Skip to main content
Top
Published in: Chiropractic & Manual Therapies 1/2012

Open Access 01-12-2012 | Research

Colorectal and uterine movement and tension of the inferior hypogastric plexus in cadavers

Author: Ian P Johnson

Published in: Chiropractic & Manual Therapies | Issue 1/2012

Login to get access

Abstract

Background

Hypotheses on somatovisceral dysfunction often assume interference by stretch or compression of the nerve supply to visceral structures. The purpose of this study is to examine the potential of pelvic visceral movement to create tension of the loose connective tissue that contains the fine branches of the inferior hypogastric nerve plexus.

Methods

Twenty eight embalmed human cadavers were examined. Pelvic visceral structures were displaced by very gentle 5 N unidirectional tension and the associated movement of the endopelvic fascia containing the inferior hypogastric plexus that this caused was measured.

Results

Most movement of the fascia containing the inferior hypogastric plexus was obtained by pulling the rectosigmoid junction or broad ligament of the uterus. The plexus did not cross any vertebral joints and the fascia containing it did not move on pulling the hypogastric nerve.

Conclusions

Uterine and rectosigmoid displacement produce most movement of the fascia containing the hypogastric nerve plexus, potentially resulting in nerve tension. In the living this might occur as a consequence of menstruation, pregnancy or constipation. This may be relevant to somatovisceral reflex theories of the effects of manual therapy on visceral conditions.
Appendix
Available only for authorised users
Literature
1.
go back to reference Holtzman DA, Petrocco-Napuli KL, Burke JR: Prospective case series on the effects of lumbosacral manipulation on dysmenorrhea. J Manipulative Physiol Ther. 2008, 31: 237-246. 10.1016/j.jmpt.2008.02.005.CrossRefPubMed Holtzman DA, Petrocco-Napuli KL, Burke JR: Prospective case series on the effects of lumbosacral manipulation on dysmenorrhea. J Manipulative Physiol Ther. 2008, 31: 237-246. 10.1016/j.jmpt.2008.02.005.CrossRefPubMed
2.
3.
go back to reference Quist DM, Duray SM: Resolution of symptoms of chronic constipation in an 8-year-old male after chiropractic treatment. J Manipulative Physiol Ther. 2007, 30: 65-68. 10.1016/j.jmpt.2006.11.005.CrossRefPubMed Quist DM, Duray SM: Resolution of symptoms of chronic constipation in an 8-year-old male after chiropractic treatment. J Manipulative Physiol Ther. 2007, 30: 65-68. 10.1016/j.jmpt.2006.11.005.CrossRefPubMed
4.
go back to reference Kreitz BG, Aker PD: Nocturnal enuresis: treatment implications for the chiropractor. J Manipulative Physiol Ther. 1994, 17: 465-473.PubMed Kreitz BG, Aker PD: Nocturnal enuresis: treatment implications for the chiropractor. J Manipulative Physiol Ther. 1994, 17: 465-473.PubMed
5.
go back to reference Gotlib A, Rupert R: Assessing the evidence for the use of chiropractic manipulation in paediatric health conditions: A systematic review. Paediatr Child Health. 2005, 10: 157-161.PubMedCentralPubMed Gotlib A, Rupert R: Assessing the evidence for the use of chiropractic manipulation in paediatric health conditions: A systematic review. Paediatr Child Health. 2005, 10: 157-161.PubMedCentralPubMed
6.
