Publication: Estudio anatómico embriológico del nervio ciático, y su relación con el músculo piriforme
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2019-01-08
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Universidad Complutense de Madrid
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Abstract
El nervio ciático es el más largo y grueso del cuerpo. Se forma en la pelvis, a partir de las raíces nerviosas L4-S3, a partir del nervio tibial y el peroneal envueltos por un epineuro común, sale de la pelvis por el foramenciático mayor y baja por la parte posterior de la pierna, inervando la parte posterior del muslo, la parte baja de la pierna y el pie. Habitualmente sale de la pelvis por debajo del músculo piriforme, sin embargo han sido descritas diferentes variaciones anatómicas respecto a la relación entre nervio y músculo. (Figura 13). Suele dividirse en sus dos ramas en la parte inferior del muslo o en la fosa poplítea, pero puede dividirse en la pelvis o a diferentes alturas del muslo (Figura 5)Las variaciones anatómicas del nervio ciático con respecto a su relacióncon el músculo piriforme pueden derivar en patologías como el síndrome piriforme y deben tenerse en cuenta para evitar lesionar el nervio a la hora de realizar cirugías pélvicas, artroplastias de cadera, inyecciones intramuscularesy canulaciones de la arteria femoral en cirugías cardíacas.Las variaciones anatómicas respecto al nivel de bifurcación del nerviociático deben tenerse en cuenta a la hora de realizar bloqueos anestésicos en la fosa poplítea, ya que si el nervio presenta una división alta, se produciría una anestesia parcial de la extremidad inferior.El desarrollo embrionario de las estructuras nerviosas, musculares y óseas se encuentra descrito en la bibliografía. Sin embargo, no se ha establecido el momento en que se define la relación anatómica del nervio ciático y el músculo piriforme...
Sciatic nerve is the longest and thickest nerve in the human body. It is originated from L4 to S3 neural roots, from tibial and peroneal nerves unsheathingin a common epineurium. It goes out the pelvic cavity through the great sciatic foramen and run down the thigh innervating the posterior face of the thigh as well as the lower side of the leg and the foot.Usually, it leaves the pelvis cavity under the piriformis muscle but different anatomical relationships have been described in relation with this relative position. It uses to divide in two end branches at the inferior border of the thigh or inside the popliteal fossa but it could be found branching into the pelvis or indifferent places at the thigh. Anatomical variations of the sciatic nerve regarding its relation with piriformis muscle could origin pathologies like piriformis syndrome and should be taken into account to avoid any lesion in the pelvic surgery, hip arthroplasty, intramuscular injection and femoral artery cannulations in cardiac surgery. Regarding sciatic nerve branching, the anatomical variations should be considering when popliteal anaesthetic blocks are performed. A partial anaesthesia of the lower limb could be caused in a high division of the nerve. Nerves, muscles and bones embrionary development has been previously described however the period in which the relation between the sciatic nerve and the piriformis muscle is established has not been stated...
Sciatic nerve is the longest and thickest nerve in the human body. It is originated from L4 to S3 neural roots, from tibial and peroneal nerves unsheathingin a common epineurium. It goes out the pelvic cavity through the great sciatic foramen and run down the thigh innervating the posterior face of the thigh as well as the lower side of the leg and the foot.Usually, it leaves the pelvis cavity under the piriformis muscle but different anatomical relationships have been described in relation with this relative position. It uses to divide in two end branches at the inferior border of the thigh or inside the popliteal fossa but it could be found branching into the pelvis or indifferent places at the thigh. Anatomical variations of the sciatic nerve regarding its relation with piriformis muscle could origin pathologies like piriformis syndrome and should be taken into account to avoid any lesion in the pelvic surgery, hip arthroplasty, intramuscular injection and femoral artery cannulations in cardiac surgery. Regarding sciatic nerve branching, the anatomical variations should be considering when popliteal anaesthetic blocks are performed. A partial anaesthesia of the lower limb could be caused in a high division of the nerve. Nerves, muscles and bones embrionary development has been previously described however the period in which the relation between the sciatic nerve and the piriformis muscle is established has not been stated...
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Tesis de la Universidad Complutense de Madrid, Facultad de Ciencias Biológicas, Departamento de Ecología, leída el 4 de Mayo de 2018