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THE CIRCULATIONS AND THE CONTROLLING NERVE MECHANISMS It is taken for granted that the reader of this book has had a basic training in anatomy and that it is only necessary here to give a general outline of the physiological functions and the controlling neural units. In the course of Neuropathic treatment, the physician generally gives first of all the “Lymphatic Treatment.” this part of the treatment consists of certain defined pressures or manipulations to empty the lymph out of an area or move it onward in the whole body. This technique is described in Chapter VI. It is very important that lymph circulation be maintained and should precede any other treatment so that the load on the general circulation and nervous systems may be lightened. The lymphatics which finally discharge their contents into the blood stream at the junction of the subclavian and internal jugular veins by means of the thoracic duct on the left, and the right lymphatic duct on the right are remarkably influenced by Neuropathic treatment. The same is true of all lymphatic glands, those of the neck, the mesenteric, mediastinal, axillary, inguinal, popliteal and the coeliac glands. Cyriax states: “The anatomical arrangements of the lymphatics are such that the slightest pressure or stretching promotes the onward flow of the lymph and hastens absorption.” The student would be wise to review once again the anatomy of the lymphatic system, and the transport of lymph. Here we are concerned only with thee physiology. Under normal conditions the lymph is drained off as it is formed; while under perversions or pathological the lymph may accumulate in the tissues owing either to an excessive formation of lymph, or to a lack of muscular contraction, or by lack of pressure which forces the plasma through the capillary walls into the extravascular and pericellular spaces or to some interruption in the nerve mechanism controlling circulation, then more or less, according to the degree of perversion the functions of the lymph are restrained. [FIGURE 1: THE LYMPH SYSTEM]
FUNCTIONS OF THE LYMPHATIC SYSTEM 1. It conveys fluid and the products of digestion. 2. It removes effete matter from the tissues. 3. It relieves the blood vascular system of excess of fluid. 4. It acts as a powerful solvent to medication and hard foreign substances. 5. It is a reserve for the blood to draw on after hemorrhage or during starvation. 6. It is a lubricant in synovial and other fluids. 7. It has a part in the healing of wounds. (Glazing of the wound surface.) Grapes outlines the following points on the lymphatic system: 1. Normal flow of lymph relieves cellular intoxication and normalizes metabolism. 2. Best method to relieve pain is to insure adequate drainage. Remove pressure caused by physiological block, for the cause is often remote from the symptoms. 3. Stabilizes the chemistry of the tissue fluid, slightly alkaline. Relative acidosis alters the rhythmical tone of nerve impulses. 4. Prevents inter-cellular pressure -- edema and fibrosis. 5. Prevents congestion, which is the main cause of disease. 6. Does away with the possibility of tumors and cancer. A. Lumps in the breast:: no cause for cancer if we have normal lymphatic drainage. 7. Gangrene and phlebitis. A lymphatic condition rather than the veins. 8. Varicose veins. Pelvic stasis of lymph. Illustration -- Glass boot. Local and does not remove the source of the trouble. 9. Pneumonia. Dr. Goode said: "Did you know that pneumonia can be broken up by freeing the auxiliary lymph glands?" 10. Filter. Nodes and glands. Colloidal changes lower vitality so that bacteria are allowed to creep into the tissues. 11. Maintain the tone of the tissues. Normal cell vibration (Ability to respond to nerve stimulus) conductivity. 12. Slow venous return. Clogged lymphatics affect the general circulation and burden the nerves to the heart. 13. Aids oxygen exchange. Disassociation of oxyhemoglobin. Completion of oxidation and energy metabolism. 14. Transports cell products. Part played in digestion. (Villi -- liver -- pancreas.) 15. Prevent and relieve shock. Loss of plasma -- oxygen starvation. 16. Storehouse for tissues. Hibernating animals. 17. The greatest safety device. A. Holds back poisons from the veins. B. Kills bacteria and such. A knowledge gained from a study of lymphatics and bloodvessels
helps us to better understand our bodies as a unit and the interrelation
of the tissues.
POINTS TO REMEMBER ABOUT LYMPHATICS IN TREATMENT 1. Lymphatic lymph runs in one direction. 2. A lymph congestion cannot be fully overcome by adjustment alone; they must be treated directly. 3. Keep recalling to mind the functions of the lymph and consciousness of their importance will soon be a habit. 4. The first step in a Neuropathic treatment is relieving lymphatic
stasis.
