Pulmonary plexus

Last revised by Jason Ma on 4 Apr 2023

The pulmonary plexus is a network of autonomic nerves and ganglia situated at the pulmonary hila of each lung which regulates bronchial smooth muscle tone, submucosal glandular mucous secretion, vascular permeability and blood flow. It is derived from both the sympathetic and parasympathetic nervous systems. Sensory fibers innervate the visceral pleura.

Gross anatomy

The pulmonary plexuses lie anterior and posterior to the bronchi and vessels at the hila as they enter each lung. The anterior component is smaller than the more dominant posterior component. Both are derived from lateral extensions of the superficial and deep cardiac plexuses.

The pulmonary plexuses are derived from sympathetic and parasympathetic inputs:

  • sympathetic: cardiac nerves originate from several sources

    • indirectly from the cervical sympathetic ganglia via the cardiac plexus

    • directly from the sympathetic cardiac nerves from the paravertebral ganglia of T2 to T6 segments of the spinal cord

  • parasympathetic: vagal trunks (cranial nerve X) via several cardiac nerves

    • an upper cardiac nerve arises below the inferior cervical ganglion

    • a lower branch arises in the root of the neck

    • the nerves descend anterior to the brachiocephalic artery on the right and over the aortic arch on the left

    • both nerves contribute to the cardiac plexus

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