Department of Anatomy & Embryology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Department of Medical Biology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Sci Rep. 2018 Aug 3;8(1):11697. doi: 10.1038/s41598-018-30145-x.
Communicating fibres between the phrenic nerve and sympathetic nervous system may exist, but have not been characterized histologically and immunohistochemically, even though increased sympathetic activity due to phrenic nerve stimulation for central sleep apnoea may entail morbidity and mortality. We, therefore, conducted a histological study of the phrenic nerve to establish the presence of catecholaminergic fibres throughout their course. The entire phrenic nerves of 35 formalin-fixed human cadavers were analysed morphometrically and immunohistochemically. Furthermore, the right abdominal phrenic nerve was serially sectioned and reconstructed. The phrenic nerve contained 3 ± 2 fascicles in the neck that merged to form a single fascicle in the thorax and split again into 3 ± 3 fascicles above the diaphragm. All phrenic nerves contained catecholaminergic fibres, which were distributed homogenously or present as distinct areas within a fascicle or as separate fascicles. The phrenicoabdominal branch of the right phrenic nerve is a branch of the celiac plexus and, therefore, better termed the "phrenic branch of the celiac plexus". The wall of the inferior caval vein in the diaphragm contained longitudinal strands of myocardium and atrial natriuretic peptide-positive paraganglia ("caval bodies") that where innervated by the right phrenic nerve.
膈神经与交感神经系统之间可能存在通讯纤维,但尚未通过组织学和免疫组织化学进行特征描述,尽管膈神经刺激用于中枢性睡眠呼吸暂停会导致交感神经活性增加,从而带来发病率和死亡率。因此,我们进行了膈神经的组织学研究,以确定其整个过程中是否存在儿茶酚胺能纤维。我们对 35 例福尔马林固定的人体尸体的整个膈神经进行了形态计量学和免疫组织化学分析。此外,还对右侧膈神经进行了连续切片和重建。膈神经在颈部包含 3±2 个束,在胸部融合成单个束,在膈肌上方再次分裂成 3±3 个束。所有膈神经都含有儿茶酚胺能纤维,这些纤维均匀分布,或者在一个束内呈现为不同的区域,或者作为单独的束存在。右侧膈神经的膈腹支是腹腔丛的分支,因此更好地称为“腹腔丛的膈神经分支”。膈下腔静脉壁包含心肌的纵行束和心房利钠肽阳性副节瘤(“腔静脉体”),这些结构由右侧膈神经支配。