Histological verification of the prehypogastric and ovarian ganglia confirms a bilaterally symmetrical organization of the ganglia comprising the aortic plexus in female human cadavers

The aortic plexus is a network of sympathetic nerves positioned along the infrarenal abdominal aorta. Recently, we characterized the aortic plexus and its ganglia (inferior mesenteric, left/right spermatic, and prehypogastric ganglion) in males; however, the literature minimally describes its anatomy in females. In the present study, we conducted the first histological examination of the left and right ovarian ganglia, while also investigating whether females, like males, exhibit a prehypogastric ganglion. The ganglia were dissected from embalmed (n = 32) and fresh (n = 1) human cadavers, and H&E staining was used to confirm the presence of a left ovarian ganglion in 31/31 specimens, a right ovarian ganglion in 29/29 specimens and a prehypogastric ganglion in 25/28 specimens. Comparable to the topographic arrangement in males, there is a bilateral organization of the ganglia comprising the aortic plexus in females. More specifically, the left and right ovarian ganglia were positioned in close relation to their respective ovarian artery, whereas the prehypogastric ganglion was positioned within the right cord of the aortic plexus, contralateral to the inferior mesenteric ganglion. Using immunohistochemistry, it was shown that all ganglia from the fresh cadaver stained positive for tyrosine hydroxylase, thereby confirming their sympathetic nature. Having provided the first topographical and histological characterization of the ovarian and prehypogastric ganglia in females, future studies should seek to determine their specific function.     

Accessory lumbar splanchnic ganglia in humans: a case report

The present study was designed and performed on 20 human adult cadavers at the level of the retroperitoneal space in order to provide evidence of the paravertebral and prevertebral sympathetic ganglia. Only one specimen, male, presented two ganglia on the left side located on the first lumbar splanchnic nerve, one proximal and the other distal. The macroscopically detected swellings were drawn and certified as autonomic ganglia after performing silver stains by the method of Bielschowsky (on blocks). No existing reference to date mentions such lumbar splanchnic ganglia, which could be the result of a fragmentation followed by displacement from the lumbar sympathetic trunk. Their demonstrated anatomical connections with the afferents of the spermatic ganglion and the intermesenteric plexus may indicate the involvement of these ganglia in vasomotor and gonadal functions.     

Nerve pathways in celiac plexus of the guinea pig.

In vitro preparations consisted of the right and left celiac, superior mesenteric and inferior mesenteric ganglia with attached extrinsic nerves, vasculature, mesentery, and colon. There were no systematic differences in membrane electrical properties (recorded intracellularly) between neurons in the different ganglia. Stimulation of associated nerve trunks produced graded synaptic responses in plexus neurons. Presynaptic fibers were found in splanchnic and mesenteric nerves. Input from celiac nerves dominated in the celiac galglia; input from the intermesenteric fibers dominated in the superior mesenteric ganglion. When the ganglia were attached to the entire colon, 33% of the neurons in the celiac and 54% in the superior mesenteric ganglion received a continuous excitatory synaptic input that was increased by distending the colon. This input was interrupted irreversibly by transsection of the mesenteric nerves. These results show that both the afferent and efferent pathways of a peripheral reflex arc are located in the mesenteric nerves and may mediate visceral reflexes between mechanoreceptors and sympathetic neurons in the colon.     

肠系膜下动脉根部自主神经保护的解剖学基础

目的　观察肠系膜下动脉（IMA）根部与其周围自主神经的解剖学关系,为肠系膜下动脉根部自主神经保护提供解剖学证据。 方法　7例10%福尔马林固定标本进行大体解剖及显微解剖;2例新鲜标本模拟腹腔镜下直肠癌D3根治术中肠系膜下动脉根部自主神经的显露和保护。 结果　上腹下丛(SHP)的左、右侧束及束间交通支与肠系膜下动脉根部关系密切。右侧束距离肠系膜下动脉根部较远,位于肾前筋膜下。以左侧束降支为界,其近端,上腹下丛左侧束、肠系膜下丛、腹主动脉丛紧贴肠系膜下动脉根部左侧壁并相互延续,其远端左侧束走行于肾前筋膜下。左侧束降支距离IMA起点的距离不恒定。 结论　在肾前筋膜前平面分离可有效保护上腹下丛右侧束及侧束间交通支;以SHP左侧束降支作为肠系膜下动脉根部离断的解剖学标志可以有效保护左侧束。     

