Paravertebral sympathetic chain ganglia (including stellate)
Ganglion · 3 cervical 11–12 thoracic 4 lumbar 4–5 sacral
A pair of trunks running from the skull base to the coccyx with about 3 cervical, 11–12 thoracic, 4 lumbar and 4–5 sacral ganglia plus the ganglion impar. They are the synapse for postganglionic fibres to skin, limbs and thoracic viscera; the stellate ganglion (fused inferior cervical and T1) sits in front of the C7 transverse process and neck of the first rib.
Traced from the start
- Sympathetic (thoracolumbar) outflow
- Intermediolateral cell column T1–L2 via white rami communicantes
- Paravertebral sympathetic chain ganglia (including stellate)
Detail
- Stellate ganglion
- Inferior cervical + T1 ganglion, anterior to C7 transverse process and neck of rib 1, behind the vertebral and subclavian arteries; relays upper limb and much cardiac supply
- Output
- Grey rami to every spinal nerve; cardiac, pulmonary and oesophageal branches from cervical and upper thoracic ganglia
- Upper limb supply
- Preganglionic T2–T6 ascend to stellate and middle cervical ganglia; postganglionic join the brachial plexus roots
When it goes wrong
Endoscopic thoracic sympathectomy at T2–T3 for palmar hyperhidrosis
Dry warm palms; compensatory truncal sweating is common and Horner syndrome follows if the stellate ganglion is damaged
Neuroblastoma or apical tumour arising in or invading the cervicothoracic chain in a child
Horner syndrome with heterochromia iridis if congenital or acquired in infancy
Practise this structure
No question in the bank is tagged to Paravertebral sympathetic chain ganglia (including stellate) yet. Questions appear here automatically once one is — the question bank is free to browse in the meantime.