Innervation is the communication of body structures with the central nervous system. Every part of our body is equipped with sensitive nerve endings. They perceive information about ongoing processes and the state of the organ and transmit it through centripetal fibers to the brain. The information received is processed - response signals are sent along the centrifugal nerves. So the central nervous system responds to the needs of the body and regulates its work.

The main link in the system of transmission of nerve impulses is the spinal cord with roots. And it is hidden in the spine. If there is an infringement of the roots or the spinal cord itself, then the conductive connection is broken. As a result, pain appears in various organs, the functionality of individual structures worsens, and even complete immobilization occurs below the affected area. According to the innervation of the spine, a number of functional deviations can be diagnosed.

Scheme of innervation of the spine

Nerve impulses are transmitted back and forth. Depending on the direction of transmission, the following types of innervation are distinguished:

• afferent (centripetal) - transmission of signals from organs and tissues to the central nervous system;
• efferent (centrifugal) - the transmission of signals from the central nervous system to the structures of the body.

Behind each vertebra are spinal nerves. They consist of nerve fibers of the anterior and posterior roots that emerge from the spinal cord. A person has 31 pairs of them. Therefore, the spinal cord includes 31 pairs of segments:

• eight cervical;
• twelve chest;
• five lumbar;
• as many sacral;
• one coccygeal.

What organs and systems do they innervate?

• Cervical vertebrae: pituitary gland and sympathetic nerves, visual and auditory systems, temporal regions; facial nerves and teeth, nasolabial areas, mouth, throat ligaments, cervical muscles, forearm, shoulder and elbow joints.
• Thoracic vertebrae: arms, trachea, bronchi, lungs, solar plexus and sternum; esophagus, gallbladder and ducts, liver, duodenum and spleen; kidneys, adrenal glands and ureters; large and small intestine; fallopian tubes, groin.
• Lumbar vertebrae: Abdomen, pelvic organs, upper thigh, knees, shins and feet (including fingers).
• Sacral vertebrae: gluteal muscles and femurs.
• Coccyx: anus and rectum.

Diagnosis of the spinal column

The incorrect position of the vertebrae leads to various disorders in the body. No wonder they say that the well-being of the whole body depends on the state of the spinal axis. Pinching in a particular area prevents the organs from fully functioning. Transmission of signals to the CNS occurs with a delay. The brain is not able to respond in a timely manner to the needs of the body. Hence the various failures.

Let's carry out diagnostics taking into account the innervation of the spine.

cervical

Thoracic

Problems in this section of the spinal column lead to functional disorders of the main internal organs. If the distance between the vertebrae is less than normal, then the function of the organ decreases. The intervertebral gap is more than normal - the function is overestimated.

• 1 and 2 vertebrae of the thoracic region - hands, little fingers go numb, elbows hurt, pneumonia.
• 3 and 4 - mastopathy, bronchitis, pneumonia.
• 5, 6, 7 - heart and chest hurts.
• 8 - problems with the pancreas, impaired insulin secretion, appetite, failure in carbohydrate metabolism.
• 9 - fat metabolism suffers.
• 10 - proteins are poorly broken down.
• 11 - pathology of the small intestine and kidneys.
• 12 - dysfunction of the large intestine.

Lumbar

This zone takes on the heaviest load. Accordingly, the lower back makes itself felt faster. The lumbar spine is practically devoid of additional support. There are no cartilaginous rings, as in the cervical region. The ribs do not help, as the thoracic region.

Nature has provided support for the lower back with strong abdominal muscles. What if they are stretched? The spine will have to hold the stomach on its own.

• With a decrease in the distance between the 1st and 2nd lumbar vertebrae, enuresis, painful periods, obstruction of the fallopian tubes, and cysts are observed. The sexual sphere weakens, miscarriages are frequent. This position of the vertebrae is fraught with infertility.
• When pinching 3 vertebrae, the knee joints hurt.
• 4th - back of the thigh.
• 5th - lateral femoral and gluteal muscles, lower leg, foot.

When the intervertebral discs wear out, a herniated disc forms. It presses on the nerve roots and provokes severe pain.

back muscles are numerous, as a result of which two groups are distinguished - superficial (two layers) and deep. Superficial muscles are attached to the shoulder girdle, shoulder and ribs, and skull. The deep muscles have retained a primitive structure, forming a strong muscle mass, united by the common name "rectifier of the body", which stretches from the head to the pelvis. Innervated by branches of the brachial plexus.

