Page 324 - Clinical Anatomy

ECA5 7/18/06 6:51 PM Page 309

The cervical sympathetic trunk 309

Fig. 220◊The cervical sympathetic chain.

cervical chain gives off cardiac branches from each of its ganglia and also vas-
cular plexuses along the carotid, subclavian and vertebral vessels. The sym-
pathetic fibres to the dilator pupillae muscle travel in this plexus along the
internal carotid artery. Grey rami pass from the superior ganglion to cranial
nerves VII, IX, X and XII.

Clinical features

1◊◊‘Cervical sympathectomy’ is a misnomer; it is an upper thoracic sympa-
thectomy carried out through a cervical incision. The sympathetic chain is
divided below the 3rd thoracic ganglion and the grey and white rami to the
2nd and 3rd ganglia are also cut. In this way the sudomotor and vasocon-
strictor pathways to the head and upper limb (from segments T2, 3 and 4)
are divided, preserving the T1 connection and the stellate ganglion, which