Cervical Sympathetic System

The cervical sympathetic system is a visceromotoric system originating in the CNS. The pars sympathetica has its nuclei in the CNS, which form the nucleus intermediolateralis of the lateral columns of the spinal cord. Preganglionic fibers emerge from the spinal cord together with the fibers of the anterior spinal roots, they separate from the spinal nerves as rr. communicantes albi. Afterwards they enter the ganglia trunci sympathici are connected to postganglionic neurons there.

Cervical ganglia[edit | edit source]

Diagram of the cervical ganglia

There are 3 ganglia in the neck: ggl. cervicale superius, medium et inferius. Ganglion cervicale inferius usually merges with the 1st thoracic ggl. into the common ggl. cervicothoracicum (ggl. stellatum).

Ganglion cervicale superius[edit | edit source]

It is deposited anterior to the transverse processes of C2–C4. Preganglionic fibers come via truncus sympathicus from the junction of the cervical and thoracic spinal cord. The ganglion sends postganglionic fibers (rr. communicantes grisei) to 4 cervical nerves:

N. jugularis – branch going into ggl. inferius nervi glossopharyngei and into ggl. superius n. vagi, sympathetic fibers go further with the branching of n. IX and n. X.
N. caroticus internus – to a. carotis interna and forms the plexus caroticus internus, on it, from which other nerves branch off along the branches of the a. carotis interna in the skull:
- nn. caroticotympanici;
- n. petrosus profundus.
Nn. carotici externi – form a periarterial plexus on the a. carotis externa. The plexus continues along all branches of the artery (plexus facialis, plexus lingualis, plexus temporalis superficialis, plexus maxillaris, atd.). Separate sympathetic branches depart from the plexus: radix sympathica ggl. otici a radix sympathica ggl. submandibulares.
N. cardiacus cervicalis superius - descends into plexus cardiacus.

Ganglion cervicale medium[edit | edit source]

It is at the level of the transverse process of C5, usually at the level where the truncus sympathicus crosses with a. thyroidea inf. Preganglionic fibers go to the ggl. via the sympathetic trunk from the junction of the cervical and thoracic spinal cord. Ganglion sends out postganglionic fibers:

rr. communicantes grisei into the C4 a C5 nerves;
branches into plexus thyroideus inferior for the thyroid gland and parathyroid glands;
n. cardiacus cervicalis medius – descends behind the a. carotis communis a afterwards before the a. subclavia into plexus cardiacus.

Ganglion stellatum[edit | edit source]

Ganglion stellatum

It is located in front of the transverse process of C7, behind the distance of the a. vertebralis from a. subclavia. Preganglionic fibers pass from the C8 and Th1–Th3 nerves. Postganglionic fibers go as rr. communicantes grisei to spinal nerves C7, C8 and Th1–Th3, both as:

branches to the plexus subclavius – they form a periarterial plexus, which then passes to all the connecting arteries of the upper limb;
n. vertebralis – goes forward toa. vertebralis where it forms the plexus vertebralis;
n. cardiacus cervicalis inferior – descends behind a. subclavia into plexus cardiacus.

Links[edit | edit source]

Used literature[edit | edit source]

MRÁZKOVÁ, Olga – DOSKOČIL, Milan. Klinická anatomie pro stomatology. 2. edition. Praha : Triton, 2001. 0 pp. ISBN 8072541722.

ČIHÁK, Radomír – GRIM, Miloš. Anatomie. 2., upr. a dopl edition. Praha : Grada Publishing, spol. s. r. o, 2004. 673 pp. vol. 3. ISBN 80-247-1132-X.