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Cervical Sympathetic Ganglia

  

There are three cervical sympathetic ganglia: superior, middle and inferior.


Superior cervical ganglion

  1. It lies just below skull, opposite the 2nd and 3rd cervical vertebrae. It is largest of three ganglia and spindle shaped. It is formed by fusion of upper 4 cervical nerve ganglia. It also has communications with cranial nerves IX, X, XI and XII, and with external and recurrent laryngeal nerve.
  2. Branches of superior cervical ganglion are :-
    1. Grey rami communicans: To ventral rami C1 to C4 cranial nerves.
    2. Internal carotid nerve: Forms plexus around ICA.
    3. External carotid nerve: Forms plexus around ECA.
    4. Pharyngeal branches: Take part in formation of pharyngeal plexus.
    5. Left superior cervical cardiac branch: For superficial cardiac plexus.
    6. Right superior cervical cardiac branch: For deep cardiac plexus.

Middle cervical ganglion

  1. It is the smallest of three ganglia. It lies in front of vertebra C6.1t is formed by fusion of 5th and 6th cervical ganglion connections. It is connected to inferior cervical ganglion directly, and also through a loop that winds round the subclavian artery. This loop is called ansa subclavia.
  2. Branch of middle cervical ganglia are :-
    1. Grey rami communicans: To ventral rami of C5 and C6 spinal nerves.
    2.  Thyroid branches: Along inferior thyroid artery.
    3.  Tracheal and esophageal branches.
    4. Middle cervical cardiac branch: It largest of sympathetic cardiac branch and goes to deep cardiac plexus.

Inferior cervical ganglion (stellate ganglion or cervicothoracic ganglion)

  1. It is formed by fusion of 7thand 8th cervical ganglia, and often fused with 1st thoracic ganglion (T1). Therefore, also called cervicothoracic ganglion. As it is star shaped, it is also called stellate ganglion. It is situated between transverse process of C7 vertebra and neck of 1st rib.
  2. Branch inferior cervical ganglion are:-
    1. Grey rami communicans: To ventral rami of C7and C8spinal nerves
    2. Vertebral branches: Form plexus around vertebral artery.
    3. Subclavian branches: Form plexus around subclavian artery.
    4.  Inferior cervical cardiac branch: For deep cardiac plexus.
  3. Destruction of stellate ganglion causes Horner's syndrome, which is characterized by ptosis, miosis, anhydrosis, enophthalmos and loss of cilia-spinal reflex.





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