肾脏的交感神经支配

采用大体解剖学方法和肾内注射HRP逆行标记神经元的方法,研究了猫肾脏的交感神经支配。发现了下述的待点。1.猫左、右侧腹腔神经节相互融合,呈半环状包绕在肠系膜上(前)动脉的起始处,于其融合部,各发出左、右肾支。肠系膜上神经节与右侧腹腔神经节融合。2.肾交感神经节后神经元,分别位于腹腔神轻节,同侧主动脉肾神经节和T_(12)～L~4节段的交感干神经节内,並具有局部定位分布的关系。3.肾交感神经节后纤维主要来自腹腔神经节(82.08％),其次是主动脉肾神经节(12.76％),交感干神经节最少(5.16％)。4.肾交感神经节后神经元,多呈圆形或椭圆形,交感干神经节中有少量呈梭形。5.支配肾周腹膜的交感神经节后神经元与肾交感神经节后神经元存在部位、数量和在各种神经节内分布形式均不相同。     

Anatomy and blood supply of the coeliac-superior mesenteric ganglion complex of the rat

Summary The anatomy of the coeliac-superior mesenteric ganglion (CSMG) complex of 28 female Wistar rats was studied by serial paraffin sections and found to be consistent in composition and in relations. The CSMG comprises two suprarenal ganglia in continuity with the major splanchnic nerves, these continuing as splanchnic trunks into paired coeliac ganglia. The left coeliac ganglion is larger than the right as it has a superior mesenteric component related to the artery of that name. Lastly, intermesenteric ganglia are related to the renal and ovarian arteries and to the origin of the intermesenteric nerves.Ink injections and microvascular casts indicate that the main extrinsic blood supply to the CSMG is derived from the inferior phrenic artery, a branch of which enters the complex at the suprarenal ganglia and supplies the CSMG via the splanchnic trunks. Also, recurrent branches of the ovarian arteries enter the intermesenteric nerves to supply the complex at its caudal pole. A few small arteries not associated with nerves and probably derived from lumbar arteries also supply the CSMG complex. The two major postganglionic nerve trunks have an abundant vasculature in continuity with that of the CSMG but whose origin and direction of blood flow has yet to be determined.     

Extrinsic innervation of the pelvic organs in the lesser pelvis of human embryos

Realistic models to understand the developmental appearance of the pelvic nervous system in mammals are scarce. We visualized the development of the inferior hypogastric plexus and its preganglionic connections in human embryos at 4–8 weeks post-fertilization, using Amira 3D reconstruction and Cinema 4D-remodelling software. We defined the embryonic lesser pelvis as the pelvic area caudal to both umbilical arteries and containing the hindgut. Neural crest cells (NCCs) appeared dorsolateral to the median sacral artery near vertebra S1 at ~5 weeks and had extended to vertebra S5 1 day later. Once para-arterial, NCCs either formed sympathetic ganglia or continued to migrate ventrally to the pre-arterial region, where they formed large bilateral inferior hypogastric ganglionic cell clusters (IHGCs). Unlike more cranial pre-aortic plexuses, both IHGCs did not merge because the 'pelvic pouch', a temporary caudal extension of the peritoneal cavity, interposed. Although NCCs in the sacral area started to migrate later, they reached their pre-arterial position simultaneously with the NCCs in the thoracolumbar regions. Accordingly, the superior hypogastric nerve, a caudal extension of the lumbar splanchnic nerves along the superior rectal artery, contacted the IHGCs only 1 day later than the lumbar splanchnic nerves contacted the inferior mesenteric ganglion. The superior hypogastric nerve subsequently splits to become the superior hypogastric plexus. The IHGCs had two additional sources of preganglionic innervation, of which the pelvic splanchnic nerves arrived at ~6.5 weeks and the sacral splanchnic nerves only at ~8 weeks. After all preganglionic connections had formed, separate parts of the inferior hypogastric plexus formed at the bladder neck and distal hindgut.     

