Innervation and Neuronal Control of the Mammalian Sinoatrial Node a Comprehensive Atlas.

[Figure: see text].

A study on preganglionic connections and possible viscerofugal projections from urinary bladder intramural ganglia to the caudal mesenteric ganglion in the pig.

The present study was designed to (1) ascertain the distribution and immunohistochemical characteristics of sympathetic preganglionic neurons supplying the caudal mesenteric ganglion (CaMG) and (2) verify the existence of viscerofugal projections from the urinary bladder trigone intramural ganglia (UBT-IG) to the CaMG in female pigs (n = 6). Combined retrograde tracing and immunofluorescence methods were used. Injections of the neuronal tracer Fast Blue (FB) into the right CaMG revealed no retrogradely labelled (FB-positive; FB+ ) nerve cells in the intramural ganglia; however, many FB+ neurons were found in the spinal cord sympathetic nuclei. Double-labelling immunohistochemistry revealed that nearly all (99.4 ± 0.6%) retrogradely labelled neurons were cholinergic (choline acetyltransferase-positive; ChAT+ ) in nature. Many FB+ /ChAT+ perikarya stained positive for vesicular acetylcholine transporter (63.11 ± 5.34%), neuronal nitric oxide synthase (53.48 ± 9.62%) or cocaine- and amphetamine-regulated transcript peptide (41.13 ± 4.77%). A small number of the retrogradely labelled cells revealed immunoreactivity for calcitonin gene-related peptide (7.60 ± 1.34%) or pituitary adenylate cyclase-activating polypeptide (4.57 ± 1.43%). The present study provides the first detailed information on the arrangement and chemical features of preganglionic neurons projecting to the porcine CaMG and, importantly, strong evidence suggesting the absence of viscerofugal projections from the UBT-IG.

A novel approach to mapping the atrial ganglionated plexus network by generating a distribution probability atlas.

INTRODUCTION: The ganglionated plexuses (GPs) of the intrinsic cardiac autonomic system are implicated in arrhythmogenesis. GP localization by stimulation of the epicardial fat pads to produce atrioventricular dissociating (AVD) effects is well described. We determined the anatomical distribution of the left atrial GPs that influence atrioventricular (AV) dissociation. METHODS AND RESULTS: High frequency stimulation was delivered through a Smart-Touch catheter in the left atrium of patients undergoing atrial fibrillation (AF) ablation. Three dimensional locations of points tested throughout the entire chamber were recorded on the CARTO™ system. Impact on the AV conduction was categorized as ventricular asystole, bradycardia, or no effect. CARTO maps were exported, registered, and transformed onto a reference left atrial geometry using a custom software, enabling data from multiple patients to be overlaid. In 28 patients, 2108 locations were tested and 283 sites (13%) demonstrated (AVD-GP) effects. There were 10 AVD-GPs (interquartile range, 11.5) per patient. Eighty percent (226) produced asystole and 20% (57) showed bradycardia. The distribution of the two groups was very similar. Highest probability of AVD-GPs (>20%) was identified in: inferoseptal portion (41%) and right inferior pulmonary vein base (30%) of the posterior wall, right superior pulmonary vein antrum (31%). CONCLUSION: It is feasible to map the entire left atrium for AVD-GPs before AF ablation. Aggregated data from multiple patients, producing a distribution probability atlas of AVD-GPs, identified three regions with a higher likelihood for finding AVD-GPs and these matched the histological descriptions. This approach could be used to better characterize the autonomic network.

The Sphenopalatine Ganglion: Anatomy, Pathophysiology, and Therapeutic Targeting in Headache.

The sphenopalatine ganglion (SPG) has attracted the interest of practitioners treating head and face pain for over a century because of its anatomical connections and role in the trigemino-autonomic reflex. In this review, we discuss the anatomy of the SPG, as well as what is known about its role in the pathophysiology of headache disorders, including cluster headache and migraine. We then address various therapies that target the SPG, including intranasal medication delivery, new SPG blocking catheter devices, neurostimulation, chemical neurolysis, and ablation procedures.

The subdiaphragmatic part of the phrenic nerve - morphometry and connections to autonomic ganglia.