Name of muscles				attachment	Muscle function	blood supply	innervation
Superficial back muscles:
1st muscle layer:
1. Trapezius muscle (m. trapezius)	external occipital protuberance, superior nuchal line, spinous processes of all thoracic vertebrae			acromial process of clavicle, acromion, spine of scapula	the upper bundles - raise the shoulder blade, the lower ones - lower it, when fixing the shoulder girdle - they pull the head back, with a one-sided contraction - tilts the head in the appropriate direction, and the face turns in the opposite direction	occipital artery, intercostal arteries, transverse artery of the neck	accessory nerve
2. The latissimus dorsi muscle (m.latissimusdorsi)	spinous processes of 6 lower thoracic and all lumbar vertebrae, dorsal surface of the sacrum, iliac crest, ribs 9-12			crest of the lesser tubercle of the humerus	leads the shoulder to the body and pulls the upper limb back to the midline, rotating it inward, with a fixed limb, brings the body closer,	subscapular artery	subscapular nerve
2nd muscle layer:
1. The muscle that lifts the scapula (m. Levatorscapulae)	transverse processes of 4 upper cervical vertebrae			superior angle of the scapula	raises the scapula, especially its inner corner, with a strengthened scapula, tilts the neck backwards and its side	transverse artery of the neck intercostal arteries	dorsal nerve of the scapula dorsal nerve of the scapula
2. Rhomboid muscles:	spinous processes of 4-5 upper thoracic vertebrae;			medial edge of the scapula below the spine;
Large (m. rhomboideus major)	spinous processes of 2 lower cervical vertebrae			medial edge of the scapula above the spine	pull the scapula to the spinal column and top, press the scapula to the chest
Small (m. rhomboideus minor)
3. Serratus posterior superior muscle (m. serratus posterior superior)	spinous processes of 2 lower cervical and 2 upper thoracic vertebrae				raise the upper ribs, participating in the act of inspiration	transverse artery of the neck, intercostal arteries	intercostal nerves
4. Serratus posterior inferior (m. serratus posterior inferior)	spinous processes of 2 lower thoracic and 2 upper lumbar vertebrae				lower 9-12 ribs, participating in the act of exhalation	lumbar artery	dorsal branches of spinal nerves
Deep back muscles
1. The sacrospinous muscle or the muscle that straightens the spine. It has 3 parts:	lateral crest of the sacrum			transverse processes of 4-6 cervical vertebrae, angles of upper 5-7 and lower 8-9 ribs	with bilateral contraction, it is a powerful extensor of the spinal column, holds the body in an upright position, with one-sided contraction, it tilts the spinal column in the appropriate direction; upper bundles pull the head in their direction	dorsal branches of intercostal arteries and vertebral artery	dorsal branches of spinal nerves
Iliocostal muscle (m. iliocostalis)	dorsal surface of the sacrum, transverse processes of the lumbar and lower 6-7 thoracic vertebrae			angles of the 10 lower ribs, mastoid process, transverse processes of all thoracic vertebrae
The longest muscle of the back (m. longissimus) Rating 4.21

Sensitive innervation of the scalp: 1) the area of ​​the face above the incision of the eyes - the frontal and supraorbital nerves (from the 1st, ophthalmic, branch of the trigeminal nerve), the ear-temporal nerve (from the 3rd, mandibular, branch of the trigeminal nerve), temporo-zygomatic nerve (from the 2nd, maxillary, branch of the trigeminal nerve), a large ear nerve (from the cervical plexus);

2) the area of ​​the face between the incision of the eyes and the incision of the mouth - the infraorbital and zygomatic-facial nerves (from the 2nd, maxillary, branch of the trigeminal nerve);

3) the area of ​​the face below the incision of the mouth - the mental nerve (from the 3rd, mandibular, branch of the trigeminal nerve);

4) occipital region - large occipital nerve (posterior branch of the second cervical spinal nerve), small occipital nerve (from the cervical plexus).

Innervation of the muscles of the head: facial muscles - facial nerve (VII pair of cranial nerves); masticatory muscles - motor branches of the same name to the muscles (from the 3rd, mandibular, branch of the trigeminal nerve).

Language. Sensitive innervation: the general sensitivity of the anterior two-thirds is provided by the lingual nerve (from the 3rd, mandibular, branch of the trigeminal nerve), the taste sensitivity of the anterior two-thirds of the tongue is provided by the tympanic string (branch of the facial nerve). Posterior third of the tongue: general sensitivity - glossopharyngeal nerve (IX pair of cranial nerves) and vagus nerve (X pair of cranial nerves); taste sensitivity of the posterior third of the tongue - glossopharyngeal nerve.

The innervation of the muscles of the tongue is the hypoglossal nerve (XII pair of cranial nerves).