The anatomy of the infrarenal lumbar splanchnic nerves in human cadavers: implications for retroperitoneal nerve‐sparing surgery

Injury to the nerves of the aortic‐ and superior hypogastric plexuses during retroperitoneal surgery often results in significant post‐operative complications, including retrograde ejaculation and/or loss of seminal emission in males. Although previous characterizations of these plexuses have done well to provide a basis for understanding the typical anatomy, additional research into the common variations of these plexuses could further optimize nerve‐sparing techniques for retroperitoneal surgery. To achieve this, the present study aimed to document the prevalence and positional variability of the infrarenal lumbar splanchnic nerves (LSNs) through gross dissection of 26 human cadavers. In almost all cases, two LSNs were observed joining each side of the aortic plexus, with 48% (left) and 33% (right) of specimens also exhibiting a third joining inferior to the left renal vein. As expected, the position of the LSNs varied greatly between specimens. That said, the vast majority (98%) of LSNs joining the aortic plexus were found to originate from the lumbar sympathetic trunk above the level of the inferior mesenteric artery. It was also found that, within specimens, adjacent LSNs often coursed in parallel. In addition to these nerves, 85% of specimens also demonstrated retroaortic LSN(s) that were angled more inferior compared with the other LSNs (P < 0.05), and exhibited a unique course between the aorta/common iliac arteries and the left common iliac vein before joining the superior hypogastric plexus below the aortic bifurcation. These findings may have significant implications for surgeons attempting nerve‐sparing procedures of the sympathetic nerves in the infrarenal retroperitoneum such as retroperitoneal lymphadenectomies. We anticipate that the collective findings of the current study will help improve such retroperitoneal nerve‐sparing surgical procedures, which may assist in preserving male ejaculatory function post‐operatively.     

Observations on the anatomy and amine histochemistry of the nerves and ganglia which supply the pelvic viscera and on the associated chromaffin tissue in the guinea-pig

Summary The organs of the lower abdominal and pelvic regions of the guinea-pig receive nerves from the inferior mesenteric ganglia and pelvic plexuses. The inferior mesenteric ganglia connect with the sympathetic chains, the superior mesenteric ganglia, the pelvic plexuses via the hypogastric nerves, and with the gut. Each pelvic plexus consists of anterior and posterior parts which send filaments to the internal generative organs and to the rectum, internal anal sphincter and other pelvic organs. The pelvic nerves enter the posterior plexuses, which also receive rami from the sacral sympathetic chains. The adrenergic neurons of the pelvic plexuses are monopolar, do not have dendrites and are supplied by few varicose adrenergic axons. Nearly all the nerves contain adrenergic fibres. After exposure to formaldehyde vapour the chromaffin cells appear brightly fluorescent with one or two long, often varicose, processes. Most of the chromaffin cells are in Zuckerkandl's organ or in chromaffin bodies associated with the inferior mesenteric ganglia. Groups of chromaffin cells are found along the hypogastric nerves and in the pelvic plexuses; they become smaller and fewer as regions more posterior to Zuckerkandl's organ are approached.This work was supported by grants from the Australian Research Grants Committee and the National Health and Medical Research Council. We thank Professor G. Burnstock for his generous support.     