Few anatomical textbooks offer much information concerning the anatomy and distribution of the phrenic nerve inferior to the diaphragm. The aim of this study was to identify the subdiaphragmatic distribution of the phrenic nerve, the presence of phrenic ganglia, and possible connections to the celiac plexus. One hundred and thirty formalin-fixed adult cadavers were studied. The right phrenic nerve was found inferior to the diaphragm in 98% with 49.1% displaying a right phrenic ganglion. In 22.8% there was an additional smaller ganglion (right accessory phrenic ganglion). The remaining 50.9% had no grossly identifiable right phrenic ganglion. Most (65.5% of specimens) exhibited plexiform communications with the celiac ganglion, aorticorenal ganglion, and suprarenal gland. The left phrenic nerve inferior to the diaphragm was observed in 60% of specimens with 19% containing a left phrenic ganglion. No accessory left phrenic ganglia were observed. The left phrenic ganglion exhibited plexiform communications to several ganglia in 71.4% of specimens. Histologically, the right phrenic and left phrenic ganglia contained large soma concentrated in their peripheries. Both phrenic nerves and ganglia were closely related to the diaphragmatic crura. Surgically, sutures to approximate the crura for repair of hiatal hernias must be placed above the ganglia in order to avoid iatrogenic injuries to the autonomic supply to the diaphragm and abdomen. These findings could also provide a better understanding of the anatomy and distribution of the fibers of that autonomic supply.

The spermatic ganglion in humans: an anatomical update.

The male gonad receives nerve fibers from the autonomic ganglionic system. By the present study, we aimed to bring detailed evidences, topographic and structural, on the spermatic ganglia (SG) in humans, as suppliers of autonomic fibers for the testis. We performed retroperitoneal dissections in 25 formalin-fixed human male adult cadavers. Histology used the Hematoxylin-Eosin and we also used Bielschowsky silver stains. Immunohistochemistry used antibodies for tyrosine hydroxylase. In 20÷10 specimens, we identified left spermatic ganglia (LSG) at the aortic origin of the left testicular artery (LTA); in five specimens the LTA left the renal artery but LSG were juxtaposed on the aorta at about the level of origin of a normal LTA. In 15÷25 cadavers, there were right spermatic ganglia (RSG) related to the right testicular artery (RTA) that in 12 cadavers had a precaval disposition. A specimen with retrocaval RTA presented an inferior renal ganglion, supplying both the renal and the RTA. The SG presented renal, lumbar and intermesenteric roots. The inferior branch of the SG connected it to the inferior mesenteric plexus while its infero-lateral branch adjoined the testicular artery. Microscopy confirmed the SG as nervous ganglia and the respective neuronal populations were tyrosine hydroxylase positive, allowing us to consider these ganglia as sympathetic. We bring here the first-time evidence of the SG topography and cathecolaminergic nature in humans; this ganglion may influence the male gonad via the inferior mesenteric plexus and via the vascular path of the testicular artery.

The changing view of neural specificity.

The generation of specific patterns of neuronal connections has usually been regarded as a central problem in neurobiology. The prevailing view for many years has been that these connections are established by complementary recognition molecules on the pre- and postsynaptic cells (the chemoaffinity theory). Experimental results obtained in the past decade, however, indicate that the view that axon guidance and synaptogenesis proceed according to restrictive chemical markers is too narrow. Although a more rigid plan may prevail in some invertebrates, the formation of specific connections in vertebrates also involves competition between axon terminals, trophic feedback between pre- and postsynaptic cells, and modification of connections by functional activity.

Neural interrelationships of autonomic ganglia from the pelvic region of male rats.

The aims of the present study were to describe, in male rats, the anatomical organization of the major and accessory pelvic ganglia (MPG, AG; respectively), the interrelationship of the pelvic plexus components, and the morphometry of the pelvic postganglionic neurons. Anatomical, histochemical and histological studies were performed in anesthetized adult Wistar male rats. We found that the pelvic plexus consists of intricate neural circuits composed of two MPG, and three pairs of AG (AGI, AGII, AGIII) anatomically interrelated through ipsilateral and contralateral commissural nerves. Around 30 nerves emerge from each MPG and 17 from AGI and AGII. The MPG efferent nerves spread out preganglionic information to several pelvic organs controlling urinary, bowel, reproductive and sexual functions, while AG innervation is more regional, and it is confined to reproductive organs located in the rostral region of the urogenital tract. Both MPG and AG contain nerve fascicles, blood vessels, small intensely fluorescent cells, satellite cells and oval neuronal somata with one to three nucleoli. The soma area of AG neurons is larger than those of MPG neurons (p < 0.005). The MPG contains about 75% of the total pelvic postganglionic neurons. Our findings corroborated previous reports about MPG inputs, and add new information regarding pelvic ganglia efferent branches, AG neurons (number and morphometry), and neural interrelationship between the pelvic plexus components. This information will be useful in designing future studies about the role of pelvic innervation in the physiology and pathophysiology of pelvic functions.

