The muscularis propria of the intestine is the functional motor apparatus of the gut, consisting of inner circular and outer longitudinal smooth muscle layers controlled by the myenteric plexus. Peristalsis is an intrinsic property of the enteric nervous system, persisting even after all extrinsic nerve connections are severed. The taeniae coli of the large bowel represent condensed longitudinal muscle segments.
| Location | Outer muscle coat of the small and large intestine, between the submucosa and the serosa |
|---|---|
| Parts |
|
| Nerve Supply | Myenteric plexus (intrinsic control); Vagus and pelvic splanchnic nerves (parasympathetic, increase motility); Sympathetic splanchnic fibres (reduce motility) |
| Blood Supply | Branches of the superior and inferior mesenteric arteries |
Mixes and propels intestinal contents by segmentation and peristalsis, largely under the control of the gut's own nerve network.
Post-operative ileus involves temporary muscularis propria dysfunction from surgical handling, anaesthetic agents, and opioids, producing absent peristalsis and bowel distension. Chronic intestinal pseudo-obstruction (Ogilvie syndrome) involves colonic muscularis propria dysfunction without mechanical obstruction. Hirschsprung disease involves absence of myenteric plexus ganglia, producing tonic smooth muscle contraction of the aganglionic segment. Irritable bowel syndrome involves abnormal muscularis propria motility patterns producing alternating constipation and diarrhoea.
Bowel handling, anaesthetic agents, opioids, and electrolyte disturbances inhibit the muscularis propria myenteric reflex arc, producing post-operative ileus with absent bowel sounds, distension, and failure to pass flatus; management includes early mobilisation, minimising opioids, prokinetics (neostigmine for colonic ileus), and nasogastric decompression if vomiting persists beyond 3-4 days.
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