The superior hypogastric plexus (in older texts, hypogastric plexus or presacral nerve) is a
plexus of
nerve
A nerve is an enclosed, cable-like bundle of nerve fibers (called axons). Nerves have historically been considered the basic units of the peripheral nervous system. A nerve provides a common pathway for the Electrochemistry, electrochemical nerv ...
s situated on the vertebral bodies anterior to the bifurcation of the
abdominal aorta. It bifurcates to form the left and the right
hypogastric nerve.
The SHP is the continuation of the
abdominal aortic plexus.
Structure
Afferents
The superior hypogastric plexus receives contributions from the two lower
lumbar splanchnic nerves (L3-L4), which are branches of the chain ganglia. They also contain parasympathetic fibers which arise from
pelvic splanchnic nerve (S2-S4) and ascend from
inferior hypogastric plexus
Inferior may refer to:
* Inferiority complex
* An anatomical term of location
* Inferior angle of the scapula, in the human skeleton
* ''Inferior'' (book), by Angela Saini
* '' The Inferior'', a 2007 novel by Peadar Ó Guilín
* Inferior good: ...
; it is more usual for these parasympathetic fibers to ascend to the left-handed side of the superior hypogastric plexus and cross the branches of the sigmoid and left colic vessel branches, as these parasympathetic branches are distributed along the branches of the
inferior mesenteric artery.
Efferents
From the plexus, sympathetic fibers are carried into the pelvis as two main trunks - the right and left hypogastric nerves - each lying medial to the
internal iliac artery and its branches. The right and left hypogastric nerves continues as
inferior hypogastric plexus
Inferior may refer to:
* Inferiority complex
* An anatomical term of location
* Inferior angle of the scapula, in the human skeleton
* ''Inferior'' (book), by Angela Saini
* '' The Inferior'', a 2007 novel by Peadar Ó Guilín
* Inferior good: ...
; these hypogastric nerves send sympathetic fibers to the
ovarian and
ureteric plexuses, which originate within the
renal and
abdominal aortic sympathetic plexuses.
Relations
The superior hypogastric plexus is often displaced somewhat to the left of the midline. It is situated between the common iliac arteries. It is anterior to the
lumbar vertebra L5 and
sacral promontory
The sacrum (: sacra or sacrums), in human anatomy, is a triangular bone at the base of the spine that forms by the fusing of the sacral vertebrae (S1S5) between ages 18 and 30.
The sacrum situates at the upper, back part of the pelvic cavit ...
, the
aortic bifurcation, and left common iliac vein. It is posterior to the parietal peritoneum (with avascular areolar tissue intervening between these two structures). It is situated near the apex of the attachment of the
sigmoid mesocolon.
Clinical significance
Presacral neurectomy is a laparoscopic procedure where superior hypogastric plexus is excised, so that the pain pathway is cut off from the spinal column. This procedure is done to manage chronic pelvic pain when conservative medical therapy fails.
Additional images
File:Gray847.png
References
External links
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Nerve plexus
Nerves of the torso
{{Neuroanatomy-stub