第二节 Section     周围神经系统 The peripheral nervous system

一、脊神经 First, the spinal nerve

（一）概述 (A) Overview

1． 1. 数目 Number

脊神经共31对，其中颈神经8对，胸神经12对，腰神经5对，骶神经5对，尾神经1对。 A total of 31 pairs of spinal nerves, including cervical nerve 8 pairs, 12 pairs of thoracic nerve, lumbar nerve 5 pairs of sacral nerve five pairs, tail nerve 1 pair.

2． 2. 成份 Element

为混合神经，含有感觉和运动纤维。 Mixed nerve containing sensory and motor fibers.

3． 3. 组成 Composition

由前根和后根组成。 By ventral root and root components. 前根为运动，后根为感觉。 Former roots movement, root for the feeling.

4． 4. 分支 Branch

脊神经出椎间孔后分为前支和后支。 After a spinal nerve foramen into the anterior branch and posterior branch. 后支细小，节段性分布于项、背、腰、骶部肌和皮肤。 After a small branch, segmental distribution in terms, back, waist, sacral muscle and skin. 前支多组成神经丛，计有颈丛、臂丛、腰丛、骶丛。 Former branch multicomponent plexus, namely cervical plexus, brachial plexus, lumbar plexus, sacral plexus.

（二）神经分布 (B) innervation

1． 1. 颈丛 Cervical plexus

由第1~4颈神经前支组成。 By 1-4 before the first cervical nerve branch components. 位于胸锁乳突肌深面。 Located deep to sternocleidomastoid. 主要分支有： The main branches are:

(1)浅支：为数条细小分支，自胸锁乳突肌后缘中点穿出,呈放射状分布于颈侧部、头后外侧、耳廓及肩部皮肤。 (1) superficial branch: several pieces small branches, since the sternocleidomastoid edge midpoint piercing, radial distribution in lateral part, the outer rear head, ear and shoulder skin.

2． 2. 臂丛 Brachial

由第5~8颈神经前支、第1胸神经部分前支组成。 From 5 to 8 cervical nerve anterior branch, the former first thoracic nerve partially branched components. 穿斜角肌间隙,经锁骨后方入腋窝。 Wear scalene gap, the clavicle behind the armpit. 分为外侧束、内侧束和后束。 Into the lateral beam, the inside of the beam and rear beam. 主要分支有： The main branches are:

(1)肌皮神经 (1) musculocutaneous nerve

由臂丛外侧束发出，沿肱二头肌深面下行，肌支支配前臂前群肌，皮支布于前臂前外侧半皮肤。 Issued by the brachial plexus lateral beam, deep surface downstream along the biceps muscle group supporting former dominant forearm muscle, cutaneous branch of the cloth in half before the lateral forearm skin.

(2)正中神经 (2) the median nerve

由来自于外侧束和内侧束的两个根合成，伴肱动脉下行至肘窝，在前臂前群肌深浅两层之间下降，经腕管入手掌。 Synthesized by two roots from the inside to the outside of the beam and the beam, with the brachial artery down to the cubital fossa, a decrease in muscle depth between the two groups before the forearm, the carpal tunnel into the palm of your hand. 肌支主要支配前臂大部屈肌，皮支主要布于手掌桡侧三个半指及相应手掌皮肤。 Muscular branches mainly dominated most of the flexor forearm, cutaneous branches mainly distributed in three and a half refers to the radial side of the palm and palm skin accordingly. 损伤后表现为“猿手”。 After the injury manifested as "ape hand."