go back to reference Green IC, Cohen SL, Finkenzeller D, Christo PJ: Interventional therapies for controlling pelvic pain: what is the evidence?. Curr Pain Headache Rep. 2010, 14: 22-32. 10.1007/s11916-009-0089-7.CrossRefPubMed Green IC, Cohen SL, Finkenzeller D, Christo PJ: Interventional therapies for controlling pelvic pain: what is the evidence?. Curr Pain Headache Rep. 2010, 14: 22-32. 10.1007/s11916-009-0089-7.CrossRefPubMed
7.
go back to reference Proctor ML, H,W , Johnson TC, Murphy PA: Spinal manipulation for primary and secondary dysmenorrhoea. Cochrane Database Syst Rev. 2006, CD002119 Proctor ML, H,W , Johnson TC, Murphy PA: Spinal manipulation for primary and secondary dysmenorrhoea. Cochrane Database Syst Rev. 2006, CD002119
8.
go back to reference Nansell DS, M : Somatic dysfunction and the phenomenon of visceral disease simulation. a probable explanation for the apparent effectiveness of somatic therapy in patients presumed to be suffering from true visceral disease. J Manipulative Physiol Ther. 1995, 18: 379-397. Nansell DS, M : Somatic dysfunction and the phenomenon of visceral disease simulation. a probable explanation for the apparent effectiveness of somatic therapy in patients presumed to be suffering from true visceral disease. J Manipulative Physiol Ther. 1995, 18: 379-397.
9.
go back to reference Leach R, Parker P: Somatoautonomic reflex hypothesis. 2004, Williams and Wilkins, London, 269-310. [Leach R (Series Editor): The chiropractic theories] Leach R, Parker P: Somatoautonomic reflex hypothesis. 2004, Williams and Wilkins, London, 269-310. [Leach R (Series Editor): The chiropractic theories]
10.
go back to reference Sato A: The reflex effects of spinal somatic nerve stimulation on visceral function. J Manipulative Physiol Ther. 1992, 15: 57-61.PubMed Sato A: The reflex effects of spinal somatic nerve stimulation on visceral function. J Manipulative Physiol Ther. 1992, 15: 57-61.PubMed
11.
go back to reference Faucheron JL: Pelvic anatomy for colorectal surgeons. Acta Chir Belg. 2005, 105: 471-474.PubMed Faucheron JL: Pelvic anatomy for colorectal surgeons. Acta Chir Belg. 2005, 105: 471-474.PubMed
12.
go back to reference Dail WG: The pelvic plexus: innervation of pelvic and extrapelvic visceral tissues. Microsc Res Tech. 1996, 35: 95-106. 10.1002/(SICI)1097-0029(19961001)35:2<95::AID-JEMT1>3.0.CO;2-#.CrossRefPubMed Dail WG: The pelvic plexus: innervation of pelvic and extrapelvic visceral tissues. Microsc Res Tech. 1996, 35: 95-106. 10.1002/(SICI)1097-0029(19961001)35:2<95::AID-JEMT1>3.0.CO;2-#.CrossRefPubMed
13.
go back to reference Sunderland SB, KC : Stress–strain phenomena of human spinal nerve roots. Brain. 1961, 84: 120-124. 10.1093/brain/84.1.120.CrossRef Sunderland SB, KC : Stress–strain phenomena of human spinal nerve roots. Brain. 1961, 84: 120-124. 10.1093/brain/84.1.120.CrossRef
14.
go back to reference Sunderland S: Nerves and nerve injuries. 1978, Churchill Livingstone, London Sunderland S: Nerves and nerve injuries. 1978, Churchill Livingstone, London
15.
go back to reference Dilley A, Lynn B, Pang SJ: Pressure and stretch mechanosensitivity of peripheral nerve fibres following local inflammation of the nerve trunk. Pain. 2005, 117: 462-472. 10.1016/j.pain.2005.08.018.PubMedCentralCrossRefPubMed Dilley A, Lynn B, Pang SJ: Pressure and stretch mechanosensitivity of peripheral nerve fibres following local inflammation of the nerve trunk. Pain. 2005, 117: 462-472. 10.1016/j.pain.2005.08.018.PubMedCentralCrossRefPubMed
