Massage Therapy Journal Spring 2024

Spring 2024 • 51

providing support during weight-bearing activities. The actions of this muscle are to invert the foot and aid with plantar flexion of the ankle. The Peripheral Nerves of the Lower Extremities: Why Are Peripheral Nerves Vital to the Nervous System? Peripheral nerves are a vital part of the nervous system that extend outward from the central nervous system, which is made up of the brain and spinal cord. These nerves connect to various parts of the body, linking the central nervous system to muscles, organs and sensory receptors. Peripheral nerves transmit sensory information from the body to the brain and spinal cord using afferent pathways, and also relay motor commands from the central nervous system to muscles and glands using efferent pathways. Peripheral nerves consist of bundles of neuronal fibers called dendrites and axons. Dendrites are responsible for bringing sensory information from the body to the central nervous system while axons take motor information from the central nervous system to the body. The nerves are also surrounded by layers of connective tissue that serve as protection from compression and other forces. Injuries to peripheral nerves can result from trauma, compression and disease, as well as other potential factors. Damage to a nerve may lead to pain, numbness, tingling, muscle weakness and loss of sensory function. Peripheral nerves may be able to repair after injury. If a nerve does sustain damage, the axons and dendrites can attempt to regrow, directed by the connective tissue structures surrounding the nerve. We will examine each nerve, describing their functions and how they connect to other parts of the body. The sciatic nerve is the longest and largest peripheral nerve in the body, and is formed by a combination of several nerve roots originating

from the lower spine. There are two major branches of the sciatic nerve: the tibial and common fibular (peroneal) nerves. The sciatic nerve begins in the low back and goes down the back of the leg. This nerve provides both sensory and motor function to the posterior thigh, calves, feet and most of the skin on the leg and begins at the nerve roots of L4 to S3, exiting through the greater sciatic foramen before running deep to or through the piriformis muscle. The sciatic nerve then passes posteriorly to the gemellus superior, gemellus inferior, obturator internus and quadratus femoris‚ and runs deep to the long head of biceps femoris and splits just superiorly to the popliteal fossa into the tibial and common fibular nerves. The sciatic nerve innervates the semitendinosus, semimembranosus, biceps femoris, and a portion of the adductor magnus muscles. The superior gluteal nerve is a major nerve that arises from the sacral plexus, specifically from the L4, L5 and S1 spinal nerve roots. This nerve plays a critical role in innervating certain muscles of the buttocks and lower limbs, as well as contributing to functional movements and stability. The superior gluteal nerve emerges from the sacral plexus and travels through the greater sciatic foramen. As it departs the pelvis, it runs between the gluteus medius and gluteus minimus muscles. The superior gluteal nerve innervates the piriformis, tensor fasciae latae, gluteus medius and gluteus minimus muscles. 11 The inferior gluteal nerve is an important nerve originating from the sacral plexus. This nerve is responsible for innervating certain muscles of the buttocks and lower limbs, contributing to various movements and functions. The inferior gluteal nerve arises from the sacral plexus, specifically from the L5, S1 and S2 spinal nerve roots, and emerges from the greater sciatic foramen in the pelvis, beneath the piriformis muscle before traveling inferiorly. The inferior gluteal nerve innervates only the gluteus maximus muscle.

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