Cervical Spinal Nerves and Sympathetic Trunk #1

Anterior rami of cervical spinal nerves (CERVICAL PLEXUS): Components (5)

- Ansa cervicali -Phrenic nerve -Cutaneous branches -Deep motor branches -Contributions to accessory nerve (CN XI)

Cervical spinal nervesAnterior rami of cervical spinal nerves (CERVICAL PLEXUS): Cutaneous branches - Supraclavicular (C3-C4) - Course

descend deep to SCM towards the shoulder region

Anterior rami of cervical spinal nerves (roots of BRACHIAL PLEXUS): Course

descends inferolaterally through lateral cervical region passes between 1strib, clavicle, and superior border of scapula to enter axilla

Posterior rami of cervical spinal nerves: Suboccipital nerve (C1) - Course

exits spinal cord between cranium and C1 and lies within the suboccipital triangle

Anterior rami of cervical spinal nerves (CERVICAL PLEXUS): Ansa Cervicalis - Superior Root - Course

initially runs anteriorly with the hypoglossal nerve then turns inferiorly to join the inferior root

Posterior rami of cervical spinal nerves: Posterior rami, nerves C3 - C7 (C3 - C7) - Supply

intrinsic mm. of back and overlying skin

Anterior rami of cervical spinal nerves (CERVICAL PLEXUS): Ascending and descending branches of adjacent anterior rami unite to form _______ from where the branches emerge

loops

Cervical sympathetic trunk: Superior cervical ganglion - Branches - Visceral branches

pharynx, larynx, thyroid

Posterior rami of cervical spinal nerves: Third (Least) occipital nerve (C3) - Course

pierces trapezius m. and ascends along posterior midline of neck

Cervical spinal nerves: Spinal nerves divide into __________ and __________ primary ramus

posterior and anterior

Posterior rami of cervical spinal nerves: Posterior rami, nerves C3 - C7 (C3 - C7) - Origin

posterior rami of spinal nerves C3 - C7

Posterior rami of cervical spinal nerves: Suboccipital nerve (C1) - Origin

posterior ramus of spinal nerve C1

Posterior rami of cervical spinal nerves: Greater occipital nerve (C2) = Origin

posterior ramus of spinal nerve C2

Posterior rami of cervical spinal nerves: Third (Least) occipital nerve (C3) - origin

posterior ramus of spinal nerve C3

Anterior rami of cervical spinal nerves (roots of BRACHIAL PLEXUS): Supply

most of upper limb

Anterior rami of cervical spinal nerves (CERVICAL PLEXUS): Phrenic nerve - motor - Origen

mostly C4, but also C3 & C5

Anterior rami of cervical spinal nerves (CERVICAL PLEXUS): Phrenic nerve - motor - Supply

motor and sensation (medial part only) to diaphragm

Posterior rami of cervical spinal nerves: Supply ____________, skin, and scalp on back of head and neck

muscles

Posterior rami of cervical spinal nerves: Suboccipital nerve (C1) - Supply

muscles of the suboccipital triangle

Anterior rami of cervical spinal nerves (CERVICAL PLEXUS): Cutaneous (sensory branches)

originate from the posterior border of the SCM

Posterior rami of cervical spinal nerves: Posterior rami, nerves C3 - C7 (C3 - C7) - Course

pass segmentally to muscles and skin of posterior neck region

Anterior rami of cervical spinal nerves (CERVICAL PLEXUS): Ansa Cervicalis - Inferior Root - Course

runs inferiorly to join the superior root

Cervical sympathetic trunk: Superior cervical ganglion - Branches - Superior cervical cardiac nerve

runs inferiorly towards the cardiac plexus

Cervical spinal nervesAnterior rami of cervical spinal nerves (CERVICAL PLEXUS): Cutaneous branches - Lesser occipital nerve (C2) - Course

runs superiorly and posteriorly (parallel to posterior border of SCM)

Posterior rami of cervical spinal nerves: Third (Least) occipital nerve (C3) - Supply

scalp of lower occipital and suboccipital region

Posterior rami of cervical spinal nerves: Greater occipital nerve (C2) - Supply

scalp of occipital region, and semispinalis capitis m.

Cervical spinal nervesAnterior rami of cervical spinal nerves (CERVICAL PLEXUS): Cutaneous branches - Transverse cervical or anterior cutaneous (C2-C3) - Supply

skin of anterior cervical region

Cervical spinal nervesAnterior rami of cervical spinal nerves (CERVICAL PLEXUS): Cutaneous branches - Lesser occipital nerve (C2) - Supply

skin of neck and scalp posterosuperior to auricle

Cervical sympathetic trunk: Middle cervical ganglion: Location

smallest of the 3 ganglia, lies anterior to the cricoid cartilage, at the level of C6 vertebra

Cervical sympathetic trunk: Superior continuation of thoracic sympathetic trunk that extends ____________ into the neck

superiorly

Anterior rami of cervical spinal nerves (roots of BRACHIAL PLEXUS): Appear between

anterior and middle scalene mm.