16.
go back to reference Gray's Anatomy. Edited by: Standring S. 2005, Elsevier, London Gray's Anatomy. Edited by: Standring S. 2005, Elsevier, London
17.
go back to reference Ali M, Johnson IP, Hobson J, Mohammadi B, Khan F: Anatomy of the pelvic plexus and innervation of the prostate gland. Clin Anat. 2004, 17: 123-129. 10.1002/ca.10187.CrossRefPubMed Ali M, Johnson IP, Hobson J, Mohammadi B, Khan F: Anatomy of the pelvic plexus and innervation of the prostate gland. Clin Anat. 2004, 17: 123-129. 10.1002/ca.10187.CrossRefPubMed
18.
go back to reference Johnson IP: Endopelvic fascial tension on the inferior hypogastric plexus and its relevance to somatovisceral dysfunction. J Chiropract Educ. 2008, 22: 90. Johnson IP: Endopelvic fascial tension on the inferior hypogastric plexus and its relevance to somatovisceral dysfunction. J Chiropract Educ. 2008, 22: 90.
19.
go back to reference HTA: Human Tissue Act. 2004, Human Tissue Authority, HTA: Human Tissue Act. 2004, Human Tissue Authority,
20.
go back to reference HMSO: Human Anatomy Act. 1984, Her Majesty's stationary Office, London HMSO: Human Anatomy Act. 1984, Her Majesty's stationary Office, London
21.
go back to reference Taylor A, Powell ME: An assessment of interfractional uterine and cervical motion: implications for radiotherapy target volume definition in gynaecological cancer. Radiother Oncol. 2008, 88: 250-257. 10.1016/j.radonc.2008.04.016.CrossRefPubMed Taylor A, Powell ME: An assessment of interfractional uterine and cervical motion: implications for radiotherapy target volume definition in gynaecological cancer. Radiother Oncol. 2008, 88: 250-257. 10.1016/j.radonc.2008.04.016.CrossRefPubMed
22.
go back to reference Pearse A: Histochemistry, theoretical and applied. 1980, Churchill Livingstone, Edingburgh, 4 Pearse A: Histochemistry, theoretical and applied. 1980, Churchill Livingstone, Edingburgh, 4
23.
go back to reference Landon DN: The peripheral nerve. 1976, Chapman and Hall, London Landon DN: The peripheral nerve. 1976, Chapman and Hall, London
25.
go back to reference Komobuchi H, Hato N, Teraoka M, Wakisaka H, Takahashi H, Gyo K, Tabata Y, Yamamoto M: Basic fibroblast growth factor combined with biodegradable hydrogel promotes healing of facial nerve after compression injury: an experimental study. Acta Otolaryngol. 2010, 130: 173-178. 10.3109/00016480902896139.CrossRefPubMed Komobuchi H, Hato N, Teraoka M, Wakisaka H, Takahashi H, Gyo K, Tabata Y, Yamamoto M: Basic fibroblast growth factor combined with biodegradable hydrogel promotes healing of facial nerve after compression injury: an experimental study. Acta Otolaryngol. 2010, 130: 173-178. 10.3109/00016480902896139.CrossRefPubMed
26.
go back to reference Madiba TE, Haffajee MR, Sikhosana MH: Radiological anatomy of the sigmoid colon. Surg Radiol Anat. 2008, 30: 409-415. 10.1007/s00276-008-0344-3.CrossRefPubMed Madiba TE, Haffajee MR, Sikhosana MH: Radiological anatomy of the sigmoid colon. Surg Radiol Anat. 2008, 30: 409-415. 10.1007/s00276-008-0344-3.CrossRefPubMed
27.
go back to reference Mauroy B, Demondion X, Drizenko A, Goullet E, Bonnal JL, Biserte J, Abbou C: The inferior hypogastric plexus (pelvic plexus): its importance in neural preservation techniques. Surg Radiol Anat. 2003, 25: 6-15. 10.1007/s00276-002-0083-9.CrossRefPubMed Mauroy B, Demondion X, Drizenko A, Goullet E, Bonnal JL, Biserte J, Abbou C: The inferior hypogastric plexus (pelvic plexus): its importance in neural preservation techniques. Surg Radiol Anat. 2003, 25: 6-15. 10.1007/s00276-002-0083-9.CrossRefPubMed
