Thoracic Part of
Sympathetic Chain
(Page 128)
Dr.Sherif Fahmy
Course & Relations
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Thoracic part of
Sympathetic
chain
Cervical part of
sympathetic
chain
Medial arcuate
lig. of diaphragm
Abdominal part of
sympathetic chain
Neck of 1st
rib
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Sympathetic
chain
Medial arcuate
ligament
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Structure
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Sympathetic
ganglion
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Branches
- Rami communicants to
corresponding intercostal nerves.
- To autonomic plexuses in thorax.
- To aorta.
- To abdominal organs through
splanchnic nerves.
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Greater
splanchnic nerve
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Applied Anatomy
1- Spinal anesthesia at high level may
lead to temporary drop of blood
pressure.
2- In case of essential hypertension,
cutting of sympathetic chain between
T2 & T5 will lead to drop of blood
pressure.
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Autonomic Plexes
(Page 136)
1- Pulmonary Plexuses.
2-Oesophageal plexuses.
3- Cardiac plexuses
(superficial and deep).
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1- Pulmonary Plexus
(Posterior & Anterior)
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2- Oesophageal Plexus
(Anterior & Posterior)
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3- Cardiac Plexus
(Superficial & Deep)
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Lymphatic Drainage
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Thoracic Lymph
Drainage
A- From Chest wall.
B- From thoracic contents.
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A- From Chest Wall
1- Superficial lymph vessels:
- From front of chest to pectoral
lymph nodes, parasternal or lower
deep cervical lymph nodes.
- From back of chest to subscapular
nodes. Dr.Sherif Fahmy
2- Deep lymph vessels:
A- From anterior chest wall to
parasternal nodes.
B- Posterior part of chest wall to
intercostal lymph nodes (opposite
neck of ribs).
C- Four diaphragmatic nodes
(anterior, posterior and 2 lateral)
which drain diaphragm and liver.
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B- from Thoracic
Contents
1- Anterior mediastinal nodes.
2- Posterior mediastinal nodes.
3- Nodes of lungs, bronchi and
trachea.
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•Lymph vessels from:
-Anterior mediastinal nodes.
-Tracheal lymph nodes.
-Parasternal lymph nodes.
Will unit together to form broncho-
medistinal lymph vessels which joins
thoracic duct on left side and right
lymphatic duct in right side.
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Deep lymph nodes of chest wall
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Anterior
mediastinal
nodes
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Thoracic Duct
(Page 121)
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Cisterna chyli
Aortic opening
of diaphragme
Left brachio-cephalic
vein
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Tributaries of Thoracic Duct
1- Lymph from intestine, abdominal wall
and lower limb through cisterna chyli.
2- Left broncho-mediastinal lymph
vessels.
3- Left subclavian lymph vessels.
4- left jugular lymph vessels.
5- posterior mediatinal lymph nodes.
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Esophagus
(Page 117)
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Parts & Course
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Level of C6 vertebra
Diaphragm
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Shape, Size and
Curves
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Relations
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Posterior
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Anterior
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Left & Right
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Constrictions
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Beginning
Esophageal
openning of
diaphragme
At level of left
bronchus
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Nerve Supply
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Blood Supply
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Left & Right
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Applied Anatomy
1- Impaction of food.
2- Barium swallow to
determine enlargement of
left atrium.
3- Esophageal varices.
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Thoracic part of Sympathetic Chain (Anatomy of the Thorax)