Structure of a Nerve

• Cordlike organ of the PNS

• Bundle of myelinated and unmyelinated
peripheral axons enclosed by connective
tissue

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 Structure of a Nerve

• Connective tissue coverings include:

• Endoneurium—loose connective tissue that
encloses axons and their myelin sheaths
• Perineurium—coarse connective tissue that
bundles fibers into fascicles
• Epineurium—tough fibrous sheath around a
nerve

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 Axon
Myelin sheath
Endoneurium
Perineurium
Epineurium

Fascicle
Blood
vessels

(b)
Copyright © 2010 Pearson Education, Inc. Figure 13.3b
 Classification of Nerves

• Most nerves are mixtures of afferent and efferent

fibers and somatic and autonomic (visceral) fibers
• Pure sensory (afferent) or motor (efferent) nerves are
rare
• Types of fibers in mixed nerves:
• Somatic afferent and somatic efferent
• Visceral afferent and visceral efferent
• Peripheral nerves classified as cranial or spinal
nerves

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 Ganglia

• Contain neuron cell bodies associated with

nerves
• Dorsal root ganglia (sensory, somatic)
(Chapter 12)
• Autonomic ganglia (motor, visceral)
(Chapter 14)

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 Cranial Nerves

• Twelve pairs of nerves associated with the

brain
• Most are mixed in function; two pairs are
purely sensory
• Each nerve is identified by a number
(I through XII) and a name
“On occasion, our trusty truck acts funny—very
good vehicle anyhow”

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 Filaments of
olfactory
Frontal lobe nerve (I)
Olfactory bulb
Olfactory tract
Temporal lobe Optic nerve
(II)
Optic chiasma
Infundibulum Optic tract
Facial Oculomotor
nerve (VII) nerve (III)
Vestibulo- Trochlear
cochlear nerve (IV)
nerve (VIII) Trigeminal
Glossopharyngeal nerve (V)
nerve (IX) Abducens
Vagus nerve (X) nerve (VI)
Cerebellum
Accessory nerve (XI)
Medulla
Hypoglossal nerve (XII) oblongata
(a)

Copyright © 2010 Pearson Education, Inc. Figure 13.5 (a)

 Cranial nerves Sensory Motor PS*
I – VI function function fibers

I Olfactory Yes (smell) No No

II Optic Yes (vision) No No
III Oculomotor No Yes Yes
IV Trochlear No Yes No
V Trigeminal Yes (general Yes No
sensation)
VI Abducens No Yes No

Cranial nerves Sensory Motor PS*

VII – XII function function fibers

VII Facial Yes (taste) Yes Yes

VIII Vestibulocochlear Yes (hearing Some No
and balance)
IX Glossopharyngeal Yes (taste) Yes Yes
X Vagus Yes (taste) Yes Yes
XI Accessory No Yes No
XII Hypoglossal No Yes No

(b) *PS = parasympathetic

Copyright © 2010 Pearson Education, Inc. Figure 13.5 (b)

I: The Olfactory Nerves
• Arise from the olfactory
receptor cells of nasal
cavity
• Pass through the cribriform
plate of the ethmoid bone
• Fibers synapse in the
olfactory bulbs
• Pathway terminates in the
primary olfactory cortex
• Purely sensory (olfactory) function

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 II: The Optic Nerves • Arise from the retinas
• Pass through the optic
canals, converge and
partially cross over at the
optic chiasma
• Optic tracts continue to the
thalamus, where they
synapse
• Optic radiation fibers run to
the occipital (visual) cortex
• Purely sensory (visual) function

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 III: The Oculomotor Nerves
• Fibers extend from the
ventral midbrain
through the superior
orbital fissures to the
extrinsic eye muscles
• Functions in raising the
eyelid, directing the
eyeball, constricting the
iris (parasympathetic),
and controlling lens
shape

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 IV: The Trochlear Nerves
• Fibers from the
dorsal midbrain
enter the orbits via
the superior orbital
fissures to innervate
the superior oblique
muscle
• Primarily a motor
nerve that directs
the eyeball