The mucous membrane of the cheeks. Sensitive innervation - buccal nerve (from the 3rd, mandibular, branch of the trigeminal nerve).

Sky. Sensitive innervation - anterior, middle and posterior palatine nerves (from the 2nd, maxillary, branch of the trigeminal nerve).

Innervation of the muscles: muscle that pulls the palatine curtain - 3rd, mandibular, branch of the trigeminal nerve; uvula muscle, palatine curtain lifter, lingo-palatine and pharyngo-palatine muscles - vagus nerve (X pair of cranial nerves).

Salivary glands. The parotid salivary gland receives sensory fibers from the ear-temporal nerve (3rd, mandibular, branch of the trigeminal nerve); parasympathetic fibers - from the glossopharyngeal nerve (IX pair of cranial nerves); sympathetic fibers - from the upper cervical node of the border sympathetic trunk (they reach the gland through the arteries that supply it with blood).

The submandibular and sublingual salivary glands receive sensory fibers from the 3rd branch of the trigeminal nerve, parasympathetic fibers from the tympanic string from the VII pair of cranial nerves, sympathetic fibers from the upper node of the cervical marginal sympathetic trunk (they reach the glands through the arteries that supply them with blood) .

Pharynx. Sensitive innervation - glossopharyngeal nerve (IX pair of cranial nerves) and vagus nerve (X pair of cranial nerves). Muscle innervation: vagus nerve (X pair of cranial nerves).

Contents of the eye socket. Sensitive innervation of all components of the orbit is carried out by the nerves of the 1st and 2nd branches of the trigeminal nerve.

Innervation of the external muscles of the eyeball: external rectus muscle of the eye - abducens nerve (VI pair of cranial nerves); superior oblique muscle of the eye - trochlear nerve (IV pair of cranial nerves); the remaining muscles are the oculomotor nerve (III pair of cranial nerves).

The internal muscles of the eyeball: the muscle that narrows the pupil, the ciliary muscle receives parasympathetic fibers from the nucleus of Yakubovich (the preganglionic fibers go as part of the oculomotor nerve to the ciliary node, from which the postganglionic fibers reach the named muscles). The muscle that dilates the pupil is innervated by sympathetic fibers coming from the cavernous plexus.

Lacrimal gland. Sensitive fibers come from the 1st branch of the trigeminal nerve; parasympathetic fibers originate from the superior salivary nucleus (preganglionic fibers as part of the facial nerve, more precisely, the intermediate nerve, reach the pterygopalatine ganglion, from which the postganglionic fibers penetrate the orbit through the infraorbital fissure and innervate the lacrimal gland). Sympathetic fibers come to the gland from the cavernous plexus.

nasal cavity. The general sensitive innervation of the mucous membrane of the nasal cavity is carried out by the 1st and 2nd branches of the trigeminal nerve; olfactory sensitivity is due to olfactory filaments (I pair of cranial nerves).

outer and middle ear. Sensitive innervation of the shell - a large ear nerve (cervical plexus), anterior ear nerves (3rd, mandibular, branch of the trigeminal nerve).

External auditory meatus and tympanic membrane. The sensitive innervation of the external auditory canal and the tympanic membrane is the ear-temporal nerve (from the 3rd, mandibular, branch of the trigeminal nerve).

Tympanic cavity and auditory tube. The sensitive innervation of the mucous membrane of the middle ear is the auricular-temporal nerve (from the 3rd mandibular, branch of the trigeminal nerve).

Middle ear muscles: stirrup muscle - facial nerve; muscle that stretches the eardrum, 3rd, mandibular, branch of the trigeminal nerve.

Neck

Neck skin: lesser occipital, greater auricular, transverse neck and supraclavicular nerves (branches of the cervical plexus).

Neck muscles. Superficial muscles of the neck. The subcutaneous muscle of the neck is the cervical branch of the facial nerve; sternocleidomastoid muscle - accessory nerve (XI pair of cranial nerves); neck muscles located below the hyoid bone - cervical loop; neck muscles located above the hyoid bone: anterior belly of the digastric muscle - 3rd, mandibular, branch of the trigeminal nerve, posterior belly - facial nerve, stylohyoid muscle - facial nerve, stylohyoid muscle - hyoid nerve: stylopharyngeal muscle - glossopharyngeal nerve; sublingual-maxillary muscle - 3rd, mandibular, branch of the trigeminal nerve; geniolingual, geniohyoid and hyoid-lingual muscles - hypoglossal nerve (XII pair of cranial nerves).

Deep neck muscles- muscular branches of the cervical and brachial plexuses.