(3)尺神经 (3) of the ulnar nerve

由臂丛内侧束发出，初伴肱动脉下降，继而绕过尺神经沟至前臂伴尺动脉入手掌。 The inside of the beam emitted by the brachial plexus, brachial artery with early fall, and then bypass the ditch to the ulnar nerve ulnar artery forearm with the palm of your hand. 肌支主要支配前臂尺侧一个半屈肌（尺侧腕屈肌和指深肌尺侧半,简称 一尺半深 ）和大多数手肌。 The main branch of the ulnar forearm muscle dominate a half flexors (flexor carpi ulnar half and refers to the deep muscle, called a Chiban deep) and most of the hand muscles. 皮支主要分布手掌尺侧一个半指、手背尺侧二个半指及相应手掌、手背皮肤。 Cutaneous branch of the ulnar palm mainly refers to one and a half, two and a half back of the ulnar finger and the corresponding palms, back of the hand skin. 肱骨髁上骨折最易损伤尺神经，表现为“爪形手”。 Supracondylar fractures of the ulnar nerve injury prone, the performance of "claw hand."

(4)桡神经 (4) the radial nerve

由臂丛后束发出，沿桡神经沟下行至前臂及手背。 After the beam emitted by the brachial, radial nerve downstream along the ditch to the forearm and hand. 肌支主要支配臂和前臂后群肌及前群的肱桡肌。 Muscular branches dominate arm and forearm major muscle group and the former group of brachioradialis. 皮支主要布于手背桡侧两个半指及相应手背皮肤。 Mainly distributed in the dorsal cutaneous branch of the radial side of the two half-back means and corresponding skin. 损伤后表现为“垂腕”。 After the injury manifested as "vertical wrist."

(5)腋神经 (5) axillary nerve

由臂丛后束发出，绕肱骨外科颈行向后外，肌支支配三角肌，皮支布于肩部皮肤。 Beam emitted by the brachial plexus, around the surgical neck of the humerus back row, the deltoid muscle branch domination, cutaneous branches distributed in the shoulder skin. 损伤后表现为“方肩”。 After the injury manifested as "shoulder."

前臂肌神经支配 Forearm muscle innervation

桡神经，真神气 Radial nerve, true air     全部伸肌肱桡肌 All extensor brachioradialis

尺神经，好委屈 Ulnar nerve, good wronged     一尺半深屈无力 A deep flexor weakness Chiban

其它屈肌归正中 Reformed in other flexor     前臂肌肉各有依 Depending on each forearm muscles

手部皮神经分布 Cutaneous nerve distribution of the hand

手背中央一条线 The back of the central line      桡尺神经分两边 Ulnar nerve points on both sides

手掌桡侧属正中 Radial side of the palm genus middle     尺侧归尺一指半 Owned by a finger and a half feet ulnar

3． 3. 胸部神经 Thoracic nerve

除第1、第12胸神经部分前支参与臂丛、腰丛外，其余均呈节段性分布于胸、腹部肌肉和皮肤。 In addition to the former first, 12 thoracic nerve branch to participate in part of brachial, lumbar plexus, the rest showed segmental distribution in the chest, abdominal muscles and skin.

胸神经皮支分布对应关系为： Thoracic nerve cutaneous branch distribution for correspondence:

第2对 —— 胸骨角平面 The first two pairs - sternal angle plane

第4对 —— 乳头平面 The first four pairs - nipple plane

第6对 —— 剑突平面 Article 6 - xiphoid plane

第8对 —— 肋弓平面 The first eight pairs - Legong plane

第10对 —— 脐平面 The first 10 pairs - umbilical plane

胸神经 Thoracic nerve

二四六八十 Eighty two hundred forty-six     角头剑弓脐 Angle head sword bow navel

4． 4. 腰丛 Lumbar plexus

由第12对胸神经部分前支、第1~3腰神经全部前支和第4 腰神经部分前支组成。 By the first part of the 12 pairs of thoracic nerve anterior branch, the first 1-3 before lumbar nerve branches and entire front part of the fourth lumbar nerve branch components. 位于腰椎两侧，腰大肌深面。 Located on both sides of the lumbar spine, psoas deep surface. 主要分支有： The main branches are:

(1)髂腹下神经和髂腹股沟神经 (1) iliohypogastric nerve and ilioinguinal nerve

(2)股神经 (2) the femoral nerve

经腹股沟韧带深面，股动脉外侧进入股三角，肌支支配股肌前群，皮支支配股前部皮肤。 After lateral femoral artery deep to the inguinal ligament into the femoral triangle, before vastus muscle branch dominated group, femoral cutaneous branches dominate the skin. 股神经皮支有一长支，伴大隐静脉下降至足内缘，称隐神经。 Cutaneous branch of the femoral nerve with a long branch, with the great saphenous vein down to within a foot edge, called the saphenous nerve. 股神经损伤，股肌前群瘫痪，膝跳反射消失。 Femoral nerve damage, paralysis before the vastus group, the knee-jerk reflex.

(3)闭孔神经 (3) the obturator nerve

穿闭孔，伴闭孔动脉走行，支配股内侧肌，闭孔神经损伤，患腿不能伸到健腿上。 Wear closed-cell, with obturator artery course, dominate the medial femoral muscle, obturator nerve injury, suffering from leg extends not healthy legs.

5． 5. 骶丛 Sacral plexus

由腰骶干、骶神经、尾神经前支组成。 By lumbosacral trunk, sacral nerve, nerve branches before the end of the composition. 位于盆腔侧壁，梨状肌前方。 Located in the pelvic sidewall, piriformis front. 主要分支有： The main branches are:

(1)臀上神经和臀下神经 (1) the superior gluteal nerve and gluteal nerve

(2)阴部神经 (2) the pudendal nerve

(3)坐骨神经 (3) the sciatic nerve

坐骨神经是全身最大的神经。 Sciatic nerve is the largest body. 于梨状肌下缘出骨盆，行于臀大肌深面，经坐骨结节与大转子连线的中点，下行至腘窝，分为胫神经和腓总神经。 At the lower edge of the pelvis piriformis, the line in the deep surface of the gluteus maximus, the midpoint of the greater trochanter and the ischial tuberosity through wiring, down to the popliteal fossa, into the tibial nerve and the common peroneal nerve. 坐骨神经本干布于髋关节和股肌后群。 The sciatic nerve with a dry cloth in the hip and thigh muscles after the group.

1)胫神经 1) tibial nerve

沿腘窝中线，经小腿后群肌深浅两层间下降，于内踝后方至足底分为足底内侧神经和足底外侧神经。 Popliteal fossa along the midline, after the calf muscle depth between the two groups decreased in the medial malleolus to the rear foot into the medial plantar nerve and lateral plantar nerves.

胫神经肌支支配小腿后群肌、足底肌。 Tibial nerve calf muscle branches after dominating muscle group, plantar muscles. 皮支布于膝关节、小腿后面皮肤、足底皮肤。 Cutaneous branches distributed in the knee, back calf skin, foot skin. 胫神经损伤后表现为足“勾状外翻”。 Posterior tibial nerve injury manifested as foot "hook-shaped valgus."

2)腓总神经 2) peroneal nerve

沿腘窝上外侧缘向外，绕腓骨胫，分为腓浅、腓深神经。 Popliteal fossa along the outer edge of the outward around the tibia fibula, into superficial peroneal, deep peroneal nerve. 腓浅神经肌支支配小腿外侧群肌，腓深神经肌支支配小腿前群肌。 Superficial peroneal nerve muscular branches dominated lateral leg muscle groups, deep peroneal nerve muscular branches dominated front leg muscle groups. 腓总神经损伤后表现为足下垂伴内翻（即“马蹄内翻”）。 Peroneal nerve injury manifested as foot drop with varus (ie "clubfoot").

主要神经损伤临床表现 The main clinical manifestations of nerve damage

尺爪桡垂腕 Claw-foot radius vertical wrist     正中手似猿 The middle of the hand like an ape

腋损方形肩 Square shoulder axillary loss     股伤四头瘫 Shares injured four paralysis

胫损勾状足 Hook-shaped foot shin loss     腓总下内翻 Peroneal under varus

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