Anatomic study of human laryngeal ganglia: number and distribution.

We have studied 12 laryngeal nerves: six internal branches of the superior laryngeal nerve (ILN) and six recurrent laryngeal nerves (RLN) from three human adult larynges (two males and one female). After dissection of each individual laryngeal nerve using a surgical microscope, the nerves were preserved in 10% formalin, embedded in paraffin wax, serially sectioned transversely at a thickness of 10 microm and stained with hematoxylin and eosin. We found 2-4 ganglia associated with the ILN. At least two ganglia were always present (six out of six cases), the largest one being associated with the branch of the nerve innervating the vestibule and the smallest one associated with the branch innervating the aryepiglottic fold. Other ganglia were found associated with the branches for the glosso-epiglottic fold and vallecula (four out of six cases) and interarytenoid muscle (three out of six cases). The RLN showed from two to six ganglia, all of them located in its anterior terminal division. Two of the ganglia were located in the part of the nerve between the origin of the branches for the interarytenoid and lateral cricoarytenoid muscles (three out of six cases). The remaining ganglia were located close to or at the origin of the muscular branches innervating the intrinsic laryngeal muscles. The cytology of the ganglia reported suggests that they were all autonomic in nature, probably parasympathetic.

[Dissection of cavernous nerves in rat and model of neurological erectile dysfunction].

OBJECTIVES: To identify rat cavernous nerve and establish a rat model of erectile dysfunction caused by injury of cavernous nerve. METHODS: Ten rats were undergone dissections. 30 experimental rats were randomized into 2 groups, cavernous nerve were identified by electrical stimulation. One month after surgery, rat models were evaluated by electrical stimulation. RESULTS: The anatomic structure of cavernous nerve in rats are highly similar to human beings, the erection can be evoked by stimulating cavernous nerves, and after cavernous nerve injury it can not be evoked (P < 0.05). CONCLUSION: Because of the highly similarity of cavernous nerve between rats and human beings, so as the suitable price, rat should be used as the ideal ED experimental animal. The model of ED caused by cavernous nerve injury is reliable.

Quantitative morphometric analysis of the myenteric nervous plexus ganglion structures along the human digestive tract.

BACKGROUND/AIM: All the functions of the digestive system are controlled, guided and initiated by the autonomic nervous system. A special part of this system placed in the wall of the gastrointestinal tract is known as the enteric or metasympathetic nervous system. The aim of this study was to analyse myenteric nervous plexus in different parts of the digestive tract. METHODS: We examined the myenteric nervous plexus of the esophagus, stomach, duodenum, jejunum, ileum, transverse colon and rectum in tissue samples taken from 30 cadavers of persons aged 20-84 years. After standard histological processing sections were stained with hematoxylin-eosin, cresyl violet (CV) and AgNO3 method. Multipurpose test system M42 was used in morphometric analysis. The results were analyzed by t-test and analysis of variance. RESULTS: The number of neurons per cm² surface was the lowest in the esophagus (2.045 ± 310.30) and the largest in the duodenum (65,511 ± 5,639). The statistical processing showed significant differences (P < 0.001) in the number of neurons between the esophagus and all other parts of the digestive tract. The maximal value of the average surface of the myenteric nervous plexus neurons was observed in the esophagus (588.93 ± 30.45 µm²) and the lowest in the stomach (296.46 ± 22.53 µm²). CONCLUSION: There are differences in the number of ganglion cells among different parts of the human digestive tract. The differences range from a few to several tens of thousands of neuron/cm2. The myenteric nervous plexus of the esophagus was characterized by a significantly smaller number of neurons but their bodies and nuclei are significantly larger compared to other parts of the digestive tract.

Unusual autonomic ganglia: connections, chemistry, and plasticity of pelvic ganglia.

