Khurana R K, Petras J M
Department of Neurology, University of Maryland School of Medicine, Baltimore 21201.
Am J Anat. 1991 Nov;192(3):293-306. doi: 10.1002/aja.1001920309.
The sensory innervation of the postpharyngeal foregut was investigated by injecting the enzyme horseradish peroxidase (HRP) into the walls of the esophagus, stomach, or duodenum. The transported HRP was identified histochemically, labeled neurons in the spinal and vagal ganglia were counted, and the results were plotted using an SAS statistical program. The spinal sensory fields of each viscus were defined using three determinations: craniocaudal extent, principal innervation field, and peak innervation field. The data revealed that innervation fields are craniocaudally extensive, the sensory field of each viscus overlaps significantly with its neighbor, yet each viscus can be characterized by a field of peak innervation density. Craniocaudal innervation of the esophagus spans as many as 22-23 paired spinal ganglia (C1-L2). There are two peak innervation fields for the cervical (C2-C6 and T2-T4) and for the thoracic (T2-T4 and T8-T12) sectors of the esophagus. The sensory innervation of the stomach extends craniocaudally over as many as 25 paired spinal ganglia (C2-L5). The peak innervation field of the stomach spans a large area comprising the cranial, middle, and the immediately adjoining caudal thoracic ganglia (T2-T10). The duodenum is innervated craniocaudally by as many as 15 paired thoracolumbar ganglia (T2-L3). Peak innervation originates in the middle and caudal thoracic ganglia and cranial lumbar (T6-L1) ganglia. There is a recognizable viscerotopic organization in the sensory innervation of the postpharyngeal foregut; successively more caudal sectors of this region of the alimentary canal are supplied with sensory fibers from successively more caudal spinal dorsal root ganglia. Vagal afferent innervation of the esophagus, stomach, and duodenum is bilateral and originates predominantly, but not exclusively, from vast numbers of neurons in the nodose (distal) ganglia. The esophagus is innervated bilaterally and more abundantly by jugular (proximal) ganglia neurons than is either the stomach or duodenum. The physiological significance of the findings are discussed in relation to the phenomena of visceral pain and referred pain.
通过将辣根过氧化物酶(HRP)注入食管、胃或十二指肠壁,研究了咽后前肠的感觉神经支配。采用组织化学方法鉴定转运的HRP,计数脊髓和迷走神经节中标记的神经元,并使用SAS统计程序绘制结果。每个内脏的脊髓感觉区域通过三种测定来定义:头尾范围、主要支配区域和峰值支配区域。数据显示,支配区域在头尾方向上广泛分布,每个内脏的感觉区域与其相邻区域有明显重叠,但每个内脏都可以通过一个峰值支配密度区域来表征。食管的头尾支配跨越多达22 - 23对脊髓神经节(C1 - L2)。食管的颈部(C2 - C6和T2 - T4)和胸部(T2 - T4和T8 - T12)区域有两个峰值支配区域。胃的感觉神经支配在头尾方向上延伸超过25对脊髓神经节(C2 - L5)。胃的峰值支配区域跨越一个大面积,包括颅侧、中间和紧邻的尾侧胸神经节(T2 - T10)。十二指肠由多达15对胸腰神经节(T2 - L3)在头尾方向上支配。峰值支配起源于胸中部和尾部神经节以及颅侧腰(T6 - L1)神经节。咽后前肠的感觉神经支配存在可识别的内脏定位组织;该消化道区域依次更靠尾侧的部分由依次更靠尾侧的脊髓背根神经节提供感觉纤维。食管、胃和十二指肠的迷走神经传入支配是双侧的,主要但并非完全起源于结节(远端)神经节中的大量神经元。与胃或十二指肠相比,食管由颈静脉(近端)神经节神经元进行双侧且更丰富的支配。结合内脏痛和牵涉痛现象讨论了这些发现的生理意义。