Humanitext Reader

Galen · The Anatomy of the Nerves §16-17

Origins and Distribution of Thoracic and Lumbosacral Nerves

Passage 7 of 7 · Greek

Summary

The author outlines the origins of the thoracic, lumbar, and sacral spinal nerves, explaining their distribution pathways to the upper limbs, thoracic and abdominal walls, lower limbs, and the perineal region.

§16Ἄλλη δ’ ἐφεξῆς συζυγία αὐτῆς προειρημέναις ταῖς συζυγίαις ἐπιμίγνυται τὸ πλεῖστον μέρος ἐκ τῶν τοῦ θώρακος ἤδη σπονδύλων ἐκφυομένη μεταξὺ τοῦ πρώτου καὶ δευτέρου κατ’ αὐτόν.
Another subsequent pairing (the first thoracic) mixes for the most part with the aforementioned pairings, arising already from the vertebrae of the thorax, between the first and second in that region.
μέρος μὲν οὖν τι σμικρὸν αὐτῆς εἴς τε τὸ πρῶτον κατασχίζεται μεσοπλεύριον καὶ εἰς τοὺς ῥαχίτας ὀπίσω μῦς ἀφικνεῖται· τὸ δ’ ἄλλο πᾶν ὑπὲρ τὴν πρώτην ἀνατεινόμενον πλευρὰν συνάπτεται τῷ μετὰ τὸν ἕβδομον σπόνδυλον νεύρῳ.
A certain small part of it, then, is split into the first intercostal space and reaches the spinal muscles behind; but all the rest, extending upward over the first rib, joins with the nerve after the seventh vertebra.
κᾄπειτα οὕτως ἄμφω τε ταῦτα καὶ τὰ ἄλλα τὰ προειρημένα διὰ τῆς μασχάλης ἐπί τε τὰ σιμὰ τῶν ὠμοπλατῶν καὶ τὸν βραχίονα φέρεται, μιγνύμενά πως πρὸς ἄλληλα καὶ ἀντεμπλεκόμενα.
And then in this way both these and the other aforementioned nerves are carried through the armpit to the concave parts of the scapulae and to the arm, mixing somehow with one another and intertwining.
διανέμεται δὲ πολὺ μὲν αὐτῶν εἴς τε τοὺς βραχίονος μῦς καὶ τοὺς τοῦ πήχεως· ὅσον δὲ ὑπόλοιπον, εἰς ἄκραν χεῖρα διασπείρεται.
A large part of them is distributed to the muscles of the arm and those of the forearm; and whatever remains is scattered to the extremity of the hand.
κατ’ εὐθὺ δὲ μάλιστά ἐστι τῇ μὲν ἐσχάτῃ τῶν εἰρημένων ἐκφύσεων, ὅσα πρὸς ἄκραν χεῖρα παραγίνεται νεῦρα· τῇ δ’ ὑπὲρ αὐτῆς τὰ κατὰ τὸν πῆχυν· ὅσα δὲ κατὰ τὸν βραχίονα, καὶ ὅσα τούτων ἔθ’ ὑψηλότερα, καὶ πρὸς τὴν μὲν ὠμοπλάτην ἀφικνεῖται νεῦρα, ταῖς ἀνωτέραις συζυγίαις ἐστὶ κατ’ εὐθύ.
And those nerves that reach the extremity of the hand are almost in a straight line with the last of the mentioned origins; and those of the forearm with the one above it; while those of the arm, and those still higher than these, and the nerves reaching the scapula, are in a straight line with the higher pairings.
οἵαν δὲ ὁδὸν διὰ τῆς ὅλης χειρὸς ποιεῖται, καὶ πῶς εἰς μυῶν ἕκαστον διανέμεται, ἐν ταῖς ἀνατομικαῖς ἐγχειρήσεσιν ἤδη εἴρηται.
What kind of course they make through the whole hand, and how they are distributed to each of the muscles, has already been said in *Anatomical Procedures*.
κατὰ δὲ τὸν αὐτὸν τρόπον ἐξ ἁπάντων τοῦ θώρακος τῶν σπονδύλων ἐκφύεται νεῦρα, παραπλησίαν ἔχοντα τὴν νομὴν πάντα, πλὴν τοῦ κατὰ τὸ δεύτερον μεσοπλεύριον.
And in the same manner, nerves arise from all the vertebrae of the thorax, all having a similar distribution, except for the one at the second intercostal space.