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 V: The Trigeminal Nerves
• Largest cranial nerves; fibers
extend from pons to face
• Three divisions
• Ophthalmic (V1) passes
through the superior orbital
fissure
• Maxillary (V2) passes through
the foramen rotundum
• Mandibular (V3) passes
through the foramen ovale
• Convey sensory impulses from
various areas of the face (V1)
and (V2), and supplies motor
fibers (V3) for mastication
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 VI: The Abducens Nerves

• Fibers from the inferior pons enter the orbits

via the superior orbital fissures
• Primarily a motor, innervating the lateral
rectus muscle

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 VII: The Facial Nerves
• Fibers from the pons travel
through the internal acoustic
meatuses, and emerge through
the stylomastoid foramina to the
lateral aspect of the face
• Chief motor nerves of the face
with 5 major branches
• Motor functions include facial
expression, parasympathetic
impulses to lacrimal and salivary
glands
• Sensory function (taste) from
the anterior two-thirds of the
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tongue
 VIII: The Vestibulocochlear Nerves
• Afferent fibers from the hearing
receptors (cochlear division)
and equilibrium receptors
(vestibular division) pass from
the inner ear through the
internal acoustic meatuses,
and enter the brain stem at the
pons-medulla border
• Mostly sensory function; small
motor component for
adjustment of sensitivity of
receptors
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 IX: The Glossopharyngeal Nerves
• Fibers from the medulla
leave the skull via the jugular
foramen and run to the throat
• Motor functions: innervate
part of the tongue and
pharynx for swallowing, and
provide parasympathetic
fibers to the parotid salivary
glands
• Sensory functions: fibers conduct
taste and general sensory
impulses from the pharynx and
posterior tongue, and impulses
from carotid chemoreceptors and
baroreceptors
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X: The Vagus Nerves • The only cranial nerves that
extend beyond the head and neck
region
• Fibers from the medulla exit the
skull via the jugular foramen
• Most motor fibers are
parasympathetic fibers that help
regulate the activities of the heart,
lungs, and abdominal viscera
• Sensory fibers carry impulses from
thoracic and abdominal viscera,
baroreceptors, chemoreceptors, and
taste buds of posterior tongue and
pharynx

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 XI: The Accessory Nerves
• Formed from ventral
rootlets from the C1–C5
region of the spinal
cord (not the brain)
• Rootlets pass into the
cranium via each
foramen magnum
• Accessory nerves exit
the skull via the jugular
foramina to innervate
the trapezius and
sternocleidomastoid muscles
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 XII: The Hypoglossal Nerves
• Fibers from the
medulla exit the
skull via the
hypoglossal canal
• Innervate extrinsic
and intrinsic
muscles of the
tongue that
contribute to
swallowing and
speech

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 Spinal Nerves

• 31 pairs of mixed nerves named according to

their point of issue from the spinal cord
• 8 cervical (C1–C8)
• 12 thoracic (T1–T12)
• 5 Lumbar (L1–L5)
• 5 Sacral (S1–S5)
• 1 Coccygeal (C0)

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 Cervical plexus Cervical
nerves
Brachial plexus C1 – C8

Cervical
enlargement
Intercostal Thoracic
nerves nerves
T1 – T12
Lumbar
enlargement
Lumbar
Lumbar plexus
nerves
L1 – L 5

Sacral plexus
Sacral nerves
S1 – S 5
Cauda equina Coccygeal nerve Co1

Copyright © 2010 Pearson Education, Inc. Figure 13.6

 Spinal Nerves: Roots

• Each spinal nerve connects to the spinal cord

via two roots
• Ventral roots
• Contain motor (efferent) fibers from the ventral
horn motor neurons
• Fibers innervate skeletal muscles)

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 Spinal Nerves: Roots

• Dorsal roots
• Contain sensory (afferent) fibers from sensory
neurons in the dorsal root ganglia
• Conduct impulses from peripheral receptors
• Dorsal and ventral roots unite to form spinal
nerves, which then emerge from the vertebral
column via the intervertebral foramina

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 Gray matter
White matter
Dorsal and
Ventral root
ventral rootlets
Dorsal root
Dorsal root of spinal nerve
ganglion
Dorsal ramus
of spinal nerve
Ventral ramus
of spinal nerve
Spinal nerve
Rami communicantes
Sympathetic trunk
ganglion

Anterior view showing spinal cord, associated nerves, and vertebrae.

