Verena B Franco-Riveros, Sofía M Pividori, Tomás I Martin, Florencia E Nicora, María Cecilia Lallana, Agustina A Pontecorvo, Juan Carlos Flores, Richard Shane Tubbs, André P Boezaart, Miguel A Reina, Bruno Buchholz
{"title":"颈椎和上胸交感干的沟通和内脏分支的解剖学研究及临床意义。","authors":"Verena B Franco-Riveros, Sofía M Pividori, Tomás I Martin, Florencia E Nicora, María Cecilia Lallana, Agustina A Pontecorvo, Juan Carlos Flores, Richard Shane Tubbs, André P Boezaart, Miguel A Reina, Bruno Buchholz","doi":"10.1002/ca.24149","DOIUrl":null,"url":null,"abstract":"<p><p>Current advances in the management of the autonomic nervous system in various cardiovascular diseases, and in treatments for pain or sympathetic disturbances in the head, neck, or upper limbs, necessitate a thorough understanding of the anatomy of the cervicothoracic sympathetic trunk. Our objective was to enhance our understanding of the origin and distribution of communicating branches and visceral cervicothoracic sympathetic nerves in human fetuses. This was achieved through a comprehensive topographic systematization of the branching patterns observed in the cervical and upper thoracic ganglia, along with the distribution of communicating branches to each cervical spinal nerve. We conducted detailed sub-macroscopic dissections of the cervical and thoracic regions in 20 human fetuses (40 sides). The superior and cervicothoracic ganglia were identified as the cervical sympathetic ganglia that provided the most communicating branches on both sides. The middle and accessory cervical ganglia contributed the fewest branches, with no significant differences between the right and left sides. The cervicothoracic ganglion supplied sympathetic branches to the greatest number of spinal nerves, spanning from C<sub>5</sub> to T<sub>2</sub> . The distribution of communicating branches to spinal nerves was non-uniform. Notably, C<sub>3</sub> , C<sub>4</sub> , and C<sub>5</sub> received the fewest branches, and more than half of the specimens showed no sympathetic connections. C<sub>1</sub> and C<sub>2</sub> received sympathetic connections exclusively from the superior ganglion. Spinal nerves that received more branches often did so from multiple ganglia. The vertebral nerve provided deep communicating branches primarily to C<sub>6</sub> , with lesser contributions to C<sub>7</sub> , C<sub>5</sub> , and C<sub>8</sub> . The vagus nerve stood out as the cranial nerve with the most direct sympathetic connections. The autonomic branching pattern and connections of the cervicothoracic sympathetic trunk are significantly variable in the fetus. A comprehensive understanding of the anatomy of the cervical and upper thoracic sympathetic trunk and its branches is valuable during autonomic interventions and neuromodulation. This knowledge is particularly relevant for addressing various autonomic cardiac diseases and for treating pain and vascular dysfunction in the head, neck, and upper limbs.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Anatomical study with clinical significance of communicating and visceral branching of the cervical and upper thoracic sympathetic trunk.\",\"authors\":\"Verena B Franco-Riveros, Sofía M Pividori, Tomás I Martin, Florencia E Nicora, María Cecilia Lallana, Agustina A Pontecorvo, Juan Carlos Flores, Richard Shane Tubbs, André P Boezaart, Miguel A Reina, Bruno Buchholz\",\"doi\":\"10.1002/ca.24149\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Current advances in the management of the autonomic nervous system in various cardiovascular diseases, and in treatments for pain or sympathetic disturbances in the head, neck, or upper limbs, necessitate a thorough understanding of the anatomy of the cervicothoracic sympathetic trunk. Our objective was to enhance our understanding of the origin and distribution of communicating branches and visceral cervicothoracic sympathetic nerves in human fetuses. This was achieved through a comprehensive topographic systematization of the branching patterns observed in the cervical and upper thoracic ganglia, along with the distribution of communicating branches to each cervical spinal nerve. We conducted detailed sub-macroscopic dissections of the cervical and thoracic regions in 20 human fetuses (40 sides). The superior and cervicothoracic ganglia were identified as the cervical sympathetic ganglia that provided the most communicating branches on both sides. The middle and accessory cervical ganglia contributed the fewest branches, with no significant differences between the right and left sides. The cervicothoracic ganglion supplied sympathetic branches to the greatest number of spinal nerves, spanning from C<sub>5</sub> to T<sub>2</sub> . The distribution of communicating branches to spinal nerves was non-uniform. Notably, C<sub>3</sub> , C<sub>4</sub> , and C<sub>5</sub> received