🥇 PLEXO CERVICAL, Anatomía (Superficial y Profundo). Fácil, Rápido y Sencillo
Summary
TLDREn este video, Juan José Sánchez nos guía a través de la anatomía del cuello, centrando la discusión en la innvación cervical. Se detalla la formación del plexo cervical, compuesto por las ramas anteriores de los nervios cervicales desde C1 hasta C4, y se divide en el plexo cervical superficial y profundo. El primero se encarga de la innvación cutánea del cuello, formado por nervios como el nervio occipital menor, el nervio auricular mayor, el nervio cervical transverso y el nervio supraclavicular. Por otro lado, el plexo cervical profundo es motor y proporciona innvación a los músculos del región anterolateral del cuello, incluyendo el músculo esternocleidomastoideo, trapézio y levador de la escápula. Además, se menciona la formación y función del nervio frénico, que innvación al diafragma y tiene una relación anatómica importante con el músculo escaleno anterior. Finalmente, se destaca la innvación de los músculos prevertebrales y los músculos infrahioideos, excluyendo el músculo tirohioideo, que es innervado directamente por las ramas anteriores de C1 y C2.
Takeaways
- 📚 El plexo cervical es una red de nervios formada por las ramas anteriores de los primeros cuatro nervios cervicales (C1 a C4).
- 🌐 El plexo cervical se divide en dos partes: el plexo cervical superficial y el plexo cervical profundo.
- 🔍 El plexo cervical superficial es responsable de la innervación cutánea del cuello, incluyendo la sensibilidad a la dolor, calor y frío.
- 💡 Los cuatro nervios que componen el plexo cervical superficial son el nervio occipital menor, el nervio auricular mayor, el nervio transverso cervical y el nervio supraclavicular.
- 🏋️ El plexo cervical profundo tiene una función motora, innervando los músculos del región anterolateral del cuello, incluyendo el músculo esternocleidomastoideo y el trapezio.
- 🔑 El plexo cervical profundo también da lugar a dos estructuras importantes: la bobina cervical y el nervio frénico.
- 🤔 La bobina cervical, formada por las uniones de C1 y C2 en la raíz superior y C2 y C3 en la raíz inferior, innerva los músculos infrahioideos, excepto el músculo tirohioideo.
- 🫁 El nervio frénico, compuesto por las ramas anteriores de C3, C4 y C5, tiene su principal función en la innervación del diafragma, aunque también proporciona sensibilidad a las serosas del tórax y abdomen.
- ⚙️ Además de la bobina cervical y el nervio frénico, el plexo cervical profundo emite ramas musculares específicas para otros músculos del cuello.
- 📌 Es importante destacar que la innervación del cuello no proviene de todas las ramas de los nervios C1 a C4, sino que puede ser una combinación de algunas de ellas.
- 🧲 La innervación cutánea del cuello por el plexo cervical superficial cubre áreas específicas, mientras que el plexo cervical profundo tiene una función motora y sensorial en otros tejidos.
Q & A
¿Qué es el plexo cervical y qué nervios forma?
-El plexo cervical es una red de nervios formada por la unión de las ramas anteriores de los primeros cuatro nervios cervicales, desde C1 hasta C4.
¿Cómo se divide el plexo cervical y cuál es la diferencia principal entre las dos divisiones?
-El plexo cervical se divide en un plexo superficial y un plexo profundo. La principal diferencia es que el plexo superficial es claramente sensible, proporcionando innervación cutánea al cuello, mientras que el plexo profundo es motor, proporcionando innervación a los músculos del cuello.
¿Cuáles son los cuatro nervios que componen el plexo cervical superficial?
-Los cuatro nervios que componen el plexo cervical superficial son el nervio occipital menor, el nervio auricular mayor, el nervio transverso cervical y el nervio supraclavicular.
¿Qué nervios componen el plexo cervical profundo y cuál es su principal función?
-El plexo cervical profundo está compuesto por dos grandes estructuras: la boucle cervical y el nervio frénico. Su principal función es proporcionar innervación motora a los músculos del cuello.
¿Qué nervio está formado por las ramas anteriores de los nervios C3, C4 y C5 y cuál es su función principal?
-El nervio frénico está formado por las ramas anteriores de los nervios C3, C4 y C5, y su función principal es innervar el diafragma.
¿Cuál es la relación anatómica del nervio frénico con el músculo anterior escaleno?
-El nervio frénico siempre está frente al músculo anterior escaleno mientras desciende.
¿Cómo se relaciona el nervio frénico con la pleura y el pericardio?
