Branches of the thoracic sympathetic trunk in the human fetus

Groen, Gerbrand J.; Baljet, B.; Boekelaar, A B; Drukker, J.

doi:10.1007/bf00310082

Cited by 46 publications

(39 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Wittmoser (1995) and Howard et al (1987) recorded that the branches formed by thoracic ganglia found in the 9th-11th intercostal spaces were destined for the upper abdomen in general and the pancreas in particular. In the fetus, Groen et al (1987) observed the LSN originating via 1-2 rami from thoracic segments T10 and T11 (range T10-T12). This study reports 10 ranges for the LSN, with the most common Adult T3-T10\11 T3-T12 T9-T12 T10\11-T12 T11-12 T11-T12 Fetus T4-L1 T4-T10 T9-T12 T9-T11\L1 T12 T10\11-T12 Combined T3-L1 T3-T12 T9-T12 T9-T11\L1 T11-T12 T10\11-T12 ganglion being T10 (9 of 38 sides, 23 %), and 5 ranges for the ISN, with T12 (20 of 38 sides, 53 %) being the most common ganglionic origin.…”

Section: mentioning

confidence: 97%

“…The thoracic sympathetic ganglia were identified by their rami communicantes to intercostals nerves, as employed previously by Groen et al (1987).…”

Section:   mentioning

confidence: 99%

“…In the fetus, Groen et al (1987) found the GSN to arise from 1-4 large branches, most frequently from the T8-9 ganglia, with the highest origin being T6 and the lowest being T11. Intraindividual differences in the origin and number of the splanchnic nerve rami were frequently observed.…”

Section: mentioning

confidence: 99%

See 2 more Smart Citations

Thoracic splanchnic nerves: implications for splanchnic denervation

et al. 2001

View full text Add to dashboard Cite

Splanchnic neurectomy is of value in the management of chronic abdominal pain. It is postulated that the inconsistent results of splanchnicectomies may be due to anatomical variations in the pattern of splanchnic nerves. The advent of minimally invasive and video-assisted surgery has rekindled interest in the frequency of variations of the splanchnic nerves. The aims of this study were to investigate the incidence, origin and pattern of the splanchnic nerves in order to establish a predictable pattern of splanchnic neural anatomy that may be of surgical relevance. Six adult and 14 fetal cadavers were dissected (n l 38). The origin of the splanchnic nerve was bilaterally asymmetrical in all cases. The greater splanchnic nerve (GSN) was always present, whereas the lesser splanchnic nerve (LSN) and least splanchnic nerve (lSN) were inconsistent (LSN, 35 of 38 sides (92 %) ; LSN, 21 of 38 sides (55 %). The splanchnic nerves were observed most frequently over the following ranges : GSN, T6-9 : 28 of 38 sides (73 %) ; LSN, when present, T10-11 : (10 of 35 sides (29 %) ; and lSN, T11-12 : 3 of 21 sides (14 %). The number of ganglionic roots of the GSN varied between 3 and 10 (widest T4-11 ; narrowest, T5-7). Intermediate splanchnic ganglia, when present, were observed only on the GSN main trunk with an incidence of 6 of 10 sides (60 %) in the adult and 11 of 28 sides (39 %) in the fetus. The higher incidence of the origin of GSN above T5 has clinical implications, given the widely discussed technique of undertaking splanchnicectomy from the T5 ganglion distally. This approach overlooks important nerve contributions and thereby may compromise clinical outcome. In the light of these variations, a reappraisal of current surgical techniques used in thoracoscopic splanchnicectomy is warranted. The 3 splanchnic nerves of the thoracic sympathetic trunk, arise from the lower 8 ganglia. The greater splanchnic nerve (GSN) is formed by branches of the T5-9 sympathetic ganglia, the lesser splanchnic nerve (LSN) from T10-11 ganglia and the least splanchnic nerve (lSN) from the T12 ganglion. These splanchnic nerves contain, predominantly, visceral efferent fibres, as well as pain conducting visceral afferent fibres (McMinn, 1994).The highest cephalad contribution of the sympathetic chain to the GSN is documented as the T4 or

show abstract

Section: mentioning

confidence: 97%

“…The thoracic sympathetic ganglia were identified by their rami communicantes to intercostals nerves, as employed previously by Groen et al (1987).…”

Section:   mentioning

confidence: 99%

See 1 more Smart Citation

Thoracic splanchnic nerves: implications for splanchnic denervation

et al. 2001

View full text Add to dashboard Cite

show abstract

“…The reported incidence of the nerve of Kuntz in the 1st intercostal space varies between 38 % (Jit & Mukerjee, 1960) and 75 % (Kirgis & Kuntz, 1942). Groen et al (1987) reported an incidence of 66n7 %, while Lemmens & Drukker (1985) reported an incidence of 40 %. Our study found an incidence of 61 %.…”

