Pudental Nerve
- The pudental nerve is crucial because blocking it helps relax the penis in bulls, making it easier to examine without affecting movement.
Formation and Origin:
- Mainly formed by the central branch of the third sacral nerve.
- Receives some contribution from the second and fourth sacral nerves.
- Originates caudoventrally, medial to the sacro-sciatic ligament, and dorsal to the internal pudendal artery.
Location Identification:
- Located by rectal palpation along the sacro-sciatic ligament.
- Best judged by feeling the internal pudendal artery on the side of the pelvic cavity via rectum.
- The artery is positioned 1" below the nerve.
Procedure for Nerve Block:
- Insert the needle through the ischio-rectal fossa.
- Identify the lesser sciatic foramen by using the middle finger.
- Insert the needle into the cranio-dorsal quadrant of the foramen.
Highlight:
- Pudental nerve block facilitates penis examination in bulls by promoting relaxation.
- Rectal palpation is used to locate the nerve along the sacro-sciatic ligament.
- Precise identification is achieved by palpating the internal pudendal artery.
- The needle is inserted through the ischio-rectal fossa into the cranio-dorsal quadrant of the lesser sciatic foramen.
- The block is performed on both sides for effective results.
Question for Regional Anatomy of Paravertebral Nerves
Try yourself:
What is the main function of blocking the pudental nerve during a penis examination in bulls?Explanation
- Blocking the pudental nerve helps relax the penis in bulls during examination.
- This relaxation makes it easier to examine the penis without affecting movement.
- By blocking the pudental nerve, the bull experiences less tension and discomfort, allowing for a more thorough examination.
- This technique is commonly used in veterinary practice to ensure the well-being of the animal during the examination process.
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Fig: Head of ox showizg the course of the cornual nerve
Fig: Skuii of ox showing tho aite of injoction for blocking the cornual nerve
Fig: Head of ox showing anaesthesia of the cornual nerve
Seven and a Part of the Fifth Cranial Nerve
Description of Median Nerve:
- It's a significant nerve in the brachial plexus, originating from spinal roots in the neck and upper chest.
- Found in the forearm, beneath the Pronator teres muscle on the back-inner side.
- It runs down between certain forearm muscles and divides into smaller nerves in the palm.
Functions and Branches:
- Provides branches to various muscles in the forearm, including pronator teris, flexor carpi radialis, and others.
- Also supplies nerves to muscles in the hand.
Medical Procedures Involving the Nerve:
- Median nerve block helps diagnose lameness in animals.
- Neurectomy, which involves removing part of the nerve, is done in incurable limb conditions to ease pain and prolong the use of draft animals.
Injection Site for Nerve Block:
- Injection is given just below a bony bump near the elbow, at the groove between the back of the radius bone and a muscle called flexor carpi radialis.
Question for Regional Anatomy of Paravertebral Nerves
Try yourself:
What is the function of the median nerve in the forearm?Explanation
- The median nerve in the forearm is responsible for providing branches to various muscles.
- These muscles include the pronator teris, flexor carpi radialis, and others.
- The median nerve does not help diagnose lameness in animals or remove part of the nerve in incurable limb conditions.
- Its main function is to supply nerves to the muscles in the forearm, allowing for their proper functioning.
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Ulnar Nerve
- Arises along with the median nerve from the neck and upper chest area (brachial plexus).
- Travels down to the inner side of the forearm, passing below the bony bump on the inner elbow (medial epicondyle of humerus).
Course and Divisions:
- Runs between muscles (flexor carpi ulnaris and ulnaris lateralis) in the forearm.
- Divides into dorsal and palmar branches near the accessory carpal bone in the lower part of the limb.
Muscular Contributions:
- Provides branches to various muscles, including flexor carpi ulnaris, flexor digitorum superficialis and profundus, ulnaris lateralis, and the elbow joint.
Injection Site for Nerve Block:
- The injection point for ulnar nerve block is about 4 inches above the upper border of the accessory carpal bone.
- Located between two specific muscles in the forearm, a hand's breadth above the accessory carpal, under the forearm's fascia.
Desensitization as an Indicator:
- Successful nerve block is indicated by the numbness felt laterally above the carpus (wrist).
Diagnostic Value for Suspensory Ligament Issues:
- Blocking the ulnar nerve can be useful in diagnosing suspected lesions in the suspensory ligament of the limb.
Radial Nerve
- The thickest among the branches of the brachial plexus, a network of nerves in the neck and upper chest.
- Travels downward and backward across muscles like subscapularis and teres major, parallel to the brachial artery.
Path and Termination:
- Runs alongside the brachial artery, separated by another nerve called ulnar nerve.
- Disappears in front of the long head of the triceps muscle, then passes behind the humerus bone, ending in the musculospinal groove.
Course in the Musculospinal Groove:
- Lies on the brachialis muscle and later on the posterior border of this muscle.
- Reaches the front of the elbow joint, passing between the brachialis and extensor carpi radialis.
Branches of the Radial Nerve:
- First Set:
- Muscular branches supply triceps and tensor fasciae antibrachii muscles.
- Second Set:
- Muscular branches provide support to the lateral head of triceps, brachialis, and anconeus muscles.
- Cutaneous branch penetrates the lateral head of triceps, supplying skin on the outer side of the forearm below the elbow.
- Third Set:
- Branches go to muscles like extensor carpi radialis, medial, common, and lateral digital extensors, extensor carpi obliquas, and ulnaris lateralis.
