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Premature termination of the sympathetic chain
, 1
Affiliations- Department of Anatomy, Lake Erie College of Osteopathic Medicine, Erie, PA, United States
- Department of Otolaryngology–Facial Plastic Surgery, Henry Ford Macomb Hospital, Clinton Twp, MI, United States
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Abstract
The sympathetic chain serves to distribute visceral efferents and afferents over the entire body. The sympathetic chain courses from the base of the skull to the coccyx and sends branches to distribute along spinal nerves and a number of visceral nerves that distribute to cardiac muscle, smooth muscle and glands. During dissection of the posterior abdominal wall, we identified a rare variation of the sympathetic chain. In this subject, the sympathetic chain failed to send grey rami to the L2–4 spinal nerves and terminated by joining the S1 anterior ramus. Such a variation has only been reported once in the literature in 1895. We provide both schematic and photographic documentation of this variation and propose a number of possible circuits whereby visceral axons can reach their target despite these anatomical barriers.
Abstract
The sympathetic chain serves to distribute visceral efferents and afferents over the entire body. The sympathetic chain courses from the base of the skull to the coccyx and sends branches to distribute along spinal nerves and a number of visceral nerves that distribute to cardiac muscle, smooth muscle and glands. During dissection of the posterior abdominal wall, we identified a rare variation of the sympathetic chain. In this subject, the sympathetic chain failed to send grey rami to the L2–4 spinal nerves and terminated by joining the S1 anterior ramus. Such a variation has only been reported once in the literature in 1895. We provide both schematic and photographic documentation of this variation and propose a number of possible circuits whereby visceral axons can reach their target despite these anatomical barriers.
Keywords
anatomy, neuroscience, neuroanatomy, human body
About this articleTitle
Premature termination of the sympathetic chain
Journal
Issue
Article type
Case report
Pages
1054-1057
Published online
2021-09-15
Page views
4042
Article views/downloads
604
DOI
Pubmed
Bibliographic record
Folia Morphol 2022;81(4):1054-1057.
Keywords
anatomy
neuroscience
neuroanatomy
human body
Authors
Y. Mansour
R. J. Kulesza
References (18)- Aurore V, Röthlisberger R, Boemke N, et al. Anatomy of the female pelvic nerves: a macroscopic study of the hypogastric plexus and their relations and variations. J Anat. 2020; 237(3): 487–494.
- Bergman RA, Thompson SA, Afifi AK. Compendium of human anatomic variation: text, atlas, and world literature. Urban & Schwarzenberg, Germany 1988.
- Crosby EC, Humphrey T, Lauer EW. Correlative Anatomy of the Nervous System. 1st Ed. The Macmillan Company, New York, NY 1962.
- Fawcett E. An unusual mode and site of termination of the right sacral sympathetic cord. J Anat Physiol. 1895; 29(Pt 2): 329.
- Gandhi KR, Verma VK, Chavan SK, et al. The morphology of lumbar sympathetic trunk in humans: a cadaveric study. Folia Morphol. 2013; 72(3): 217–222.
- Guérin P, Obeid I, Bourghli A, et al. The lumbosacral plexus: anatomic considerations for minimally invasive retroperitoneal transpsoas approach. Surg Radiol Anat. 2012; 34(2): 151–157.
- Higuchi K, Sato T. Anatomical study of lumbar spine innervation. Folia Morphol. 2002; 61(2): 71–79.
- Iwanaga J, Singh V, Ohtsuka A, et al. Acknowledging the use of human cadaveric tissues in research papers: Recommendations from anatomical journal editors. Clin Anat. 2021; 34(1): 2–4.
- Jain P, Raza K, Singh S, et al. Lumbar sympathetic chain: anatomical variation and clinical perspectives. Clin Ter. 2016; 167(6): 185–187.
- Kruepunga N, Hikspoors JP, Hülsman CJM, et al. Development of the sympathetic trunks in human embryos. J Anat. 2021; 239(1): 32–45.
- Murata Y, Takahashi K, Yamagata M, et al. Variations in the number and position of human lumbar sympathetic ganglia and rami communicantes. Clin Anat. 2003; 16(2): 108–113.
- Standring S. Gray’s Anatomy: The anatomical basis of clinical practice. 40th ed. Elsevier, London, UK 2008.
- Tubbs RS, Kelly DR, Shoja MM, et al. Does the ganglion of Ribes exist? Folia Neuropathol. 2006; 44(3): 197–201.
- Tubbs RS, Shoja MM, Loukas M. Bergman's Comprehensive Encyclopedia of Human Anatomic Variation. 1st Ed. , Hoboken, NJ 2016.
- Webber RH. An analysis of the sympathetic trunk, communicating rami, sympathetic roots and visceral rami in the lumbar region in man. Ann Surg. 1955; 141(3): 398–413.
- Woźniak W. The lumbar part of the sympathetic trunk in human fetuses and newborns. Anat Anz. 1969; 125(3): 289–295.
- Woźniak W, Grzymisławska M, Lupicka J. The first appearance of sympathetic ganglia in human embryos at stage 13. Folia Morphol. 2009; 68(4): 215–217.
- Żytkowski A, Tubbs R, Iwanaga J, et al. Anatomical normality and variability: Historical perspective and methodological considerations. Trans Res Anat. 2021; 23: 100105.