ἐντεῦθεν γάρ ἐκπίπτει σαφὲς νεῦρον ἐπὶ τὸ δέρμα τοῦ βραχίονος παραγινόμενον.
For from there a conspicuous nerve emerges, reaching the skin of the arm.
αἱ δ’ ἄλλαι πᾶσαι συζυγίαι κατὰ μὲν τὴν ἔκφυσιν αὐτίκα μέρος τι τοῖς ῥαχίταις μυσὶ διδόασι καὶ τοῖς ἄλλοις τοῖς κατὰ τὸ μετάφρενον, οἷον τοῖς τε τὰς ὠμοπλάτας κινοῦσι καὶ τοῖς ἄνω φερομένοις ἐπὶ τὴν κατ’ ὦμον διάρθρωσιν.
All the other pairings, immediately at their origin, give a certain part to the spinal muscles and to the others in the back, such as those that move the scapulae and those carried upward to the joint at the shoulder.
ὅλως δὲ τῷ λοιπῷ καὶ πλείστῳ μέρει σφῶν αὐτῶν διὰ τῶν μεσοπλευρίων προερχόμεναι μέχρι τοῦ κατὰ τὸ στέρνον ὀστοῦ τούς τ’ ἐν αὐτοῖς τοῖς μεσοπλευρίοις μῦς διαπλέκουσι καὶ τοὺς ἔξωθεν ἐπικειμένους τῷ θώρακι, διεκβάλλουσαι μόρια σφῶν αὐτῶν, περὶ ὧν ἑκάστου κατὰ μέρη ἐν ταῖς ἀνατομικαῖς ἐγχειρήσεσιν εἴρηται.
On the whole, with their remaining and greatest part, proceeding through the intercostal spaces as far as the bone at the sternum, they interlace both the muscles in the intercostal spaces themselves and those lying upon the thorax from the outside, sending out parts of themselves, about each of which has been said in detail in *Anatomical Procedures*.
αἵ γε μὴν κατὰ τὰς νόθας πλευρὰς συζυγίαι τῶν ἀπὸ τοῦ νωτιαίου νεύρων, ἐπειδὴ πρὸς τὸ στέρνον οὐκ ἐξήκουσιν αἱ νόθαι, βραχὺ μέν τι τῷ καθ’ ἑαυτὴν ἑκάστη μεσοπλευρίῳ διανέμει· τῷ δὲ ἄλλῳ παντὶ ἐκπίπτει πρὸς ὑποχόνδριον, εἴς τε τοὺς πρώτους ἐπιβεβλημένους ἔξωθεν μῦς τοὺς λοξοὺς τοὺς ἄνωθεν ἐκ τοῦ θώρακος καταφερομένους καὶ τοὺς κατάντεις τοὺς σαρκώδεις διανεμομένη.
Moreover, the pairings of the spinal nerves at the false ribs, since the false ribs do not reach the sternum, each distributes a small part to its own intercostal space; and with all the rest it emerges toward the hypochondrium, being distributed to the first oblique muscles applied from the outside, which are carried downward from the thorax above, and to the descending fleshy muscles.
§17Μετὰ δὲ ταύτας εἰσὶν αἱ κατὰ τὴν ὀσφὺν ἐκφύσεις τῶν νεύρων, οὐκ ἐκ κοινοῦ τρήματος, ὥσπερ αἱ κατὰ τὸν τράχηλον.
After these are the origins of the nerves in the loins, not from a common foramen, as those in the neck.
ὁ γὰρ ὑπερκείμενος σπόνδυλος ἐνταῦθα μόνος διατετρημένος ἔξοδον ἐπιτήδειον παρέχει τῷ νεύρῳ κοινῷ ἐκείνῳ τρήματι τῷ ἐν τραχήλῳ ἐκ τοῖν ἀμφοῖν σπονδύλοιν γινομένῳ κατὰ μικρὸν εἰς ὑπερκείμενον μετατιθεμένῳ· ὡς πρῶτον μὲν ἐκείνου διαγλύφηται πολὺ ἐν αὐτῇ, εἶτα δὲ τὸ πᾶν, ἔπειτα καὶ ἀναφέρηται ἀπὸ τοῦ πέρατος τοῦ σπονδύλου, καὶ ἔκφυσις αὐτὴ γένηται ὑπὲρ τὸ πέρας.
For there the overlying vertebra alone, being perforated, provides a suitable exit for the nerve, that common foramen in the neck, which was formed from both vertebrae, being gradually transferred to the overlying one; so that first a large part of it is carved out in the vertebra itself, then the whole of it, and then it is also carried up from the end of the vertebra, and the origin itself comes to be above the end.
κοινὸν δὲ καὶ τούτοις ἅπασι τοῖς νεύροις, εἴς τε τοὺς ῥαχίτας ἰέναι μῦς καὶ τοὺς κατ’ ἐπιγάστριον ἐπί τε τὰς ψόας.
