Stellate ganglion

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The stellate ganglion is a nerve node ( ganglion ) of the vegetative nervous system . It is the fusion of two ganglia of the sympathetic trunk of the sympathetic nervous system . Since the lowest cervical ganglion ( ganglion cervicale inferius ) - in humans in 80% of cases - fuses with the first, rarely also with the second thoracic ganglion ( ganglion thoracicum I or II ), it is also called the ganglion cervicothoracicum (from Latin cervix " Neck ", Thorax " Chest harness "," Chest "). The adjectival addition stellatum (from Latin stella "star") is derived from the nerve cords running in all directions , which give it a star-shaped appearance. Sympathetic fibers supply the head , neck , arm (front leg), heart and lungs from the stellate ganglion .

anatomy

The stellate ganglion is a collection of nerve cells and lies on the side of the first thoracic vertebra . In humans it is three to four centimeters deep, between the arteria vertebralis and arteria thyroidea inferior , on the back of the pleural dome in front of the first rib head. It receives neural inflows via axons, the nerve cell bodies of which lie in the gray matter of the spinal cord and enter the trunk via the communicating rami of the spinal nerves. Some of the fibers are switched in the ganglion, others pass through it without switching.

There are several pathways leading away from the stellate ganglion:

  • Ansa subclavia : This nerve cord forms a loop around the subclavian artery and runs to the medium cervical ganglion . From here the sympathetic trunk runs to the superior cervical ganglion , where it is switched to postganglionic fibers to supply the head. In animals, the neck of the sympathetic trunk usually unites with the vagus nerve coming from the head to form a common cord, the vagosympathetic trunk .
  • Vertebral nerve : It runs with the artery of the same name to the 6th cervical vertebra and through the transverse process canal (foramen transversarium), sometimes forming a vertebral plexus and sends sympathetic fibers to the cervical nerves.
  • Subclavian plexus : These are nerve fibers that surround the subclavian artery and pull it to the upper (front) extremity.
  • Nervus cardiacus cervicalis inferior : It pulls to the plexus cardiacus , a plexus of nerves at the base of the heart. The animals usually consist of several branches, which are called Nervi cardiaci cervicales .

Stellate blockade

A stellate blockade is the targeted local conduction anesthesia of the stellate ganglion. It is used to resolve arteriovenous cramps (vascular spasms), as blood vessels are sympathetically innervated. This blockage leads to vasodilation in the entire catchment area, reduced sweat secretion ( anhidrosis ) and Horner's syndrome . The latter is a sign of the successful implementation of the blockade. It is also used for migraines and unilateral headaches . Furthermore, in case of complaints after a head injury , osteochondrosis of the cervical spine , periarthritis of the shoulder joint ( frozen shoulder ), phantom pain after amputation in the catchment area of the sympathetic fibers, and trigeminal and zoster neuralgia . Surgical removal of the stellate ganglion is the last resort of choice for Raynaud's disease . Contraindications are coagulation disorders, recurrent palsy on the opposite side and phrenic nerve palsy on the opposite side.

See also

Individual evidence

  1. ↑ a b c d Walther Graumann, Dieter Sasse: Compact textbook anatomy . Volume 4, Schattauer Verlag, 2005, ISBN 978-3-7945-2064-0 , pp. 516-517.
  2. ↑ a b c Christine Aurich: Anatomy of domestic mammals: textbook and color atlas for study and practice . Schattauer Verlag, 2012, ISBN 978-3-7945-2832-5 , p. 554.
  3. ↑ Johannes W. Rohen: Topographische Anatomie: Textbook with special consideration of the clinical aspects and the imaging procedures . Schattauer Verlag, 2008, ISBN 978-3-7945-2616-1 , p. 237.
  4. ^ Justus Benrath: Repetitorium Schmerztherapie . Springer-Verlag, 3rd edition 2011, ISBN 978-3-642-20024-3 , pp. 58-59.