Inferior hypogastric plexus

Inferior hypogastric plexus
The right sympathetic chain and its connections with the thoracic, abdominal, and pelvic plexuses. (Pelvic plexus labeled at bottom right.)
Lower half of right sympathetic cord. (Hypogastric plexus labeled at bottom left.)
Details
Identifiers
Latin	plexus hypogastricus inferior
TA98	A14.3.03.048
TA2	6715
FMA	6643
Anatomical terms of neuroanatomy [edit on Wikidata]

The inferior hypogastric plexus (or pelvic plexus^[1]) is a paired autonomic nerve plexus innervating organs of the pelvic cavity.^[2] It gives rise to the prostatic plexus in males and the uterovaginal plexus in females.

Anatomy

Structure

The plexus consists of an irregular, fenestrated layer containing small ganglia.^[2]

Relations

The inferior hypogastric plexus is situated in the sagittal plane just outside the peritoneum, between the anterior sacral foramina (posteriorly), and the posterior aspect of the urinary bladder (anteriorly). It is situated lateral to the rectum and vagina, and media lto the internal iliac artery and internal iliac vein of either side.^[2]

Afferents

hypogastric nerve - a continuation of either superior hypogastric plexus.^[3]^{[better source needed]}
sacral splanchnic nerves (from sympathetic trunk)^{[citation needed]}
pelvic splanchnic nerves (from sacral nerves S2-S4) also contribute parasympathetic efferent fibers to the plexus.^{[citation needed]}

Efferents

Efferents branches form secondary plexuses that accompany the internal iliac artery along its course.^[2] They gives rise to the middle and inferior rectal plexuses, vesical plexus, deferential plexus, and prostatic plexus (in males) or uterovaginal plexus (in females).^[2]

Distribution

Efferents of the plexus are responsible for innervating the genital erectile tissues.^[2]

Clinical significance

Due to its location, injury to this structure can arise as a complication of pelvic surgeries and may cause urinary dysfunction and urinary incontinence. Testing of bladder function is used in that case to show a poorly compliant bladder, with bladder neck incompetence, and fixed external sphincter tone.^[4]

Additional images

References

This article incorporates text in the public domain from the 20th edition of Gray's Anatomy (1918)

^ Yokochi, Chihiro; Rohen, Johannes W. (2006). Color Atlas of Anatomy: A Photographic Study of the Human Body. Hagerstown, MD: Lippincott Williams & Wilkins. p. 346. ISBN 0-7817-9013-1.
^ ^a ^b ^c ^d ^e ^f "inferior hypogastric plexus - Dictionnaire médical de l'Académie de Médecine". www.academie-medecine.fr. Retrieved 2024-08-06.
^ Ramirez C, Donnellan N (2017). "Pelvic denervation procedures for dysmenorrhea". Curr Opin Obstet Gynecol. 29 (4): 225–230. doi:10.1097/GCO.0000000000000379. PMID 28683027. S2CID 205607600.
^ CAMPBELL-WALSH UROLOGY, ed 11. p. 1781.

External links

Autonomics of the Pelvis - Page 5 of 12 anatomy module at med.umich.edu
Autonomics of the Pelvis - Page 6 of 12 anatomy module at med.umich.edu
figures/chapter_32/32-6.HTM: Basic Human Anatomy at Dartmouth Medical School
posteriorabdomen at The Anatomy Lesson by Wesley Norman (Georgetown University) (posteriorabdmus&nerves)

Anatomy of the autonomic nervous system

Head

Sympathetic	Cervical ganglia: roots long ciliary Deep petrosal
Parasympathetic	Ciliary ganglion Roots Short ciliary Pterygopalatine ganglion deep petrosal nerve of pterygoid canal branches of distribution: greater palatine inferior posterior nasal branches lesser palatine nasopalatine medial superior posterior nasal branches pharyngeal Submandibular ganglion Otic ganglion

Neck

Sympathetic	paravertebral ganglia: Cervical ganglia Superior Middle Inferior Stellate ganglion prevertebral plexus: Cavernous plexus Internal carotid

Thorax

Sympathetic	paravertebral ganglia: Thoracic ganglia prevertebral plexus: Cardiac plexus Esophageal plexus Pulmonary plexus Thoracic aortic plexus splanchnic nerves: cardiopulmonary thoracic cardiac nerves: Superior Middle Inferior

Abdomen

Sympathetic

paravertebral ganglia: Lumbar ganglia

prevertebral plexus:
Celiac plexus

aorticorenal
- Abdominal aortic plexus
- Renal/Suprarenal
Superior mesenteric
- Gastric
Inferior mesenteric
- Spermatic
- Ovarian
Superior hypogastric
- hypogastric nerve
- Superior rectal
Inferior hypogastric

splanchnic nerves: Lumbar splanchnic nerves

Enteric

Pelvis

Sympathetic	paravertebral ganglia: Sacral ganglia Ganglion impar splanchnic nerves: Sacral splanchnic nerves
Parasympathetic	splanchnic nerves: Pelvic splanchnic nerves

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