28.
go back to reference Wall EJ, Massie JB, Kwan MK, Rydevik BL, Myers RR, Garfin SR: Experimental stretch neuropathy. Changes in nerve conduction under tension. J Bone Joint Surg Br. 1992, 74: 126-129.PubMed Wall EJ, Massie JB, Kwan MK, Rydevik BL, Myers RR, Garfin SR: Experimental stretch neuropathy. Changes in nerve conduction under tension. J Bone Joint Surg Br. 1992, 74: 126-129.PubMed
29.
go back to reference Singh NA, Clements KM, Fiatarone MA: A randomized controlled trial of progressive resistance training in depressed elders. J Gerontol. 1997, Series A, Biological: M27-M35.CrossRef Singh NA, Clements KM, Fiatarone MA: A randomized controlled trial of progressive resistance training in depressed elders. J Gerontol. 1997, Series A, Biological: M27-M35.CrossRef
30.
go back to reference Spackman R, Wrigley B, Roberts A, Quinn M: The inferior hypogastric plexus: a different view. J Obstet Gynaecol. 2007, 27: 130-133. 10.1080/01443610601113839.CrossRefPubMed Spackman R, Wrigley B, Roberts A, Quinn M: The inferior hypogastric plexus: a different view. J Obstet Gynaecol. 2007, 27: 130-133. 10.1080/01443610601113839.CrossRefPubMed
31.
go back to reference Korr I: Somatic dysfunction, osteopathic manipulative treatment and the nervous system: a few facts, some theories and many questions. J Am Osteopath Soc. 1986, 86: 109-114. Korr I: Somatic dysfunction, osteopathic manipulative treatment and the nervous system: a few facts, some theories and many questions. J Am Osteopath Soc. 1986, 86: 109-114.
32.
go back to reference Budgell BS: Reflex effects of subluxation: the autonomic nervous system. J Manipulative Physiol Ther. 2000, 23: 104-106. 10.1016/S0161-4754(00)90076-9.CrossRefPubMed Budgell BS: Reflex effects of subluxation: the autonomic nervous system. J Manipulative Physiol Ther. 2000, 23: 104-106. 10.1016/S0161-4754(00)90076-9.CrossRefPubMed
33.
go back to reference Paungmali A, O'Leary S, Souvlis T, Vicenzino B: Hypoalgesic and sympathoexcitatory effects of mobilization with movement for lateral epicondylalgia. Phys Ther. 2003, 83: 374-383.PubMed Paungmali A, O'Leary S, Souvlis T, Vicenzino B: Hypoalgesic and sympathoexcitatory effects of mobilization with movement for lateral epicondylalgia. Phys Ther. 2003, 83: 374-383.PubMed
34.
go back to reference Cervero F, Laird JM, Pozo MA: Selective changes of receptive field properties of spinal nociceptive neurones induced by noxious visceral stimulation in the cat. Pain. 1992, 51: 335-342. 10.1016/0304-3959(92)90219-2.CrossRefPubMed Cervero F, Laird JM, Pozo MA: Selective changes of receptive field properties of spinal nociceptive neurones induced by noxious visceral stimulation in the cat. Pain. 1992, 51: 335-342. 10.1016/0304-3959(92)90219-2.CrossRefPubMed
35.
go back to reference Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ: The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man Ther. 2009, 14: 531-538. 10.1016/j.math.2008.09.001.PubMedCentralCrossRefPubMed Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ: The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man Ther. 2009, 14: 531-538. 10.1016/j.math.2008.09.001.PubMedCentralCrossRefPubMed