The pelvic ganglia provide the majority of the autonomic nerve supply to reproductive organs, urinary bladder, and lower bowel. Of all autonomic ganglia, they are probably the least understood because in many species their anatomy is particularly complex. Furthermore, they are unusual autonomic ganglia in many ways, including their connections, structure, chemistry, and hormone sensitivity. This review will compare and contrast the normal structure and function of pelvic ganglia with other types of autonomic ganglia (sympathetic, parasympathetic, and enteric). Two aspects of plasticity in the pelvic pathways will also be discussed. First, the influence of gonadal steroids on the maturation and maintenance of pelvic reflex circuits will be considered. Second, the consequences of nerve injury will be discussed, particularly in the context of the pelvic ganglia receiving distributed spinal inputs. The review demonstrates that in many ways the pelvic ganglia differ substantially from other autonomic ganglia. Pelvic ganglia may also provide a useful system in which to study many fundamental neurobiological questions of broader relevance.

Comparative anatomical study of the autonomic cardiac nervous system in macaque monkeys.

The main aim of this study was to clarify the general morphology of the autonomic cardiac nervous system in macaque monkeys. A submacroscopic comparative anatomical study of the autonomic cardiac nervous system was performed by examining 22 sides of 11 bodies of four species of macaque monkeys, including some previously unreported species (pig-tailed and stump-tailed monkeys), under a surgical stereomicroscope. The following results were obtained. 1) The basic arrangement of the autonomic cardiac nervous system is constant in all examined macaques. 2) A superior cardiac nerve originating from the superior cervical ganglion was not observed, whereas the thoracic cardiac nerve originating from the sympathetic trunk/ganglia under the cervicothoracic ganglion was rarely observed in all the examined macaques. 3) The main cardiac nerve is the middle cardiac nerve originating from the middle cervical ganglion, similar to the situation in humans. 4) Although the superior, inferior, and thoracic cardiac branches of the vagus nerve were consistently observed, the left thoracic cardiac branch is rarely absent because of its lower origin to the heart. 5) The cranial autonomic nerves tend to distribute into the heart medially (arterial porta), and the caudal autonomic nerves tend to distribute into the heart laterally (venous porta). To comprehend the comparative morphological and evolutionary changes more completely, these results were compared with our previous studies and some references. Consequently, differences in the sympathetic cardiac nerves of macaques and humans are recognized, in spite of the similar morphologies of the vagal cardiac branches. These differences include the composition of the cervicothoracic ganglion, the lower positions of the middle cervical and cervicothoracic ganglia, and the narrow range for the origin of the cardiac nerves in macaques compared to that in humans.

[Distribution of the epicardiac neural ganglia in human fetuses of different age]. / Epikardiniu nerviniu mazgu pasiskirstymas skirtingo amziaus zmogaus vaisiuje.

OBJECTIVE: The epicardiac neural ganglia of the adult human heart are distributed in the seven neural ganglionated subplexuses. The aim of the present investigation was to determine the distribution of the epicardiac ganglia in human fetuses of different age, because intrinsic cardiac nervous system of the human fetus has not been enough investigated so far. MATERIAL AND METHODS: In the present study seventeen human fetus hearts were investigated, in which epicardiac neural ganglionated plexus was visualized by histochemical method for acetylcholinesterase. RESULTS: Analysis of the total hearts preparations showed that: (1) the epicardiac neural ganglionated plexus of the fetus at fifteen weeks of gestation has already differentiated into seven ganglionated subplexuses, structure of which is typical for the adult human heart; (2) the epicardiac plexus of fetuses at 15-40 weeks of gestation contains on average 865+/-40 epicardiac ganglia, that may widely range in number from 644 to 1193; (3) the largest number of the neural ganglia is concentrated on the posterior surface of both atria, where up to 76% of all ganglia maybe located; (4) the difference between the number of epicardiac ganglia in the human fetuses at the early (15-25 weeks) and late (26-40 weeks) stages of fetogenesis is not statistically significant (p>0.05). In conclusion, both the distribution and the number of the epicardiac ganglia of fetuses ranging from 15 to 40 weeks of gestation are not age-dependent but varied substantially from heart to heart.

Localization of neurons in the rat superior cervical ganglion that project into different postganglionic trunks.

