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Section 9—Floppy Infant
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Section 10—Motor Neuron and Its Disorders
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INDEX

A Anosmia, 6–7 Autonomic nerves (Continued)
Aβ fiber-mediated pain, low-threshold, 207 Ansa cervicalis, 46, 116 in pelvis, 193
Abdomen, autonomic nerves and ganglia, 186 Ansa subclavia, 179 in thorax, 182–183
Abdominal wall, internal view, 214 Anterior atlanto-occipital membrane, 83
Abdominopelvic splanchnic nerves, 184 Anterior cervical spine, decompression and stabilization, Autonomic nervous system
Abducens nerve (VI) abnormal pupillary conditions, 199
95 cholinergic and adrenergic nerves, 177
course and chief functions, 3 Anterior horn, 62 disorders of, 200
motor and sensory fibers, 2 Anterior horn cells, 233 enteric plexuses, 190
origins, 15 Anterior interosseous nerve, 124–125 general topography of, 174–175
Abnormal illness behavior, 223 Anterior longitudinal ligament, 87 reflex pathways, 176
Abscess, epidural, 68–69 Anterior median fissure, 51
Accessory nerve (XI), 116 Anterior pulmonary plexus, 182 Autonomic testing, 198
course and chief functions, 5 Anterior spinal artery, 53, 77 Axillary nerve, 130
disorders, 45 Anterior spinal artery syndrome, 66–67 Axillary neuropathies, 123
injury to, 122 Anterior spinocerebellar tract, 61, 203 Axis, 81, 83–84
motor and sensory fibers, 2 Anterior sulcal (central) vein, 54 Axons, 143
nerve fibers, 44–45 Anterolateral funiculus, 56
Accommodation reflex, 13, 181 Anticholinesterase drugs, 250 of autonomic nerve cells, 175
Acetylcholine Antigen-presenting cell, 251 destruction, in Guillain-Barré syndrome, 160
hydrolysis, 246 Aorta, 191 unmyelinated, olfactory, 7
release from presynaptic nerve ending, 248 Aorticorenal ganglion, 174, 189, 194–197 Axoplasm, 244, 246
Acetylcholine receptors, 244–245, 250–251 Apical ligament, 84 displacement, 118
Acoustic neuroma, 34 Arachnoid mater, 51, 106 Azidothymidine, 274
Acquired myopathies, 262 Arcuate eminence, 33 B
Acromegalic myopathy, 274 Argyll Robertson pupil, 199 Babinski sign, 76
Actin, 257 Arrector muscle of hair follicle, 175 Back pain
Action potentials Arsenic poisoning, 169 and lumbar disk disease, 102–104
conduction velocity, 150 Arteries lumbar zygapophyseal joint, 215
generation of, 147 Base of sacrum, 88
motor nerve, 258 peripheral, 177 Basement membrane, 244
muscle fiber, 248, 259 of spinal cord and nerve roots, 52–53 Basivertebral vein, 54
propagation of, 149 Arteriovenous malformations, 75 Becker muscular dystrophy, 265
Active contraction, 155 Artery of Adamkiewicz, 52–53 Beevor sign, 65
Active zone of neuromuscular junction, 244 Arthrogryposis multiplex congenita, 230 Bell palsy, 29
Acute inflammatory demyelinating Articular capsules, 83 Benign paroxysmal positional vertigo, 33–35
Articular cartilage, degeneration, 215 Beriberi, 170
polyradiculoneuropathy, 160–161 Articular processes, 86 Beta motor neurons, 63
Acute intermittent porphyria, 161 Articularis genus muscle, 132 Biceps brachii muscle, 128
Acute nerve compression, 118 Ascending cervical artery, 52 Biceps femoris muscle, 134, 219
Acute peripheral autonomic disorders, 200 Ascending pathways Biliary tract, innervation of, 191
Acute spinal cord syndromes, 68–69 spinal cord fiber tracts, 55 Bipolar cells, retinal, 9–10
Addison disease, 275 spinal origin or termination of, 61 Blood vessels, innervation of, 184–185
Adductor pollicis muscle, 128 Astrocytes, 145 Body of tongue, 31
Adenosine diphosphate (ADP), 257 Astrocytomas, 71–72 Bone graft, 96
Adenosine triphosphate (ATP), 257 Atlas, 81, 83–84 Botulin, 247
Adie’s tonic pupil, 199 Atrophy Botulism
Adrenal glands, innervation of, 192 asymmetric, of intrinsic hand muscles, 239 foodborne, 254
Adrenergic nerves, 177 in inclusion body myositis, 272 infantile, 228
Afferent auditory pathways, 36 of interosseous muscles, 222 Brachial plexopathy, 114
Afferent inhibition, 64 multiple system, 200 neonatal, 113
Afferent vagal fibers, 183 spinal muscular type I, 227 Brachial plexus, 50
Alar ligaments, 84 thenar, 127 divisions and cords, 112
Alcohol use, neuropathy in, 170 Auditory pathways injuries at birth, 113
Alpha motor neurons, 63, 232 afferent, 36 Brachioradialis muscle, 128
Amacrine cell, 9 centrifugal, 37 Brachium of superior colliculus, 12
Amygdaloid body, 6 Auerbach’s plexus, 190 Bracing
Amyloid neuropathy, 164–165 Auriculotemporal nerve, 23, 40–41 for cervical spine injury, 94
Amyloidosis, 200 Autonomic ganglia, 174 for spinal cord injury, 97
Amyotrophic lateral sclerosis (ALS) in abdomen, 186 Brainstem
in pelvis, 193 decussation of pyramids, 57
diagnosis, 239–240 Autonomic impairment, 67 retinal projections to, 12
familial, 236 Autonomic innervation Brown-Séquard syndrome, 66–67
headdrop in, 237 of adrenal glands, 192 Buccal nerve, 20
mimics of, 238–239 of blood vessels, 184–185 Bulbar conjunctiva, 9
treatment, 240–241 of eye, 19, 180–181 Bungarotoxin, 247
Amyotrophy of intestines, 188–189 Bursitis, trochanteric, 220
juvenile monomelic, 238 of kidneys, ureters, and urinary bladder, 194–195 Burst fracture, cervical, 91
neuralgic, 114 of liver and biliary tract, 191 Buttock pain, 219–220
Anconeus muscle, 131 motor innervation, 145 C
Andersen-Tawil syndrome, 275 of reproductive organs, 196–197 C-type fibers, 202
Anesthesia, malignant hyperthermia due to, 277 of stomach and proximal duodenum, 187 Café au lait spots, 67
Ankle clonus, 76 Autonomic nerves
Ankle joints, dissolution of, 159 in abdomen, 186
Ankledrop, 166 in head and neck, 178–179
Annulospiral endings, 154
THE NETTER COLLECTION OF MEDICAL ILLUSTRATIONS 283

