Sacral plexus

{{Short description|Nerve plexus}}

{{Infobox nerve

| Name = Sacral plexus

| Latin = plexus sacralis

| Image = Gray828.png

| Caption = Plan of sacral and pudendal plexuses.

| Image2 = Relations_of_the_sacral_plexus.png

| Caption2 = Relations of the sacral plexus. Dissection of side wall of pelvis showing sacral and pudendal plexuses.

| Innervates =

| BranchFrom = L4-L5, S1-S4

| BranchTo =

}}

In human anatomy, the sacral plexus is a nerve plexus which provides motor and sensory nerves for the posterior thigh, most of the lower leg and foot, and part of the pelvis. It is part of the lumbosacral plexus and emerges from the lumbar vertebrae and sacral vertebrae (L4-S4).Thieme Atlas of Anatomy (2006), pp 470-471 A sacral plexopathy is a disorder affecting the nerves of the sacral plexus, usually caused by trauma, nerve compression, vascular disease, or infection. Symptoms may include pain, loss of motor control, and sensory deficits.

Structure

The sacral plexus is formed by:

The nerves forming the sacral plexus converge toward the lower part of the greater sciatic foramen, and unite to form a flattened band, from the anterior and posterior surfaces of which several branches arise.

The band itself is continued as the sciatic nerve, which splits on the back of the thigh into the tibial nerve and common fibular nerve; these two nerves sometimes arise separately from the plexus, and in all cases their independence can be shown by dissection. Often, the sacral plexus and the lumbar plexus are considered to be one large nerve plexus, the lumbosacral plexus. The lumbosacral trunk connects the two plexuses.

=Relations=

The sacral plexus lies on the back of the pelvis in front of the piriformis muscle and the pelvic fascia. In front of it are the internal iliac artery, internal iliac vein, the ureter, and the sigmoid colon. The superior gluteal artery and vein run between the lumbosacral trunk and the first sacral nerve, and the inferior gluteal artery and vein between the second and third sacral nerves.

Nerves formed

All the nerves entering the plexus, with the exception of the third sacral, split into ventral and dorsal divisions, and the nerves arising from these are as follows of the table below:

File:Sacral plexus.JPG

class="wikitable" align="center"

|+ Nerves of the sacral plexusThieme Atlas of Anatomy (2006), pp 476, 478, 482

NerveSegmentInnervated musclesCutaneous branches
Superior gluteal

| L4-S1

| Gluteus medius
Gluteus minimus
Tensor fasciae latae

|

Inferior gluteal

| L5-S2

| Gluteus maximus

|

Posterior cutaneous femoral

| S1-S3

|

|

Perforating cutaneous

| S2-S3

|

|

colspan=4 | Direct branches from plexus
* Piriformis

| S1-2

| Piriformis

|

* Obturator internus

| L5, S1-2

| Obturator internus and Superior gemellus

|

* Quadratus femoris

| L4-5, S1

| Quadratus femoris and Inferior gemellus

|

colspan=4 | Sciatic
Sciatic

| L4-S3

| Semitendinosus (Tib)
Semimembranosus (Tib)
Biceps femoris

  • Long head (Tib)
  • Short head (Fib)

Adductor magnus (medial part, Tib)

|

Common fibular

| L4-S2

|

| Lateral sural cutaneous
Communicating fibular

* Superficial fibular

|

| Fibularis longus
Fibularis brevis

| Medial dorsal cutaneous
Intermediate dorsal cutaneous

* Deep fibular

|

| Tibialis anterior
Extensor digitorum longus
Extensor digitorum brevis
Extensor hallucis longus
Extensor hallucis brevis
Fibularis tertius

| Lateral cutaneous nerve of big toe
Intermediate dorsal cutaneous

Tibial nerve

| L4-S3

| Triceps surae(Gastrocnemius, Soleus)
Popliteus
Plantaris
Tibialis posterior
Flexor digitorum longus
Flexor hallucis longus

| Medial sural cutaneous
Medial calcaneal
Lateral dorsal cutaneous

* Medial plantar

|

| Abductor hallucis
Flexor digitorum brevis
Flexor hallucis brevis (medial head)
Lumbrical (first and second)

| Proper digital plantar

* Lateral plantar

|

| Flexor hallucis brevis (lateral head)
Quadratus plantae
Abductor digiti minimi
Flexor digiti minimi
Lumbrical (third and fourth)
Plantar interossei (first to third)
Dorsal interossei (first to fifth)
Adductor hallucis

| Proper plantar digital

colspan=4 | Pudendal and coccygeal
Pudendal
(Pudendal plexus)

| S2-S4

| Muscles of the pelvic floor:
Levator ani
Superficial transverse perineal
Deep transverse perineal
Bulbospongiosus
Ischiocavernosus
Sphincter anus externus
Urethral sphincter

| Inferior rectal
Perineal

Coccygeal
(Coccygeal plexus)

| S5-Co1

| Coccygeus

| Anococcygeal
Dorsal branches

Additional images

File:Gray838.png|The right sympathetic chain and its connections with the thoracic, abdominal, and pelvic plexuses.

File:Sacral plexus schematic.svg|A schematic depiction.

File:Sacral plexus.gif| Diagram of the sacral plexus

See also

Notes

{{Reflist}}

References

{{one source|date=January 2009}}

{{Gray's}}

  • {{cite book

| title = Thieme Atlas of Anatomy: General Anatomy and Musculoskeletal System

| publisher = Thieme | year = 2006 | isbn = 1-58890-419-9

}}