the fewest branches, and more than half of the specimens showed no sympathetic connections. C<sub>1</sub> and C<sub>2</sub> received sympathetic connections exclusively from the superior ganglion. Spinal nerves that received more branches often did so from multiple ganglia. The vertebral nerve provided deep communicating branches primarily to C<sub>6</sub> , with lesser contributions to C<sub>7</sub> , C<sub>5</sub> , and C<sub>8</sub> . The vagus nerve stood out as the cranial nerve with the most direct sympathetic connections. The autonomic branching pattern and connections of the cervicothoracic sympathetic trunk are significantly variable in the fetus. A comprehensive understanding of the anatomy of the cervical and upper thoracic sympathetic trunk and its branches is valuable during autonomic interventions and neuromodulation. This knowledge is particularly relevant for addressing various autonomic cardiac diseases and for treating pain and vascular dysfunction in the head, neck, and upper limbs.</p>\",\"PeriodicalId\":50687,\"journal\":{\"name\":\"Clinical Anatomy\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-03-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Anatomy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ca.24149\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ANATOMY & MORPHOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Anatomy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ca.24149","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANATOMY & MORPHOLOGY","Score":null,"Total":0}
Anatomical study with clinical significance of communicating and visceral branching of the cervical and upper thoracic sympathetic trunk.
Current advances in the management of the autonomic nervous system in various cardiovascular diseases, and in treatments for pain or sympathetic disturbances in the head, neck, or upper limbs, necessitate a thorough understanding of the anatomy of the cervicothoracic sympathetic trunk. Our objective was to enhance our understanding of the origin and distribution of communicating branches and visceral cervicothoracic sympathetic nerves in human fetuses. This was achieved through a comprehensive topographic systematization of the branching patterns observed in the cervical and upper thoracic ganglia, along with the distribution of communicating branches to each cervical spinal nerve. We conducted detailed sub-macroscopic dissections of the cervical and thoracic regions in 20 human fetuses (40 sides). The superior and cervicothoracic ganglia were identified as the cervical sympathetic ganglia that provided the most communicating branches on both sides. The middle and accessory cervical ganglia contributed the fewest branches, with no significant differences between the right and left sides. The cervicothoracic ganglion supplied sympathetic branches to the greatest number of spinal nerves, spanning from C5 to T2 . The distribution of communicating branches to spinal nerves was non-uniform. Notably, C3 , C4 , and C5 received the fewest branches, and more than half of the specimens showed no sympathetic connections. C1 and C2 received sympathetic connections exclusively from the superior ganglion. Spinal nerves that received more branches often did so from multiple ganglia. The vertebral nerve provided deep communicating branches primarily to C6 , with lesser contributions to C7 , C5 , and C8 . The vagus nerve stood out as the cranial nerve with the most direct sympathetic connections. The autonomic branching pattern and connections of the cervicothoracic sympathetic trunk are significantly variable in the fetus. A comprehensive understanding of the anatomy of the cervical and upper thoracic sympathetic trunk and its branches is valuable during autonomic interventions and neuromodulation. This knowledge is particularly relevant for addressing various autonomic cardiac diseases and for treating pain and vascular dysfunction in the head, neck, and upper limbs.
期刊介绍:
Clinical Anatomy is the Official Journal of the American Association of Clinical Anatomists and the British Association of Clinical Anatomists. The goal of Clinical Anatomy is to provide a medium for the exchange of current information between anatomists and clinicians. This journal embraces anatomy in all its aspects as applied to medical practice. Furthermore, the journal assists physicians and other health care providers in keeping abreast of new methodologies for patient management and informs educators of new developments in clinical anatomy and teaching techniques. Clinical Anatomy publishes original and review articles of scientific, clinical, and educational interest. Papers covering the application of anatomic principles to the solution of clinical problems and/or the application of clinical observations to expand anatomic knowledge are welcomed.