Compound muscle action potential, 248 Index
Compression
Canal of Schlemm, 9 Déjerine-Sottas disease, 156, 158
Canalith repositioning, 35 of nerve, chronic, 119 Deltoid muscle, 130
Capsule of lens, 9 of nerve root, 218 Demographics of myasthenia gravis, 249
Carbohydrate metabolism, 260 of spinal cord Demyelination of peripheral nerve, 148
Cardiac plexus, 42, 174, 183 Dendrites, 233
Cardiovagal testing, 198 cervical disk herniation causing, 77 Dens, 81
Carnitine palmitoyltransferase deficiency, 276 degenerative disease with, 76 Dentate gyrus, 6
Carotid body, 185 Compression neuropathies, 118 Denticulate ligament, 51
Carotid sinus, 40, 185 electrodiagnostic studies, 120 Depressor anguli oris muscle, 27
Carpal tunnel syndrome, 126–127 Compressive extension, 92 Depressor septi nasi, 26
Catastrophizing, 223 Compressive flexion, 91 Dermal segmentation, 107
Cauda equina, 50, 53, 71, 107 Conduction block, and temporal dispersion, 148 Dermatomal pattern, 66, 93, 107, 138–139
Cavernous plexus, 193 Conduction velocity, 150 Dermatomyositis, 270–271, 273
Cavernous sinus, nerves of, 15 ulnar nerve, 161 Descending pathways
CD4+ T cells, 273 Conductive hearing loss, 34
Celiac ganglion, 176, 186–187, 192 Cones, 9, 11 nociceptive, 204–205
Celiac plexus, 189 Congenital myasthenia syndromes, 228, 253 spinal cord fiber tracts, 55
Cell body of motor neuron, 233 Congenital myopathies, 229 Desmosomes, 30
Cell types, of nervous system, 145 Connective tissue disorders, associated with neuropathy, Diabetic lumbosacral radiculoplexus neuropathy, 110, 166
Central cord syndrome, 67, 92 166–167 Diabetic peripheral neuropathy, 221–222
Central core disease, 229 Contraction Diabetic radiculoplexus neuropathy, 163
Central disk herniation, 101 active, 155 Diagnostic radiography
Central disorders, 200 of muscle fiber, 257 for low back pain, 218
Central nervous system (CNS) Contralateral extension, 64 for radiculopathy, 101
Conus medullaris, 50, 106–107 Diaphragm, 214
cell types of, 145 Conversion disorders, 223–224 Diaphragma sellae, 15
correlates of pain, 206–207 Coracobrachialis muscle, 123 Digastric muscle, 24
Central poststroke pain, 208–209 Cords, of brachial plexus, 112, 123–124 Dilator pupillae muscle, 181
Central sensitization, 206–207 Cornea, 9 Disinhibition, 207
Centrifugal auditory pathways, 37 Corticoreticular pathway, 60 Disk extrusion, L4-5, 104
Centronuclear/myotubular myopathy, 229 Corticospinal system, motor component, 57 Distal median neuropathies, 126–127
Cerebellum, inputs to rubrospinal tract, 58 Corticosteroid myopathies, 274 Distal radial neuropathies, 131
Cerebral cortex Corticosteroid therapy Distal ulnar nerve lesions, 129
inputs to rubrospinal tract, 58 for Duchenne muscular dystrophy, 266 Distractive extension, 92
motor centers, 57 for polymyositis, 271 Distractive flexion, 90
pain pathways, 204 Costovertebral joints, 85 Disuse osteoporosis, 210
Cervical curvature, 80 Cranial nerves Dopaminergic pathways, 205
Cervical disk herniation, 100 chief functions of, 3–5 Dorsal accessory olivary nucleus, 47
causing cord compression, 77 distribution of motor and sensory fibers, 2 Dorsal rami, 106
Cervical nerve root injuries at birth, 113 Cranial parasympathetic preganglionic fibers, 175 of thoracic nerves, 108
Cervical plexus, 116 Craniocervical ligaments Dorsal root ganglion, 176, 204, 211, 232
Cervical spine injury, 93–94 external, 83 Dorsal scapular nerve, 122–123
anterior, decompression and stabilization, 95 internal, 84 Dorsal spinocerebellar tract, 203
posterior, stabilization and fusion, 96 Creatine kinase, 265–266, 276 Drug targets, CNS, 207
Cervical spondylosis, 76 Cribriform plate of ethmoid bone, 6–8 Duchenne muscular dystrophy, 264–265
Cervical vertebrae, 52 Cricothyroid muscle, 43 Ductus deferens, 196
anterior dislocation of, 90 Cristae, of membranous labyrinth, 38 Dumb-bell tumor, 71
transverse processes, 82 Critical illness myopathy, 274 Duodenojejunal junction, 219
Cervix, 197 Cross-bridges, 256–259 Duodenum, proximal, innervation of, 187
Chambers of eye, 9 Cuneate fasciculus, 55–56, 61 Dura mater, 6, 51, 219
Charcot-Marie-Tooth disease, 156–157 Curare, 247 Dysautonomia, 200
Chiasmal neurologic deficits, 12 Curvature of spinal column, 80 Dystroglycan complex, 266
Chloroquine, 274 Cushing syndrome, 274 Dystrophinopathies, 264–266
Choline acetyltransferase deficiency, 253 Cutaneous distribution of peripheral nerves, 223 E
Cholinergic nerves, 177 Cutaneous innervation Ectopic impulse generation, 206
Chorda tympani nerve, 20 deep fibular nerve, 136 Edema, endoneurial, 119
Choroid, 9 femoral and saphenous nerves, 132 Edinger-Westphal nucleus, 13, 180, 199
Choroid plexus, 47 musculocutaneous nerve, 123 Edrophonium chloride, 247
Chronic inflammatory demyelinating posterior femoral cutaneous nerve, 135 Efferent endings, visceral, 151
from radial and axillary nerves, 131 Electrical circuit model, using Ohm’s law, 146
polyradiculoneuropathy, 162, 168 of sole, 137 Electrodiagnostic studies, in compression neuropathy,
Chronic nerve compression, 119 Cutaneous nerve pattern, 138–139
Chronic peripheral autonomic disorders, 200 Cutaneous receptors, 152 120
Chronic progressive ophthalmoplegia, 276 Cytoarchitecture of spinal cord gray matter, 62 Electromyography (EMG), 120–121
Ciguatera, 254 D
Ciliary ganglion, 14–15, 19, 181, 199 Deafness in ALS, 240
cochlea as source of, 39 in Guillain-Barré syndrome, 161
roots of, 178 nerve-type, 36 needle, 235
Ciliary processes, 9 Decamethonium, 247 in polymyositis, 271
Cisterna chyli, 186 Deconditioning of extensor musculature, 213 in Werdnig-Hoffmann disease, 227
Coccygeal nerve, 50 Decussation of pyramids, 57 Emergency room and acute management, for cervical
Coccygeal plexus, 111 Deep fibular nerve, 136
Coccyx, 50, 80 Deep petrosal nerve, 40 spine injury, 93
Deep temporal nerves, 24 Encapsulated ending, 145
ligaments of, 89 Degeneration End-plate potential, 248
transverse processes of, 88 of acetabulum, 220 End plates
Cochlear nerve disorders, 33–34 of articular cartilage, 215
Cochlear receptors, 39 subacute combined, of spinal cord, 74 motor, 234, 236, 245
Common carotid artery, 179, 185 muscle, 251
Common fibular nerve, 136 Endoneurial edema, 119
Common peroneal nerve, cutaneous innervation, 138 Endorphin system, 202–203, 205
Common tendinous ring (of Zinn), 15 Endothelial cells, carotid body, 185
Compartment syndrome, gluteal, 134–135 Energy utilization in muscle, 260
Complex regional pain, 210
THE NETTER COLLECTION OF MEDICAL ILLUSTRATIONS
284

