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Thermal Physiology and Thermoregulation
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
The two sympathetic trunks, which are located paraspinally from the second cervical vertebra to the coccyx, control the vasomotor, piloerector, and sudomotor activity of the entire skin surface (Figure 5.9).78 Thus a difference of the “tone” along or between the sympathetic trunks is often visible to thermography. Central nervous system control of sympathetic vasoconstrictive tone appears to be primarily inhibitory, thus increased sympathetic constriction of the skin vasculature occurs with spinal cord disruption or hemispheric stroke. There is cranial-caudal distribution of neural signaling in each sympathetic trunk, but apparently no direct signaling between the right and left trunks except at the caudal end, where they fuse together near the coccyx. Thus, a difference in the sympathetic tone between the trunks produces qualitative and quantitative thermographic differences from one side of the body to the other, with the cooler side having greater adrenergic sympathetic tone due to increased vasoconstriction (Figure 5.10a). If generalized along one entire sympathetic trunk, the entire ipsilateral hemi-body from head to foot will be affected. This produces sympathetic imbalance or sympathetic dominance, an important phenomenon to recognize, especially in breast thermography, where it can adversely affect the accuracy of the exam interpretation.
Miscellaneous
Published in Bobby Krishnachetty, Abdul Syed, Harriet Scott, Applied Anatomy for the FRCA, 2020
Bobby Krishnachetty, Abdul Syed, Harriet Scott
The ramus communicans is a communicating branch that connects two other nerves. With respect to the sympathetic nervous system, it is the branch that transmits signals between the spinal nerves and the sympathetic trunk. There are two types of rami communicantes – white and grey. The white rami communicantes appear white as they have more myelinated fibres than the grey. These only exist in the intermedio-lateral column, T1 to L2, and contain preganglionic fibres from the spinal cord to the paravertebral ganglia.The grey rami exist at every level throughout the spinal cord and contain postganglionic fibres, they connect from the sympathetic trunk to the spinal nerves.
Nervous System
Published in Sarah Armstrong, Barry Clifton, Lionel Davis, Primary FRCA in a Box, 2019
Sarah Armstrong, Barry Clifton, Lionel Davis
Ganglia form the sympathetic trunk – a nerve chain that extends from base of skull to coccyx and lies 2–3 cm lateral to the vertebrae Cervical ganglia – superior, middle and inferiorThoracic ganglia – usually 12 to splanchnic and intercostal nervesLumbar ganglia – usually 4Sacral ganglia – usually 4
Anterior cervical discectomy and fusion is more effective than cervical arthroplasty in relieving atypical symptoms in patients with cervical spondylosis
Published in British Journal of Neurosurgery, 2022
Giovanni Grasso, Fabio Torregrossa, Brian A. Karamian, Jose A. Canseco, Alexander R. Vaccaro
Prior studies have shown that atypical symptoms in patients with cervical spondylosis improve after double-door laminoplasty.17,27 Given that in this type of surgery the intervertebral disc and PLL are unaffected, these studies refute the idea that sympathetic fibers within the PLL or intervertebral disc serve as the primary driver of atypical symptoms. However, the common factor between posterior and anterior cervical surgery is spinal cord decompression. Accordingly, it has been suggested that spinal cord compression along with stimulation of sympathetic nerves in the PLL may account for atypical symptoms in patients with cervical spondylosis.27 The cervical spinal tissues are rich in sympathetic fibers stemming from the cervical sympathetic trunk, consisting of a main trunk and 2–4 ganglia located anterior to the transverse processes.44,49. Irritation of the spinal cord, dura mater, or PLL may activate the sympathetic nervous system, resulting in atypical symptoms generation50 (Figure 4). By the same mechanism, it has been proposed that cervical spondylosis may be responsible for hypertension which has been shown to improve after surgery.51
Topography of the pelvic autonomic nerves – an anatomical study to facilitate nerve-preserving total mesorectal excision
Published in Acta Chirurgica Belgica, 2022
Jan Gaessler, Friedrich Anderhuber, Sabine Kuchling, Ulrike Pilsl
Its parasympathetic afferences reach the plexus via the PSN. Zhang et al. [12] located the PSN underneath the presacral fascia. Hypogastric nerves and the sacral sympathetic trunks provide sympathetic input to the plexus [26,29]. Kirkham et al. [29] qualified the latter ones' contributions as 'less significant' by comparison with the hypogastric nerves. At the level of the sacral promontory, the hypogastric nerves are usually seen roughly 10 mm lateral to the midline [18]. Following their entry into the lesser pelvis, the hypogastric nerves run parallel to the 20 mm laterally located ureters [10,12]. In the majority of examined bodies, the hypogastric nerves appeared as networks of fine filaments instead of distinct nerves. Lin et al. [10] and Kirkham et al. [29] have made similar observations. Our results matched the observation of Bissett et al. [24] that the hypogastric nerves are confined to the presacral space and, thus, do not enter the 'holy plane'. In contrast, other studies found the hypogastric nerves in front of the presacral fascia and closely attached to the MRF [10,29]. We agree with Bisset et al. [24] who postulated that the existence of 'multiple layers in the parietal fascia with the presence of intervening loose areolar tissue' could pose the reason for such misconceptions. Dissection outside the hypogastric nerves in a separate layer of PPF would thereby be possible, and explain for the nerves' erroneous localisation in relation to the presacral fascia.
Anterolateral approach for subaxial vertebral artery decompression in the treatment of rotational occlusion syndrome: results of a personal series and technical note
Published in Neurological Research, 2021
Sabino Luzzi, Cristian Gragnaniello, Alice Giotta Lucifero, Stefano Marasco, Yasmeen Elsawaf, Mattia Del Maestro, Samer K. Elbabaa, Renato Galzio
The sympathetic chain is formed by a set of cervical ganglia and small fibers, also referred as sympathetic trunk. Although the sympathetic chain has an anatomical variability [58], most commonly is formed by a superior, middle, and inferior ganglion, as well as a stellate and vertebral ganglions. Superior, middle, and inferior ganglion are located at the level of the third, fifth and seventh cervical vertebra, respectively, whereas stellate and vertebral ganglia are related to the seventh cervical or first thoracic vertebra. Non infrequently, inferior cervical and stellate ganglion are fused [58]. The course of the sympathetic chain is oblique upward and laterally, under the prevertebral fascia. Its major axis forms an angle with the midline ranging between 10 and 11.5 degrees, and the distance of the inferior and superior ganglion from the medial border of the longus colli muscle measures 12.4 mm and 17.2 mm, respectively, on average [59,60]. The superior cervical ganglion is located above the longus capitis muscle and, at the level of C4/C5 disc, the sympathetic trunk crosses the line between the longus colli and longus capitis muscle.