36.
go back to reference Euchner-Wamser I, Sengupta JN, Gebhart GF, Meller ST: Characterization of responses of T2-T4 spinal cord neurons to esophageal distension in the rat. J Neurophysiol. 1993, 69: 868-883.PubMed Euchner-Wamser I, Sengupta JN, Gebhart GF, Meller ST: Characterization of responses of T2-T4 spinal cord neurons to esophageal distension in the rat. J Neurophysiol. 1993, 69: 868-883.PubMed
37.
go back to reference Miranda A, Peles S, Rudolph C, Shaker R, Sengupta JN: Altered visceral sensation in response to somatic pain in the rat. Gastroenterology. 2004, 126: 1082-1089. 10.1053/j.gastro.2004.01.003.CrossRefPubMed Miranda A, Peles S, Rudolph C, Shaker R, Sengupta JN: Altered visceral sensation in response to somatic pain in the rat. Gastroenterology. 2004, 126: 1082-1089. 10.1053/j.gastro.2004.01.003.CrossRefPubMed
38.
go back to reference Nakamura SI, Takahashi K, Takahashi Y, Yamagata M, Moriya H: The afferent pathways of discogenic low-back pain. Evaluation of L2 spinal nerve infiltration. J Bone Joint Surg Br. 1996, 78: 606-612.PubMed Nakamura SI, Takahashi K, Takahashi Y, Yamagata M, Moriya H: The afferent pathways of discogenic low-back pain. Evaluation of L2 spinal nerve infiltration. J Bone Joint Surg Br. 1996, 78: 606-612.PubMed
39.
40.
go back to reference Ogata M, Mateer JR, Condon RE: Prospective evaluation of abdominal sonography for the diagnosis of bowel obstruction. Ann Surg. 1996, 223: 237-241. 10.1097/00000658-199603000-00002.PubMedCentralCrossRefPubMed Ogata M, Mateer JR, Condon RE: Prospective evaluation of abdominal sonography for the diagnosis of bowel obstruction. Ann Surg. 1996, 223: 237-241. 10.1097/00000658-199603000-00002.PubMedCentralCrossRefPubMed
41.
go back to reference Lee NK, Kim S, Jeon TY, Kim HS, Kim DH, Seo HI, Park do Y, Jang HJ: Complications of congenital and developmental abnormalities of the gastrointestinal tract in adolescents and adults: evaluation with multimodality imaging. Radiographics. 2010, 30: 1489-1507. 10.1148/rg.306105504.CrossRefPubMed Lee NK, Kim S, Jeon TY, Kim HS, Kim DH, Seo HI, Park do Y, Jang HJ: Complications of congenital and developmental abnormalities of the gastrointestinal tract in adolescents and adults: evaluation with multimodality imaging. Radiographics. 2010, 30: 1489-1507. 10.1148/rg.306105504.CrossRefPubMed
42.
go back to reference Piiroinen O, Kaihola HL: Uterine size measured by ultrasound during the menstrual cycle. Acta Obstet Gynecol Scand. 1975, 54: 247-250. 10.3109/00016347509157770.CrossRefPubMed Piiroinen O, Kaihola HL: Uterine size measured by ultrasound during the menstrual cycle. Acta Obstet Gynecol Scand. 1975, 54: 247-250. 10.3109/00016347509157770.CrossRefPubMed
43.
go back to reference Engstrom JL: Measurement of fundal height. J Obstet Gynecol Neonatal Nurs. 1988, 17: 172-178. 10.1111/j.1552-6909.1988.tb00422.x.CrossRefPubMed Engstrom JL: Measurement of fundal height. J Obstet Gynecol Neonatal Nurs. 1988, 17: 172-178. 10.1111/j.1552-6909.1988.tb00422.x.CrossRefPubMed
44.
go back to reference Kiff ES, Barnes PR, Swash M: Evidence of pudendal neuropathy in patients with perineal descent and chronic straining at stool. Gut. 1984, 25: 1279-1282. 10.1136/gut.25.11.1279.PubMedCentralCrossRefPubMed Kiff ES, Barnes PR, Swash M: Evidence of pudendal neuropathy in patients with perineal descent and chronic straining at stool. Gut. 1984, 25: 1279-1282. 10.1136/gut.25.11.1279.PubMedCentralCrossRefPubMed