CIRCULATION OF THE BLOOD The blood is a circulating -- a living tissue, and, since the blood is intimately linked to every organ and cell in the body, disease or changes of such organs are reflected immediately in blood circulation and constituent changes. An ordinary routine examination of the blood may show nothing abnormal -- for, due to faulty circulation, stasis, congestion, etc., it is possible that the blood may be of different constituents in different parts of the body, and it is only when systematic acceleration of the circulation is induced that blood taken from various parts of the body will show similar counts. During the life of a healthy person the blood flows at varying rates
of speed, rapidly when the cells need much Oxygen or nutriment, slowly
when the need is small. It may not be literally true that the functions
of the individual organs depend entirely upon the material they receive
from the blood, but it is certain that the same organs will perish when
the blood supply is cut off.
THE CONSTITUENTS OF THE BLOOD It is not generally realized how complex are the constituents of the living blood, nor how all important a part it plays in the maintenance of life. The blood consists of an amber colored fluid -- the plasma -- in which are suspended the red and white cells. The red cells being in proportion of approximately 6 to 1 of the white cells. In addition the plasma contains proteins and all the various chemical extractives taken from the digestive processes such as fats, sugar, nitrogenous material, salts such as sodium chloride, calcium, etc. the blood also contains various gases in the fluid itself, and in the Oxygen combined with Hemoglobin which is carried in the red cells. There are also various mysterious substances or solutions that so far have not been identified by chemical means, which play an all important part in maintaining glandular and cell life. Each particular cell seems to be able to extract from the blood exactly the solutions that it must have for its own existence and activity. Again, each organ after it has taken its own requirements from the blood, deposits its own waste products and other solutions it has manufactured to the circulating blood for exchange and disposal in other organic activities. On this intricate exchange between the glandular organs -- the cells -- tissue and blood -- depends the health or disease -- pleasure or misery -- vitality or inertia of every individual. The blood gets its nutritive material from three sources: Oxygen from the outside air by the activity of the lungs; extracts and solutions taken from the digestive action of the intestines through its surface channels, and it also receives the synthetic processes and hormones from the various glands. In fact, all substances required by the body -- with the sole exception of Oxygen -- come either directly or indirectly from the intestinal activity. The blood also contains other ingredients such as mysterious bodies
-- called platelets -- various ferments which come into action when the
blood is attacked by an invader. These bodies apparently form part of the
defensive mechanism of life and remain dormant until called upon by the
organism for help.
THE FUNCTION OF THE CIRCULATION The function of the circulation is to carry blood to the tissues so as to maintain a proper environment for the tissue cells. This cellular or internal environment is the intercellular fluid which is both extravascular and extracellular; by virtue of the relative permeability of the endothelial walls of the capillaries it is in equilibrium with the blood within these vessels. A relatively constant condition of the internal environment is a prime requisite for normal existence and this is achieved by a transfer of material in both directions across the capillary walls. The circulating blood must therefore do many things. It must carry oxygen to the tissue and remove carbon dioxide from them. It must absorb food materials in the intestine and carry them to muscles, glands and other active tissues and to depots where reserves may be stored. It must carry waste products to the kidney and other excretory glands where they may be eliminated. It must distribute heat throughout the body, moving it from the tissues where it is generated to the surfaces where it may be dissipated. It must also carry from one tissue to another those specific chemical substances known as hormones which serve to regulate the activities of various parts of the body. The internal environment is kept relatively constant largely because the slight variations which do occur, when reflected in the blood, induce compensatory reactions. These responses are set up by changes in the composition of the blood (humoral changes) acting on other parts of the body, directly or indirectly, by stimulation of some nervous mechanism. In this way many of the functions of the various organs are coordinated with one another to effect a physiological unity of the individual. Of these various functions the most urgent is that of oxygen supply, since the reserves of oxygen held within the body are relatively slight. [See writer's book: Endo-Nasal, Aural and Allied Techniques, page 22.] The pulmonary system is fed by the right heart and serves to bring the
blood into contact with the alveolar air in the lungs where it may gain
oxygen and lose carbon dioxide; thus all the blood is exposed to
this contact each time it completes a double circuit. The larger or systemic
circulation is supplied by the left ventricle and serves to carry the aerated
blood to the various tissues of the body. It also serves all the other
functions of the circulation. Here the blood flow is by no means evenly
distributed; as a matter of fact an elaborate system of controls exists
for the diversion of the stream to the various tissues according to their
needs.