The dorsal and ventral roots arise medially as rootlets and join
laterally to form the spinal nerve.
Copyright © 2010 Pearson Education, Inc. Figure 13.7 (a)
 Spinal Nerves: Rami

• Each spinal nerve branches into mixed rami

• Dorsal ramus
• Larger ventral ramus
• Meningeal branch
• Rami communicantes (autonomic pathways)
join to the ventral rami in the thoracic region

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 Spinal Nerves: Rami

• All ventral rami except T2–T12 form interlacing

nerve networks called plexuses (cervical,
brachial, lumbar, and sacral)
• The back is innervated by dorsal rami via
several branches
• Ventral rami of T2–T12 as intercostal nerves
supply muscles of the ribs, anterolateral
thorax, and abdominal wall

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 Dorsal ramus
Ventral ramus
Spinal nerve

Rami communicantes Intercostal nerve

Sympathetic trunk Dorsal root
ganglion ganglion
Dorsal root
Ventral root
Branches of intercostal
nerve
• Lateral cutaneous
• Anterior cutaneous

Sternum

(b) Cross section of thorax showing the main roots and

branches of a spinal nerve.
Copyright © 2010 Pearson Education, Inc. Figure 13.7 (b)
 Cervical Plexus

• Formed by ventral rami of C1–C4

• Innervates skin and muscles of the neck, ear,
back of head, and shoulders
• Phrenic nerve
• Major motor and sensory nerve of the
diaphragm (receives fibers from C3–C5)

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 Ventral rami

Segmental
branches

Hypoglossal Ventral
nerve (XII) rami:
Lesser occipital C1
nerve
Greater auricular C2
nerve
Transverse C3
cervical nerve
Ansa cervicalis
C4
Accessory nerve (XI)
Phrenic nerve C5
Supraclavicular
nerves

Copyright © 2010 Pearson Education, Inc. Figure 13.8

Copyright © 2010 Pearson Education, Inc. Table 13.3
 Brachial Plexus

• Formed by ventral rami of C5–C8 and T1 (and often C4

and T2)
• It gives rise to the nerves that innervate the upper
limb
• Major branches of this plexus:
• Roots—five ventral rami (C5–T1)
• Trunks—upper, middle, and lower
• Divisions—anterior and posterior
• Cords—lateral, medial, and posterior

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 Roots (ventral rami):
C4
Dorsal scapular
C5
Nerve to
subclavius C6
Suprascapular
Upper
Posterior C7
divisions Middle Trunks
Lateral C8
Lower
Cords Posterior T1
Long thoracic
Medial Medial pectoral
Lateral pectoral
Axillary Upper subscapular
Musculo-
Lower subscapular
cutaneous
Radial Thoracodorsal
Median Medial cutaneous
nerves of the arm
Ulnar
and forearm
(a) Roots (rami C5 – T1), trunks, divisions, and cords

Anterior Posterior Trunks Roots

divisions divisions
Copyright © 2010 Pearson Education, Inc. Figure 13.9 (a)
 Anterior Posterior Trunks Roots
divisions divisions

Major terminal Roots

branches Cords Divisions Trunks
(ventral
(peripheral nerves) rami)
Musculocutaneous Anterior
Upper C5
Lateral Posterior
Median C6
Medial Anterior
Ulnar Middle C7
Posterior
Radial C8
Posterior Anterior
Axillary Lower T1
Posterior
(d) Flowchart summarizing relationships within the
brachial plexus

Copyright © 2010 Pearson Education, Inc. Figure 13.9 (d)

 Brachial Plexus: Nerves

• Axillary—innervates the deltoid, teres minor, and skin

and joint capsule of the shoulder
• Musculocutaneous—innervates the biceps brachii and
brachialis and skin of lateral forearm
• Median—innervates the skin, most flexors and pronators
in the forearm, and some intrinsic muscles of the hand
• Ulnar—supplies the flexor carpi ulnaris, part of the flexor
digitorum profundus, most intrinsic muscles of the hand,
and skin of medial aspect of hand
• Radial—innervates essentially all extensor muscles,
supinators, and posterior skin of limb

