The Abdominal and Pelvic Plexuses

The chief plexuses which distribute nerves to the viscera and vessels of the abdominal and pelvic cavities are two in number, the solar and the pelvic. From them fibers proceed to form numerous subsidiary plexuses which are named according to the organs which they supply or the vessels which they enlace.

The Solar Plexus

The solar plexus (Fig. ) is situated on the dorsal wall of the abdominal cavity in relation to the aorta and the origin of its chief visceral branches. It comprises the cœliaco-mesenteric ganglia and the cœliac and anterior mesenteric plexuses.

The cœliaco-mesenteric ganglia are two in number, right and left. They are situated on each side of the aorta, in relation to the origin of the cœliac and anterior mesenteric arteries. The right ganglion is concealed by the posterior vena cava; it is irregularly quadrilateral and is about two inches (4 to 6 cm.) in length. The left ganglion is largely covered by the left adrenal; it is narrower than the right one and is three or four inches (ca. 8 to 10 cm.) long. The two ganglia are united by irregular connecting branches in front of and behind the anterior mesenteric artery. Each receives the splanchnic nerve of its own side and branches from the dorsal œsophageal continuation of the vagus nerves. Branches from the ganglia and the cords which connect them pass back to the small stellate posterior mesenteric ganglia, which are situated at the origin of the posterior mesenteric artery.

The cœliac plexus (P. cœliacus) consists of a feltwork of nerve-fibers in which are small ganglia. It surrounds the cœliac artery and from it proceed the following unpaired secondary plexuses which accompany the arterial branches:

1. The gastric plexus (P. gastricus) enlaces the gastric artery and divides like the artery into two parts, forming the anterior and posterior gastric plexuses. These receive branches of the vagus nerves.

2. The hepatic plexus (P. hepaticus) is formed by several nerves of considerable size which accompany the hepatic artery and the portal vein. It receives fibers from the left vagus, ramifies in the liver, and gives off branches which accompany the collateral branches of the hepatic artery and supply the areas in which these vessels are distributed.

3. The splenic plexus (P. lienalis) resembles the preceding in its arrangement. In addition to its terminal branches to the spleen, it gives collateral twigs to the pancreas and the left part of the greater curvature of the stomach.

The anterior mesenteric plexus (P. mesentericus cranialis) is formed mainly by branches from the posterior part of the cœliaco-mesenteric ganglia; it is continuous with the cœliac plexus in front and the posterior mesenteric behind. It surrounds the anterior mesenteric trunk and its branches, and supplies the viscera to which these vessels are distributed.

The posterior mesenteric plexus (P. mesentericus caudalis) accompanies the artery of like name in its distribution.

The secondary plexuses which accompany the branches of the mesenteric arteries give off branches which form two fine peripheral plexuses in the wall of the intestine. One of these, the myenteric plexus (P. myentericus) or plexus of Auerbach, lies between the layers of the muscular coat, and is provided with microscopic ganglia. The other is in the submucous tissue, and is therefore termed the submucous plexus (P. submucosus) or plexus of Meissner.

The following paired plexuses are derived mainly from branches of the cœliac and aortic plexuses:

1. The renal plexuses (P. renales) proceed largely from the cœliaco-mesenteric ganglia, but receive fibers also from the small splanchnic nerves. They enlace the renal arteries and supply the kidneys. Minute renal ganglia occur on the course of the nerves along the renal vessels.

2. The adrenal plexuses (P. suprarenales) are formed by a relatively very large number of fine fibers derived in great part directly from the cœliaco-mesenteric ganglia. Numerous minute ganglia occur in their meshes.

3 a. The spermatic plexuses (P. spermatid) proceed largely from the aortic and renal plexuses. Each accompanies the corresponding (internal) spermatic artery to the testicle.

3 b. The utero-ovarian plexuses (P. ovarici) are the homologues in the female of the preceding. They accompany the utero-ovarian arteries to the ovary and the cornua of the uterus.

The hypogastric or pelvic plexus (P. hypogastricus) is the pelvic continuation of the aortic and posterior mesenteric plexuses. The chief nerves which form it enter the pelvic cavity ventral to the large vessels, anastomose with each other and with branches from the third and fourth sacral nerves, and ramify on the pelvic viscera. The peripheral plexuses derived therefrom are named according to the organs which they supply; the chief of these are the hæmorrhoidal, vesical, uterovaginal, prostatic, cavernous (of the penis or clitoris).