Index

Enkephalin-containing neuron, 204–205 Flexor hallucis longus muscle, 137 Helicotrema, 33
Enteric nervous system, 189 Flexor withdrawal reflex, 64 Hematoma, compressing sacral plexus, 115
Enteric plexuses Floppy infant, 228 Hemianesthesia, 224
Flower spray endings, 154 Hemicholinium, 247
of alimentary tract, 190 Foodborne neurotoxins, 254 Hemiparesis, in intracerebral hemorrhage, 209
of gut, 176 Foramen magnum, 44 Hepatic plexus, 42, 191
Entrapment Foramina, vertebral, 82 Hepatitis C virus, 171
fibular nerve at knee, 136 Forearm Hereditary myopathies, 262
median nerve, 121, 125 Hereditary neuropathies
radial nerve, 131 exercise test, 276
ulnar nerve at elbow, 129 median nerve, 124 motor and sensory (HMSN), 156–158
Ependymomas, 71 radial nerve, 130 with predisposition to pressure palsies, 139
Epididymis, 196 Fovea centralis in macula, 9 sensory and autonomic (HSAN), 159
Epidural abscess, 68–69 Free nerve ending, 145, 152, 154 Hereditary spastic paraparesis, 239
Episcleral space, 9 Frontal eye fields, 16 Hereditary spastic paraplegia, 78
Epley maneuver, 35 Fungiform papillae, 30–31 Herniation
Equilibrium potential, 146 Fusion cervical disk, 100
Erb palsy, 113 interbody, 95
Erector spinae muscle, 108 posterior cervical spine, 96 causing cord compression, 77
Esophageal plexus, 42, 174 G lumbar disk, 103
Exercises, for chronic lumbar strain, 216 Gallbladder, innervation of, 191 Herpes zoster, 25, 29, 109, 211
Expansion mutation, in myotonic dystrophy-1, 268 Gamma motor neurons, 63, 232 Hip pain, 220
Extensor musculature, deconditioning of, 213 Ganglion cells, retinal, 9 Hippocampal fimbria, 6
Extensor supinator muscles, 131 Gastrocnemius muscle, 135 Horizontal saccade pathway, 17
External carotid artery, 41, 185 Gastrointestinal tract, 177 Horner syndrome, 19, 199
External craniocervical ligaments, 83 Gating mechanism, in nociceptive processing, 206 Human immunodeficiency virus (HIV), 171
External vertebral plexus, 54 Gaze palsy, right horizontal, 17 Human T-cell lymphocytic virus-1 (HTLV-1)
Exteroceptive fibers, 63 Genetics of dystrophinopathies, 265
Extracellular potential, 149 Geniculate ganglion of facial nerve, 24, 26, 29 myelopathy, 78
Extradural tumors, 70 Genioglossus muscle, 46 Hyperacusis, 28
Extramedullary lesion, 66 Geniohyoid muscle, 116 Hyperkalemia, 275
Extraocular motor neurons, 145 Genitofemoral nerve, 115, 133 Hyperlordosis, lumbar, 216
Eye Giant pyramidal cells, 58 Hyperparathyroid myopathy, 274
anatomy, 9 Gigantocellular nucleus, 60 Hyperthermia, malignant, 277
autonomic innervation, 19, 180–181 Glabrous skin, receptors, 152 Hyperthyroid myopathy, 274
movements, control of, 16–18 Gliding capacity of peripheral nerve, 119 Hypogastric nerves, 174, 193, 196–197
muscles, 14 Glossopharyngeal nerve (IX), 185 Hypoglossal nerve (XII), 116
F motor and sensory fibers, 2
Facet joints, lumbar, 215 nerve fibers, 40 disorders, 47–48
Facial muscles, 26–27 origin and chief functions, 4 motor and sensory fibers, 2
Facial nerve (VII), 24, 41 Glove-and-stocking hypesthesia, 156, 158 nerve fibers, 46
anatomy, 26 Gluteal nerves, 134 origin and distribution, 5
Bell palsy, 29 Gluteus maximus muscle, 219 Hypokalemia, 275
disorders, 27–29 Gluteus medius muscle, 134 Hypoparathyroid myopathy, 274
etiologies of facial neuropathy, 29 Glycogen, formation and breakdown, 260 Hypotension, orthostatic, 164
motor and sensory fibers, 2 Golgi tendon organs, 154–155 Hypothenar muscles, 128
motor division, 26–27 Golgi-type endings, 154 Hypothyroid myopathy, 274
origin and distribution, 4 Gracile fasciculus, 55–56, 61 Hypothyroidism, 170
sensory and parasympathetic division, 27 Gracilis muscle, 133 Hypotonia, neonatal, 226
Facial plexus, 178 Gray matter, spinal cord, 106 Hysterical conversion reactions, 224
Facial vein, 185 cytoarchitecture, 62 I
Facioscapulohumeral dystrophy, 269 Gray ramus communicans, 19, 41, 51, 106, 174, 179, 181 Idiopathic facial palsy, 29
Fasciculations, in ALS, 238–239 Great auricular nerve, 116 IgM MGUS neuropathy, 164
Fast-twitch muscle fibers, 261 swelling of, 156 Iliac crest, 89
Fat Greater palatine nerve, 20, 178 Iliacus muscle, 132, 214
in epidural space, 106 Greater petrosal nerve, 26 Iliohypogastric nerve, 50, 133
formation and breakdown, 260 Greater splanchnic nerve, 108, 174 Ilioinguinal nerve, 50, 111, 115, 133
Fear-avoidance beliefs, 223 Guillain-Barré syndrome, 160–161, 200 Iliolumbar ligament, 89
Feet immunopathogenesis, 168 Iliopectineal line, 89
diabetic neuropathy, 222 Gut motility, autonomic system role, 189 Immunopathology
intractable deformities, 230 Guyon canal, 129 of inflammatory myopathies, 273
peripheral nerves, 221 H of myasthenia gravis, 251
Female reproductive organs, innervation of, 197 Hair cells, 36–39 Impulse propagation, 149
Femoral head deformity, 220 Hairy skin, receptors, 152 Incisive canal, 8
Femoral nerve, 111, 115, 132 Halo ring, 94 Inclusion body myositis, 272–273
cutaneous innervation, 138 Hamstring syndrome, 220 Incus, 32
Fiber tracts of spinal cord, 55, 203 Hand deformities, 230 Infantile neuromuscular junction disorders, 228
Fiber-type disproportion, congenital, 229 Hansen disease, 171 Infarction, spinal cord, 68
Fibroblast, carotid body, 185 Head, autonomic nerves, 178–179 Infection, associated with cranial neuropathies, 2
Fibular (peroneal) nerve, 136–137, 221 Head-up tilting, 198 Infectious myelopathy, 78
Filum terminale internum, 50 Headdrop, in ALS, 237 Inferior alveolar nerve, 41
Flexion Hearing Inferior cerebellar peduncle, 32
compressive, 91 conductive loss, 34 Inferior colliculus, 37
distractive, 90 frequency analysis, 39 Inferior gluteal nerve, 115, 134
lumbar, effect on spinal nerves, 216 Heart, 42, 177 Inferior hypogastric plexus, 193
of middle finger against resistance, 125 innervation of, 182–183 Inferior mesenteric ganglion, 193, 195, 197
Flexor carpi radialis muscle, 124 Heavy metal poisoning, 169 Inferior oblique muscle, 14
Flexor carpi radialis tendon, 126 Inferior olivary nucleus, 58
Flexor digitorum profundus muscle, 128 Inferior olive, 12
THE NETTER COLLECTION OF MEDICAL ILLUSTRATIONS Inferior rectus muscle, 14
Inferior salivatory nucleus, 180
Inferior vestibular nucleus, 32