THE NATURE OF THE CONTROL OF THE CIRCULATION The circulation has to be controlled, not only to maintain an adequate supply of oxygen and food for active tissues, but also to effect an adequate transfer of heat and removal of waste matter. The principles of the circulation are simple, but the regulation of the circulation to meet the demands made upon it introduces many complexities. The blood must be distributed differently along various alternate paths according to the demands of different tissues. These adjustments have to be attained without serious disturbance in the average level of capillary pressure, which, if long maintained, would result in abnormalities of fluid distribution. They must also be attained without any sudden considerable change in blood volume. In addition, adjustments have to be made to overcome the considerable pressures created by gravity, and safeguards have to be provided to prevent the pump from being overstrained. This complex control is partly attained by carefully balanced nerve reflex effects, partly by the action of chemical substances on the vessels, and partly by physical effects, such as the balances between filtration and osmotic pressures. Neuropathy like many other therapies base the primary cause of disease
on the imbalance of the nervous system while others base it on irritations
aroused mentally and physically by wrong habits of thinking and living.
It is much like the argument, which came first, the chicken or the egg.
Both are complementary to the other. No physician can create a balanced
nerve action to the ailing stomach of the glutton without due consideration
to his eating habits, and an insistence that nothing can bee done for him
by treatments unless he conforms to a more reasonable diet. This same rule
applies to all habits of the patient that irritate any organ or tissue
of the brain that cause an imbalance of the Cerebro spinal nervous system.
THE CONTROLLING NERVOUS MECHANISM The nervous mechanisms consist of nerve cells which have become altered in form, and specialized in function to respond to changes in external conditions. Before me are a hundred closely typewritten pages that give a complete outline of the Anatomy and Physiology of the neural units to all parts of the body. After reading them over many times, it was decided to only publish the list of segments that have a direct bearing on treatment areas so the physician can get along with his task of healing the sick. Detailed outlines are already in the subconscious of the trained neurologist or can be easily looked up in reference books. Practically all tissues of the body have a dual nerve supply or two sets of controlling neural units. One set is restraining or inhibiting in function, and the other set is accelerating or dilating in function. We will take the heart and arteries, for example, then we will give a table of the constrictor and dilator neural units for the whole body. The coordinated action of the muscle cells of the heart is regulated by a nervous mechanism consisting of two sets of neural units. The cell bodies of the restraining neural units are located in the nucleus of the tenth carinal nerve. Their paths of exit pass down through the tenth cranial nerve to the heart, where they come in contact with the neural units located in the ganglia in and about the heart. The neural units of these ganglia send their paths of exit directly to the muscle cells of the heart. The accelerating neural units are located in the medulla, in the cervical segments, and in the first dorsal segments of the spinal cord. Their paths of exit pass to the inferior cervical and to the first thoracic ganglia. The accelerating neural units in these ganglia send their paths of exit directly to the muscle cells of the heart. The heart is therefore under the influence of two sets of neural units, one tending to constantly restrain its activities and the other tending to increase its activity. The restraining neural units are constantly active, and their activity may be compared to the constrictor neural units of the blood vessels. The accelerating neural units are only occasionally active, and their activity may be compared to the dilator neural units of the blood vessels. In addition to these two sets of neural units are only occasionally active, and their activity may be compared to the dilator neural units of the blood vessels. In addition to these two sets of neural units, there are in the heart the beginning of the paths of entrance of the depressor neural units, which pass upward in man through the tenth cranial nerves. The paths of exit of these neural units pass from the cell bodies in the ganglia, through the tenth cranial nerves to the medulla, where they come in contact with constrictor neural units in the governing arterio-constrictor nucleus. Activity upon the part of the depressor neural units brings about a dilation of the blood vessels, especially those of the neural units in the governing arterio-constrictor nucleus. When the resistance against which the heart has to pump is increased by a constriction of the arterioles, due to hyperactivity of the arterio-constrictor neural units, messages are carried through the depressor paths to the governing