Studies On Intramural Nerves Of Ureter And Ileal Wall In Adults

Objective: To explore the distribution of nerve in adult ureter and ileum wall,and to provide services for material matching of ileum instead of ureter.Methods: The ureter and distal ileum were carefully cut from 6 Chinese adults(60±8.5)after local anatomy teaching and applied anatomy study.The fresh ureters obtained during the surgical resection of nonfunctional kidney and the ileum segment of the right proximal colon were collected.With the help of 5 times magnifying glass,carefully dissection,trim,remove part of the fat,with 10% formaldehyde solution to continue fixed for 1 month.Three ureters and three segments of ileum were taken for HE staining and immunohistochemical staining,and the rest were stained as a whole by the modified Sihler's staining.The nerve branches,distribution,deformation,recording and photography in the ureter and ileum wall were observed under X-ray reading lamp.According to the nerve direction,part of the tissue block containing the nerve was carefully cut into a size of about 1.0×1.0cm,and directly pressed on a slide.The nerve structure was observed under a microscope and photographs were taken.According to the observation results and photographic data,the muscular nerve branches,distribution rules and morphological characteristics of the two were analyzed and summarized to find the similarities and differences and the neuroanatomical basis of the intestinal ureter.Results: Gross anatomy makes it difficult to identify the origin of the ureter,and some fine white nerve branches in the mesentery of the gyrus are seen entering the intestinal wall.HE observed that the ureter had an outer membrane,muscular layer and mucosal layer,but no cell structure was found in the outer membrane,which was loose connective tissue and passed by blood vessels,lymphatics and nerves.The muscular layer is divided into two layers: inner and outer ring,and the lower segment is divided into three layers: inner,central and outer.The lumen of the mucosa was stellate in cross section,and the epithelium had about 4~5 layers of cells.There are scattered nerve fibers in the tube wall.Ileum is divided into four layers: mucosa,submucosa,muscle and serous membrane,with annular plica in the mucosa layer and inner ring and outer longitudinal layers in the muscle layer.More nerve fibers inreticular distribution were seen between muscles.After Sihler's staining,the ureter and ileum were transparent gelatinous,the intramural nerve branches were dark blue,and the serosal surface was more clear.The nerves and blood vessels in the ureteral outer membrane go along with each other,approximately vertically entering the wall of the ureter,gradually extending to the muscle layer and distributing along the longitudinal axis.As a whole,the nerves on the tube wall and the middle part were rare,the branches gradually became thin,and the adjacent branches crossed less.Lower ureteral nerve relatively dense,see the bladder ureter connection enter into clusters of lower ureteral proximally extension of rough neural,distribution density,upward gradually separate primary and secondary nerve branch,branch crisscross and with lines between adjacent nerve,every nerve branch not fixed on a plane,can be observed in the field of vision found ganglion.The ileum is complete in appearance,and the serosal nerve branches show dark blue accompanying with the arteries,and give off primary and secondary nerve branches to the intestinal wall.Some of them are directly distributed across the vascular network to the lateral mesenteric wall,and the intramural nerve reaches the intestinal wall and distributes vertically to the intestinal wall in a dendritic shape.The adjacent nerve branches cross each other,and the branches of each nerve bundle are not fixed on a plane.No definite ganglion can be seen in the field of observation.Sihler's staining of clear ureter and ileum tissue slices were taken: nerve fibers in both of them were distributed from the outward to the mucosal layer;the inner ureter wall was along the longitudinal axis;the intestinal wall was approximately perpendicular to the opposite mesangial side,showing reticular distribution;the branches were gradually thinning;the nerve fibers were obviously crossed;no clear ganglion-like structure was observed.Immunohistochemistry showed that the intramural nerve fibers of the ureter were fasciculate and distributed longitudinally,with less crossing.There is a grid distribution of nerve fibers in the intramuscular walls of the ileum and a large number of ganglion structures in the intramuscular walls.Conclusion: The adult ureter and ileum are muscular cavity viscera,and the intramural nerve branches and distribution have their own characteristics,and they are adapted to their functions.The intramural nerve is accompanied by the flow of its innervation artery,and the intramural nerve flows from the outside to the mucosal layer,with the branches gradually becoming thinner,and no definite ganglion is seen.Except the submucosa wall structure similar,mainly by the ring with longitudinal smooth muscle power,are controlled by the splanchnic nerve,organ nerve towards the outside wall along its artery accompanying,intramural nerve have similar segmental distribution,this may be the ileum generation of ureteral postoperative clinical,ileal ureter can be similar to the original ureteral peristalsis rhythmic the neural anatomy basis of urination.