285

Index

Inflammatory myopathies, 273 Lateral atlantoaxial joints, 84 Medial geniculate body, 36–37
Infraclavicular branches of brachial plexus, 112 Lateral cutaneous nerve of thigh, 133 Medial lemniscus, 32
Inguinal ligament (Poupart), 214 Lateral femoral cutaneous nerve, 132–133 Medial longitudinal fasciculus, 16–17, 32
Innervation Lateral geniculate body, 19, 181 Medial rectus muscle, 14
Lateral geniculate nuclei, 11–12 Medial reticulospinal tract, 203
of blood vessels, 184 Lateral lemnisci, 36 Medial vestibular nucleus, 32
of heart, 183 Lateral rectus muscle, 14 Medial vestibulospinal tract, 59
of intestines, 188–189 Lateral vestibulospinal tract, 59, 61 Median arcuate ligament, 214
of muscle fibers, 234 Latissimus dorsi muscle, 108, 219 Median atlantoaxial pivot joint, 84
of stomach and proximal duodenum, 187 Lead poisoning, 169 Median nerve, 124
Interbody fusion, anterior cervical spine, 95 Lens, 9
Intercostal arteries, 52 Leprosy, 171 distal median neuropathies, 126–127
Intercostal muscles, 108 Lesser occipital nerve, 116 entrapment, 121
Intercostal nerves, 50, 111, 133 Lesser palatine nerve, 20, 178 proximal median neuropathies, 125
Intermesenteric plexus, 195 Lesser splanchnic nerve, 108, 174 Medulla, 12
Internal carotid artery, 15, 179, 185 Levator ani muscle, 214 hypoglossal nerve intramedullary course, 47
Internal carotid nerve, 177 Levator palpebrae superioris muscle, 14–15 Medulla oblongata, 177, 194, 205
Internal craniocervical ligaments, 84 Levator scapulae muscle, 130 Medullary reticulospinal system, 60
Internal jugular vein, 46 Levator veli palatini muscle, 42 Meissner’s plexus, 190
Internal vertebral venous plexus, 54 Lid retraction, secondary to pineal mass, 18 Membrane attack complex, 270
Interneurons, 145 Ligamenta flava, 83, 87 Membranous labyrinth, 38–39
Interosseous nerve of leg, 137 Ligamentum nuchae, 83 Ménière disease, 33
Interosseous sacroiliac ligaments, 89 Light reflexes, pupillary, 13, 181 Meningeal sheath of optic nerve, 9
Interstitial nucleus of Cajal, 16 Meninges, spinal cord, 50–51
Intertrochanteric crest, 134 loss of, 158 Meningioma, 72
Intervertebral disks, 83, 86 Limb deformities, in arthrogryposis multiplex congenita, subfrontal, 7
lumbar, degeneration of, 222 Merkel disks, 152
Intervertebral joint, 82 230 Mesencephalon, 56, 205
Intervertebral vein, 54 Limb-girdle muscular dystrophy, 269 Mesoappendix, 189
Intestines, innervation of, 188–189 Linea alba, 108 Mesothelial septum, 51
Intracellular potential, 149 Lingual nerve, 23, 41 Metabolic myopathy, 276
Intracerebral hemorrhage, 209 Lingual tonsil, 31 Metabotropic receptors, 207
Intradural tumors, 70–71 Lingual vein, 185 Metameres, 107
Intraepidermal nerve fiber density, 221 Lipid metabolism, 260 Metastatic deposits, acute spinal cord syndrome caused
Intrafascicular circulation, pressure gradient, 119 Liver, 42
Intrafusal muscle fiber, 155 by, 68–69
Intramedullary lesion, 66 innervation of, 191 Micrographs of peripheral nerves, 144
Intramedullary tumors, 71 Long thoracic nerve damage, 45, 122 Microvilli, 30
Intrapontine lesions, 28–29 Longitudinal intramuscular plexus, 190 Midbrain, 21, 202
Intrinsic dorsal horn neurons, 202 Low back pain, 102
Intrinsic muscles of tongue, 46 retinal projections to, 12
Ion channel mechanics, 147 and lumbar hyperlordosis, 216 Middle cervical ganglion, 178–179
Ionotropic receptors, 207 myofascial factors in, 213–214 Middle colic artery, 189
Ipsilateral flexion, 64 Low-threshold Aβ-fiber-mediated pain, 207 Midline disk herniation, 104
Iridocorneal angle, 9 Lower brachial plexus injury, 113 Mimics of ALS, 238–239
Iris, 9 Lower motor neuron signs, 236 Mitochondria, 244
Ischial bursitis, 219 Lumbar curvature, 80 Mitochondrial myopathies, 276
Isometric handgrip, 198 Lumbar disk disease, back pain and, 102–104 Molecular genetic testing, in dystrophinopathies, 266
Isotype switching, 168 Lumbar hyperlordosis, effect on spinal nerves, 216 Monoclonal protein-associated neuropathies, 164–165
J Lumbar medial branch neurotomy, 215 Mononeuropathies
Joint receptors, 154 Lumbar plexus, 50, 111, 132–133
Jugular foramen, 42, 44 Lumbar vertebrae, 52 clinical assessment, 120–121
Jugular nerve, 179 intervertebral disks, 86 diagnostic studies, 121
Junctional fold, 244–245 section through, 106 femoral nerve, 132
Junctional sarcoplasmic reticulum, 258 Lumbar zygapophyseal joint back pain, 215 shoulder girdle, 122
Juvenile monomelic amyotrophy, 238 Lumbosacral junction, 89 ulnar, 129
K Lumbosacral plexopathy, 115 Motor and sensory neuropathies, hereditary (HMSN),
Kennedy disease, 242 Lumbosacral radiculoplexus neuropathy, diabetic, 110,
Kidneys, innervation of, 194–195 156–158
Klumpke palsy, 113 166 Motor component of pyramidal system, 57
Knee hyperextension, 230 Lumbosacral spinal stenosis, 105 Motor division of facial nerve, 26–27
Knee jerk, loss of, 110 Lyme disease, 29, 171 Motor end plates, 234, 236, 245
Krebs cycle, 260 Lymphoma Motor impairment, 65
Kugelberg-Welander disease, 242 Motor neuron disease, 129
Kyphosis, progressive thoracic, 218 invading spinal canal, 72
L median nerve, 121 primary, 236
Laboratory tests, for muscle weakness, 263 M Motor neurons, 61
Labyrinth, vestibular, 38 Macula, 11–12
Lacrimal nerve, 178 Maculae of membranous labyrinth, 38 cell body, 233
cutaneous branch, 23 Magnetic resonance imaging (MRI), of spinal tumors, 72 classes of, 63
Lambert-Eaton myasthenic syndrome, 248, 252 Major descending tracts, spinal origin or termination of, innervation of autonomic system, 145
Lamina cribrosa of sclera, 9 of limbs and trunk, 62
Lamina neurons, 202 61 motor unit, 233–234
Laminae of Rexed, 62 Male reproductive organs, innervation of, 196–197 motor unit potentials, 235
Laryngeal nerve lesion, 43 Malignant hyperthermia, 277 somatic, 232
Mandibular gland, efferent endings, 151 Motor root, ciliary ganglion, 14–15
286 Mandibular nerve (V3), 15, 20, 22, 24, 41 Motor unit, 233–234
Maxillary nerve (V2), 15, 20, 22–23, 41 Motor unit potentials, 235
McArdle disease, 276 Mucosa, olfactory, 7
Mechanoreceptors Müller cell, 9
Multiple system atrophy, 200
muscle and joint receptors, 154 Muscle biopsy
pacinian corpuscle, 153 in dystrophinopathies, 266
Medial brainstem reticular formation, 60 in polymyositis, 270–271
Medial dorsal cutaneous nerve, 136 Muscle cell
Medial epicondyle, 128–129 metabolism of, 260
nucleus, 244