-El nervio frénico sensiblemente innerva la serosa del tórax y el abdomen, lo que incluye la pleura y el pericardio.
¿Qué músculos del cuello son innervados por el plexo cervical profundo a excepción de la boucle cervical y el nervio frénico?
-El plexo cervical profundo también proporciona ramas musculares a los músculos esternocleidomastoideo, trapezius, escaleno y los cuatro músculos prevertebrales.
¿Cómo se llama la estructura que forma la boucle cervical y qué músculos innerva?
-La boucle cervical se forma a partir de C1 a C3, incluyendo C2, y innerva todos los músculos infrahioideos excepto el músculo tirohioideo.
¿Cuál es la innervación del músculo tirohioideo y cómo se relaciona con el nervio hipogloso?
-El músculo tirohioideo es innervado por una rama directa de C1 y C2, no por el nervio hipogloso, a pesar de que antiguamente se pensó que lo era.
¿Qué nervios componen la primera rama del plexo cervical superficial y cuál es su función?
-La primera rama es el nervio occipital menor, que proporciona innervación sensorial al área lateral de la cabeza y a la parte craneal del oído.
¿Cómo se relacionan los nervios del plexo cervical superficial con el músculo esternocleidomastoideo y la vena yugular interna?
-Los nervios del plexo cervical superficial emergen detrás o profundamente a la vena yugular interna y detrás del músculo esternocleidomastoideo, volviéndose muy superficiales justo en el borde posterior del esternocleidomastoideo.
Outlines
📚 Anatomía del plexo cervical: Innervación del cuello
Juan José Sánchez comienza explicando la innervación del cuello, específicamente el plexo cervical, que es una red formada por las ramas anteriores de los primeros cuatro nervios cervicales (C1 a C4). Se divide en plexo cervical superficial y profundo. El plexo superficial es sensible y compuesto por cuatro nervios: nervio occipital menor, nervio auricular mayor, nervio transverso cervical y nervio supraclavicular. Estos nervios proporcionan la innervación cutánea del cuello, es decir, la sensibilidad a la piel para percibir dolor, calor, frío, etc. Por otro lado, el plexo profundo es motor y compuesto por dos grandes estructuras: la boucle cervical y el nervio frénico, además de ramas específicas para los músculos del cuello como el esternocleidomastoideo, trapézio, levador de la escápula y los músculos prevertebrales y escalenos.
💡 Descripción detallada de las ramas del plexo cervical superficial
Se profundiza en la descripción de las ramas del plexo cervical superficial, destacando que estas están ubicadas superficialmente al plato muscular del cuello y son sensibles, no motoras. El nervio occipital menor sirve al área lateral de la cabeza y la parte craneal del oído. El nervio auricular mayor, a veces llamado rama auricular posterior, innerva la piel sobre el proceso mastoides y la parte craneal y extracraneal del oído. El nervio transverso cervical, único en su orientación transversa, innerva la piel del cuello antero-lateral. Finalmente, el nervio supraclavicular se subdivide en tres ramas y sirve la piel que cubre el clavícula, el hombro y la parte superior de la región pectoral. Además, se menciona que no todos los nervios tienen contribuciones de los cuatro nervios cervicales, sino que pueden ser una combinación de uno o varios de ellos.
🏋️♂️ Innervación motora del plexo cervical profundo y del nervio frénico
Se describe la innervación motora del plexo cervical profundo, contrastando con la superficial. Destaca la boucle cervical, compuesta por las uniones de C1 y C2 (rama superior) y C2 y C3 (rama inferior), que innerva los músculos infrahioideos, excepto el músculo tirohioideo, que es innervado por una rama directa de C1 y C2. El nervio frénico, formado por las ramas anteriores de C3, C4 y, en menor medida, C5, tiene su principal relación anatómica estando siempre frente al músculo escaleno anterior. Cruza el tórax para innervarse en el diafragma, y también proporciona innervación sensitiva a la serosa del tórax y abdomen, incluyendo la pleura, el pericardio y la peritoneum. Además, se menciona la innervación de los músculos del cuello por parte de las ramas del plexo cervical, incluyendo el esternocleidomastoideo, el trapézio, los músculos escalenos y prevertebrales.
Mindmap
Keywords
💡plexus
💡innervation
💡cervical plexus
💡superficial cervical plexus
💡deep cervical plexus
💡lesser occipital nerve
💡greater auricular nerve
💡transverse cervical nerve
💡supraclavicular nerve
💡cervical loop
💡phrenic nerve
Highlights
Juan José Sánchez continúa discutiendo la anatomía del cuello, específicamente la innvación cervical.