45.
go back to reference Landmann RG, Wexner SD: Paradoxical puborectalis contraction and increased perineal descent. Clin Colon Rectal Surg. 2008, 21: 138-145. 10.1055/s-2008-1075863.PubMedCentralCrossRefPubMed Landmann RG, Wexner SD: Paradoxical puborectalis contraction and increased perineal descent. Clin Colon Rectal Surg. 2008, 21: 138-145. 10.1055/s-2008-1075863.PubMedCentralCrossRefPubMed
46.
go back to reference Camilleri M, Lee JS, Viramontes B, Bharucha AE, Tangalos EG: Insights into the pathophysiology and mechanisms of constipation, irritable bowel syndrome, and diverticulosis in older people. J Am Geriatr Soc. 2000, 48: 1142-1150.CrossRefPubMed Camilleri M, Lee JS, Viramontes B, Bharucha AE, Tangalos EG: Insights into the pathophysiology and mechanisms of constipation, irritable bowel syndrome, and diverticulosis in older people. J Am Geriatr Soc. 2000, 48: 1142-1150.CrossRefPubMed
47.
go back to reference Jorge JM, Wexner SD, Ehrenpreis ED, Nogueras JJ, Jagelman DG: Does perineal descent correlate with pudendal neuropathy?. Dis Colon Rectum. 1993, 36: 475-483. 10.1007/BF02050014.CrossRefPubMed Jorge JM, Wexner SD, Ehrenpreis ED, Nogueras JJ, Jagelman DG: Does perineal descent correlate with pudendal neuropathy?. Dis Colon Rectum. 1993, 36: 475-483. 10.1007/BF02050014.CrossRefPubMed
48.
go back to reference Fowler CJ, Panicker JN, Emmanuel A: Pelvic Organ Dysfunction in Neurological Disease: Clinical Management and Rehabilitation. 2010, University Press, CambridgeCrossRef Fowler CJ, Panicker JN, Emmanuel A: Pelvic Organ Dysfunction in Neurological Disease: Clinical Management and Rehabilitation. 2010, University Press, CambridgeCrossRef
50.
go back to reference Scott-Connor CEH, Dawson DL: Operative anatomy. 2009, Lippincott Williams and Wilkins, Sydney Scott-Connor CEH, Dawson DL: Operative anatomy. 2009, Lippincott Williams and Wilkins, Sydney
51.
go back to reference Barleben A, Mills S: Anorectal anatomy and physiology. Surg Clin North Am. 2010, 90: 1-15. 10.1016/j.suc.2009.09.001. Table of ContentsCrossRefPubMed Barleben A, Mills S: Anorectal anatomy and physiology. Surg Clin North Am. 2010, 90: 1-15. 10.1016/j.suc.2009.09.001. Table of ContentsCrossRefPubMed
52.
go back to reference Travell J, Rinzler SH: Relief of cardiac pain by local block on somatic trigger areas. Proc Soc Exp Biol Med. 1946, 63: 480-482.CrossRefPubMed Travell J, Rinzler SH: Relief of cardiac pain by local block on somatic trigger areas. Proc Soc Exp Biol Med. 1946, 63: 480-482.CrossRefPubMed
53.
go back to reference Lindgren I: A study of cardiac pain by means of local anaesthesia of the precordium and section of the sympathetic pathways. Acta Med Scand. 1948, 131: 37-49.PubMed Lindgren I: A study of cardiac pain by means of local anaesthesia of the precordium and section of the sympathetic pathways. Acta Med Scand. 1948, 131: 37-49.PubMed
Metadata
Title
Colorectal and uterine movement and tension of the inferior hypogastric plexus in cadavers
Author
Ian P Johnson
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Chiropractic & Manual Therapies / Issue 1/2012
Electronic ISSN: 2045-709X
DOI
https://doi.org/10.1186/2045-709X-20-13

Other articles of this Issue 1/2012

Chiropractic & Manual Therapies 1/2012 Go to the issue