And it is common also to all these nerves to go to the spinal muscles and to those of the epigastrium and to the psoas muscles.
ἐκ δὲ τῶν πρώτων κατὰ τὸ διάφραγμα σπονδύλων καὶ τοῖς ἄνωθεν καταφερομένοις ἐξ ἐγκεφάλου νεῦρον ἐπιμίγνυται τὸ μικρὸν ἀφ’ ἑκάστου, κατὰ δὲ τοὺς τελευταίους τῆς ὀσφύος σπονδύλους δύο ἐκφύσεις μέγισται γίγνονται νεύρων ἐπὶ τὰ σκέλη φερομένων· ἀναμίγνυνται δ’ αὐταῖς ἄλλαι μικραὶ, μία μὲν ὑπερκειμένη, μία δὲ ἄλλη κατωτέρω τοῦ πρώτου κατὰ τὸ πλατὺ καλούμενον ὀστοῦν τρήματος ἐκφυομένη.
And from the first vertebrae near the diaphragm, a small nerve from each also mixes with those carried downward from the brain. And at the last two vertebrae of the loins, two very large origins of nerves occur, carried to the legs; and with these other small ones mix, one overlying, and another lower down, arising from the first foramen of the bone called flat.
αὗται μὲν οὖν εὐθὺς ἀποχωρισθεῖσαι τοῖς πρώτοις μυσὶ τοῖς κινοῦσι τὴν κατ’ ἰσχίον διάρθρωσιν ἐκφύονται· τὸ δ’ ἄλλο πᾶν εἰς τὰ σκέλη καταφέρεται, διασχιζόμενον ἄχρι τοῦ πέρατος ἐν αὐτοῖς εἰς ἕκαστον μῦν, ἀνάλογον τοῖς ἐν χερσὶν, ὥσπερ ἐν ταῖς ἀνατομικαῖς ἐγχειρήσεσιν ἤδη εἴρηται.
These, then, having immediately separated, insert into the first muscles that move the joint at the hip; but all the other part is carried down to the legs, being split in them as far as the extremity into each muscle, analogous to those in the hands, just as has already been said in *Anatomical Procedures*.
νῦν γὰρ καθάπερ τινὰ ὑποτύπωσίν τε καὶ σύνοψιν τούτων τῶν ἀκριβῶς ἐν ἐκείνοις τοῖς βιβλίοις γεγραμμένων χρήσιμον τοῖς εἰσαγομένοις ἐσομένην πεποιήμεθα.
For now we have made, as it were, a sketch and summary of these things precisely written in those books, which will be useful for beginners.
οὕτω δὴ καὶ ὅσα τὰ διὰ λοιπῶν ὀστοῦ πλατέος τρημάτων ἔκφυσιν νεῦρα καὶ εἰς τοὺς ἐνταῦθα ὑπάρχοντας μῦς διασπείρονται, ἐν ἑκάστῃ πραγματείᾳ ἀκριβῶς διηγήμεθα.
In this way also, all the nerves that have their origin through the remaining foramina of the flat bone and are scattered into the muscles existing there, we have precisely described in each treatise.
νῦν τοῦτο μόνον εἰρῆσθαι ἱκανῶς ἐστι, τοῖς τῆς ἕδρας τε καὶ τοῦ αἰδοίου καὶ τῆς κύστεως μυσὶν αὐτῷ τῷ αἰδοίῳ, ἔτι καὶ μυσὶ τοῖς ἀπὸ τοῦ πλατέος ὀστοῦ καὶ ἀπὸ τοῦ ἔνδον μέρους τοῦ τῆς ἥβης ὀστοῦ ἐκφυομένοις, καὶ πᾶσι σώμασι τοῖς ἔξωθεν κατ’ αὐτὸ ὀστοῦν πλατὺ καὶ ἱερὸν καλούμενον ἐγκειμένοις, ἐκ τούτων ἔνδοθεν καὶ ἔσωθεν αὐτοῦ τοῦ ὀστοῦ ἱεροῦ τρημάτων τὰς νεύρων ἐκφύσεις ἀπὸ νωτιαίου γεννᾶσθαι εἰς τὸ κόκκυγος ὀστοῦν καλούμενον τελευτώσας.
Now it is sufficient for only this to be said, that for the muscles of the seat, the pudendum, and the bladder, for the pudendum itself, and also for the muscles arising from the flat bone and from the inner part of the pubic bone, and for all the bodies lying from the outside upon that bone called flat and sacred, from the foramina of this sacred bone, both within and on its inner side, the origins of the nerves from the spinal cord are generated, ending at the bone called the coccyx.

