関: lumbar plexus、lumbosacral plexus

WordNet

of or relating to sacred rites; "sacral laws"
of or relating to or near the sacrum
a network of intersecting blood vessels or intersecting nerves or intersecting lymph vessels (同)rete

PrepTutorEJDIC

聖礼の
(神経・血管などの)網状組織

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/09/25 05:14:22」(JST)

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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, the entire foot, and part of the pelvis. It is part of the lumbosacral plexus and emerges from the lumbar vertebrae and sacral vertebrae (L4-S4).^[1] 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.

Composition

The sacral plexus is formed by:

the lumbosacral trunk
the anterior division of the first sacral nerve
portions of the anterior divisions of the second and third sacral nerves

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 between 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:

Sacral plexus

Nerves of the sacral plexus^[2]
Nerve	Segment	Innervated muscles	Cutaneous branches
Superior gluteal	L4-S1	Gluteus medius Gluteus minimus Tensor fasciae latae
Inferior gluteal	L5-S2	Gluteus maximus
Posterior cutaneous femoral	S1-S3		Posterior cutaneous femoral • Inferior cluneal nerves • Perineal branches
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
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		Peroneus longus Peroneus brevis	Medial dorsal cutaneous Intermediate dorsal cutaneous
• Deep fibular		Tibialis anterior Extensor digitorum longus Extensor digitorum brevis Extensor hallucis longus Extensor hallucis brevis Peroneus tertius	Lateral cutaneous nerve of big toe Intermediate dorsal cutaneous
Tibial nerve	L4-S3	Triceps surae Plantaris Popliteus Tibialis posterior Flexor digitorum longus Flexor hallucis longus	Medial sural cutaneous Lateral calcaneal 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
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 • Posterior scrotal/labial • Dorsal penis/clitoris
Coccygeal (Coccygeal plexus)	S5-Co1	Coccygeus	Anococcygeal Dorsal branches

Additional images

The right sympathetic chain and its connections with the thoracic, abdominal, and pelvic plexuses.
A schematic depiction.

Notes

^ Thieme Atlas of Anatomy (2006), pp 470-471
^ Thieme Atlas of Anatomy (2006), pp 476, 478, 482

References

Thieme Atlas of Anatomy: General Anatomy and Musculoskeletal System. Thieme. 2006. ISBN 1-58890-419-9.

This article incorporates text from a public domain edition of Gray's Anatomy.

External links

Wikimedia Commons has media related to Sacral plexus.

1490026564 at GPnotebook
Lumbosacral Plexus at the US National Library of Medicine Medical Subject Headings (MeSH)
Cross section at UV pembody/body15a
MedicalMnemonics.com: 3544 2382
Sacral+plexus at eMedicine Dictionary
Illustration at backpain-guide.com

UpToDate Contents

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1. 腰仙部神経叢症候群 lumbosacral plexus syndromes
2. 糖尿病性筋萎縮症および特発性腰仙骨骨神経叢神経障害 diabetic amyotrophy and idiopathic lumbosacral radiculoplexus neuropathy
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English Journal

Tumefactive appearance of peripheral nerve involvement in hematologic malignancies: a new imaging association.

Capek S1, Hébert-Blouin MN, Puffer RC, Martinoli C, Frick MA, Amrami KK, Spinner RJ.
Skeletal radiology.Skeletal Radiol.2015 Jul;44(7):1001-9. doi: 10.1007/s00256-015-2151-3. Epub 2015 Apr 29.
OBJECTIVE: In neurolymphomatosis (NL), the affected nerves are typically described to be enlarged and hyperintense on T2W MR sequences and to avidly enhance on gadolinium-enhanced T1WI. This pattern is highly non-specific. We recently became aware of a "tumefactive pattern" of NL, neuroleukemiosis (
PMID 25920386

Magnetic Resonance Neurography of the Lumbar Plexus at the L4-L5 Disc: Development of a Preoperative Surgical Planning Tool for Lateral Lumbar Transpsoas Interbody Fusion (LLIF).