El plexo cervical está formado por la unión de las ramas anteriores de los primeros cuatro nervios cervicales, desde C1 hasta C4.
Se diferencia el plexo cervical en plexo superficial y plexo profundo según su ubicación y funciones.
El plexo superficial cervical es responsable de la innvación cutánea del cuello.
El plexo profundo cervical tiene una función motora, innvando los músculos en la región anterolateral del cuello.
El plexo superficial se compone de cuatro nervios: nervio occipital menor, nervio auricular mayor, nervio transverso cervical y nervio supraclavicular.
El plexo profundo contiene estructuras grandes como la boucle cervical y el nervio frénico.
El nervio frénico está formado por las ramas anteriores de C3, C4 y C5, siendo C4 la mayor contribución.
El nervio frénico tiene una relación anatómica importante al estar siempre frente al músculo escáleno anterior.
El nervio frénico penetra el torax para innvatar el diafragma, aunque no innvata nada en el cuello.
El nervio frénico también innvata sensitivamente la serosa del tórax y del abdomen, incluyendo la pleura, pericardio y peritoneo.
La boucle cervical innvata todos los músculos infrahioideos, excepto el músculo tirohioideo.
El músculo tirohioideo es innvado directamente por una rama de C1 y C2, no por el nervio hipogloso.
Las ramas del plexo profundo también innvatan a los músculos esternocleidomastoideos, trapezios y escalenos.
Algunos textos sugieren que los músculos escalenos también pueden ser innervados por C5 y C6.
Todos los músculos prevertebrales son innvados por el plexo cervical completo, es decir, las ramas anteriores de C1 a C4.
Juan José Sánchez finaliza la discusión sobre la innvación cervical y alienta a sus oyentes a suscribirse y seguir su canal.
Transcripts
[Music] good good friends, nice to greet you again my name is Juan José Sánchez and today
we will continue talking about the anatomy of the neck, specifically today we will talk about
the innervation of the neck, that is, the nerves that are found in the neck;
This first delivery of the nerves of the neck corresponds to the class of the cervical plexus,
so the first thing we have to know as an outline is that the plexus is nothing more
than a union, a network, okay? Plexus in anatomy is a network and the nervous plexuses that we find
in the body are always formed by anterior branches of the spinal nerves or the
spinal nerves, okay? So specifically, the cervical plexus is formed by the union of
the anterior branches of the first four cervical nerves, that is, from C1 to C4,
when I say up to, it is including everything behind C4, that is, C1, C2 , C3 and C4,
it is different for me to say C1 and C4, which excluded C2 and C3, then you already know previous branches from C1
to C4. We are going to divide this cervical plexus into a superficial cervical plexus and a
deep cervical plexus, okay? Apart from the location, which differentiates the name by location
, there are also differences between both plexuses, since the superficial cervical plexus is going to be responsible
for providing cutaneous innervation to the neck, that is, a clearly sensitive innervation,
it will be made up of by four nerves that are the lesser occipital nerve, greater auricular nerve,
transverse cervical nerve and the supraclavicular nerve; While the
deep cervical plexus is the complete opposite of the superficial one, it is responsible for providing motor innervation, that is,
it innervates the muscles that we find in the anterolateral region of the neck.