Thyroid and parathyroid glands. These glands are innervated by the fibers of the vagus nerve and the border sympathetic trunk, sensory fibers are obtained from the cervical plexus.

Larynx. Innervation of the mucous membrane of the larynx: above the glottis - the superior laryngeal nerve (a branch of the vagus nerve), below the glottis - the inferior laryngeal nerve (a branch of the laryngeal age nerve).

Innervation of the muscles of the larynx: cricoid-thyroid muscle - superior laryngeal nerve; the remaining muscles of the larynx are the inferior laryngeal nerve (branches of the vagus nerve).

Breast

The intrinsic muscles of the chest are innervated by the intercostal nerves, the skin of the chest region receives sensory fibers mainly from the intercostal nerves, partly due to the branches of the cervical (subclavian region) and brachial (in the lateral sections) plexuses.

A heart. Autonomic innervation: sympathetic - from the cervical border trunk (from its three nodes the upper, middle and lower cardiac nerves, respectively, depart to the heart), parasympathetic - sa due to the vagus nerve (the upper cardiac branch departs from the upper yurt nerve, the lower cardiac branches - from laryngeal recurrent nerve). Afferent fibers to the heart come as part of the same cardiac branches from the vagus nerve and from the cervical and upper thoracic spinal nerves through the border sympathetic trunk.

Thymus. Innervation is autonomic, carried out by branches of the vagus nerve and the border sympathetic trunk, sensory fibers come from the cervical spinal nodes along the branches of the border sympathetic trunk.

Esophagus. Sensitive innervation - vagus and glossopharyngeal nerves and afferent fibers of the thoracic spinal nerves. The striated muscles of its upper section receive motor somatic fibers from the vagus nerve, the smooth muscles of the lower section have autonomic innervation: from the border sympathetic trunk and the vagus nerve.

Lungs. Autonomic innervation: due to the branches of the border sympathetic trunk and the vagus nerve.

Stomach

The skin of the anterior and lateral surface of the abdomen receives innervation from the 6-12th intercostal nerves, the ilio-hypogastric and ilio-inguinal nerves. The lateral and anterior abdominal muscles are innervated by the same nerves as the skin. The posterior abdominal muscles and the iliopsoas receive motor fibers from the lumbar plexus.

The organs of the abdominal cavity have autonomic innervation: parasympathetic, sympathetic and afferent. All these fibers reach the organs through the plexus on the vessels that supply them with blood. The parasympathetic fibers of the abdominal organs are obtained from two sources: the vagus and pelvic nerves. The vagus nerves, having entered the abdominal cavity, form the anterior and posterior chords on the stomach and then enter the solar plexus, and from there through the vessels to the liver, pancreas, kidneys, adrenal glands, stomach and small intestine. Parasympathetic fibers come to the large intestine and pelvic organs from the sacral spinal cord, through the pelvic nerves and the hypogastric plexus.

Sympathetic fibers to the organs of the abdominal cavity and pelvis go as part of the visceral branches of the borderline sympathetic trunk (the largest of them are the celiac nerves), solar, lower mesenteric and hypogastric plexuses.

Afferent fibers (processes of cells of the spinal nodes) reach the organs in the same ways as sympathetic fibers (through the border sympathetic trunk and its branches).

Back

The skin of this area is innervated by the posterior branches of all spinal nerves, excluding the 2nd cervical. Innervation of the superficial muscles: latissimus dorsi - thoracic-spinal nerve (from the brachial plexus); trapezius muscle - accessory nerve (XI pair): levator scapula and rhomboid muscle - spinal nerve of the scapula (from the brachial plexus); the superior and inferior serratus muscles are the intercostal nerves. Innervation of deep muscles: muscles of the occipital-vertebral group - along the occipital nerve (posterior branch of the 1st cervical spinal nerve); rib lifters - intercostal nerves; the rest of the deep muscles of the back are the posterior branches of the cervical, thoracic and lumbar spinal nerves.

Upper limb

Shoulder area. Skin innervation: Above the deltoid muscle, the skin is innervated by the supraclavicular nerves (from the cervical plexus) and the deltoid nerves (from the brachial plexus).

Innervation of the muscles: deltoid and small round muscles - deltoid nerve (from the posterior bundle of the brachial plexus), supraspinatus and infraspinatus muscles - suprascapular nerve (from the supraclavicular part of the brachial plexus), subscapularis muscle - subscapular nerves (from the supraclavicular part of the brachial plexus), large and small pectoral muscles - anterior pectoral nerves (from the supraclavicular part of the brachial plexus), latissimus dorsi and teres major - thoracic-spinal nerve (from the supraclavicular part of the brachial plexus), serratus anterior - long pectoral nerve (from the supraclavicular part of the brachial plexus), subclavian muscle - subclavian nerve (from the supraclavicular part of the brachial plexus).