Quinn JC1, Fruauff K, Lebl DR, Giambrone A, Cammisa FP, Gupta A, Chazen JL.
Spine.Spine (Phila Pa 1976).2015 Jun 15;40(12):942-947.
STUDY DESIGN: Observational study.OBJECTIVE: To demonstrate use of magnetic resonance (MR) neurography to visualize the course of the lumbar plexus at the L4-L5 disc space.SUMMARY OF BACKGROUND DATA: Risk of injury to the lumbar plexus during lateral transpsoas approach for lumbar interbody fusion (
PMID 25811264

Human Embryonic Stem Cell-Derived Progenitors Assist Functional Sensory Axon Regeneration after Dorsal Root Avulsion Injury.

Hoeber J1, Trolle C1, Konig N1, Du Z2, Gallo A3, Hermans E3, Aldskogius H1, Shortland P4, Zhang SC2, Deumens R3, Kozlova EN1.
Scientific reports.Sci Rep.2015 Jun 8;5:10666. doi: 10.1038/srep10666.
Dorsal root avulsion results in permanent impairment of sensory functions due to disconnection between the peripheral and central nervous system. Improved strategies are therefore needed to reconnect injured sensory neurons with their spinal cord targets in order to achieve functional repair after b
PMID 26053681

Japanese Journal

下肢痛を主訴とした仙骨神経叢近傍に発生した後腹膜膿瘍の1例

齊藤英知,千葉光穂,奥山幸一郎,鵜木栄樹,小西奈津雄,木戸忠人,千田秀一,黒田泰生
東北整形災害外科学会雑誌 = Tohoku journal of orthopaedics and traumatology 54(1), 12-16, 2010-06-01
NAID 10026381483

Enhancement of the intrinsic defecation reflex by mosapride, a 5-HT_4 agonist, in chronically lumbosacral denervated guinea pigs

KOJIMA Yu,FUJII Hisao,KATSUI Renta,NAKAJIMA Yoshiyuki,TAKAKI Miyako
日本平滑筋学会機関誌 42(5), 139-147, 2006-10
… These R-R and R-IAS reflexes are controlled via extrinsic sacral excitatory nerve pathway (pelvic nerves), lumbar inhibitory nerve pathways (colonic nerves) and by intrinsic cholinergic excitatory and nitrergic inhibitory nerve pathways. … In this model, the myenteric plexus remains undamaged and the distribution of myenteric and intramuscular interstitial cells of Cajal is unchanged. …
NAID 110004862723

Related Pictures

★リンクテーブル★

リンク元	「仙骨神経叢」
関連記事	「sacral」「plexus」「plexuses」

「仙骨神経叢」

Nerve: Sacral plexus
	Plan of sacral and pudendal plexuses.
	Relations of the sacral plexus. Dissection of side wall of pelvis showing sacral and pudendal plexuses.
Latin	plexus sacralis
Gray's	p.957
From	L4-L5, S1-S4
	Anatomical terms of neuroanatomy

　　[★]

英: sacral plexus
ラ: plexus sacralis
関: 腰神経叢、腰仙骨神経幹

図：N.481 M.205
仙骨の仙骨翼を下行してきた腰仙骨神経幹と仙骨神経の前枝が合流して仙骨神経叢を形成 (M.204)
仙骨神経叢は梨状筋の前面に密接する (M.204)
主として、下肢の後側(背側)に分布する神経を出す (KL.209)
外寛骨筋(梨状筋、内閉鎖筋、双子筋、大腿方形筋)を直接支配 (KL.209)

仙骨神経叢

KL.209, 488,489

神経	L4	L5	S1	S2	S3	S4
上殿神経	○	○	○
下殿神経		○	○	○
後大腿皮神経			○	○	○
坐骨神経	○	○	○	○	○
総腓骨神経	○	○	○
脛骨神経	○	○	○	○	○
陰部神経			○	○	○	○
骨盤内臓神経				○	○	○

M.204,205

神経	L4	L5	S1	S2	S3	S4
上殿神経	○	○	○
下殿神経		○	○	○
後大腿皮神経				○	○
坐骨神経	○	○	○	○	○
陰部神経				○	○	○
骨盤内臓神経				○	○	○
貫通皮枝				○	○
梨状筋へ			○	○
大腿四頭筋・下双子筋へ	○	○	○
内閉鎖筋・上双子筋へ		○	○	○
肛門挙筋・尾骨筋へ					○	○