THE NETTER COLLECTION OF MEDICAL ILLUSTRATIONS

Neuralgia Index
glossopharyngeal, 41
Muscle fibers occipital, 212 Occipital neuralgia, 212
anatomy trigeminal, 21, 25 Oculomotor nerve (III)
basic sarcomere subdivisions, 256
biochemical mechanics of contraction, 257 Neuralgic amyotrophy, 114 motor and sensory fibers, 2
innervation of, 234 Neurilemma, 244 nuclei, 14
necrotic, 273 Neurilemmoma, 71 origin and chief functions, 3
types of, 261 Neurochemical foundations of descending pain Oculopharyngeal muscular dystrophy, 269
Odorant transduction, 7–8
Muscle membrane system, 258 modulation, 205 Ohm’s law, 146
Muscle receptors, 154 Neurochemical testing, 198 Olecranon, 129
Muscle response to nerve stimulation, 259 Neuroimmune interactions, 207 Olfactory bulb
Muscle-specific tyrosine kinase, 253 Neuroleptic malignant syndrome, 277 cells, 6
Muscle spindle, 154–155 Neurologic deficits in olfactory pathway, 8
Muscle stretch reflex, 64 Olfactory nerve (I), 2
Muscle tension eye movement disorders, 18 anatomy, 6
of retina and optic nerve, 12 disorders, 6–7
proprioceptive reflex control of, 155 Neuromatrix model of pain, 223 olfactory pathway, 6, 8
relationship with muscle length, 259 Neuromuscular junction origin and chief functions, 3
Muscle weakness congenital myasthenic syndromes, 253 receptors, 7–8
clinical approach to myopathies, 262–263 disorders in infant, 228 Olfactory tract, and central connections, 8
in inclusion body myositis, 272 foodborne neurotoxins, 254 Oligodendrocytes, 145
in muscular dystrophies, 269 myasthenia gravis, 249–251 Omohyoid muscle, 116
in myasthenia gravis, 249 physiology of, 245 Ophthalmic artery, 19, 181
in polymyositis and dermatomyositis, 270–271 repetitive motor nerve stimulation, 248 Ophthalmic nerve (V1), 20–23, 41
Muscular dystrophies, 264–266, 269 structure of, 244 Ophthalmoplegia, right internuclear, 17
Muscularis mucosae, 190 synaptic transmission, 246–247 Opioid pathways, from hypothalamus, 204
Musculocutaneous nerve, 123 transmission disorders, presynaptic, 252 Optic nerve (II), 2, 199
Myasthenia gravis, 248 Neurons chiasmal and postchiasmal neurologic deficits, 12
diagnosis, 249–250 ion channel mechanics and action potentials, 147 course and distribution, 3
immunopathology of, 251 pseudounipolar, 190 human eye, 9
transient neonatal, 228 resting membrane potential, 146 neurologic deficits of retina and optic nerve, 12
Myelin-associated glycoprotein (MAG) autoantibodies, types of, 145 pupillary light reflex and accommodation reflex, 13
Neuropathic pain, 206 retina, 9–11
164 Neuropathies retinal projections, 12–13
Myelin sheath, 145, 244–245 compression neuropathy, 118 retinogeniculostriate visual pathway, 11–12
Myelitis, transverse, 69 diabetic, 163 Ora serrata, 9
Myelography, diagnostic, for radiculopathy, 101 diabetic lumbosacral radiculoplexus, 110 Orbit, nerves of, 15
Myelopathies, infectious and hereditary, 78 distal median, 126–127 Organ of Corti, 39
Myenteric plexus, 190 facial, 29 Orthoses
Mylohyoid nerve, 23 hereditary functional wrist devices, 97
Myoclonus epilepsy with ragged-red fibers, 276 thoracolumbosacral, 94
Myofascial pain syndrome, 213–214 motor and sensory, 156–158 Orthostatic hypotension, 164
Myofibrils, 244, 246 with predisposition to pressure palsies, 139 Osteitis condensans ilii, 220
Myofilaments, 256 sensory and autonomic, 159 Osteoporosis, disuse, 210
Myoglobinuric syndromes, 277 hypoglossal, 48 Otic ganglion, 24, 41
Myopathies monoclonal protein-associated, 164–165 Otitis media, 34
peripheral Oval window, 39
congenital, 228 caused by heavy metal poisoning, 169 Ovary, 197
hypokalemia/hyperkalemia, 275 caused by leprosy, 171 P
inflammatory, 270–273 metabolic, toxic, and nutritional, 170 Pacinian corpuscle, 153–154
metabolic and mitochondrial, 276 proximal median, 125 Pain
periodic paralysis, 275 radial nerve, 131 ascending pathways, endorphin system, 202–203
toxic, 274 sciatic nerve, 134–135 back
Myotonia congenita, 267–268 tibial, 137
Myotonic dystrophy, 267–268 vasculitic, 166–167 and lumbar disk disease, 102–104
N Neurophysiologic testing, 148 lumbar zygapophyseal joint, 215
Nasal mucosal glands, 180 Neurotoxins, foodborne, 254 buttock, 219–220
Nasal septum, 7–8 Neurotransmitters, CNS, 207 CNS correlates of, 206–207
Nasociliary nerve, 19 Neutral cells, 205 complex regional, 210
Nasociliary root of ciliary ganglion, 181 Nifedipine, 247 descending nociceptive pathways, 204–205
Nasopalatine nerve, 8 Nociceptive processing, and CNS correlates of pain, diabetic peripheral neuropathy, 221–222
Nasopharynx, 33 206–207 herpes zoster, 211
Neck, autonomic nerves, 178–179 Nociceptive system, 203 hip, 220
Needle electromyography, 235 Nodes of Ranvier, 118–119, 143 low back
Nemaline myopathy, 229 Noninvasive positive-pressure ventilation, 241 diagnosis, 219
Neonatal brachial plexopathy, 113 Noradrenergic neurons, 205 and lumbar hyperlordosis, 216
Neonatal hypotonia, 226 Normal appearance of optic nerve, 11 myofascial factors in, 213–214
Nerve compression, chronic, 119 Nuclear bag fibers, 154 patient examination, 217–218
Nerve conduction studies Nuclei neurologic evaluation of somatoform patient, 223–224
for carpal tunnel syndrome, 127 cochlear, 36 occipital neuralgia, 212
for compression neuropathy, 120 cranial nerve, 4–5 thalamic pain syndrome, 208–209
for demyelinating diseases, 157–158 hypoglossal, 47–48 Pain behaviors, 223–224
in focal conduction block, 148 oculomotor, 14 Pain fibers, afferent, 183
ulnar motor nerve, 162 thalamic, 208 Pale optic nerve, 11
Nerve fibers vestibular, 32, 59 Palmar digital nerves, 124
classification by size and conduction velocity, 150 Nucleus ambiguus, 44 Palmaris longus tendon, 126
cochlear, 39 Nucleus proprius of posterior horn, 62 Parahippocampal gyrus, 6
glossopharyngeal, 40 O Paralysis
myelinated, 118, 143 Obturator nerve, 111, 132, 133 hypoglossal nerve, 43
taste pore, 30 cutaneous innervation, 138 periodic, thyrotoxic, 275
Nerve stimuli, muscle response to, 259
Nervus intermedius, 27 287