Sympathetic efferent pathways projecting bilaterally to the vas deferens in the rat

ABSTRACT Background: The laterality of the signals passing through the splanchnic nerves to the vas deferens has not been well studied. Methods: The present study was designed to determine the bilateral distribution of sympathetic nerves to the rat vasa deferentia by measuring intravasal pressure (VP) responses to electrical stimulation of left lumbar splanchnic nerves (LSN) following consecutive transections of more distal nerves. Results: L₂-L₆ LSN stimulation increased VP bilaterally. Left VP responses decreased slightly (<20%) after section of the right hypogastric nerve (HGN) and then were abolished by subsequent section of branches (B-M-APG) between the left major pelvic (MPG) and accessory pelvic ganglia (APG). Left VP responses were decreased by >80% after section of left HGN, not changed further by subsequent section of commissural branches (CB-MPG) between the MPG, and completely eliminated by section of commissural branches between the APG (CB-APG). Right VP responses were decreased slightly (<20%) by section of the left HGN and then abolished by section of the right B-M-APG. These responses were also decreased by >70% by section of right HGN, not changed by section of CB-MPG, but then completely eliminated by section of CB-APG. Conclusions: These results indicate that the left lumbar sympathetic pathway to the vas deferens is distributed bilaterally and exhibits two crossing points at the level of the inferior mesenteric ganglion and APG. Anat. Rec. 248:291-299, 1997. © 1997 Wiley-Liss, Inc.     

Origin of peptide-containing fibers in the inferior mesenteric ganglion of the guinea-pig: Immunohistochemical studies with antisera to substance P,enkephalin, vasoactive intestinal polypeptide,cholecystokinin and bombesin

After different denervation procedures the guinea-pig inferior mesenteric ganglion was analysed by immunohistochemistry using antisera to substance P, enkephalin, vasoactive intestinal polypeptide, cholecystokinin and bombesin. The results demonstrate that each of the nerve trunks connected to the ganglion carries specific peptidergic pathways. Thus, the lumbar splachnic nerves contain substance P-immunoreactive primary afferent neurons, which to a large extent traverse the ganglion, and enkephalin-immunoreactive preganglionic neurons; the colonie nerves carry vasoactive intestinal polypeptide-, cholecystokinin- and bombesin-immunoreactive fibers from the distal colon to the ganglion; the hypogastric nerves contain vasoactive intestinal polypeptide-positive fibers from the pelvic plexus; and the intermesenteric nerve contains vasoactive intestinal polypeptide, cholecystokinin, substance P and enkephalin from divergent sources. By studying accumulations of peptides in ligated lumbar splanchnic, intermesenteric, hypogastric and colonic nerves the existence of these major peptidergic pathways was confirmed and evidence was obtained for additional, not so prominent, peptidergic projections. The results are discussed in view of earlier morphological and physiological studies.     

Locations and innervation of cell bodies of sympathetic neurons projecting to the gastrointestinal tract in the rat

The locations of cell bodies of sympathetic neurons projecting to the stomach, the duodenum, the ileum, the colon, the spleen and the pancreas have been studied using retrograde tracing. Projections arose from both pre- and paravertebral ganglia. In the rat, the prevertebral ganglia are the paired coeliac ganglia lying caudo-lateral to the root of the coeliac artery, paired splanchnic ganglia in the abdominal segments of the greater splanchnic nerves, unpaired superior mesenteric and inter-renal ganglia and the inferior mesenteric ganglia. The projections from the prevertebral sympathetic ganglia to the different parts of the gut were organised somatotopically. The most rostral ganglia (splanchnic, coeliac, and superior mesenteric ganglia) contained neurons innervating all regions of the gastrointestinal tract, the pancreas and the spleen. The inter-renal and inferior mesenteric ganglia, located more caudally, contained neurons innervating the distal part of the gut (distal ileum and colon). The innervation of the spleen and the pancreas came from the closest ganglia (sympathetic chains, splanchnic and coeliac ganglia). This organotopic organisation was not found in the sympathetic chain ganglia; the innervation of all organs came predominantly from the lower part of the thoracic chains. A large proportion of the retrogradely labelled nerve cells in the splanchnic ganglia received nitric oxide synthase immunoreactive innervation probably from the spinal cord. In the other prevertebral ganglia, most of the neurons received nitric oxide synthase immunoreactive innervation and/or bombesin immunoreactive innervation. This leads to the conclusion that, in these ganglia, many neurons receive projections from the gastrointestinal tract in addition to the spinal cord.     

