Sympathetic Plexus Research Articles

The silver diammine ion staining of peripheral nerve elements and the interpretation of the results: with a modification of the Bielschowsky-Gros method for frozen sections.

1. A modification of the Bielschowsky‐Gros silver diammine ion (ammoniacal silver) method of staining frozen sections is given in detail. This method has been extensively used in the study of peripheral innervations and has given good results. Examples of these are figured. The method has the great advantages of (a) giving good results both after short and very long periods of formalin fixation, (b) allowing microscopic control of the actual staining process, and (c) permitting completely finished specimens to be made in one day after fixation is complete.2. A short discussion of the rationale of this type of silver staining is given.3. The interpretation of the results of silver‐staining methods is discussed, and a plea is made for trying to build up a complete picture from a series of varying impregnations of peripheral innervations. Such a series is illustrated for the sympathetic ground plexus. It is suggested that this plexus has few “end‐points”, and that humoral substances may be released in the continuity of the strands from the “beads” on the finest fibrils.

The tympanic plexus; an anatomic study.

NEW THEORETIC considerations concerning the role of the tympanic plexus and chorda tympani nerve in deafness, tinnitus and vertigo have focused attention on these long-neglected nerve structures. 1 It is important to gather intimate knowledge of the structure, relations, distribution and variations of the tympanic plexus in order to evaluate properly the effects of surgical interruption of the plexus. The main trunk of the tympanic plexus is Jacobson's nerve, which arises from the glossopharyngeal, pierces the floor of the tympanum and extends upward on the promontory and anastomoses with the lesser superficial petrosal nerve. The sympathetic components arise from the carotid sympathetic plexus and anastomose with Jacobson's nerve anteriorly. Smaller branches of Jacobson's nerve go to the oval and round windows posteriorly. A large branch of Jacobson's nerve goes to the eustachian tube. This delicate group of ramifying nerves may function as a significant link in the mechanism of deafness, tinnitus

UNILATERAL FRONTAL ANHIDROSIS AND MIOSIS OCCURRING AFTER PETROUS APICECTOMY (RAMADIER TECHNIC)

THE COURSE of the sympathetic fibers arising from the superior cervical ganglion and supplying the sweat glands of the face has not been definitely established. However, much evidence has accumulated to suggest that the ophthalmic division of the trigeminal nerve receives fibers within the cranium from the sympathetic plexus of the internal carotid artery, and that the maxillary and mandibular divisions receive fibers outside the cranium from the sympathetic plexus of the external carotid artery. List and Peet 1 in an excellent paper on this subject summarized all the available anatomic information in a diagram (fig. 1). It is known that the cutaneous distribution of the sympathetic fibers supplying the face corresponds closely to the cutaneous distribution of fibers conducting pain and temperature sensations. This relationship in respect to the ophthalmic division has been well illustrated in a recent report by Tarlov and Herz. 2 They described a patient with

Intermittent Raynaud's phenomenon resulting from non-united fracture of the navicular bone

A report has been presented of a patient who exhibited a non-united fracture of the navicular bone of twenty-two years' duration, associated with intermittent Raynaud's phenomenon of the corresponding hand. Functional restoration of the hand followed upon operative removal of the projecting movable fragment. Preoperatively, the Raynaud's phenomenon could be reproduced by weight carrying but not by exposure to cold. Its occurrence could be prevented by local infiltration of novocain around the loose fragment. The discussion essentially centers on the mechanism of Raynaud's phenomenon as produced by this relatively simple lesion and under reasonably well controlled clinical conditions. It is concluded that in all probability Raynaud's phenomenon in the present case resulted from stimulation of the perivascular sympathetic plexus leading to vasoconstriction of the distally located arteriolar branches. It is implied that this represents one simple mechanism explaining Raynaud's phenomenon. Others definitely exist. Certain parallels are drawn to the more complex problem of vascular phenomena noted in cases of the cervical rib and scalenus anticus syndrome.

THE NATURAL HISTORY OF HUMAN POLIOMYELITIS

1. Studies on a large number of tissues obtained from fatal cases of human poliomyelitis have revealed that the virus is distributed predominantly in two systems: (a) certain regions of the nervous system, and (b) the alimentary tract. 2. Poliomyelitis virus was demonstrated in the walls of the pharynx, ileum, and only once in those of the descending colon, while the contents of the descending colon regularly contained the virus. 3. The presence of virus in the walls of the alimentary tract appears to be the result neither of generalized dissemination of the virus nor of secondary centrifugal spread, but rather that of primary localization or portal of entry. 4. In the absence of evidence of any demonstrable centrifugal spread to peripheral collections of nerve cells (e.g., in the superior cervical sympathetic ganglia, suprarenals, salivary glands), the presence of virus in the abdominal sympathetic plexus of one case may be indicative of at least one pathway of centripetal virus progression. 5. The absence of demonstrable virus in the nasal mucosa, olfactory bulbs, and anterior perforated substance suggests that neither the upper respiratory tract nor the olfactory pathway were affected in the cases of human poliomyelitis studied in the present investigation.

