Abdomen

• Sympathetic supply


  1. Lumbar part of sympathetic chain enters abdomen behind medial arcuate ligament, descends in front of lumbar vertebrae, right trunk behind IVC, left trunk along left margin of aorta, passes in front of lumbar vessels but behind common iliac vessels

  2. Ganglia - usually 4 in number, give off both somatic and visceral branches

  3. Somatic branches (grey rami communicantes) pass from ganglia to all five lumbar nerves, supply body wall & lower limb

  4. Visceral Branches (Lumbar splanchnic nerves) arise from all lumbar ganglia, join aortic & superior hypogastric plexus
• Sympathetic supply - Celiac plexus (solar plexus)


  Lies around origin of celiac trunk, consists of right & left celiac ganglia, lower detached part - aorticorenal ganglion receives pre ganglionic sympathetic fibres through greater and lesser splanchnic nerves, pre-ganglionic fibres relay in celiac ganglion, post ganglionic fibres from ganglia form celiac plexus, pass along all visceral branches of aorta to reach all abdominal viscera
• Actions of sympathetic supply


  • Vasomotor
  • Motor to sphincters
  • Inhibitory to peristalsis
  • Carry sensory fibres for all viscera
  • Suprarenal medulla receives preganglionic fibres directly without relay, causes release of adrenalin
• Parasympathetic part


  Receive fibres from both vagal trunks, both trunks contain fibres from right and left vagus nerves, enter celiac plexus, pass without relay, supply viscera, gut is supplied only up to transverse colon by vagus, splenic flexure onwards parasympathetic supply received through pelvic splanchnic nerves derived from S2, S3 & S4
• Actions of parasympathetic supply


  • Stimulates peristalsis
  • Inhibitory to sphincters
  • Secretomotor to the gut and its glands up to transverse colon (vagus), beyond splenic flexure of colon to rectum (pelvic splanchnic nerves)
• Appendix & right psoas major muscle
• Retrocaecal appendix
• Inflammation of appendix causes spasm of psoas major
• Patient keeps right thigh in flexed & medially rotated position, this forms basis of PSOAS TEST
• Psoas abscess
• Meralgia Paraesthetica