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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...

BACKGROUND External carotid arteries account for a major share of arterial supply of head and neck regions. As variations are frequently observed in the branching pattern of external carotid artery, surgeons, radiologists and anaesthetists often encounter difficulties in various procedures of head and neck. The purpose of this study is to describe the variations in the branching pattern of external carotid artery as observed in South Indian population which definitely reduces its iatrogenic injuries associated with surgical and radiological procedures of head and neck. METHODS This is cross-sectional descriptive study. Bilateral neck dissection was done on twenty-two formalin fixed cadavers to study the branching pattern of external carotid artery during a period of two years in the Department of Anatomy in Government Medical College, Alappuzha. Common carotid, external carotid and internal carotid arteries were dissected. All the branches of external carotid artery were traced and the variations were noted. The distance between carotid bifurcation and point of origin of individual branches of external carotid were measured and statistically analyzed. RESULTS In the present study along with normal branching pattern of external carotid artery, variations like origin of superior thyroid artery from common carotid artery and also from carotid bifurcation were seen. A common linguofacial trunk and direct origin of superior laryngeal artery from external carotid artery were also observed. CONCLUSIONS Prior knowledge of the variations will be helpful to surgeons and anaesthetists while dealing with these vessels during procedures of head and neck regions. KEYWORDS External Carotid Artery, Carotid Bifurcation, Superior Thyroid Artery, Linguofacial Trunk

Introduction: Physical models are being used in embryology lectures along with PowerPoint presentations to improve the spatial orientation of students. But the demonstration of the sequence of changes is not possible with commercial models due to nonavailability and high expenses. The latest audio-visual aids including three-dimensional projections like simulation-based screens, or virtual reality enhance the visual-spatial ability of the students but are very costly and not affordable for all institutions. Aim: To compare the effectiveness of hand-made physical models with the PowerPoint presentation mode of teaching in understanding the 3D concept of embryology, among first-year MBBS students and to assess the students’ perception of this model-based teaching. Materials and Methods: The study was conducted using a quasi-experimental study design, on 218 phase 1 medical students of Government Medical College, Thiruvananthapuram, Kerala, India, from February 2020 to August 2020. The students were divided into two equal groups. Group B was taught the topic “Second week of embryonic life” with a PowerPoint lecture session (n=109) and the Group A had in addition a demonstration with the handmade models (n=109). Pretest and post-test were conducted with an internally validated questionnaire. Feedback on the student’s acceptance of teaching/ learning with models were also collected. The improvement of the test scores was analysed using paired t-tests in both the test and control groups. Results: Statistically significant improvement in knowledge score was obtained while comparing the post-test scores of the intervention group (mean score was 4.83±2) with that of the non intervention group (mean score was 3.99±2.06) (student’s t-test, p-value <0.05). It was observed, 99.1% of students were satisfied with this model-assisted teaching, especially with the series of models demonstrating the sequence of events. A 93.1% of students said that they needed such model-assisted lectures in other subjects also. Conclusion: Series of models pertaining to a particular event is beneficial and effective for learning complex concepts of embryology. Also, it’s a long-lasting, innovative mode of teaching which can be done cost-effectively

BACKGROUNDGreat divergences are there regarding the occurrence and nomenclature of Middle Cervical Ganglion (MCG) and Vertebral Ganglion (VG) in human cervical sympathetic chain. The lack of a detailed knowledge of its branching pattern and vascular relations will lead to iatrogenic injury complicating many surgical procedures in the neck. MATERIALS AND METHODSThe study was done on 50 cervical sympathetic chains by bilateral neck dissection of 25 adult cadavers in the Department of Anatomy, Medical College, Thiruvananthapuram. The vascular relations, branches and dimensions of Superior Cervical Ganglion (SCG), Inferior Cervical Ganglion (ICG), Stellate Ganglion and other intermediate ganglia were carefully dissected out and studied. RESULTSSCG was seen in 100% cases, Inferior Cervical Ganglion (ICG) in 72% cases and stellate ganglion in 28% chains. Out of the two intermediate ganglia between SCG and ICG, one seen in close relation to Inferior Thyroid Artery (ITA) was concluded as MCG (44%) and another ganglion which was always over vertebral artery was concluded to be VG (72%). The branches arising from the ganglia were Gray Rami Communicantes (GRC), vascular branches and medial visceral branches. Vertebral nerve from VG was present in 5.6% cases. CONCLUSIONThe VG is more frequently present than MCG. Also, comparative studies between the dimensions of MCG and VG when seen alone or together show no significant relation suggesting that both are independent ganglia and one is not a detached part of another.