There we will find two large structures that It is the cervical loop and the phrenic nerve, and in
that deep cervical plexus I get the specific muscle branches for the muscles of the
neck, which are going to be four specific muscle branches for the sternocleidomastoid,
trapezius, and the angle of the scapula, also called the levator. the scapula and the thyroid
and the branches for two muscle groups that are the three scalenes and the four prevertebral muscles
. Let's start then with the superficial cervical plexus, I remind you that in addition
to being superficial and that's why it received its name, it differs from the deep one
because the superficial cervical plexus is clearly sensitive, okay? They are cutaneous and anatomical branches;
When we talk about cutaneous ones, which are branches that go to the skin, he is not responsible for moving anything
in my neck, but rather he simply innervates my skin. Why? so that we can have
sensations of pain in the neck, of heat, of cold, of any sensation at the level of the neck,
that is why it is said that they are sensitive branches or the same as in anatomy, that is, afferent branches
that is that go to the central nervous system carrying information, then this branch
of the superficial cervical plexus all of these, remember here is the sternocleidomastoid and
behind it if I dissected it I find the internal jugular vein, then these nerves
emerge from behind or arise from behind the internal jugular vein and obviously behind
the sternocleidomastoid, by behind I mean deeply to them, to those two structures,
so they emerge in the neck and become very superficial just at the posterior edge of the
sternocleidomastoid but specifically in the middle part , see in the middle third
of the posterior edge of the sternocleidomastoid, then it will be made up of four branches:
the first branch and the most superior and posterior one, we will call it the lesser occipital nerve,
in many theories you will find this lesser occipital nerve with the name of
the mastoid branch, then it is the one that is going to be in charge of giving the sensory, that is,
cutaneous, innervation to what is the lateral region of the head and it is also said that to the cranial aspect of the
ear, that is , the part of the ear that faces my skull; Then we have the greater auricular nerve
, this greater auricular nerve found in many theories as the posterior auricular branch is
the same, you have to learn both names, this posterior auricular branch or auricular nerve
major innervates the skin of the mastoid process, although it is not the mastoid branch, it is the one
that theoretically innervates the mastoid process in the skin that covers the parotid gland and also
helps me in the sensory innervation of both sides of the ear, both cranial and exocranial;
Then we have the transverse cervical nerve, which is the only one that goes transversely,
that is why it receives that name and innervates the skin of the anterior and lateral aspects of the neck. Don't
forget the skin, see that even these three nerves are all four. They put superficial to the platysma of the
neck because superficial to the platysma is that we are going to find the skin and after the
transverse cervical we find the supraclavicular nerve which in turn is subdivided into three branches,
see an anterior branch, a middle branch and a posterior branch; So the supraclavicular is responsible
for innervating the skin that covers the clavicle, the shoulder and the uppermost part
of the pectoral region, okay? See here how they are arranged superficial to the sternocleidomastoid,
superficial to what is the trapezius, but they are posterior to what is the
external jugular vein. Remember that these nerves also pierce the platysma muscle to become even more
superficial, so this image is very Well, I love it too much, it is an image of Nétter where
he shows me both cervical plexuses, what you see there in deep red, that is the deep one, I
am not interested in you seeing it right now, I am interested in seeing the superficial branches that are Those
that are in blue, those are the cutaneous branches, so you see that there is something very important,
although I tell you that the cervical plexus is formed by the union of the anterior branches from
C1 to C4, it does not mean that all nerves have a contribution from the four nerves, no,
it can have a contribution only from C1 or from c1 and c2, that already makes it part of the cervical plexus
because C1 and C are part of the cervical plexus, that is why we are going to find that the three
first nerves of the lesser occipital, the greater auricular and the transverse cervical, notice
how it is a union of C2 with C3 and in that union of C2 with C3 is where the three branches come out,
here you can see the auricular, the lesser occipital sorry , here you can see the greater auricular and here
you can see the transverse cervical nerve, union of c2 and c3 while from the union of c3 and c4 I get the
supraclavicular nerve but that is called cervical plexus so why do you see here
cutaneously what you see Here shaded in black is the area of the neck that is innervated by the
superficial cervical plexus, the other parts of the face do not have these nerves, what matters to me
is explaining the innervation of the neck. Let's move on then to the cervical plexus,
deep, I remind you that it is purely motor unlike the superficial one that was sensitive,
the motor in anatomy is also called efferent innervation, so the sensitive
is deferent and the motor is deferent, so it will be made up of two large structures
and a group of branches that are muscular, we are going to start talking about those two large structures
first about the cervical loop, it is called loop because you see that they have the shape of a handle of a cup, the cervical loop
will be made up of for two roots: a superior root, okay? which is the union of c1 and c2,
see they join together and form the upper root which is also called the descending branch of the hypoglossus, I
am going to explain to you why even though it is a name that is incorrectly said, it is called that, while that