腹腔-肠系膜上神经节内腹部内脏器官的代表区

目的 探讨支配腹部内脏器官的交感节后神经元在腹腔－肠系膜上神经节内的代表区。方法 用ＨＲＰ逆行标记法，显微镜描图仪做连续切片描图记录，计数标记细胞的面数密度，并经统计学处理。结果 猫脾、胰、肾、十二指肠和空间肠交感节后神经元在腹腔－肠系膜上神经节内具有各自的集中分布区和分散分布区，亦即各自的局部定位区。支配脾的交感节后神经元集中区位于该节的左侧上部，支配胰的交感节后神经元集中区位于该节两侧的上中后     

经家兔肠系膜下节的内脏传入神经元的节段性分布——HRP法研究

将HRP注入8只家兔的肠系膜下节内,观察内脏传入神经元的胞体在脊神经节的分布节段,结果如下。标记细胞分布在双侧的T_(11)-L_6脊神经节,89.83％的标记细胞集中分布在L_1—L_4节段,其中以L_3最多,占标记细胞总数的29.67％。向颅、尾侧逐渐减少,表明内脏感觉经交感途径的传入节段既有弥散又有相对集中的特点。此外,路经家兔肠系膜下节的传入神经元与支配该节的节前神经元在分布节段上存在着对应关系,这种对应关系可能为内脏活动的反射通路提供了形态学证据。左、右侧脊神经节内标记细胞的数量相差不多。标记细胞的基本形态为圆形或椭圆形,97.66％的标记细胞为50μm以下的中、小型细胞。     

Origin of sympathetic efferent axons in the renal nerves of the cat

The origin of efferent axons in the renal nerves of the cat was examined using retrograde transport of horseradish peroxidase (HRP). Nerves on the surface of the left renal blood vessels were dissected 5-7 horseradish mm proximal to the medial margin of the kidney, transected and the central cut ends exposed to HRP. Labeled neurons were typically identified in three locations: (1) centrally along the renal nerve, (2) in the superior mesenteric ganglion, and (3) in the ipsilateral sympathetic chain ganglia (T12-L3). HRP was not detected in preganglionic neurons in the thoracolumbar spinal cord. Labeled cells ranged in size from 15 to 50 micrometers, with those in the renal nerve at the smaller end of the spectrum and those in the superior mesenteric ganglion at the larger end. In the superior mesenteric ganglion labeled cells were typically localized to a small region in the caudal pole of the ganglion around the origin of the renal nerve. The results show that the sympathetic efferent innervation of the kidney is derived from both paravertebral and prevertebral ganglia. In the latter (superior mesenteric ganglion), renal efferent neurons exhibited a topographic distribution.     

Can intestinal innervation be preserved in pancreatoduodenectomy for cancer? Results of an anatomical study

Twenty dissections were carried out, in all of which the splanchnic nerves, celiac plexuses, capital pancreatic plexus and superior mesenteric plexus were identified and traced. The capital pancreatic plexus was formed from two bundles, the first taking its origin from the right celiac plexus, the second from the superior mesenteric plexus. These two bundles joined together just behind the head of the pancreas. Two preganglionic bundles, a ganglion and two postganglionic bundles composed the superior mesenteric plexus. Postganglionic bundles received fibers from both right and left celiac plexuses. In small cancers a thin layer of nervous tissue around the superior mesenteric artery might be spared in order to avoid diarrhea from intestinal denervation. This study has provided anatomical evidence that a part of the mesenteric plexus, which receives fibers from both left and right celiac plexuses, maintains a sufficient intestinal innervation.     

Distributions of neuropeptide Y, vasoactive intestinal peptide and somatostatin in populations of postganglionic neurons innervating the rat kidney, spleen and intestine.

