陰部神経そうと骨盤神経そうの構成と分布

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  • Composition and Distribution of the Pudendal and Pelvic Plexuses

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Detailed dissections were performed under a stereomicroscope in twelve pelvic-halves to provide more accurate data of the composition and distribution of the pudendal and pelvic plexuses for improving the method of operation upon cancer of the rectum.<BR>The results may be summarized as follows :<BR>(1) According to their sites of origin the branches from the pudendal plexus are classified into two groups, the medial and the lateral ; the medial is composed of the pelvic splanchnic nerves, the nerve to the levator ani and the nerve to the coccygeus, whereas the lateral of the dorsal nerve of the penis or clitoris, the perineal nerve and the inferior rectal nerve. The pelvic splanchnic nerves are the most ventral components of the medial groups.<BR>(2) The external sphincter ani is mainly supplied by the perineal and the inferior rectal nerves, though its posterior end is innervated by either the perineal branch of the fourth sacral nerve or the anococcygeal nerves.<BR>(3) The levator ani is supplied by the nerve to the levator ani (nervus musculi levatoris ani, JNA) except its lowest portion which is innervated by the perineal and the inferior rectal nerves.<BR>(4) The chief components of the pelvic plexus are branches from the hypogastric nerve and the pelvic splanchnic nerves. The sacral splanchnic nerves make minor contributions to the formation of the pelvic plexus.<BR>(5) The rectal branches which arise from the pelvic plexus are divided into the superior and inferior groups according to their sites of entry into the rectal wall.

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