Notes

  1. §16Ἄλλη δ’ ἐφεξῆς συζυγία αὐτῆς προειρημέναις ταῖς συζυγίαις ἐπιμίγνυται — The subject `Ἄλλη δ’ ἐφεξῆς συζυγία` (another subsequent pairing, i.e., the first thoracic nerve) is singular, and the verb `ἐπιμίγνυται` is also singular. It takes the dative `προειρημέναις ταῖς συζυγίαις` (the aforementioned pairings, referring to the lower cervical nerves) as its object, describing the formation of the brachial plexus. `αὐτῆς` (or `αὐταῖς` in some manuscripts) indicates its continuation immediately after those pairings.
  2. ¦249¦κατ’ εὐθὺ δὲ μάλιστά ἐστι τῇ μὲν ἐσχάτῃ τῶν εἰρημένων ἐκφύσεων, ὅσα πρὸς ἄκραν χεῖρα παραγίνεται νεῦρα· — The relative clause `ὅσα πρὸς ἄκραν χεῖρα παραγίνεται νεῦρα` (the nerves that reach the extremity of the hand) is the subject, with `ἐστι` as the verb. `κατ’ εὐθὺ` (in a straight line with) takes the dative `τῇ μὲν ἐσχάτῃ τῶν εἰρημένων ἐκφύσεων` (the last of the mentioned origins) as its complement. The subsequent clauses (`τῇ δ’ ὑπὲρ αὐτῆς...` and `ὅσα δὲ κατὰ τὸν βραχίονα...`) share this parallel contrastive structure with ellipsis of the verb and the adverbial phrase.
  3. §17κοινῷ ἐκείνῳ τρήματι τῷ ἐν τραχήλῳ ἐκ τοῖν ἀμφοῖν σπονδύλοιν γινομένῳ κατὰ μικρὸν εἰς ὑπερκείμενον μετατιθεμένῳ· — The dative `τρήματι` and its accompanying participles `γινομένῳ` and `μετατιθεμένῳ` function as a dative of circumstance or means. It explains the circumstance under which the intervertebral foramen (the common hole formed by both vertebrae in the neck) gradually shifts into the body of the overlying vertebra in the lumbar region.
  4. ¦p.856¦τοῖς τῆς ἕδρας τε καὶ τοῦ αἰδοίου καὶ τῆς κύστεως μυσὶν... τὰς νεύρων ἐκφύσεις... γεννᾶσθαι — The final structure of the sentence is an accusative and infinitive (AcI) construction governed by `νῦν τοῦτο μόνον εἰρῆσθαι ἱκανῶς ἐστι` (now it is sufficient for only this to be said). The accusative subject is `τὰς νεύρων ἐκφύσεις` (the origins of the nerves) and the infinitive is `γεννᾶσθαι` (to be generated). The datives `τοῖς ... μυσὶν` indicate the targets of distribution (dative of advantage).

Cite this passage

Galen, The Anatomy of the Nerves §16-17. Humanitext Reader, https://reader.humanitext.ai/en/text/urn:cts:greekLit:tlg0057.tlg014.humanitext-grc1:16-17

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