Shoulder. Skin innervation: medial surface - medial cutaneous nerve of the shoulder (from the medial bundle of the brachial plexus), lateral surface - lateral cutaneous nerve of the shoulder (branch of the axillary nerve), posterior surface of the shoulder - posterior cutaneous nerve of the shoulder (branch of the radial nerve).

Muscle innervation: anterior group - musculocutaneous nerve (from the lateral bundle of the brachial plexus); posterior group - radial nerve (from the posterior bundle of the brachial plexus).

Forearm. Innervation of the skin: anterior surface - the medial cutaneous nerve of the forearm (from the medial bundle of the brachial plexus) and the lateral cutaneous nerve of the forearm (a branch of the musculocutaneous nerve); posterior surface - posterior cutaneous nerve of the forearm (branch of the radial nerve).

Muscle innervation: posterior group - deep branch of the radial nerve; anterior group: carpo-ulnar flexor and medial half of the deep flexor of the fingers - ulnar nerve; the remaining muscles of the anterior group of the forearm are the median nerve.

Brush. Innervation of the skin: the skin of the palm in the area of ​​3 1/2 fingers (starting with the thumb) - branches of the median nerve; the region of the remaining 1 1/2 fingers is the branches of the ulnar nerve; back of the hand: skin of 2 1/2 fingers (starting with the thumb) - radial nerve; the skin of the remaining 2 1/2 fingers is the ulnar nerve. Branches of the median nerve extend to the rear of the middle and nail phalanges of the II and III fingers.

Muscle innervation. The short abductor thumb muscle, which opposes the thumb, the superficial head of the short flexor thumb, the first and second worm-like muscles are innervated by branches of the median nerve; and the rest of the muscles of the hand - a deep branch of the ulnar nerve.

lower limb

Taz. Cutaneous innervation of the gluteal region. The upper floor of the skin of the gluteal region is innervated by the superior cutaneous gluteal nerves (posterior branches of the three upper lumbar spinal nerves), the middle floor by the middle cutaneous gluteal nerves (posterior branches of the three upper sacral spinal nerves) and the lower floor by the inferior cutaneous gluteal nerves ( branches of the posterior femoral cutaneous nerve).

Innervation of the pelvic muscles: gluteus maximus - inferior gluteal nerve (sacral plexus); tensor fascia lata, gluteus medius and minimus - superior gluteal nerve (sacral plexus); internal, obturator, twin and square muscles - muscular branches of the sacral plexus; external obturator muscle - obturator nerve (lumbar plexus).

Innervation of the skin of the thigh: anterior surface - the anterior cutaneous nerves of the thigh (femoral nerve); lateral surface - lateral cutaneous nerve of the thigh (lumbar plexus); medial surface - obturator nerve (lumbar plexus) and genitofemoral nerve (lumbar plexus); posterior surface - posterior cutaneous nerve of the thigh (sacral plexus).

Innervation of the thigh muscles: anterior group - femoral nerve (lumbar plexus); the medial group is the obturator nerve (lumbar plexus) (the large adductor muscle additionally receives motor fibers from the sciatic nerve); posterior group - sciatic nerve (sacral plexus).

Shin. Innervation of the skin: the posterior surface of the skin of the lower leg - lateral (branch of the common peroneal nerve) and medial (branch of the tibial) cutaneous nerves of the lower leg; lateral surface - lateral cutaneous nerve of the leg; the medial surface is the saphenous nerve (a branch of the femoral nerve).

Muscle innervation: anterior group - deep peroneal nerve (a branch of the common peroneal nerve); lateral group - superficial peroneal nerve (a branch of the common peroneal nerve); the posterior group is the tibial nerve (a branch of the sciatic nerve).

Foot. Skin innervation: most of the skin on the rear of the foot is a branch of the superficial peroneal nerve; area of ​​the 1st interdigital space - deep peroneal nerve; lateral edge of the foot - cutaneous nerve of the leg; the medial edge of the foot is the saphenous nerve.

On the sole, the skin in the area of ​​3 1/2 fingers (starting from the thumb) is innervated by the medial plantar nerve (a branch of the tibial nerve), the rest of the skin of the sole (the area of ​​the last 1 1/2 fingers) is innervated by the lateral plantar nerve (a branch of the tibial nerve).

Innervation of the muscles: the muscles of the rear of the foot - the deep peroneal nerve, the muscles of the sole - the medial and lateral plantar nerves.