Epineurium | |
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Details | |
Identifiers | |
Latin | Epineurium |
TA98 | A14.2.00.016 |
TA2 | 6155 |
FMA | 12234 |
Anatomical terminology |
The epineurium is the outermost layer of dense irregular connective tissue surrounding a peripheral nerve. [1] [2] It usually surrounds multiple nerve fascicles as well as blood vessels which supply the nerve. Smaller branches of these blood vessels penetrate into the perineurium. [3] In addition to blood vessels which supply the nerve, lymphocytes and fibroblasts are also present and contribute to the production of collagen fibers that form the backbone of the epineurium. In addition to providing structural support, lymphocytes and fibroblasts also play a vital role in maintenance and repair of the surrounding tissues. [4]
When the spinal nerve leaves the vertebral canal via an intervertebral foramen, two layers of the spinal meninges, the arachnoid and the dura invaginate the nerve to form a dural sleeve of connective tissue, which is the epineurium. The outer portion of this sleeve comprises the external epineurium which permits longitudinal nerve excursion and absorption of longitudinal stress. The layer of the epineurium that extends within the nerve to define the fascicles is termed the internal epineurium. Together, these two layers form the epineurium, which varies in thickness along the course of a nerve. [5] The epineurium is usually most abundant around joints, as its function is to protect the nerves from stretching and subsequent injury. Epineurium is primarily made from collagen. [3]
A common surgical procedure to repair a torn nerve via the epineurium is termed an epineurial repair. [6]
Schwannomas often remain completely encapsulated by the epineurium as they grow. [7]
Epineurial barriers can be used to limit the formation of neuromas after neurotmesis. [8] The epineurium is an effective barrier against axon growth. [8]
Pronator quadratus is a square-shaped muscle on the distal forearm that acts to pronate the hand.
The flexor digitorum profundus is a muscle in the forearm of humans that flexes the fingers. It is considered an extrinsic hand muscle because it acts on the hand while its muscle belly is located in the forearm.
The axillary nerve or the circumflex nerve is a nerve of the human body, that originates from the brachial plexus at the level of the axilla (armpit) and carries nerve fibers from C5 and C6. The axillary nerve travels through the quadrangular space with the posterior circumflex humeral artery and vein to innervate the deltoid and teres minor.
The dorsal scapular nerve is a branch of the brachial plexus. It supplies rhomboid major muscle, rhomboid minor muscle, and levator scapulae muscle. It causes the scapula to be moved medially towards the vertebral column. Dorsal scapular nerve syndrome can cause a winged scapula, with pain and limited motion.
The long thoracic nerve innervates the serratus anterior muscle.
The cervical plexus is a plexus of the anterior rami of the first four cervical spinal nerves which arise from C1 to C4 cervical segment in the neck. They are located laterally to the transverse processes between prevertebral muscles from the medial side and vertebral from lateral side. There is anastomosis with accessory nerve, hypoglossal nerve and sympathetic trunk.
The sternothyroid muscle, or sternothyroideus, is an infrahyoid muscle in the neck. It acts to depress the hyoid bone. It is below the sternohyoid muscle. It is shorter and wider than the sternohyoid.
The medial pectoral nerve arises from the medial cord of the brachial plexus, and through it from the eighth cervical and first thoracic roots (C8/T1).
The thoracodorsal nerve is a nerve present in humans and other animals, also known as the middle subscapular nerve or the long subscapular nerve. It supplies the latissimus dorsi muscle.
The posterior cutaneous nerve of the thigh is a sensory nerve in the thigh. It supplies the skin of the posterior surface of the thigh, leg, buttock, and also the perineum.
The superior gluteal nerve is a nerve that originates in the pelvis. It supplies the gluteus medius muscle, the gluteus minimus muscle, the tensor fasciae latae muscle, and the piriformis muscle.
The iliohypogastric nerve is a nerve that originates from the lumbar plexus that supplies sensation to skin over the lateral gluteal and hypogastric regions and motor to the internal oblique muscles and transverse abdominal muscles.
The anococcygeal nerve is a nerve in the pelvis which provides sensory innervation to the skin over the coccyx.
The lower subscapular nerve, also known as the inferior subscapular nerve, is the third branch of the posterior cord of the brachial plexus. It innervates the inferior portion of the subscapularis muscle and the teres major muscle.
The iliac fossa is a large, smooth, concave surface on the internal surface of the ilium.
The bicipital aponeurosis is a broad aponeurosis of the biceps brachii, which is located in the cubital fossa of the elbow. It separates superficial from deep structures in much of the fossa.
The lumbosacral trunk is nervous tissue that connects the lumbar plexus with the sacral plexus.
The perineurium is a protective sheath that surrounds a nerve fascicle. This bundles together axons targeting the same anatomical location. The perineurium is composed from fibroblasts.
The endoneurium is a layer of delicate connective tissue around the myelin sheath of each myelinated nerve fiber in the peripheral nervous system. Its component cells are called endoneurial cells. The endoneuria with their enclosed nerve fibers are bundled into groups called nerve fascicles, each fascicle within its own protective sheath called a perineurium. In sufficiently large nerves multiple fascicles, each with its blood supply and fatty tissue, may be bundled within yet another sheath, the epineurium.
A nerve fascicle, or fasciculus is a bundle of funiculi. A funiculus is a bundle of axons.