Stellate ganglion

Stellate ganglion
Nerve: Stellate ganglion
Plan of right sympathetic cord and splanchnic nerves. (Stellate ganglion not visible, but region is shown.)
Latin ganglion cervicothoracicum, ganglion stellatum
From inferior cervical ganglion, first thoracic ganglia
MeSH Stellate+ganglion

The stellate ganglion (or cervicothoracic ganglion or inferior cervical ganglion) is a sympathetic ganglion formed by the fusion of the inferior cervical ganglion and the first thoracic ganglion. Stellate ganglion is located at the level of C7 (7th cervical vertebrae), anterior to the transverse process of C7, anterior to the neck of the first rib, and just below the subclavian artery.

Contents

Clinical significance

The clinical significance of these ganglia is that they may be cut in order to decrease the symptoms exhibited by Raynaud's phenomenon and hyperhydrosis (extreme sweating) of the hands. Injection of local anesthetics near the stellate ganglion can sometimes mitigate the symptoms of sympathetically mediated pain such as complex regional pain syndrome type I (reflex sympathetic dystrophy).

Stellate-ganglion block also shows great potential as a means of reducing the number of hot flashes and night awakenings suffered by breast cancer survivors and women experiencing extreme menopause.[1]

Complications associated with a stellate ganglion block include Horner's syndrome, intra-arterial or intravenous injection, difficulty swallowing, vocal cord paralysis, epidural spread of local anaesthetic and pneumothorax.

Blunt needling of the stellate ganglion with an acupuncture needle is used in Traditional Chinese Medicine to decrease sympathetically mediated symptoms as well.

Block of the stellate ganglion has also been explored in coronary artery bypass surgery.[2]

Anatomy

The stellate ganglion lies in front of the neck of the first rib. The vertebral artery lies anterior to the ganglion as it has just originated from the subclavian artery. After passing over the ganglion, it enters the vertebral foramen and lies posterior to the anterior tubercle of C6. [3]

References

  1. ^ Lancet, 2008
  2. ^ Yildirim V, Akay HT, Bingol H, et al. (2007). "Pre-emptive stellate ganglion block increases the patency of radial artery grafts in coronary artery bypass surgery". Acta anaesthesiologica Scandinavica 51 (4): 434–40. doi:10.1111/j.1399-6576.2006.01260.x. PMID 17378781. 
  3. ^ Raj, Practical Management of Pain, 3rd ed, pp656-657

External links

v · d · eNerves – autonomic nervous system (sympathetic nervous system/ganglion/trunks and parasympathetic nervous system/ganglion) (TA A14.3, GA 9.968)
Head/
cranial
Sympathetic
Parasympathetic
Neck/
cervical
Sympathetic
Chest/
thorax
Sympathetic
Abdomen/
Lumbar
Sympathetic
Pelvis/
sacral
Sympathetic
Parasympathetic

M: PNS

anat(h/r/t/c/b/l/s/a)/phys(r)/devp/prot/nttr/nttm/ntrp

noco/auto/cong/tumr, sysi/epon, injr

proc, drug(N1B)



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