THE NETTER COLLECTION OF MEDICAL ILLUSTRATIONS

Posterior midbrain syndrome, 18 Index
Posterior nerve of penis, 193, 196
Paramedian pontine reticular formation, 16 Posterior sacrococcygeal ligaments, 89 Red nucleus, 58, 199
Paraneoplastic autonomic neuropathy, 200 Posterior spinocerebellar tract, 61 Red tide poisoning, 254
Paraparesis, hereditary spastic, 239 Postfixed plexus, 112 Reflex pathways
Parasympathetic cardiac nerves, 182 Postsynaptic membrane, 244–245
Parasympathetic fibers Posture, in lumbosacral spinal stenosis, 105 autonomic, 176
Predisposing causes of acute spinal cord syndromes, spinal, 64
autonomic, 175–176 Reflex sympathetic dystrophy, 210
for eye, 19, 180 68–69 Reflexes
for liver and biliary tract, 191 Prefixed plexus, 112 in cervical disk herniation, 100
for stomach and proximal duodenum, 187 Preganglionic sympathetic fibers, 192 in herniated lumbar nucleus pulposus, 103
Parasympathetic preganglionic (vagal) fibers, 183 Prehospital management of cervical spine injury, 93 pupillary light and accommodation, 13
Parasympathetic relay ganglia, 175 Pressure gradient, for intrafascicular circulation, 119 Refsum disease, 158
Paresthesias, in buttocks, 66 Presynaptic membrane, 244 Rehabilitation, early spinal cord injury, 97
Parieto-occipito-temporal eye fields, 16 Presynaptic neuromuscular junction transmission Renal ganglion, 192
Parkinson disease, 200 Repetitive motor nerve stimulation, 248
Parotid gland, 41, 175, 177, 180 disorders, 252 Repolarizing current, 149
Passive stretch, 155 Pretectal nucleus, 199 Reproductive organs, innervation of, 196–197
Patient examination for low back pain, 102, 217–218 Primary afferent fibers, 202 Respiratory failure, in ALS, 241
Pelvic splanchnic nerves, 188 Primary motor neuron disease, 236 Resting membrane potential, 146
Pelvis, autonomic nerves and ganglia in, 193 Progressive brachial plexus lesions, 114 Reticular formation, 12, 32
Periaqueductal gray, 204–205 Progressive muscular atrophy, 236 Reticulospinal pathway, 60
Periglandular plexus, 190 Progressive systemic sclerosis, 25 Retina
Periodic paralysis, hyperkalemic, 275 Progressive thoracic kyphosis, 218 layers of, 9–11
Peripheral autonomic disorders, 200 Pronator teres muscle, 128 neurologic deficit, 12
Peripheral nerve Proprioception, from muscle spindles, 21 Retinal projections, 12–13
anatomy, 143 Proprioceptive fibers, 63 Retinitis pigmentosa, 158
cutaneous distribution, 223 Proprioceptive reflex, control of muscle tension, 155 Retinogeniculostriate visual pathway, 11–12
demyelination, 148 Propriospinal pathways, 55 Retromandibular vein, 185
histology, 144 Prostatic plexus, 174, 193 Rhodopsin, 10
Peripheral neuropathies Proximal duodenum, innervation of, 187 Rhomboid minor muscle, 130
caused by Proximal median neuropathies, 125 Ribs, 50
Proximal myotonic myopathy, 267 attachments, 85
heavy metal poisoning, 169 Proximal radial neuropathies, 131 Riche-Cannieu anastomosis, 126
leprosy, 171 Proximal sciatic nerve, 134 Rods, 9–10
diabetic, 221–222 Proximal spinal accessory nerve lesions, 45 Romberg sign, 74
metabolic, toxic, and nutritional, 170 Proximal ulnar nerve lesions, 129 Root of tongue, 31
Peripheral sensitization, 206 Psoas major muscle, 214 Rootlets, 51
Peripheral somatic sensory neurons, 232 Pterygopalatine ganglion, 8, 20, 26, 178 Rostral ventromedial medulla, 204–205
Peroneal nerve, schwannoma, 121 Ptosis Round window, 39
Pharmacology of neuromuscular transmission, 247 Rubrospinal tract, 55, 58, 61
Pharyngeal plexus, 40, 178–179 bilateral, 253 Ruffini terminals, 152, 154
Pharynx, neurogenic disorders, 43 in myasthenia gravis, 249 S
Phenotypic manifestations in spinal muscular atrophy, in myotonic dystrophy, 267 Saccadic pathways, 17–18
242 in oculopharyngeal muscular dystrophy, 269 Saccule, 39
Photoreceptor cells, 10–11 Pubic tubercle, 214 Sacral canal, 88
Phrenic nerve, 113, 116, 186 Pudendal nerve, 50, 115, 188, 193, 195 Sacral curvature, 80
Physostigmine, 247 Pulmonary plexus, 42, 174 Sacral plexus, 50, 111, 133, 188, 196
Pia mater, 51, 106 Pulsatile tinnitus, 34–35 hematoma compressing, 115
Pial arterial plexus, 53 Pulvinar, 12 Sacroiliac joints, 89
Pineal mass, 18 Pupillary light reflex, 13, 181 Sacrospinous ligament, 134
Piriformis muscle, 214, 219 loss of, 158 Sacrotuberous ligament, 134
Pituitary gland, 15 Pupils Sacrum, 52
efferent endings, 151 abnormal conditions, 199–200 base of, 88
Plantar nerves, 135, 137, 221 in intracerebral hemorrhage, 209 ligaments of, 89
Plantaris muscle, 137 Pyramidal tract, 57 Safety factor, 248
Plasma cell, 251 Q Salivary gland, lymphocytic infiltration, 167
Platysma, 26 Quadratus femoris muscle, 134 Saphenous nerve, cutaneous innervation, 132
Plexopathy Quadratus lumborum muscle, 219 Sarcoglycan complex, 266
brachial, 114 Quadriceps femoris muscle, 132 Sarcolemma, 244, 250, 256
lumbosacral, 115 weakness of, 272 Sarcomere subdivisions, 256
neonatal brachial, 113 R Sarcoplasmic reticulum, 258
POEMS syndrome, 162, 165 Radial nerve, 130 Sartorius muscle, 132
Polymyositis, 270–271, 273 compression/entrapment neuropathies, 131 Satellite cell, 256
Polyneuropathy Radicular arteries, 52–53 Scala vestibuli, 39
diabetic, 163 spinal angiogram of, 75 Scalp, 27
painful, 221–222 Radicular veins, 54 Scapular winging, 45, 122
Pompe disease, 276 Radiculomedullary arteries, 52–53 Schistosomal myelopathy, 78
Pons, 12, 41, 60, 202 Radiculopathy, radiographic diagnosis, 101 Schwann cell, 143, 152, 244–246
Pontine reticular formation, 21 Radiculoplexus neuropathy, diabetic lumbosacral, 110 Schwannomas
Pontine reticulospinal fibers, 60 Range of motion, in lumbar spine, 217–218 peroneal nerve, 121
Popliteus muscle, 137 Raphe nuclei, 204 vestibular, 34, 36
Porphyria, hereditary, 200 Recruitment by convergence, 206 Schwartz-Jampel syndrome, 268
Postcentral gyrus, 21, 56 Rectal plexus, 174 Sciatic nerve, 50, 111, 115, 134–135, 174
Postchiasmal neurologic deficits, 12 Rectococcygeus muscle, 214 compression of, 220
Posterior arch, 81 Rectus abdominis muscle, 108 cutaneous innervation, 138
Posterior atlanto-occipital membrane, 83 Recurrent inhibition, 64 Sclera, 9
Posterior cervical spine, stabilization and fusion, 96 Recurrent laryngeal nerve, 43, 182 Sclerodactyly, 25
Posterior femoral cutaneous nerve, 134–135 Scleroderma, 25
Posterior horn, 62 Scoliosis, early-onset progressive, 229
Posterior intercostal artery, 53 THE NETTER COLLECTION OF MEDICAL ILLUSTRATIONS
Posterior interosseous nerve, 131
Posterior longitudinal ligament, 87