arterio-constrictor nucleus, and the activity of the governing nucleus is lessened, the muscle cells of the walls of the arterioles relax and the heart is automatically relieved of the resistance against which it is working. The arterio-motor mechanisms consist of an orderly arrangement of neural units whose cell bodies are located in the medulla, in the spinal cord and in the ganglia of the ganglionic system. All these neural units come in contact with each other and form paths through which messages are carried out from the central nervous system to all parts of the body and from all parts of the body into the central nervous system. The governing arterio-motor nucleus is located in the floor of the fourth ventricle of the brain. The cell bodies of this nucleus are arranged in groups; the activity of one group brings about dilation of the blood vessels, and it is called arterio-dilator nucleus; the activity of the other group brings about a constriction of the blood vessels, and it is called the arterio-constrictor nucleus. This governing nucleus controls the constriction and dilation of the blood vessels in all parts of the body through subsidiary neural units whose cell bodies are located in the nucleus of the cranial nerves and in the anterior horns of the spinal cord: these subsidiary neural units send their paths of exit to the ganglia of the ganglionic system. The neural units in the ganglia of the ganglionic system send their paths of exit to the muscle cells in the walls of the arterioles. The arterio-constrictor portion of the governing nucleus is in a constant state of activity, keeping up a partial constriction of the arterioles and thereby preserving arterial tone. The functional activity of the governing arterio-motor nucleus is modified by the centripetal messages carried to it through the ingoing paths from all parts of the body and from the cerebral cortex. Messages coming to the nucleus through these paths produce arterial constriction by increasing the functional activity of the arterio-constrictor portion of the nucleus, or they produce arterial dilation by decreasing the functional activity of the arterio-constrictor portion of the nucleus, or by increasing the functional activity of the arterio-dilator portion of that nucleus. The afferent paths which decrease the functional activity of the arterio-constrictor nucleus are called depressors; those which increase the functional activity of the arterio-constrictor portion of the nucleus are called reflex constrictors; and those which increase the functional activity of the arterio-dilator portion of the nucleus are called reflex dilators. Located in the various areas of the cerebral cortex are the cell bodies of neural units of the governing arterio-dilator portion of the governing nucleus and others to the arterio-constrictor portion of the governing nucleus. Thus, various emotional and mental conditions will modify the circulation in various parts of the body. As example of this we have dilation of the blood vessels of the skin of the face producing a blush of the face, or constriction of the blood vessels of the skin of the face, producing a pallor of the face. The paths of exit from the cell bodies of the governing arterio-motor nucleus pass into the cranial nerves and into the spinal cord. Those passing into the spinal cord pass down, chiefly through the antero-lateral descending pathway, and come in contact with neural units located in the anterior horns of the spinal cord. One path of exit may, by means of side paths, come in contact with a number of neural units in the anterior horns. Those paths of exit which come from the arterio-dilator portion of the governing nucleus comes in contact with arterio-constrictor neural units in the anterior horns of the spinal cord. Both the constrictor and dilator neural units located in the anterior horns of the spinal cord send their paths of exit out through the anterior bundles into the spinal nerve. They leave the spinal nerve a short distance beyond the junction of the anterior and posterior bundles, and pass through the white connecting pathways to one of the ganglia of the ganglionic system of nerves as the pre-ganglionic paths of exit. In the ganglion the pre-ganglionic path of exit ends in contact with one or more neural units whose paths of exit, as post-ganglionic paths of exit, are distributed to the muscle cells of the blood vessels. The post-ganglionic paths of exit of both the constrictor and dilator neural units are found together, except those supplying the blood vessels of the head, the blood vessels of the abdomen and pelvic viscera and the external organs of generation. The post-ganglionic paths of exit to the blood vessels of the legs, trunk and the arms follow the path of distribution of the spinal nerves, reaching the spinal nerves through the gray connecting pathways, between the ganglionic systems and the spinal nerves. Those which supply the blood vessels of the muscles follow the course of distribution of the musculo-motor nerves, and those supplying the blood vessels of the skin follow the paths of distribution of the sensory nerves. The post-ganglionic paths to the blood vessels of the brain, the retina, the thoracic