Dissecting aneurysm: A study of six recent cases

Six cases of dissecting aneurysm of the aorta, autopsied between January and July 1937, are reported. In two cases the correct diagnosis was made during life. One patient presented a conspicuous increase in the pulse volume of the left common carotid artery. Dissection along this vessel causing interference with the periarterial sympathetic plexus is proposed as the explanation of this sign. One patient presented electrocardiographic changes characteristic of coronary occlusion, which apparently resulted from extravasation of blood about the right coronary artery. Four patients lost consciousness at the onset, and all complained of dizziness or weakness. The importance of syncope in the differential diagnosis between dissecting aneurysm and coronary thrombosis is discussed. Pain was not a prominent symptom in four of the six cases. An elevated blood pressure at the time of admission was observed in only one case. Intimal tears were observed in four cases.

Memoirs: The Autonomic (Enteric) Nervous System of Amphioxus Lanceolatus

In this, paper is described a nervous plexus on the wall of the liver and the adjoining parts of the intestine of Amphioxus lanceolatus with numerous stellate ganglion cells, which may be compared with the plexus of Auerbach of the higher vertebrates. A layer of smooth muscle-cells is present, with which the processes of the ganglion cells and the nerve-fibres of the plexus are in synaptic connexion. Covering this layer of smooth muscle-cells a thin layer of connective tissue is present, in which is found a more delicate nervous plexus, connected with the first plexus, analogous to the plexus of Meissner. The nature of the synaptic connexions of the ganglion cells with the pre-ganglionic and post-ganglionic nerve-fibres of the plexus is discussed. The ganglion cells may be compared with the interstitial elements of the sympathetic plexus of the higher vertebrates. The cross-striated trapezius muscle (Legros) is innervated by the same plexus as the muscular coat of the intestine and not by the somatic nerves. The enteric plexus is connected by means of the visceral nerves and dorsal roots with the central nervous system.

A Study of the Effect of Irradiation upon the Lumbar Sympathetic Ganglia in Rats

SINCE 1930, we have been interested in the treatment of cases of angina pectoris with roentgen therapy. It was thought that the effect of irradiation, if any, was upon the sympathetic ganglia, and that pain was relieved in a manner analogous to the relief sometimes obtained after alcoholic injection. A similar line of reasoning was used by others in the justification of roentgen therapy in many diverse conditions, including Raynaud's disease, lichen planus, pruritus, and dysmenorrhea. It soon became obvious that it was extremely difficult to evaluate the results. Patients with angina pectoris frequently pursue a very variable course; they are of necessity treated with several therapeutic agents simultaneously. An improved morale and spirit of optimism may in certain cases mislead both patient and physician as to the true progression of the condition. The technic of roentgen therapy entails manipulations which may act powerfully on the psyche. Thus it was found that, while many cases of severe angina showed improvement, and so stated, they all tended to relapse. Other persons with anginoid pains, definite nervous disturbances, but little in the way of organic cardiac findings, might remain permanently improved. It seemed desirable that some objective experimental data be procured, preferably on animals, bearing upon the basic question: Can roentgen irradiation affect the sympathetic ganglia? The following three possible procedures suggested themselves: (1) Irradiation of the ganglia in situ and subsequent microscopic examination. The objection to this was technical. It is uncertain what degree of damage to a ganglion must exist before it is apparent in the fixed stained preparations now available. It is probable that an attack upon the problem in this manner would require the development of an entirely new technic. (2) After ganglionectomy the temperature of the skin which has suffered an interruption of its vasomotor nerve supply will be relatively high, at least for a time. It is customary to compare corresponding parts on opposite sides. This method is satisfactory and simple following operative procedures, which can easily be unilateral. The proximity of the paravertebral ganglia to each other, especially in small animals where they may lie only from 2 to 3 mm. to each side of the midline, practically precludes the use of this method following irradiation. (3) After ganglionectomy the peripheral sympathetic nerve plexuses, lying in the adventitia of blood vessels, degenerate. This degeneration is complete in from 45 to 60 days. It was realized that failure to obtain this degeneration would not necessarily mean that there had been no effect on the sympathetic ganglia, but only that the effect was not comparable to operative ganglionectomy. This was the method chosen.

The method of wetting arterial trunks with 80% alcohol instead of Lericheʹa surgery

The surgery of the sympathetic nervous system is being persistently developed, and of all the operative methods with which this new department of nervous surgery has managed to enrich itself, the periarterial sympathectomy is especially popular. The idea and the first experiments of this operation belong to Jaboulay, the further development and propaganda of the method to Leriche. By proposing the mentioned operation, these authors meant to change the blood supply to the limb, thus causing hyperemia in it by destroying the sympathetic plexuses, which lie in the periarterial tissue and vessel walls, for a certain extent.

Anatomy of accessory organs of the sympathetic nerve

In 1901, E. Zttckerkandl described in humans new, previously unknown organs that are permanent formations for embryos and newborns, and called them, due to their close topographic and genetic relationship to sympathicus, additional organs of the latter - Nebenorgane des Sympathicus.
 The data of Zuckerkandl's work, based on the study of these organs in 37 fetuses and 27 newborns, are summarized as follows. Accessory organs of the sympathetic nerve in newborns are small bodies, in most cases two, located behind the peritoneum, symmetrically on both sides of the art. mesent, inf., in the sympathetic plexus of the abdominal aorta, adjacent to its wall. The shape of these bodies is elongated, somewhat narrowing towards the ends, flattened from front to back.