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 Axillary Anterior Posterior Trunks Roots
nerve divisions divisions

Humerus
Radial nerve
Musculocutaneous nerve
Ulna
Radius
Ulnar nerve
Median nerve
Radial nerve (superficial branch)
Dorsal branch of ulnar nerve
Superficial branch of ulnar nerve
Digital branch of ulnar nerve
Muscular branch
Median nerve
Digital branch
(c) The major nerves of the upper limb
Copyright © 2010 Pearson Education, Inc. Figure 13.9 (c)
Copyright © 2010 Pearson Education, Inc. Table 13.4
 Lumbar Plexus

• Arises from L1–L4

• Innervates the thigh, abdominal wall, and
psoas muscle
• Femoral nerve—innervates quadriceps and
skin of anterior thigh and medial surface of leg
• Obturator nerve—passes through obturator
foramen to innervate adductor muscles

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 Ventral rami
Ventral
rami: Iliohypogastric
L1 Ilioinguinal
Femoral
L2 Lateral femoral
Iliohypogastric cutaneous
Ilioinguinal Obturator
Genitofemoral L3
Anterior femoral
cutaneous
Lateral femoral L4 Saphenous
cutaneous
Obturator
Femoral L5
Lumbosacral
trunk
(a) Ventral rami and major branches
of the lumbar plexus
(b) Distribution of the major nerves from
the lumbar plexus to the lower limb
Copyright © 2010 Pearson Education, Inc. Figure 13.10
Copyright © 2010 Pearson Education, Inc. Table 13.5
 Sacral Plexus

• Arises from L4–S4

• Serves the buttock, lower limb, pelvic structures, and
perineum
• Sciatic nerve
• Longest and thickest nerve of the body
• Innervates the hamstring muscles, adductor magnus,
and most muscles in the leg and foot
• Composed of two nerves: tibial and common fibular

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 Ventral rami Ventral rami:
L4

Superior
gluteal L5
Lumbosacral
trunk
S1
Inferior
gluteal
Common S2
fibular
Tibial
Posterior S3
femoral
S4
cutaneous
Pudendal S5
Sciatic Co1

Ventral rami and major branches

of the sacral plexus
Copyright © 2010 Pearson Education, Inc. Figure 13.11 (a)
 Superior gluteal
Inferior gluteal
Pudendal
Sciatic
Posterior femoral
cutaneous
Common fibular
Tibial
Sural (cut)
Deep fibular
Superficial fibular
Plantar branches

(b) Distribution of the major nerves from

the sacral plexus to the lower limb
Copyright © 2010 Pearson Education, Inc. Figure 13.11 (b)
Copyright © 2010 Pearson Education, Inc. Table 13.6
 Innervation of Skin

• Dermatome: the area of skin innervated by

the cutaneous branches of a single spinal
nerve
• All spinal nerves except C1 participate in
dermatomes
• Most dermatomes overlap, so destruction of a
single spinal nerve will not cause complete
numbness

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 C2

C3
C2 C4
C3 C5
C6
C4 C7
C8
C5 T1
T1 T2 C5
T2 T3
T3 T4
T4 T5
T2 T2 T6
T5 T7
T6 T8
T9
T7 T10
T8 C6 C6
C5 T9 C5 T11
C7 T12 C7
T10 L1
C6 C6 L2 S1
T11 C8 L3 C8
L4 S2 L5
T12 S3
C6 L1 L1 C6 S4
S2 C7 S5
C7
C8 S3 C8
L2 L2
S1 S2 S2 S1

L3 L3 L1

L5 L2 L5
L4 L4

L3
L5 L5

L4

S1 S1

Anterior (b) Posterior L4 L4

view view
L5 L5 S1

Copyright © 2010 Pearson Education, Inc. Figure 13.12

 Innervation of Joints

• Hilton’s law: Any nerve serving a muscle that

produces movement at a joint also innervates
the joint and the skin over the joint

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