Anterior rami of cervical spinal nerves (CERVICAL PLEXUS): Supply skin and muscle on _____________region of neck, extending into head, shoulder girdle, and upper limb

anterolateral

Cervical sympathetic trunk: Location

anterolateral to transverse processes of cervical vertebrae

Anterior rami of cervical spinal nerves (CERVICAL PLEXUS): Motor Branches

arise from the anterior border of the SCM

Cervical spinal nervesAnterior rami of cervical spinal nerves (CERVICAL PLEXUS): Cutaneous branches - Great auricular nerve (C2-C3) - Course

ascends across the SCM to inferior pole of parotid gland where it divides

Cervical sympathetic trunk: Superior cervical ganglion - Location:

at the level of C1 and C2 vertebrae

Anterior rami of cervical spinal nerves (CERVICAL PLEXUS): Ansa Cervicalis - Superior Root - Origin

between loop of C1 - C2

Anterior rami of cervical spinal nerves (CERVICAL PLEXUS): Ansa Cervicalis - Inferior Root - Origin

between loop of C2 - C3

Cervical spinal nervesAnterior rami of cervical spinal nerves (CERVICAL PLEXUS): Cutaneous branches - Transverse cervical or anterior cutaneous (C2-C3) - Course

curves around the posterior border of SCM and passes anteriorly superficial to the SCM and deep to the EJV

Anterior rami of cervical spinal nerves (CERVICAL PLEXUS): Origin

deep to SCM, comprised by the anterior rami of spinal nerves C1 - C4, which form the roots of the cervical plexus

Anterior rami of cervical spinal nerves (CERVICAL PLEXUS): Ansa Cervicalis - Branches (4)

-Omohyoid m. -Sternothyroid m. -Sternohyoid m. -Geniohyoid and Thyrohyoid mm. (just before the superior root turns inferiorly there are 2 branches running anteriorly)

Cervical spinal nerves: There are _____ pairs of cervical spinal nerves

8

Anterior rami of cervical spinal nerves (CERVICAL PLEXUS): Deep motor branches - Branches supply

Branches supply prevertebral muscles (e.g. middle scalene, longus colli and capitis m.)

Cervical spinal nerves: Spinal nerves ________-_________ emerge superior to the correspondingly numbered vertebrae

C1 - C7

Anterior rami of cervical spinal nerves (roots of BRACHIAL PLEXUS): Anterior rami of

C5 - C8 and T1

Cervical spinal nerves: Nerve ______ emerges inferiorly to vertebra C7 (below this area, all remaining nerves emerge inferior to the correspondingly numbered vertebrae)

C8

Cervical sympathetic trunk Presynaptic sympathetic fibers emerging from ______ - _________.

C8 - T2

Anterior rami of cervical spinal nerves (CERVICAL PLEXUS): Deep motor branches - Contributions to

Contributions to accessory nerve (C2 - C4): C2 - C3 & C3 - C4

Cervical sympathetic trunk: Inferior cervical ganglion - Branches (2)

Inferior cervical cardiac nerve: runs inferiorly along the trachea to the deep cardiac plexus Arterial branches: run along the vertebral artery into the cranial cavity

Cervical spinal nervesAnterior rami of cervical spinal nerves (CERVICAL PLEXUS): Cutaneous branches - Supraclavicular (C3-C4) - Supply

Medial: skin over base of neck and upper sternum Intermediate: skin over superior portion of pectoralis major m. Lateral: skin over superior 1/3rd of deltoid muscle

Cervical sympathetic trunk: Middle cervical ganglion: Branches (2)

Middle cervical cardiac nerve: runs inferiorly towards cardiac plexus Arterial branches: runs anteriorly towards the thyroid gland

Cervical spinal nervesAnterior rami of cervical spinal nerves (CERVICAL PLEXUS): Cutaneous branches - Great auricular nerve (C2-C3) - Supply

Parotid gland Auricle Area over mastoid process

Cervical sympathetic trunk: Ganglia (3)

Superior cervical ganglion Middle cervical ganglion Inferior cervical ganglion: in about 80% of humans it fuses with 1st thoracic ganglion to form the cervicothoracic ganglion (stellate ganglion)

Cervical sympathetic trunk: Superior cervical ganglion - Branches - Internal carotid artery branch

branches following the internal carotid artery. Innervates structures supplied by branches of the internal carotid artery

Cervical sympathetic trunk: Superior cervical ganglion - Branches -External carotid artery branch

branches that ride on the external carotid artery following it, and innervating the structures supplied by it

Anterior rami of cervical spinal nerves (CERVICAL PLEXUS): Phrenic nerve - motor - Course

descends with the IJV across the anterior scalene m. in the neck, superficially to anterior scalene --> through the thorax --> to diaphragm

Posterior rami of cervical spinal nerves: Greater occipital nerve (C2) - Course

emerges inferior to obliquus capitis inferior pierces semispinalis capitis during its ascend to posterior scalp

Cervical sympathetic trunk: Inferior cervical ganglion- Location:

lies at the level of C7 vertebra