Pulmonary Plexus

plexus pulmonalis

The pulmonary plexus is an autonomic network at each pulmonary hilum, formed by the pulmonary branches of the vagus nerve (parasympathetic) and the thoracic sympathetic trunk (sympathetic, from T2-T5 ganglia). The anterior pulmonary plexus lies in front of the bronchi and pulmonary artery, and the posterior plexus lies behind. Parasympathetic fibres cause bronchoconstriction and increase bronchial secretion; sympathetic fibres cause bronchodilation and reduce secretion.

Region: Chest

Clinical Relevance

Clinical Notes

The pulmonary plexus innervates the bronchial smooth muscle, mucous glands, and pulmonary vasculature. Disruption during pneumonectomy and lobectomy causes post-operative cough reflex changes and altered bronchial secretion clearance, contributing to retained secretions. Vagal cooling (cryoablation) targeting the pulmonary plexus around the pulmonary veins is performed during some AF ablation procedures to reduce post-ablation cough and bronchospasm. The pulmonary plexus carries visceral afferents responsible for the Hering-Breuer reflex (stretch receptors) and cough reflex pathways.

Pathology

Common Injuries & Conditions

Post-Pneumonectomy Cough Reflex Changes

Division of the pulmonary plexus branches during pneumonectomy denervates the remaining airway, altering the cough reflex and reducing secretion clearance in the post-operative period, contributing to the increased risk of pneumonia and retained secretions in the remaining lung.