Variations in the gross anatomy of the stellate and lumbar sympathetic ganglia

Perlow, Samuel; Vehe, Karl L.

doi:10.1016/s0002-9610(35)91210-7

Cited by 21 publications

(14 citation statements)

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“…Katritsis et al (1981) made no mention of arterial anatomical variability and went as far as to state that the course of the vertebral artery is a constant landmark for the identification of the CTG itself. The only other paper to make specific mention of the intimate relationship between the vertebral artery and the CTG was by Perlow and Vehe (1935) (see Fig. 2a and 2b for detail).…”

Section: Discussionmentioning

confidence: 99%

An anatomical investigation of the cervicothoracic ganglion

et al. 2011

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Anatomical variability within the autonomic nervous system has long been accepted. This study evaluated the anatomical variability of the cervicothoracic ganglion (CTG) according to its form and, in addition, provided precise measurements between the CTG and the anterior tubercle of the transverse process of the sixth cervical vertebra (C6TP), the first costovertebral articulation, and the vertebral artery. Forty-two adult cadavers were dissected, 22 male and 20 females. Five main forms of CTG were documented; spindle (31.9%), dumbbell (23.2%), truncated (21.7%), perforated (14.5%), and inverted-L (8.7%). The means for length, width, and thickness of the CTG were 18.5 mm, 8.2 mm, and 4.5 mm, respectively. The dimensions were found to be slightly larger in the males than females and on the left sides as compared to the right. The mean shortest distance between the CTGs and the vertebral artery was found to be 2.8 mm, whilst the mean shortest distances to C6TP was 25.7 mm and to the first costovertebral articulation was 1.7 mm. There is great variability in the morphology of the CTG with five common forms consistently seen. The relation to the vertebral artery may influence the form of the ganglion. Two previously undocumented forms are recorded; the truncated which describes the important juxtaposition of the CTG and the vertebral artery and the perforated which describes the piercing of the ganglion itself by the artery. The findings are considered to be of clinical importance to anesthetists, surgeons, neurosurgeons, and anatomists.

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Section: Discussionmentioning

confidence: 99%

An anatomical investigation of the cervicothoracic ganglion

et al. 2011

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“…In all the cases it was present dorsal to the subclavian artery, at the point of origin of vertebral artery, in confirmation with the findings of Kuntz. 10,13,5 Branches: Lateral Branches Kuntz (1927) mentioned the formation of ICG by the fusion of the 7 th and 8 th cervical sympathetic ganglia and origin of GRC as lateral branches to 7 th and 8 th cervical spinal nerves. In the present study, GRC to C7 and C8 was seen in 47.2% cases and to C8 alone in 52.8% cases.…”

Section: Discussionmentioning

confidence: 99%

Inferior Cervical Ganglion and Stellate Ganglion- Concepts Revisited

Raveendran¹,

Kamalamma²

2018

jemds

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BACKGROUND Awareness of the regional anatomy of the cervical sympathetic chain may help the surgeons in identifying and preserving this structure during related surgical procedures. Care must be taken by the spinal surgeon to protect the chain and its branches, while dissecting the longus colli muscle especially in the root of neck for anterior spinal surgeries. 1 The present study aims to define the lower two ganglia, i.e. inferior cervical ganglion and stellate ganglion by tracing their vascular relations, dimensions and branches. The frequency of occurrence of these ganglia, which is surgically significant is also studied. MATERIALS AND METHODSThe study was descriptive, done in 50 cervical sympathetic chains by bilateral neck dissection of 25 adult cadavers in the Department of Anatomy, Medical College, Thiruvananthapuram. The superior cervical ganglion (SCG), inferior cervical ganglion (ICG), stellate ganglion (SG) and the intermediate ganglia were carefully dissected out and studied. RESULTSSCG was seen in 100% cases, middle inferior ganglion (MCG) in 44%, vertebral ganglion (VG) in 72%, ICG in 72% cases and stellate ganglion in 28% chains. The branches arising from the ganglia were Gray rami communicantes (GRC), vascular branches and medial visceral branches. Vertebral nerve from ICG was present in 4% cases and from stellate in 2% cases. CONCLUSIONIn the lower part of cervical sympathetic chain, ICG is more frequently present than SG. KEYWORDSCervical Sympathetic Chain, Cervical Sympathetic Ganglia, Inferior Cervical Ganglion, Stellate Ganglion, Vertebral Nerve. HOW TO CITE THIS ARTICLE: Raveendran VL, Kamalamma GK. Inferior cervical ganglion and stellate ganglion-concepts revisited. J. Evolution Med. Dent. Sci. 2018;7(13):1653-1658, DOI: 10.14260/jemds/2018/373 BACKGROUND The cervical sympathetic chain lies ventral to the transverse process of the cervical vertebrae and dorsal to the carotid vessels. It extends from the base of the skull to the level of the neck of first rib, where it continues as the thoracic sympathetic chain. The classical chain was described as having 3 ganglion masses named as superior cervical ganglion, middle cervical ganglion and inferior cervical ganglion or cervico-thoracic ganglion. The varying frequency of occurrence of ICG and SG is mentioned in the previous studies, leaving a questionable concept that will the ICG and first thoracic ganglion almost universally fused to form the stellate ganglion.The ganglia in the cervical region were named as "ganglion cervical medium" and "ganglion cervicothoracicum" or "ganglion stellatum" in the International Anatomical Nomenclature Committee [Nomina Anatomica, Paris (1955)]. The term "inferior cervical ganglion" had been discarded in Nomina Anatomica and was justified by the fact that the "inferior cervical ganglion" appeared only exceptionally as an independent formation. 2 'Financial or Other Competing Interest': None. Submission 17-02-2018, Peer Review 12-03-2018, Acceptance 19-03-2018, Published 26-03-2018. Corresponding...