Horseradish peroxidase (HRP) was used to determine whether neurons in the rat superior cervical ganglion (SCG) are localized in regions of the ganglion as a function of the postganglionic trunk they utilize. In separate experiments, each of the two major postganglionic trunks was cut 1-3 mm from the SCG and solid HRP was applied to the cut end proximal to the ganglion. The results demonstrated that the cell bodies of neurons whose axons project out the internal carotid nerve (ICN) were located primarily in the rostral part of the ganglion. Cell bodies of neurons whose axons project out the external carotid nerve (ECN) were located primarily in the caudal part. The total percentages of neuronc with axons in the ICN and ECN were about 35% and 45%, respectively. When HRP was applied to both these trunks, 73% of the neurons in the SCG were labeled. In the caudal portion of the ganglion, an additional group of neurons was observed whose axons project into the cervical sympathetic trunk. Control studies indicated that the neuronal labeling observed in our experiments was due to retrograde axonal transport rather than the direct uptake of HRP by neuronal cell bodies. Thus, neuronal subpopulations exist in specific regions of the rat SCG. The significance of these results to biochemical and electrophysiological studies is discussed.

Categories of axons in mammalian rami communicantes. Part II.

The mammalian rami communicantes consist of preganglionic, postganglionic and sensory axons. The present study focusses on the number of sensory axons in the midthoracic rami communicantes in the cat. The conclusions are that the white rami contain approximately 250 myelinated and 200 unmyelinated sensory axons and the grey rami 4 to 5 myelinated and 20 to 25 unmyelinated sensory axons. A previous study determined the numbers of pre- and postganglionic fibers in these same rami. Thus the total number of axons in these rami are as follows: for the grey rami there are: (1) 3,000 to 5,000 unmyelinated postganglionic axons, (2) 25 myelinated postganglionic axons, (3) 20 to 25 unmyelinated sensory axons and; (4) 4 to 5 myelinated sensory axons; and for the white rami there are approximately: (1) 1,000 unmyelinated preganglionic axons, (2) 1,500 myelinated preganglionic axons, (3) 2,000 unmyelinated postganglionic axons, (4) 250 unmyelinated sensory axons and (5) 200 myelinated sensory axons. The implications of these findings are discussed.

The hypogastric nerve innervates a population of penile neurons in the pelvic plexus.

Retrograde dye staining, enkephalin immunocytochemistry and nerve lesion paradigms were used to determine if penile neurons in the pelvic plexus are innervated by fibers in the hypogastric nerve. In the intact major pelvic ganglion of the rat, some 80% of penile neurons are enclosed by an enkephalin-positive fiber plexus. Following surgical interruption of the pelvic nerve, 20% of penile neurons were still surrounded by an enkephalin plexus. After interruption of the pelvic nerve and the hypogastric nerve, the enkephalin plexus in the ganglion was virtually absent, including the plexus around penile neurons. Therefore, possible intrinsic sources of the enkephalin fibers such as enkephalin-positive principal neurons and small intensely fluorescent cells, do not account for the delicate enkephalin fiber system in the pelvic ganglion. It is concluded that the pelvic nerve is the major source of preganglionic innervation to penile neurons in the major pelvic ganglion. However, it is significant that the hypogastric nerve is preganglionic to about 20% of penile neurons. The pathway through the hypogastric nerve may represent an alternate vasodilator system to penile erectile tissue.

Anatomy of human extrinsic cardiac nerves and ganglia.

The anatomy of the human extrinsic cardiac nerves and ganglia was reinvestigated because descriptions of human cardiac innervation vary, detailed analyses of subhuman mammalian cardiac innervation reveal considerable similarities among species and the anatomic pattern of cardiac innervation observed in subhuman mammals differs significantly from those described for humans. The presence of a consistent pattern of cardiac innervation in subhuman mammals raised the question as to whether a similar pattern exists in humans. To investigate this, the cervical and thoracic autonomic nerves and ganglia were dissected in 13 embalmed and 10 autopsy cadavers. All major sympathetic cardiopulmonary nerves were found to arise from the stellate ganglia and the caudal halves of the cervical sympathetic trunks below the level of the cricoid cartilage. These sympathetic cardiopulmonary nerves usually consisted of 3 nerves on the right side and 4 on the left. In contrast to widely accepted reports, no sympathetic cardiopulmonary nerves were found to arise from the superior cervical ganglia or the thoracic sympathetic trunks inferior to the stellate ganglia. Parasympathetic cardiopulmonary nerves were found to arise from the recurrent laryngeal nerves and the thoracic vagi immediately distal to them. These nerves interconnected with sympathetic cardiopulmonary nerves anterior and posterior to the main pulmonary artery to form the ventral and dorsal cardiopulmonary plexuses. These plexuses contained relatively large discrete nerves as well as smaller interconnections. Emerging from these plexuses to innervate the ventricles were 3 distinct relatively large cardiac nerves, the right and left coronary cardiac nerves and the left lateral cardiac nerve. In addition to these 3 major nerves, small cardiac nerves arose from the plexuses and the thoracic vagi. Histologic examination of representative dissections confirmed the presence of neural tissue and identified the locations of neuronal cell bodies in these structures. Cell bodies were located in the nodose, superior cervical, middle cervical, stellate and thoracic sympathetic ganglia. The middle cervical ganglia varied in size and number. Neuronal cell bodies were found in the cervical and thoracic sympathetic trunks and in small mediastinal ganglia located along the courses of the cardiopulmonary and cardiac nerves. Marked similarities exist between the anatomy of the cardiopulmonary nerves and ganglia of humans and baboons.

