The cervical sympathetic trunk extends from the base of the skull to the first rib. It contains three ganglia - the superior, middle, and inferior cervical ganglia. The largest is the superior cervical ganglion, located in front of the C2 and C3 vertebrae. The middle cervical ganglion is often small or absent. The inferior cervical ganglion, also called the stellate ganglion, is formed from the fusion of the C7, C8, and T1 ganglia and is located between the neck of the first rib and the C7 vertebra. The cervical sympathetic trunk supplies the head and neck region with sympathetic fibers originating from the T1-T5 segments of the spinal cord.

1. Cervical Sympathetic Trunk
Dr Asma Lashari
University Of Health Sciences
Lahore Pakistan

2. Autonomic nervoussystem
Sympathetic nervoussystem

3. SympatheticTrunk
3
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•
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Two ganglionated nerve
cords –either side of
vertebral column
White & greyrami
communicantes
Location –neck,thorax,
abdomen, pelvis

4. Preganglionicneurones:
4
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•
• Cell bodies of preganglionic
sympathetic neurons –in
lateral horn
Axons –myelinated ,diam
-1.5 - 4microm
Leavecord in ventralnerve
roots – passinto spinal
nerves, soon leave in white
rami communicants

5. CervicalSympatheticTrunk
5
•This extends from the base of the skull to
the first rib.
•Lies in the neck embedded in the deep
fascia between the carotid sheath
anteriorly and longus coli and longus capitis
muscles posteriorly.
•Internal carotidnerve threecervicalganglia.
– Superior
– Middle
– Inferior

6. SuperiorCervicalGanglion
6
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•
•
Largestganglion
Liesin front oftransverse
processesof C2andC3
vertebrae
Branches
– Medial
– Lateral
• It lies deep to the sheath of
the internal carotid
artery and internal jugular vein,
and anterior to the Longus
capitis muscle.

7. Middle CervicalGanglion
7
It’s quite small and frequently absent.
It is located in the lower part of the neck,
in front of transverse process of C6 just
above the inferior thyroid artery.
It’s created by the fusion of the 5th and
6th archaic cervical ganglia.
Branches
– Greyramicommunicantes
– Cardiacbranch
– VascularBranch

8. Inferior Cervical Ganglion/Stellate
Ganglion
8
• Formed by the fusion of C7,C8 and T1
ganglia.
• Lies b/w neck of 1st Rib and transverse
process of C7 vertebra.
Branches:
•Grey rami communicans
•Vascular branches
It’s usually fused with the 1st thoracic
ganglion to create the cervicothoracic
ganglion
Also referred to as stellate ganglion due to
its star shaped look.

9. Sympatheticsupply–HeadandNeck
9
•Preganglionic fibres – T1-T5
segments of Spinal Cord
•Ascend in Sympathetic Trunk
•Synapse in cervical ganglia

10. THANKYOU…