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“…In 1935, Perlow demonstrated grey communicating rami occasionally arising from the second thoracic ganglion to the first thoracic nerve. As these rami additionally provide sympathetic supply to the upper extremity [34], their importance in obtaining complete denervation has become clear.…”

Section: The Sympathetic Trunkmentioning

confidence: 99%

The sympathetic trunk and its neural pathway to the upper limb: review of the literature

2005

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Zusammenfassung. Grundlagen: Kenntnisse der Anatomie des Truncus sympathicus und des autonomen Nervensystems sind von großer Bedeutung in der Sympathikuschirurgie. Allerdings existiert eine Vielzahl an unterschiedlichen sympathischen Nervenverbindungen zur oberen Extremität, wobei der Großteil im ersten Zwischenrippenraum zu liegen kommt. Aus unterschiedlichsten Gründen führt die chirurgische Sympathektomie im Bereich der oberen thorakalen Ganglien zu einer Unterbrechung der sympathischen Innervation der oberen Extremität. Entscheidend ist, diese variablen Verbindungen zu durchtrennen, um optimale chirurgische Ergebnisse zu erzielen.Methodik: Diese Arbeit basiert auf einer Durchsicht der Literatur der letzten 80 Jahre über die Anatomie des kranialen thorakalen Truncus sympathicus und seiner Verbindungen, die in der Sympathikuschirurgie von besonderer Bedeutung sind. Die Evaluation basiert auf einer Literaturrecherche in der Medline, ergänzt um Wissen aus Anatomiebüchern; es wird zudem eine Übersicht über die historische Entdeckung des sympathischen Systems gegeben.Ergebnisse: Zwei wichtige Ergebnisse liegen vor. 1. Intrathorakale Nervenverbindungen zwischen zweitem und erstem intrathorakalen Nerv dürften sympathische Fasern der oberen Extremität zuführen. Diese Verbindungen kommen bei mehr als 50 % der Menschen vor und dürften für Misserfolge und/oder Rezidive nach Sympathektomie verantwortlich sein.2. Aktuelle chirurgische Studien weisen darauf hin, dass das Hauptganglion für die sympathische Innervation der oberen Extremität im Segment T4 liegen könnte. Dies steht jedoch im Gegensatz zur bisher anerkannten Ansicht, dass das Hauptganglion der sympathischen Innervation für die obere Extremität das T2-Ganglion sei. Bislang können diese klinischen Erkenntnisse nicht durch anatomisches Wissen erklärt werden.Schlussfolgerungen: Profunde anatomische Kenntnisse sind eine unabdingbare Voraussetzung, um in der Sympathikuschirurgie optimale Ergebnisse zu erzielen.Schlüsselwörter: Truncus sympathicus, Thorakoskopie, Sympathektomie, Nervenverbindungen.Summary. Background: Knowledge of the anatomy of the sympathetic trunk and the autonomous nervous system is of great importance for sympathetic surgeons. However, a variety of different sympathetic pathways to the upper limb exist, most of them appearing in the first intercostal space. For several reasons, surgical sympathectomy of the upper thoracic ganglia interrupts the sympathetic innervation to the upper limb. It is crucial to reach these variable connections for gaining optimal surgical results.Methods: This paper is based on a review of the literature over a period of 80 years, concerning the anatomy of the upper thoracic sympathetic connections and their importance for surgical sympathectomy. The evaluation is based on research in Medline, broadened by knowledge of anatomical books; a review on the historical discovery of the sympathetic system is also provided.Results: There are two main findings.(1) Intrathoracic rami connecting the second and first thoracic nerve pr...

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Variations in the gross anatomy of the stellate and lumbar sympathetic ganglia

Cited by 21 publications

References 1 publication

An anatomical investigation of the cervicothoracic ganglion

An anatomical investigation of the cervicothoracic ganglion

Inferior Cervical Ganglion and Stellate Ganglion- Concepts Revisited

The sympathetic trunk and its neural pathway to the upper limb: review of the literature

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