Action of 6-hydroxydopamine on lamb sympathetic ganglia, vas deferens and adrenal medulla: a combined histochemical, ultrastructural and biochemical comparison with the effects of reserpine.

1. The effects of a single dose of 6-hydroxydopamine (6-OHDA) compared with those of chronic reserpine treatment were studied in lamb sympathetic neurones and adrenal medulla by a combination of fluorescence histochemistry, electron microscopy and radiochemical assay.2. In sympathetic ganglia, 6-OHDA produced a rise in noradrenaline concentration within 24 h, and falls in tyrosine hydroxylase and monoamine oxidase activities, whereas reserpine caused a fall in noradrenaline, a rise in tyrosine hydroxylase activity and no change in monoamine oxidase activity. The fluorescence of intra- and postganglionic axons increased greatly within 24 h of 6-OHDA, and there was a corresponding accumulation of large dense-core vesicles within many axons whose neurotubules were disrupted. The changes were almost reversed after 3 weeks.3. In the vas deferens, the concentration of noradrenaline and tyrosine hydroxylase and monoamine oxidase activities had all fallen 24 h after 6-OHDA treatment and had started to recover 3 weeks later. In the adrenal medulla, 6-OHDA did not alter NA concentrations but increased tyrosine hydroxylase activity whereas reserpine depleted noradrenaline and increased tyrosine hydroxylase activity.4. The changes produced in sympathetic ganglia by 6-OHDA may be due both to a direct action on the axoplasmic transport of noradrenaline containing vesicles and indirectly to the reaction of the neurones to loss of the integrity of their axons.

Cardiac neurones of autonomic ganglia.

The properties of the postganglionic sympathetic neurones supplying the heart and arising in the stellate and adjacent paravertebral ganglia of various species are discussed with respect to their location, morphology, synaptic input and membrane characteristics. Results from our laboratory on the morphology of rat stellate neurones projecting to the heart were obtained either by intracellular injection of hexammine cobaltic (III) chloride or by retrograde labelling of cells using cobalt-lysine complex. Intracellular recordings were made from cells using electrodes filled either with potassium chloride plus hexammine cobaltic chloride or potassium acetate. Neurones which projected axons into cardiac nerve branches arising from the stellate ganglion were termed putative cardiac neurones, because of the possibility that some supply pulmonary targets. Putative cardiac neurones had unbranched axons and were ovoid or polygonal in shape, but showed considerable variation in soma size and in the complexity of dendritic trees. The mean two-dimensional surface area was 463 microns2 and the mean number of primary dendrites was seven. Other studies have found that the morphology of rat stellate ganglion neurones is similar to that of superior cervical ganglion cells. However, in strains of rat displaying spontaneous hypertension, dendritic length may be increased. Histochemical studies do not, as yet, seem to have demonstrated a distinctive neurochemical profile for stellate cardiac neurones, but various types of peptide-containing intraganglionic nerve fibres have been identified in the guinea pig. In our electrophysiological studies, putative cardiac neurones were found to receive a complex presynaptic input arising from the caudal sympathetic trunk and from T1 and T2 thoracic rami. In addition, 16% of cardiac neurones received a synaptic input from the cardiac nerve. The properties of postganglionic parasympathetic neurones distributed in the cardiac plexus and termed intrinsic cardiac neurones are discussed, including the results of studies on cultures of these neurones.