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NEUROLOGY of ABDOMINAL REGION
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Vagus Nerve Provides parasympathetic innervation to abdominal viscera:
To left colic flexure. Branches: Esophageal branches (to esophageal plexus). Gastric branches: Anterior gastric to stomach. Posterior gastric to stomach. Gall bladder. Intestinal.
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Lumbar Plexus Ventral rami of L1-3 and most of L4. Muscular branches:
Nerve to quadratus lumborum (T12-L3). Nerve to psoas major (L1-L3) Nerve to psoas minor (L1)
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Lumbar Plexus Iliohypogastrric nerve: L1.
Travels lateral to psoas major. Innervates: Lateral buttock. Hypogastric region.
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Lumbar Plexus Ilioinguinal nerve: L1. Travels lateral to psoas major.
Innervates: Skin of groin. Scrotum. Labia.
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Lumbar Plexus Genitofemoral nerve (L1-2.):
Travels through psoas major. Divides into genital and femoral branches. Lateral femoral cutaneous nerve (L2-3.): Travels lateral to psoas major. Femoral nerve (L2-4): Largest branch of lumbar plexus.
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Lumbar Plexus Obturator nerve (L2-4):
Travels medial to psoas major. To adductor muscles of lower extremity. Accessory obturator nerve (L3-4): To pectineus muscle.
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Nerves of Abdominal Wall
Thoracoabdominal nerves (T7-T11): Innervate anterior abdominal muscles, overlying skin and peripheral diaphragm. Anterior cutaneous nerves. Lateral cutaneous nerves. Subcostal nerve (T12): Inferior external oblique and skin over anterior superior iliac spine and hip.
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Thoracic Sympathetic Trunk
Greater splanchnic nerve (T5-9): Celiac ganglia: Prevertebral. Superior to celiac trunk. Celiac plexus: Sympathetic to: stomach, duodenum, ileum, jejunum, spleen, pancreas, gall bladder, kidneys, suprarenal glands. Hepatic plexus: Sympathetic to liver.
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Thoracic Sympathetic Trunk
Lesser splanchnic nerve (T10-11): Superior mesenteric ganglia: Prevertebral. Superior mesenteric plexus: Sympathetic to: duodenum, ileum, jejunum, cecum, vermiform appendix, ascending colon, transverse colon, pancreas.
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Thoracic Sympathetic Trunk
Least splanchnic nerve (T12): Aorticorenal ganglia: Prevertebral. Sympathetic to: kidneys, suprarenal glands.
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Abdominal Sympathetic Trunk
Paravertebral. Continuous with thoracic sympathetic trunk. Lumbar splanchnic nerves (T11-L2): Inferior mesenteric ganglion (prevertebral). Superior hypogastric plexus: Sympathetic innervation to descending colon and sigmoid colon.
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