Question for Regional Anatomy of Paravertebral Nerves
Try yourself:
What is the function of the ulnar nerve?Explanation
- The ulnar nerve arises along with the median nerve from the neck and upper chest area.
- It travels down to the inner side of the forearm, passing below the bony bump on the inner elbow.
- The ulnar nerve provides branches to various muscles, including those in the hand.
- These branches supply muscles such as the flexor carpi ulnaris, flexor digitorum superficialis and profundus, ulnaris lateralis, and the elbow joint.
- Therefore, the function of the ulnar nerve is to supply nerves to muscles in the hand.
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Highlight: The radial nerve is a major player in the brachial plexus, controlling various muscles in the arm and forearm, as well as providing sensation to the skin.
Fig: Brachial Plexus and its branches median, ulnar and radial: nerve with the forelimb reflected outwards and forwards
Fig: Ulnar and Radial Nerve (Lateral View)
Tibial Nerve
- It's a continuation of the ischiatic nerve, found in the leg.
- Travels diagonally between the two heads of the calf muscle (gastrocnemius).
Division and Path:
- Splits into two plantar nerves in the upper part of the leg, either just above or around the ankle.
- Runs along the inner side of the superficial digital flexor muscle, beneath the gastrocnemius cover.
Lower Course and Accompanying Structures:
- Further down, it lies between the deep flexor muscle and the inner edge of the Achilles tendon.
- Accompanied by the recurrent tibial vein and artery.
Muscular Supply:
- Provides nerves to muscles like gastrocnemius, popliteus, soleus, and flexors of the toes.
- Also has small branches supplying sensation to the skin along its path.
Injection Site:
- For medical procedures involving the tibial nerve, the injection site is on the inner side of the leg.
- Located approximately a hand's breadth above the heel and half an inch in front of the Achilles tendon.
Highlight: The tibial nerve plays a crucial role in controlling muscles and providing sensation to the leg and foot.
Fibular Nerve
- It's a significant nerve branching off from the ischiatic nerve in the leg.
- Travels downward along with the main trunk until it reaches the origin of the calf muscle (gastrocnemius).
Path and Division:
- At the gastrocnemius, it takes a lateral and upward turn under the cover of the biceps femoris muscle.
- Divides into superficial and deep fibular nerves at the point where the extensor digitorum lateralis muscle begins.
Superficial Fibular Nerve:
- Supplies branches to the extensor digitorum lateralis muscle.
- Descends between this muscle and the long extensor of the toes, piercing the deep fascia.
- Branches out under the skin on the top and side of the foot or around the joint above the hoof (fetlock joint).
Deep Fibular Nerve:
- Continues from the fibular nerve and passes between specific muscles.
- Gives branches to muscles like extensor digitorum longus, extensor digitorum lateralis, tibialis cranialis, and fibularis tertius.
- Divides on the top side of the hock (ankle joint) into medial and lateral branches.
Nerve Block Site:
- For medical procedures involving the fibular nerve, the injection site is specified:
- Below and behind the lateral bump of the shinbone (tibia) and
- On the side of the leg, about 6 inches above the ankle (hock), in a groove between certain muscles.
Highlight: The fibular nerve is essential for controlling muscles and providing sensation in the leg and foot. Procedures involving this nerve often target specific injection sites for effective treatment.
Question for Regional Anatomy of Paravertebral Nerves
Try yourself:
Which nerve is responsible for providing sensation to the skin along its path in the leg?Explanation
- The tibial nerve is responsible for providing sensation to the skin along its path in the leg.
- It travels diagonally between the two heads of the calf muscle (gastrocnemius) and splits into two plantar nerves in the upper part of the leg.
- It runs along the inner side of the superficial digital flexor muscle, beneath the gastrocnemius cover.
- The tibial nerve also provides nerves to muscles like gastrocnemius, popliteus, soleus, and flexors of the toes.
- In medical procedures involving the tibial nerve, the injection site is on the inner side of the leg, located approximately a hand's breadth above the heel and half an inch in front of the Achilles tendon.
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Digital Nerves
- There are two sets of digital nerves: those in the forelimb, arising from the brachial plexus, and those in the hindlimb, arising from the lumbosacral plexus.
Forelimb Digital Nerves:
- Originating from the median nerve, the internal branch divides into internal and external divisions.
- The internal division supplies the medial accessory digit and continues as the postero-internal digital nerve along the inner aspect of the medial digit.
- The external division combines with a branch of the external branch of the median nerve to form the posterior common digital nerve.
Hindlimb Digital Nerves:
- The superficial peroneal nerve, after crossing beneath the peroneus longus muscle, passes down between the lateral digital extensors.
- It then travels between the lateral and common digital extensors, reaching the hock, and descending over the anterior annular ligament of the tarsus.
- This nerve divides into internal, middle, and external branches, each running down different aspects of the digits.
Branches and Divisions:
- The middle branch joins a branch from the deep peroneal nerve to form the anterior common digital nerve, which divides further into internal and external proper digital nerves.
- Another branch of the deep peroneal nerve divides into external and internal branches upon reaching the front of the tarsus.
Injection Sites and Paths:
- The internal branch of the deep peroneal nerve descends subcutaneously on the anterior face of the metatarsus.
- The external branch travels down the anterior groove of the metatarsus, eventually joining with the superficial peroneal nerve to form the anterior common digital nerve.
Highlight: Digital nerves supply sensation to the digits (fingers/toes) of animals. They arise from different nerve branches in the limbs and follow specific paths to reach their destinations.
Fig: Digital and Tibial Nerves
Fig: Digital nerves in the hind limb