and abdominal viscera, as a rule, follow the course of the blood vessels supplying those parts. The blood vessels of the legs, arms and trunk, with the exception of those of the ano-genital region, receive their post-ganglionic, arterio-dilator and arterio-constrictor paths through the spinal nerves. The blood vessels of the head, face, eyes, ears, nose, salivary glands, tongue and mucous membrane of the mouth receive their arterio-dilator paths through the cranial nerves, while they receive their arterio-constrictor paths through the ganglionic system of nerves. The paths to the skin follow, as a rule, the distribution of the sensory nerves, and those to the deeper parts follow the course of the blood vessels. The following is a brief outline with a chart appended for quick reference:
SPINAL SEGMENTS The Spinal Segments controlling the vaso-motor mechanism to the different parts of the body are found as follows: Heart: The 7th and 8th Cervical, 1st and 2nd Dorsal send branches to the inferior cervical and first dorsal ganglion. These send branches to the ganglia in around the heart. These transmit impulses controlling both the constrictor and vaso-motor dilators to the coronary arteries, and the accelerators to the heart muscle. The restraining nerve is found in the nucleus of the 10th Cranial nerve. Brain: The 2nd and 3rd Dorsal nerves give off branches to the superior cervical ganglion, which give off branches that follow the internal carotid arteries and give off branches to all the arteries of the brain. The 2nd and 3rd Dorsal are both constrictors and dilators to all the brain tissue. Face, Scalp, Eye, Nose, Palate, Parotid, Lingual, Sublingual Glands: The 2nd, 3rd, 4th, Dorsal nerves give off constrictor branches to the superior cervical ganglion which gives off branches that follow the internal carotid arteries and give off branches that follow the facial and lingual arteries to the sympathetic ganglia on and about the trifacial nerve. The dilator nucleus to these parts are found in the 5th, 7th, and 9th Cranial nerves. Mouth, Tonsils, Pharynx, and Larynx: The 2nd, 3rd, 4th, and 5th, Dorsal nerves send branches to the superior, middle, and inferior cervical ganglia, which gives off branches that follow the arteries to thee parts named. The blood constriction can bee controlled through these parts or nerves. For dilation of parts named, treat the 5th, 7th, and 9th Cranial nerves. The 5th Cranial nerve can be treated through its maxillary region at the side of the nose, and through its mandibular division on the mandible below the canine teeth. The 9th can be treated at the angle of the jaw. The dilator directly to the tonsil is found in thee middle cervical ganglia. Lungs and Bronchial Tubes: The 3rd, 4th, 5th, 6th, and 7th, Dorsal nerves send branches to the corresponding ganglia of the sympathetic, which send branches that follow the blood vessels to the lungs. The blood supply to these parts can be constricted and dilated through these segments. Extra dilation can be secured by treating the 10th Cranial nerve. Stomach: The Stomach -- the 5th, 6th, 7th, 8th, and 9th Dorsal nerves on the left side send branches to the corresponding Dorsal ganglia of the sympathetic which communicates with the semilunar ganglion. This gives off branches that follow the arteries or blood vessels to the wall of the stomach. The blood supply of the stomach can be controlled through these segments in connection with the dilator nucleus of the 10th Cranial nerve. Small and Large Intestines: On both sides of the spine. The liver on the right side. The 6th, 7th, 8th, 9th, 10th, 11th, and 12th Dorsal nerves send branches to the corresponding ganglia of the sympathetic, which send branches to the solar plexus. This gives off fibers that follow the blood vessels to the parts named. The blood supply to these parts can be controlled through these segments, in connection with the 10th Cranial dilator nucleus. This sends fibers to the parts named. The dilator nucleus is found in the 1st, 2nd, 3rd, and 4th Sacral. The blood supply to the parts named can be regulated through these segments. Spleen and Pancreas: The 6th, 7th, 8th, 9th, 10th, 11th, and 12th Dorsal and the 1st, 2nd, 3rd, and 4th Lumbar nerves send branches to the solar plexus. This gives off fibers, that follow the arteries to the parts named. The dilator nucleus is found in the 6th Dorsal, and the 1st Lumbar and the 10th Cranial nerve. The blood supply can be regulated through these segments. Bladder: The 1st, 2nd, 3rd, and 4th Lumbar nerves through direct mechanism control the vaso-constrictors to the bladder. The 3rd and 4th Sacral nerves through the nerve mechanism control the vaso-dilators to the bladder. Penis, Testicles, Scrotum, Anus, Vagina, Tubes, Ovaries interfuse: The 2nd, 3rd, 4th, and 5th Lumbar nerves through the nerve mechanism control the vaso-motor dilator nerves to the parts named. The blood supply to these parts can be increased through these segments. A restrainer nerve is one that will decrease the functional activity of an organ. An accelerator nerve is one that will increase the functional activity of an organ. When an accelerator nerve to the sigmoid is active, there must be a restraining nerve