288

Index

Second lumbar splanchnic nerve, 186 Spinal cord (Continued) Superior oblique muscle, 14–15
Segmentation, dermal, 107 principal fiber tracts, 55 Superior olivary complex, 37
Semicircular canals, 39 reticulospinal and corticoreticular pathways, 60 Superior rectus muscle, 14–15
Seminal vesicle, 193 rubrospinal tract, 58 Superior salivatory nucleus, 180
Semispinalis capitis muscle, 212 sacral part, 177, 195 Superior vagal ganglion, 42–43
Semitendinosus muscle, 135 somatosensory afferents to, 203 Supraclavicular branches of brachial plexus, 112
Sense of smell, 8 somesthetic system of body, 56 Supraclavicular nerves, 116
Sensitization spinal dural fistulas, 75 Supranuclear lesions, 28
spinal effector mechanism, 63 Supraorbital nerve, 15, 20
central, 206–207 spinal nerves, 50 Suprarenal gland, 192
peripheral, 206 spinal reflex pathways, 64 Suprascapular nerve, 123, 130
Sensory and autonomic neuropathy, hereditary (HSAN), subacute combined degeneration, 74 Supraspinal ligaments, 87
syringomyelia, 73 Sural nerve, 137
159 thoracic part, 176–177, 181
Sensory and parasympathetic division of facial nerve, tumors biopsy specimens, 157
extradural, 70 conduction testing, 159
27 intradural, 70–71 Suspensory ligament of lens, 9
Sensory ganglionopathy, 139 neuroimaging characteristics, 72 Sweat glands, 177
Sensory impairment, 65–67 upper lumbar part, 177 Sweat testing, 198
Sensory loss, in cervical disk herniation, 100 veins, 54 Swollen optic nerve, 11
Sensory neurons vestibulospinal tracts, 59 Sympathetic cardiac nerves, 182
Sympathetic fibers
endings, 145 Spinal dural fistulas, 75 autonomic, 175–176
in taste pathway, 31 Spinal effector mechanism, 63 for eye, 19, 180
types of, 232 Spinal muscular atrophy type I, 227, 242 for intestines, 188–189
Serratus anterior muscle, 108 Spinal nerve roots for liver and biliary tract, 191
Shellfish poisoning, 254 for pelvis, 193
Shingles, 25, 29, 109, 211 arteries, 52–53 for stomach and proximal duodenum, 187
Shoulder drop, 45 deformed by tumor, 71 Sympathetic nervous system dysfunction, 210
Shoulder girdle mononeuropathies, 122 effects of lumbar hyperlordosis, 216 Sympathetic preganglionic cardiac fibers, 183
Sjögren syndrome, 167 filaments, 51 Synaptic transmission, 246–247
Skeletal muscles, motor neurons supplying, 145 thoracic, disorders, 109 Synaptic trough, 244, 246
Skull base, 50 veins, 54 Syringomyelia, 73
Slow-channel congenital myasthenic syndromes, 253 Spinal nerves, 50, 106, 184 Systemic lupus erythematosus (SLE), 167
Slow-twitch muscle fibers, 261 lumbar hyperlordosis effect on, 216
Small cell lung cancer, 252 T1, 19 T
Small intestine, autonomic innervation, 189 Spinal root of accessory nerve, 44 T cells, CD8+, 273
Smooth muscle, efferent endings, 151 Spinal stenosis, lumbosacral, 105 Taste bud anatomy, 30
Sodium channelopathies, 268 Spinocervical tract, 56 Taste pathways, 31
Solitary tract nucleus, 42 Spinothalamic tract, 56, 202–203 Taste receptors, 30–31
Somatic motor neurons, 232–233 Spinous processes, 82–83, 85 Tectospinal tract, 12, 32, 55, 181, 203
Somatic neuromuscular transmission, 246 Spiral organ of Corti, 39 Tegmen tympani, 33
Somatoform patient, neurologic evaluation of, 223–224 Splanchnic nerves Tendon organ reflex, 64
Somatosensory cortex, 203 abdominopelvic, 184 Tendons of rectus muscles, 9
Somesthetic system, 56 lumbar, 186, 192–193, 197 Tenon’s capsule, 9
Sphincter of hepatopancreatic ampulla, 191 pelvic, 188, 193 Tensor fasciae latae muscle, 134, 219
Sphincter pupillae muscle, 181 thoracic, 182, 192 Tensor tympani muscle, 37
Spinal bulbar muscular atrophy, 242 Splenic artery, 191 Terminal cisternae, 258
Spinal column Spondylolisthesis, 217 Testicular artery, 196
anterior cervical spine decompression and stabilization, Spondylolysis, 217 Testis, 196
Spurling maneuver, 100 Thalamic pain syndrome, 208–209
95 Stapes, 33, 39 Thalamus, 22
atlas and axis, 81 Stenosis, lumbosacral spinal, 105
cervical spine injury, 93 Sternocleidomastoid muscle, 44–45, 116 retinal projections to, 12
cervical vertebrae, 82 Sternohyoid muscle, 46, 116 Thalamus medial complex, 203
compressive flexion, 91 Steroid injection, intra-articular, 215 Thallium poisoning, 169
craniocervical ligaments Stocking-glove anesthesia, 224 Thenar muscles, 124
Stomach, innervation of, 187 Thiamine deficiency, 170
external, 83 Strains, lumbar, 216 Thick filaments, 256–258
internal, 84 Striated muscle, 177 Thin filaments, 256–258
curvatures of, 80 Styloglossus muscle, 46 Third lumbar splanchnic nerve, 186
distractive extension, 92 Subacute combined degeneration of spinal cord, 74 Thomsen disease, 267–268
distractive flexion, 90 Subarachnoid space, 9 Thoracic (descending) aorta, 53
ligaments of, 87 Subclavian artery, 179 Thoracic aortic plexus, 174
lumbar vertebrae and intervertebral disk, 86 Subcostal nerve, 50 Thoracic curvature, 80
posterior cervical stabilization and fusion, 96 Subfrontal meningioma, 7 Thoracic nerves, 108
sacrum and coccyx, 88–89 Sublingual nerve, 24 Thoracic spinal nerve root disorders, 109
thoracic vertebrae, 85 Subluxation of C4-C6, 90 Thoracic sympathetic trunk ganglia, 184
traction and bracing, 94 Submandibular ganglion, 178, 180 Thoracic vertebrae, 52
Spinal cord Submandibular gland, 26
acute spinal cord syndromes, 68–69 Submucosal plexus, 190 costovertebral joints, 85
arteries, 52–53 Subserous plexus, 190 section through, 106
cervical disk herniation causing cord compression, 77 Substantia gelatinosa, 21 Thoracoabdominal nerves, 108
cervical spondylosis, 76 Succinylcholine, 247 Thoracolumbosacral orthosis, 94
corticospinal system, 57 Sudomotor testing, 198 Thorax
cross-section, in patient with ALS, 240 Superficial fibular nerve, 136 autonomic nerves in, 182–183
dysfunction Superficial sensory radial branch, 130 vagal nerve branches in, 43
autonomic impairment, 67 Superior cervical sympathetic ganglion, 179 Thymic hyperplasia, 251
motor impairment, 65 Superior colliculus, 16, 18 Thyrotoxic periodic paralysis, 275
sensory impairment, 65–67 Superior gluteal nerve, 115, 134 Tibial nerve, 135, 137, 221
gray matter cytoarchitecture, 62 Superior mesenteric artery, 188 cutaneous innervation, 138
infectious and hereditary myelopathies, 78 Superior mesenteric ganglion, 176 Tinnitus, pulsatile, 34–35
injury, 97
lumbar, 202
major descending tracts and ascending pathways, 61
meninges, 50–51

