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Anatomy
Published in J. Richard Smith, Giuseppe Del Priore, Robert L. Coleman, John M. Monaghan, An Atlas of Gynecologic Oncology, 2018
Ernest F. Talarico, Jalid Sehouli, Giuseppe Del Priore, Werner Lichtenegger
The anterior and posterior rami of the lumbar spinal nerves contain sensory and motor fibers. L1 and L2 (occasionally L3) give rise to white rami communicantes conveying presynaptic sympathetic fibers to the lumbar sympathetic trunks. Postsynaptic fibers leave the trunks within gray rami communicantes and enter spinal nerves. The medial aspect of the lumbar sympathetic trunk also gives rise to lumbar splanchnic nerves carrying presynaptic fibers responsible for sympathetic innervation of the pelvic viscera.
Male Sexual Function
Published in Anthony R. Mundy, John M. Fitzpatrick, David E. Neal, Nicholas J. R. George, The Scientific Basis of Urology, 2010
Giulio Garaffa, Suks Minhas, David J. Ralph
The sympathetic pathway arises from the eleventh thoracic to the second lumbar spinal segment (T11-L2) and its fibers are carried through the white rami to reach the sympathetic chain ganglia. Some of these fibers then travel via the lumbar splanchnic nerves to the superior and inferior hypogastric plexuses. Some fibers originated from the superior hypogastric plexus form the hypogastric nerve and reach the pelvic plexus.
Anatomy of the Rectum and Anus
Published in Laurence R. Sands, Dana R. Sands, Ambulatory Colorectal Surgery, 2008
José Marcio Neves Jorge, Newton Luiz T. Gasparetti
The sympathetic and parasympathetic components of the autonomic innervation of the large intestine closely follow the blood supply (Fig. 12). The sympathetic supply arises from L1, L2, and L3. Preganglionic fibers, via lumbar sympathetic nerves, synapse in the preaortic plexus, and the postganglionic fibers follow the branches of the inferior mesenteric artery and superior rectal artery to the upper rectum and left colon. The lower rectum is innervated by the presacral nerves, which are formed by fusion of the aortic plexus and lumbar splanchnic nerves. Just below the sacral promontory, the presacral nerves form the hypogastric plexus (or superior hypogastric plexus). Two main hypogastric nerves, on either side of the rectum, carry sympathetic innervation from the hypogastric plexus to the pelvic plexus. The pelvic plexus lies on the lateral side of the pelvis at the level of the lower third of the rectum, adjacent to the lateral stalks. The term inferior hypogastric plexus has been used to mean the hypogastric nerves or the pelvic plexus; therefore it is inaccurate.
Spinal cord involvement in Lewy body-related α-synucleinopathies
Published in The Journal of Spinal Cord Medicine, 2020
Raffaele Nardone, Yvonne Höller, Francesco Brigo, Viviana Versace, Luca Sebastianelli, Cristina Florea, Kerstin Schwenker, Stefan Golaszewski, Leopold Saltuari, Eugen Trinka
Sympathetic pathways which originate in the dorsolumbar spinal cord reach the penis via the lumbar splanchnic nerves or the paravertebral chain, while parasympathetic neurons, which are located in the sacral parasympathetic nucleus, reach the penis via the pelvic plexus. The Onuf’s nucleus which is located in the sacral cord also innervates the perineal striated muscles. Dorsolumbar sympathetic, sacral parasympathetic, and sacral pudendal neurons are coordinated by interneurons located in laminae VII and X to regulate the processes of erection and ejaculation in men. The supraspinal control is regulated by some brain areas, such as the preoptic area or paraventricular nucleus of the hypothalamus, which project directly to the spinal cord. Therefore, the spinal cord is the key structure upon which the peripheral and central inputs converge.84–86 Sexual dysfunction is common at the early stages of PD;71,87 moreover, it may also precede motor symptoms.88 Erectile dysfunction is an important and early symptom in men with MSA.89 Its earlier occurrence suggests a lack of a causal relationship to autonomic failure and hypotension.