The peripheral nervous system (PNS) is one of two components that make up the nervous system of bilateral animals, with the other part being the central nervous system (CNS). The PNS consists of nerves and ganglia, which lie outside the brain and the spinal cord. The main function of the PNS is to connect the CNS to the limbs and organs, essentially serving as a relay between the brain and spinal cord and the rest of the body. Unlike the CNS, the PNS is not protected by the vertebral column and skull, or by the blood–brain barrier, which leaves it exposed to toxins.
Tetraplegia, also known as quadriplegia, is defined as the dysfunction or loss of motor and/or sensory function in the cervical area of the spinal cord. A loss of motor function can present as either weakness or paralysis leading to partial or total loss of function in the arms, legs, trunk, and pelvis; paraplegia is similar but affects the thoracic, lumbar, and sacral segments of the spinal cord and arm function is retained. The paralysis may be flaccid or spastic. A loss of sensory function can present as an impairment or complete inability to sense light touch, pressure, heat, pinprick/pain, and proprioception. In these types of spinal cord injury, it is common to have a loss of both sensation and motor control.
The brachial plexus is a network of nerves formed by the anterior rami of the lower four cervical nerves and first thoracic nerve. This plexus extends from the spinal cord, through the cervicoaxillary canal in the neck, over the first rib, and into the armpit, it supplies afferent and efferent nerve fibers to the chest, shoulder, arm, forearm, and hand.
A spinal nerve is a mixed nerve, which carries motor, sensory, and autonomic signals between the spinal cord and the body. In the human body there are 31 pairs of spinal nerves, one on each side of the vertebral column. These are grouped into the corresponding cervical, thoracic, lumbar, sacral and coccygeal regions of the spine. There are eight pairs of cervical nerves, twelve pairs of thoracic nerves, five pairs of lumbar nerves, five pairs of sacral nerves, and one pair of coccygeal nerves. The spinal nerves are part of the peripheral nervous system.
The phrenic nerve is a mixed motor/sensory nerve that originates from the C3-C5 spinal nerves in the neck. The nerve is important for breathing because it provides exclusive motor control of the diaphragm, the primary muscle of respiration. In humans, the right and left phrenic nerves are primarily supplied by the C4 spinal nerve, but there is also a contribution from the C3 and C5 spinal nerves. From its origin in the neck, the nerve travels downward into the chest to pass between the heart and lungs towards the diaphragm.
The cervical plexus is a nerve plexus of the anterior rami of the first four cervical spinal nerves C1-C4. The cervical plexus provides motor innervation to some muscles of the neck, and the diaphragm; it provides sensory innervation to parts of the head, neck, and chest.
The suprascapular nerve is a mixed nerve that branches from the upper trunk of the brachial plexus. It is derived from the ventral rami of cervical nerves C5-C6. It provides motor innervation to the supraspinatus muscle, and the infraspinatus muscle.
A nerve plexus is a plexus of intersecting nerves. A nerve plexus is composed of afferent and efferent fibers that arise from the merging of the anterior rami of spinal nerves and blood vessels. There are five spinal nerve plexuses, except in the thoracic region, as well as other forms of autonomic plexuses, many of which are a part of the enteric nervous system. The nerves that arise from the plexuses have both sensory and motor functions. These functions include muscle contraction, the maintenance of body coordination and control, and the reaction to sensations such as heat, cold, pain, and pressure. There are several plexuses in the body, including:
The upper (superior) subscapular nerve is the first branch of the posterior cord of the brachial plexus. The upper subscapular nerve contains axons from the ventral rami of the C5 and C6 cervical spinal nerves. It innervates the superior portion of the subscapularis muscle. The inferior portion of the subscapularis is innervated by the lower subscapular nerve.
The nerve point of the neck, also known as Erb's point, is a site at the upper trunk of the brachial plexus located 2–3 cm above the clavicle. It is named for Wilhelm Heinrich Erb. Taken together, there are six types of nerves that meet at this point.
The deep petrosal nerve is a post-ganglionic branch of the (sympathetic) internal carotid (nervous) plexus that enters the cranial cavity through the carotid canal, then passes perpendicular to the carotid canal in the cartilaginous substance which fills the foramen lacerum to unite with the (parasympathetic) greater petrosal nerve to form the nerve of pterygoid canal.
The subclavian nerve, also known as the nerve to the subclavius, is a small branch of the upper trunk of the brachial plexus. It contains axons from C5 and C6. It innervates the subclavius muscle.
The middle cervical ganglion is the smallest of the three cervical sympathetic ganglia. It presumably represents the merging of the sympathetic ganglia of cervical segments C5–C6. It is usually situated at the level of the sixth cervical vertebra.
The ventral ramus is the anterior division of a spinal nerve. The ventral rami supply the antero-lateral parts of the trunk and the limbs. They are mainly larger than the dorsal rami.
The upper (superior) trunk is part of the brachial plexus. It is formed by joining of the ventral rami of the fifth (C5) and sixth (C6) cervical nerves. The upper trunk divides into an anterior and posterior division.
Cervical spinal nerve 4, also called C4, is a spinal nerve of the cervical segment. It originates from the spinal cord above the 4th cervical vertebra (C4). It contributes nerve fibers to the phrenic nerve, the motor nerve to the thoracoabdominal diaphragm. It also provides motor nerves for the longus capitis, longus colli, anterior scalene, middle scalene, and levator scapulae muscles. C4 contributes some sensory fibers to the supraclavicular nerves, responsible for sensation from the skin above the clavicle. C4 and C5 are the areas that see the highest amount of cervical spine trauma.
The cervical spinal nerve 6 (C6) is a spinal nerve of the cervical segment.
The cervical spinal nerve 8 (C8) is a spinal nerve of the cervical segment.
The spinal root of accessory nerve is firm in texture, and its fibers arise from the motor cells in the lateral part of the anterior column of the gray substance of the medulla spinalis as low as the fifth cervical nerve.
The spinal cord is a long, thin, tubular structure made up of nervous tissue that extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (backbone) of vertebrate animals. The center of the spinal cord is hollow and contains a structure called the central canal, which contains cerebrospinal fluid. The spinal cord is also covered by meninges and enclosed by the neural arches. Together, the brain and spinal cord make up the central nervous system.