to the anus active to make defecation possible. The accelerator to the sigmoid and rectum will increase the peristaltic action of the bowel and rectum. The accumulated fecal matter in the sigmoid flexure creates impulses that are sent to the center of defecation in the cortex of the cerebrum. From here impulses are reflexed to the intellectual center. If convenient to empty the bowel, accelerating impulses are sent to the sigmoid and rectum. After defecation the restrainer to the sigmoid and rectum will become active to lessen the peristaltic action and the accelerator to the anus will become active to contract the sphincter ani. The same nerve mechanism controls the bladder and uterus. Defecation is the act of sigmoid flexure expelling the fecal matter through the anus and the fecal matter is passed from the body. If it is not convenient to empty the bowel, the intellectual center sends restraining impulses to the sigmoid and rectum and accelerating impulses to the sphincter ani and defecation is postponed. Urination: Urination is the act of the bladder expelling the urine through the urethra. The accumulation of urine in the bladder creates impulses that are sent to the center of urination. If convenient to empty the bladder, the impulses that are reflexed to the intellectual center return accelerating impulses to the muscle cells of the bladder wall and restraining impulses to the muscle cells in the neck of the bladder and the urine is passed from the body. If not convenient to empty the bladder, the intellectual center returns restraining impulses to the muscle cells in the neck of the bladder and urination is postponed. In urination, the glottis closes, the abdominal walls contract and the downward pressure of the diaphragm makes the abdominal cavity smaller, thus assisting the bladder in expelling the urine. Restrainers of the Bladder: The 10th, 11th, and 12th Dorsal and the 1st, 2nd, 3rd, and 4th Lumbar nerves control through the nerve mechanism, the restrainers to the sigmoid, rectum, and uterus, also the accelerators to the neck of the uterus and sphincter of the anus. Accelerators to the Sigmoid and Rectum: The 1st, 2nd, and 3rd Sacral nerves through the nerve mechanism control the accelerators to the Sigmoid and rectum, also the restrainers to the sphincter of the anus. Accelerators to the Uterus: The 2nd, 3rd, and 4th Sacral nerves control, through the nerve mechanism, the accelerators to the body of the uterus, also the restrainers to the neck of the uterus, sphincter, vaginae and the floor of the perineum. Accelerators to the Bladder: The 2nd, 3rd, 4th, and 5th Sacral nerves control, through nerve mechanism, the accelerators to the bladder, also the restrainers to the neck of the bladder. [FIGURE 2: CEREBROSPINAL AND SYMPATHETHIC NERVOUS SYSTEMS] Spinal Cord: The blood supply to the spinal cord can be controlled by the segments of the entire length of the cord. Skin and Muscles of the Trunk and Limbs: The blood of the skin and muscles of the trunk and limbs controlled by the segments of the spine from the 4th cervical to the sacral nerves. Muscles: The fourth Cervical nerve controls through its motor branches of the supra-spinatus, intra-spinatus, teres major, and biceps. The fifth cervical nerve through its motor branches, the brachialia, anticus, deltoid, supinator, and longus. The sixth Cervical nerve controls through its motor branches, the subscapularis, pronator radii teres, latissimus dorsi, pectoralis major and serrator magnus. The seventh Cervical nerve controls through its motor branches, the extensors to the wrist. The fourth Cervical nerve to the eighth control through their sensory branches the skin of the arm, forearm, wrist and hand. The Dorsal nerves supply through their motor branches, the muscles of the thorax and abdomen, also through their sensory branches, the skin of the parts. The first Lumbar nerve controls through the sensory branches, the skin of the Ilie-hypogastric regions. The second Lumbar nerve controls through the sensory branches, the skin of the thigh. The third Lumbar nerve controls through the motor branches, the abductor muscles of the thigh; third lumbar vertebra on a line with umbilicus. The fourth Lumbar nerve controls through the motor branches, the semi-tendinosis, semi-membranosus, and biceps muscles, also the sensory branches to skin on the posterior aspect of the thigh. The first sacral nerve controls through the motor branches, the muscles of the gluteal region, perineum and calf of the leg. The second Sacral nerve controls through the motor branches, the extensors of the ankle of the foot. The third Sacral nerve controls through the motor branches, the muscles of the perineum, erector penis and accelerator urine. The fourth Sacral nerve through the motor branches controls the bladder and rectum. The fifth Sacral, and branch of the fourth Sacral and coccygeus nerves
supply the coccygeal muscle with motor fibers and sensory fibers to the
skin over the coccyx.
POINTS TO REMEMBER 1. The function of the circulation is to carry blood to the tissues to maintain a healthy environment.. 2. The control of the circulation is influenced by a number of factors:
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