muscles, organs and perineum are pudendal nerve, nerve to piriformis , pelvic splanchic nerves. Superior Gluteal Nerve Thesuperior gluteal nerve leaves the pelvis via the greater sciatic foramen, entering the gluteal region superiorly to the piriformis muscle.
It is accompanied by the superior gluteal artery and vein for much of its course.
Roots: L4, L5, S1.
Motor Functions: Innervates the gluteus minimus, gluteus medius and tensor fascia lata. Sensory Functions: None.
A useful memory aid for the major branches of
the sacral plexus is ‘Some Irish Sailor Pesters Polly’. This stands for Superior Gluteal, Inferior Gluteal, Sciatic, Posterior cutaneous nerve of thigh, Pudendal. Inferior Gluteal Nerve The inferior gluteal nerve leaves the pelvis via the greater sciatic foramen, entering the gluteal region inferiorly to the piriformis muscle. It is accompanied by the inferior gluteal artery
and vein for much of its course.
Roots: L5, S1, S2. Motor Functions: Innervates gluteus
Motor Functions: ◦ Tibial portion – Innervates the muscles in the posterior compartment of the thigh that are semitendinosus, semimembranosus, biceps femoris (apart from the short head of the biceps femoris), and the hamstring component of adductor magnus. ◦ Innervates all the muscles in the posterior compartment of the leg and sole of the foot that are soleus, plantaris, popliteus, tibilias posterior, flexor digitorum longus, flexor halluces longus, and via the medial and lateral plantar branches to the muscles of sole of foot. Cont.. Common fibular portion – Short head of biceps femoris, all muscles in the anterior and lateral compartments of the leg that are tibilias anterior, extensor halluces longus, extensor digitorum longus, fibularis tertius, and extensor digitorum brevis through deep fibular branch. Fibularis longus and fibularis brevis through superficial fibular branch Sensory functions Tibialportion: sural branch supplies the skin of lateral leg , lateral foot Fibular portion: supplies the skin over
the lower third of anterior surface of leg
and dorsum of foot Posterior Femoral Cutaneous The posterior cutaneous nerve of thigh leaves the pelvis via the greater sciatic foramen, entering the gluteal region inferiorly to the piriformis muscle. It descends deep to the gluteus maximus and runs down the back of the thigh to the knee.
Roots: S1, S2, S3
Cont.. Motor Functions: None
Sensory Functions: Innervates the skin
on the posterior surface of the thigh and popliteal fossa and also lower part of buttocks, scrotum and labia majora Pudendal Nerve Thisnerve leaves the pelvis via the greater sciatic foramen, then re-enters via the lesser sciatic foramen. It moves anterosuperiorly along the lateral wall of the ischiorectal fossa, and terminates by dividing into several branches.
Roots: S2, S3, S4
Cont.. Motor Functions: Innervates the skeletal muscles in the perineum including the external anal sphincter, lower half of anal canal Sensory Functions: Innervates the skin of
penis, scrotum, labia majora and minora
and the clitoris and most of the skin of the perineum. Other Branches In addition to the five major nerves of the sacral plexus, there are a number of smaller branches. These tend to be nerves that directly supplying muscles (with the exception of the perforating cutaneous nerve, which supplies the skin over the lower medial part of buttock and the pelvic splanchnic nerves, arise from S2, S3, S4 which innervate the pelvic viscera):
Nerve to piriformis (S1, S2): piriformis
Nerve to obturator internus (L5 to S2): Obturator
internus and superior gamellus
Nerve to quadratus femoris (L4, L5, S1): quadratus
femoris and inferior gamellus
Clinical Relevance - Lumbosacral Plexopathy
A lumbosacral plexopathy is a disorder
affecting either the lumbar or sacral plexus of nerves. They are rare syndromes, caused by damage to the nerve bundles.
A plexopathy is suspected if the symptoms
cannot be localised to a single nerve. Patients may complain of neuropathic pains, numbness or weakness and wasting of muscles. One of the main causes of lumbosacral plexopathy is diabetic amyotrophy, also known as lumbosacral radioplexus neurophagy. In this condition, the high blood sugar levels damage the nerves.
Idiopathic plexopathy is another cause, being the
lumbosacral equivalent of Parsonage-Turner syndrome (which affects the brachial plexus).
Tumours and other local invasions can cause the
plexopathy due to the compression of the plexus. RX Treatment depends on what is causing the symptoms. For tumours and space-occupying lesions,
they should be removed if possible.
Fordiabetic and idiopathic causes,
treatment with high- dose corticosteroids can be useful. Reference: Snell’s Neuro anatomy Google images Thank You