Some peripheral peptidergic nerves selectively innervate different types of tissue in abdominal organs. Neuropeptide Y- and vasoactive intestinal peptide-immunoreactive nerve terminals have been identified in the kidney, spleen and intestine and these peptides may have important physiological actions. Somatostatin has been found in sympathetic ganglia, and nerve terminals containing this peptide have been identified in the intestine. We have used fluorescent retrograde tracers to identify renal, splenic and mesenteric postganglionic neurons in rat sympathetic ganglia and then used immunocytochemistry to determine the proportions of these three identified groups of neurons displaying immunoreactivity for neuropeptide Y, vasoactive intestinal peptide and somatostatin. Most renal, splenic and mesenteric neurons were immunoreactive for neuropeptide Y and less than 1% of cells innervating these organs were immunoreactive for vasoactive intestinal peptide. Somatostatin immunoreactivity was present only in a small percentage of mesenteric neurons and not in renal or splenic neurons. The present study demonstrates that (i) the rat kidney, spleen and intestine do not differ in the proportion of innervation by neuropeptide Y-immunoreactive neurons, (ii) the solar plexus, splanchnic ganglion and chain ganglia (T12 and T13) provide very little vasoactive intestinal peptide-immunoreactive inputs to these organs, and (iii) somatostatin-immunoreactive neurons innervate the intestine but not the kidney or spleen.     

The origins of the adrenergic fibres which innervate the internal anal sphincter, the rectum, and other tissues of the pelvic region in the guinea-pig

Summary The adrenergic innervation of the pelvic viscera was examined by the fluorescence histochemical technique, applied to tissue from untreated guinea-pigs and from guinea-pigs in which nerve pathways had been interrupted at operation. It was found that adrenergic neurons in the inferior mesenteric ganglia give rise to axons which run in the colonic nerves and end in the myenteric and submucous plexuses and around the arteries of the distal colon. In the rectum, part of the innervation of the myenteric plexus and all of the innervation of the submucous plexus comes from the inferior mesenteric ganglia. The rest of the adrenergic innervation of the myenteric plexus comes from the posterior pelvic ganglia or the sacral sympathetic chains. The innervation of the blood vessels of the rectum is from the posterior pelvic ganglia. Adrenergic nerves run from the sacral sympathetic chains and pass via nerves accompanying the rectal arteries to the internal anal sphincter. Other adrenergic fibres to the internal anal sphincter either arise in, or pass through, the posterior pelvic plexuses. The anal accessory muscle is innervated by adrenergic axons arising in the posterior pelvic plexuses. Adrenergic nerves which run in the pudendal nerves, probably from the sacral sympathetic chains, innervate the erectile tissue of the penis.This work was supported by grants from the Australian Research Grants Committee and the National Health and Medical Research Council. We thank Professor G. Burnstock for his generous support.     

Anatomy of thoracic splanchnic nerves for surgical resection

Thoracic splanchnic nerves conduct pain sensation from the abdominal organs around the celiac ganglion. Splanchnicectomy is the procedure used mainly for the control of intractable visceral pain. Forty-six human posterior thoracic walls were dissected. The formation pattern, course, and incidence of communication of the thoracic splanchnic nerves were investigated. The greater splanchnic nerves (GSNs) were formed by nerve branches from the T4-T11 thoracic sympathetic ganglia and the most common type was formed by T5-T9 (21.7%). The uppermost branches originated from T4-T9 while the lowermost branches emanated from the T7-T11. Two to seven ganglia contributed to the GSNs. In 54.3% of the specimens, at least one ganglion in the GSN-tributary ganglionic array did not branch to the GSN. The lesser splanchnic nerves (LSNs) were formed by the nerve branches of the T8-T12 thoracic sympathetic ganglia and the most common type was formed by T10 and T11 (32.6%). One to five ganglia were involved in the LSNs. The least splanchnic nerves (lSNs) were composed of branches from the T10-L1 thoracic sympathetic ganglia and the most common type was composed of nerve branches from T11 and T12 or from T12 only (each 30.4%). One to three ganglia were involved in the lSNs. In 54.3% of the specimens, interconnection between the GSNs and the LSNs existed, bringing the possible bypass around the transection of the GSNs. The splanchnic nerves that appear in textbooks occurred in a minority of our specimens. We provided expanded anatomical data for splanchnicectomy in this report.