the lower root is the union of c3 and c2, both roots, the lower and upper, join together, you already
know that the upper is called the hypoglossal descending and the lower is called the
cervical descending. So what is happening? See that c1 and c2 join here, you can see and they form a branch
that joins the hypoglossal nerve, which is the twelfth cranial nerve, 12 and here you see it and then they separate
that upper root and it is the one that forms my cervical loop, So it is not the hypoglossus that
is going to form the upper root of the cervical loop, it is only c1 and c2 that joined the hypoglossus, that
is, together but not mixed, they joined and then detached, they separated, the
same fibers of c1 and c2 complete, okay? while the lower root is good only in the
union of c2 and c3. Well, that is why it is said that the cervical loop is formed from c1 to
c3, including c2, that cervical loop is going to innervate all the infrahyoid muscles,
except for one that is super important, except, so who is it going to supply? innervate? See that it innervates
the two bellies of the omohyoid muscle, it also innervates the sternocleidohyoid and the
sternohyoid, but not the thyrohyoid, who is going to innervate the thyrohyoid? See here a unit branch
c1 and c2 also joins the hypoglossus, here the upper root of the cervical loop comes out
and you will see that there is another group of branches that follows and then they separate and innervate the thyrohyoid
so that the thyrohyoid also innervated by the deep cervical plexus, but not by the
cervical loop but directly innervated by a branch of c1 and c2 directly branch of c1 and c2,
okay? So there are many books that say that the thyrohyoid is innervated by the hypoglossal nerve,
but that is wrong, what happens is that before, when electromyography studies were not available, the
great anatomists saw that the branch for the thyrohyoid detached from the hypoglossus. And
obviously they said at that time that it was innervated by the hypoglossus but today it is
known that it is not, it is the anterior branch of c1 and anterior branch of c2, ok? See here the cervical loop which
is a structure that is superficial to the neurovascular bundle of the neck, in fact it is
even outside the carotid sheath, what happens is that in this image this dissection of the carotid sheath,
there you can see its branches to the infrahyoid muscles and here in this lateral edition you
can also see the union of c2 and c3 forming the lower stripe and here above you can see the hypoglossus and
you can see how it gives them to the upper root, they join together and make the handle that goes then for the
thyrohyoid, for the sternocleidomastoid and for the sternothyroid and here you see the root that comes
out of the hypoglossus, which you already know is not the hypoglossus, which is what innervates the thyrohyoid
and then we are going to have what the phrenic nerve is. , phrenic in anatomy means diaphragm,
okay? then the phrenic nerve is formed by the anterior branches of c3, c4 and c5, it is said that
the greatest contribution is from c4, the nerve that contributes the most branches to the plexus, to the phrenic nerve and the least
contribution from c3, while c5 is accessory, In anatomy accessory means that sometimes it is there and
sometimes it is not there, some people only consist of c3 and c4 then and some people of c3,
c4 and c5, that is why it is said that the contribution of c5 is accessory; So once
this phrenic nerve emerges, its most important atomic relationship is that it is always in front of the
anterior scalenus. Once it descends, it is placed behind what is the subclavian vein.
It penetrates the thorax because its function is innervate the diaphragm, it does not innervate anything in the neck
but it is simply born in the neck, that is why it has to be given in the contents of the neck,
then it penetrates the thorax and has a few nerves of the neck that is mixed, why
mixed? Because he sensitively innervates the serosa of the thorax and abdomen. What are the
serosa? Well, you see that he gets between what is the parietal pleura and the parietal pericardium,
so he gets into three of those two structures and he sensitively innervates the pericardium and he
sensitively innervates the pleura; Then it comes, it reaches the diaphragm is that its end, it innervates the diaphragm
motorically because it is the one that does not move and after that the diaphragm minerva motorally perforates it and
sensitively minervates the serous membrane of the abdomen which is the peritoneum, made of wood so that
they are not damaged. I forgot mnemonics innervates me at 3 p. What are the 3 p? pleura, pericardium and peritoneum,
in addition to that the motor fibers go to the diaphragm, you know. Seeing here
again, the union of c5, c4 and c3 forms what is the phrenic nerve that pierces the thorax and this
greyish membrane that you see here makes up precisely the parietal pleura, always in front,
riding on what is the scalene muscle. above, then we already saw the
superficial cervical plexus with its branches, we saw the deep cervical plexus that I told you was formed by two
large structures that are the cervical loop and the phrenic nerve that I explained to you and in addition to
that it gives muscular branches that are the branches that go directly to the other muscles of the neck that
I do not name them as a summary, those muscles are going to be the anterior branch of c2 and c3 attached to the
eleventh cranial nerve, which is the accessory, they go to the sternocleidomastoid, c3 and c4
anterior branch to the angular trapezius of the scapula and the scalenus, some books They maintain that the
scalenes are also innervated by their c5 and c6 fibers; then all the prevertebral muscles
, which are four, are innervated by the entire cervical plexus, that is, the anterior branch from c1 to c4,
all the infrahyoid muscles, as I told you, by the cervical loop, which is from c1 to c3, except the thyroid,
which is innervated. through the direct anteriors of c1 and c2 and the phrenic nerve innervates the diaphragm
of the roots from c3 to c5, that is, they include c4, okay? So well friends, I hope
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