Sympathetic Innervation To The Head And Neck

Sympathetic Innervation To The Head And Neck

Describe the Cervical Sympathetic Chain in brief and discuss its applied anatomy.
Answer.

Cervical Sympathetic Chain Location and extent

• Cervical Sympathetic Chain is part of the sympathetic chain that lies in front of the transverse processes of the cervical vertebrae and neck of 1st rib.
• Cervical Sympathetic Chain continues upwards into the carotid canal as internal carotid nerve and downwards as thoracic part of the sympathetic chain.

Cervical Sympathetic Chain Ganglia

The cervical sympathetic chain possesses three ganglia:

• Superior cervical ganglion: It lies in front of the transverse processes of C2 and C3, and represents the fused C1 to C4 primitive ganglia.
• Middle cervical ganglion: It lies in front of the transverse process of C6 and represents the fused C5 and C6 primitive ganglia.
• Inferior cervical ganglion: It lies in front of the transverse process of C7 and neck of 1st rib, and represents the fused ganglia of C7 and C6 primitive ganglia. It often fuses with T1 ganglion to form stellate ganglion.

Cervical Sympathetic Chain Applied anatomy

Horner syndrome

Horner syndrome occurs due to the lesion of cervical sympathetic chain involving T1 fibres supplying head and neck.

Horner syndrome Clinical features

• Anhydrosis (loss of sweating)
• Partial ptosis (partial drooping of the upper eyelid)
• Myosis (constriction of pupil)
• Enophthalmos (recession of the eyeball)
• Absence of the ciliospinal reflex