THE RENAL CIRCULATION 



I467 



fig. 13. Renal plexuses of the human kidney, anterior aspects. 1 : Hypogastric nerves. 2: Middle 

 spermatic and ureteric nerve. 3 : R. spermatic artery. 4 : Renal branch from sup. hypogastric plexus. 

 5: Lumbar splanchnic nerve. 6: Sup. ureteric nerve. 7: Communication between renal plexus and 

 spermatic nerve. 8: Small renal ganglion. 9: Renal branch from lumbar sympathetic trunk. 10: Post, 

 renal ganglion. 1 1 : Aorticorenal ganglion. 12 : Communication between suprarenal and renal plexuses. 

 1 3 Right coeliac ganglion. 14: R. phrenic nerve. 15: Post, vagal trunk and coeliac di v. i6:Ant. vagal 

 trunks. 17: Esophagus. 18: L. phrenic nerve. 19: Greater (thoracic) splanchnic nerve. 20: Lesser 

 (thoracic) splanchnic nerve. 21 : Lowest (thoracic) splanchnic nerve. 22: Sup. mesenteric ganglion. 

 23: Post, renal ganglion. 24: Intermesenteric nerves. 25: Renal branches from lower ends of inter- 

 mesenteric nerves. 26 : Lumbar sympathetic trunk. 27 : L. ureter. 28 : Inf. mesenteric plexus. 29 : Sup. 

 hypogastric plexus. [After Mitchell (211).] 



NERVE SUPPLY TO THE KIDNEY: ANATOMICAL ASPECTS 



Extrinsic Nerves 



It is generally agreed that the major nerve supply 

 to the kidney has its origin largely from the twelfth 

 thoracic to the second lumbar ganglia of the sym- 

 pathetic nervous system in man (51), and in the dog 

 from T4 through L2, but most abundantly from 

 T10 through T12 (31). Relative to its size, the kidney 

 receives a more profuse and widespread supply than 

 almost any other viscus. Mitchell (211) has written 

 comprehensively on the anatomical aspects of the 

 nerve supply to the human kidney, with an extensive 

 historical review, and with good anatomical illustra- 

 tions to which the reader is referred. Christensen 

 el a/. (55) have given a detailed description of the 



innervation of the cat kidney. The renal nerves of 

 the human kidney are derived from the following: 



celiac plexus. The renal branches arise from the 

 celiac or aorticorenal ganglia, and contain sympa- 

 thetic and almost certainly parasympathetic fibers. 

 Most investigators feel that the posterior vagal trunk 

 supplies the kidney via the celiac plexus, although 

 several have indicated that it may pass directly to the 

 renal plexus (fig. 13). 



thoracic splanchnic nerve. The greater (superior 

 thoracic) splanchnic nerve occasionally, and the 

 lesser (middle thoracic) splanchnic nerve almost 

 invariably send direct filaments to the aorticorenal 

 ganglion or renal plexus, while the least (inferior 

 thoracic) splanchnic nerve ends in the renal plexus. 