Section: mentioning

confidence: 99%

Thoracic origin of a sympathetic supply to the upper limb: the ‘nerve of Kuntz’ revisited

et al. 2001

View full text Add to dashboard Cite

An understanding of the origin of the sympathetic innervation of the upper limb is important in surgical sympathectomy procedures. An inconstant intrathoracic ramus which joined the 2nd intercostal nerve to the ventral ramus of the 1st thoracic nerve, proximal to the point where the latter gave a large branch to the brachial plexus, has become known as the ' nerve of Kuntz ' (Kuntz, 1927). Subsequently a variety of sympathetic interneuronal connections down to the 5th intercostal space were reported and also described as the nerve of Kuntz. The aim of this study was to determine : (1) the incidence, location and course of the nerve of Kuntz ; (2) the relationship of the nerve of Kuntz to the 2nd thoracic ganglion ; (3) the variations of the nerve of Kuntz in the absence of a stellate ganglion ; (4) to compare the original intrathoracic ramus with sympathetic variations at other intercostal levels ; and (5) to devise an appropriate anatomical classification of the nerves of Kuntz.Bilateral microdissection of the sympathetic chain and somatic nerves of the upper 5 intercostal spaces was undertaken in 32 fetuses (gestational age, 18 wk to full term) and 18 adult cadavers. The total sample size comprised 99 sides.Sympathetic contributions to the first thoracic nerve were found in 60 of 99 sides (left 32, right 28). Of these, 46 were confined to the 1st intercostal space only. The nerve of Kuntz (the original intrathoracic ramus) of the 1st intercostal space had a demonstrable sympathetic connection in 34 cases, and an absence of macroscopic sympathetic connections in 12. In the remaining intercostal spaces, intrathoracic rami uniting intercostal nerves were not observed. Additional sympathetic contributions (exclusive of rami communicantes) were noted between ganglia, interganglionic segments and intercostal nerves as additional rami communicantes. The eponym nerve of Kuntz should be restricted to descriptions of the intrathoracic ramus of the 1st intercostal space. Any of these variant sympathetic pathways may be responsible for the recurrence of symptoms after sympathectomy surgery.

show abstract

“…The cardiac sympathetic nerves arise from the medial aspect of the cervical and upper thoracic parts of the sympathetic chain and contribute the majority of branches to the cardiac plexus. Several authors have described contributions of the cervical ganglia as cervical cardiac nerves (CCNs) to the cardiac plexus (Kuntz & Morehouse, 1930;Kalsey et al, 2000;Pather et al, 2003) whilst only a few report on the thoracic cardiac nerves (TCNs) to this plexus (Kuntz & Morehouse;Groen et al, 1987). The CCNs arise from the superior (SCG), middle (MCG) and inferior (ICG) or cervicothoracic (CTG) cervical ganglia and the TCNs arise from the thoracic sympathetic chain (Standring et al).…”

Section: Introductionmentioning

confidence: 99%

The Sympathetic and Parasympathetic Contributions to the Cardiac Plexus: a Fetal Study

et al. 2012

View full text Add to dashboard Cite

SUMMARY:The cardiac plexus is formed by sympathetic nerves originating from the superior, middle, inferior cervical or cervicothoracic ganglia as well as from the first to the fifth thoracic ganglia. Furthermore, the vagus nerve and its counterpart, the recurrent laryngeal nerve supply the cardiac plexus with parasympathetic cardiac nerves. This investigation aimed to review and record the medial contributions of the cervical ganglia, first to fifth thoracic ganglia and medial contributions of the vagus and recurrent laryngeal nerves to the cardiac plexus. The study involved bilateral micro-dissection of forty cadaveric fetal specimens (n=80). The origins of sympathetic contributions to the cardiac plexus were described as either ganglionic, inter-ganglionic or from both the ganglion and the inter-ganglionic sympathetic chain. The number of cervical sympathetic ganglia varied from two to five in this study; the superior cervical ganglion was constant while the middle cervical, vertebral, inferior cervical or cervicothoracic ganglia were variable. The prevalence of cardiac nerves were as follows: superior cervical cardiac nerve (95%); middle cervical cardiac nerve (73%); vertebral cardiac nerve (41%); inferior cervical cardiac nerve (21%) and cervicothoracic cardiac nerve (24%). This investigation records the thoracic caudal limit of the thoracic sympathetic contributions to the cardiac plexus as the T5 ganglion. The findings of this study highlight the importance of understanding the medial sympathetic contributions and their variations to the cardiac plexus as this may assist surgeons during minimal access surgical procedures, sympathectomies, pericardiectomies and in the management of diseases like Raynaud's Phenomenon and angina pectoris.

show abstract

Branches of the thoracic sympathetic trunk in the human fetus

Cited by 46 publications

References 23 publications

Thoracic splanchnic nerves: implications for splanchnic denervation

Thoracic splanchnic nerves: implications for splanchnic denervation

Thoracic origin of a sympathetic supply to the upper limb: the ‘nerve of Kuntz’ revisited

The Sympathetic and Parasympathetic Contributions to the Cardiac Plexus: a Fetal Study

Contact Info

Product

Resources

About