THE NETTER COLLECTION OF MEDICAL ILLUSTRATIONS 289

Uncinate process, 82 Index
Uncus, 6
Tongue, 30–31 Unmyelinated axons, olfactory, 7 Vestibulocochlear nerve (VIII)
fasciculations of, 238 Unmyelinated nerve fibers, 143 canalith repositioning maneuvers, 35
intrinsic muscles, 46 Upgaze palsy, 18 cochlear nerve, 33
weakness of, 48 Upper arm course and chief functions, 4
disorders
Toxic myopathy, 274 median nerve, 124 cochlear, 34–35
Trachea, 42 proximal ulnar nerve, 128 vestibular, 33–34
Traction, for cervical spine injury, 94 Upper brachial plexus injury, 113 motor and sensory fibers, 2
Tractus solitarius, 32, 47 Upper extremity, proximal nerves of, 122–123 vestibular nerve, 32–33
Transient neonatal myasthenia gravis, 228 Upper motor neuron signs, 236
Transmembrane ion concentrations, 146 Uremia, 170 Vestibulospinal tracts, 59, 203
Transverse ligament of atlas, 84 Ureters, innervation of, 194–195 Visceral efferent endings, 151
Transverse myelitis, 69 Urinary bladder, 177 Visual fields, 10
Transverse process, 81, 85 innervation of, 194–195 Visual fixation, vestibular projections important for,
Transverse (T) tubules, 258 Uterus, 197
Transversus abdominis muscle, 108 Utricle, 39 16–18
Trapezium bone, 126 V Visual reflex centers, 180–181
Trapezius muscle, 44–45, 108, 212 Vagal trunks, 174, 189 Visual system
Trapezoid body, 37 Vagina, 197
Trapezoid bone, 126 Vagus nerve (X), 179 lesions, 10
Triceps brachii muscle, 130 branches in thorax, 43 retinal projections, 12–13
Trichinosis, 254 course and chief functions, 5 Vitamin B1 deficiency, 170
Trigeminal ganglion, 181 motor and sensory fibers, 2 Vitreous body, 9
Trigeminal nerve (V), 41 vagal nuclei, 42 W
Vallate papilla, 30–31 Weakness
anatomy, 20–23 Valsalva maneuver, 198 in cervical disk herniation, 100
disorders, 24–25 Varicella-zoster, 25 facial, 27–28
motor and sensory fibers, 2 Vasculitic neuropathy, 166–167 in herniated lumbar nucleus pulposus, 103
origin and distribution, 3 Veins of spinal cord, nerve roots, and vertebrae, 54 of lower limb, 76
Trigeminal neuralgia, 21, 25 Ventral posteromedial nucleus of thalamus, 21, 56 in mononeuropathies, 120
Trochlear nerve (IV) Ventral rami, 106 motor, in ALS, 237
course and distribution, 3 of spinal nerves, 112 muscle. See Muscle weakness
motor and sensory fibers, 2 of thoracic nerves, 108 of tongue, 48
origins, 15 Ventral root, 232 Werdnig-Hoffmann disease, 227, 242
Tropomyosin, 257 Ventroposteromedial nuclei, 203 White ramus communicans, 19, 41, 51, 106, 113, 176,
Troponin, 257 Verapamil, 247
Tumors Vertebrae, veins of, 54 179, 181
compressing lumbar plexus, 115 Vertebral bodies, 86 Winged scapula, 45, 122
spinal cancer within, 218 Wristdrop, 130, 166
cervical, 82 Z
extradural, 70 trauma, 91 Z band, 257–259
intradural, 70–71 Vertigo, benign paroxysmal positional, 33–35 Z disks, 256–257
neuroimaging characteristics, 72 Vesical plexus, 174, 196 Zonular fibers, optic, 9
vertigo caused by, 34 Vestibular nerve, 32–33 Zygapophyseal joints, 82–83
Tympanic cavity, 24 Vestibular projections, important for visual fixation, Zygomatic nerve, 23
Tympanic nerve (of Jacobson), 40
Tympanic plexus, 19, 41 16–18
U Vestibular receptors, 38
Ulcer, diabetic, of feet, 222 Vestibular schwannoma, 34, 36
Ulnar nerve, 128
conduction velocity, 161
mononeuropathies, 129

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290 THE NETTER COLLECTION OF MEDICAL ILLUSTRATIONS