Neck plexus. Cervical sympathetic trunk

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(plexus cervicalis) is formed by the anterior branches of the 4 upper cervical spinal nerves (C I -C IV), which have connections with each other. The plexus lies lateral to the transverse processes between the vertebral (posterior) and prevertebral (anterior) muscles (Fig. 1). The nerves emerge from under the posterior edge of the sternocleidomastoid muscle, slightly above its middle, and spread in a fan-like manner upward, forward and downward. The following nerves depart from the plexus:

Rice. 1.

1 - hypoglossal nerve; 2 - accessory nerve; 3, 14 - sternocleidomastoid muscle; 4 - great auricular nerve; 5 - lesser occipital nerve; 6 - greater occipital nerve; nerves to the anterior and lateral rectus capitis muscles; 8 - nerves to the long muscles of the head and neck; 9 - trapezius muscle: 10 - connecting branch to the brachial plexus; 11 - phrenic nerve: 12 - supraclavicular nerves; 13 - lower belly of the omohyoid muscle; 15 - neck loop; 16 - sternohyoid muscle; 17 - sternothyroid muscle; 18 - upper belly of the omohyoid muscle: 19 - transverse nerve of the neck; 20 - lower root of the neck loop; 21 - upper root of the neck loop; 22 - thyrohyoid muscle; 23 - geniohyoid muscle

1. Lesser occipital nerve(p. occipitalis mino) (from C I - C II) spreads upward to the mastoid process and further to the lateral parts of the back of the head, where it innervates the skin.

2. Great ear nerve(p. auricularis major) (from C III - C IV) runs along the sternocleidomastoid muscle upward and anteriorly, to the auricle, innervates the skin of the auricle (posterior branch) and the skin above the parotid salivary gland (anterior branch).

3. Transverse cervical nerve(p. transverses colli) (from C III - C 1 V) goes anteriorly and at the anterior edge of the sternocleidomastoid muscle it is divided into upper and lower branches that innervate the skin of the anterior neck.

4. Supraclavicular nerves(pp. supraclaviculares) (from C III - C IV) (numbering from 3 to 5) spread downwards in a fan-shaped manner under the subcutaneous muscle of the neck; They branch in the skin of the posterior lower part of the neck (lateral branches), in the region of the clavicle (intermediate branches) and the upper anterior part of the chest to the third rib (medial branches).

5. Phrenic nerve(n. phrenicis) (from C III - C IV and partly from C V), predominantly a motor nerve, goes down the anterior scalene muscle into the chest cavity, where it passes to the diaphragm in front of the root of the lung between the mediastinal pleura and the pericardium. Innervates the diaphragm, gives off sensory branches to the pleura and pericardium (rr. pericardiaci), sometimes to the cervicothoracic nerve plexus. In addition, it sends diaphragmatic-abdominal branches (rr. phrenicoabdominales) to the peritoneum covering the diaphragm. These branches contain nerve ganglia (ganglii phrenici) and connect to the celiac nerve plexus. The right phrenic nerve especially often has such connections, which explains the phrenicus symptom - irradiation of pain to the neck area due to liver disease.

6. Lower spine of the neck loop (radix inferior ansae cervicalis) is formed by nerve fibers from the anterior branches of the second and third spinal nerves and goes anteriorly to connect with upper spine (radix superior) arising from the hypoglossal nerve (XII pair of cranial nerves). As a result of the connection of both roots, a cervical loop is formed ( ansa cervicalis), from which branches extend to the scapular-hyoid, sternohyoid, thyroid-hyoid and sternothyroid muscles.

7. Muscular branches (rr. musculares) go to the prevertebral muscles of the neck, to the muscle that lifts the scapula, as well as to the sternocleidomastoid and trapezius muscles.

Lies in front of the transverse processes of the cervical vertebrae on the surface of the deep muscles of the neck (Fig. 2). In each cervical region there are 3 cervical nodes: upper, middle ( ganglia cervicales superior et media) and cervicothoracic ( stellate ) ( ganglion cervicothoracicum (stellatum)). The middle cervical node is the smallest. The stellate node often consists of several nodes. The total number of nodes in the cervical region can vary from 2 to 6. Nerves depart from the cervical nodes to the head, neck and chest.

Rice. 2.

1 - glossopharyngeal nerve; 2 - pharyngeal plexus; 3 - pharyngeal branches of the vagus nerve; 4 - external carotid artery and nerve plexus; 5 - superior laryngeal nerve; 6 - internal carotid artery and sinus branch of the glossopharyngeal nerve; 7 - carotid glomus; 8 - carotid sinus; 9 - superior cervical cardiac branch of the vagus nerve; 10 - upper cervical cardiac nerve: 11 - middle cervical node of the sympathetic trunk; 12 - middle cervical cardiac nerve; 13 - vertebral node; 14 - recurrent laryngeal nerve: 15 - cervicothoracic (stellate) node; 16 - subclavian loop; 17 - vagus nerve; 18 - lower cervical cardiac nerve; 19 - thoracic cardiac sympathetic nerves and branches of the vagus nerve; 20 - subclavian artery; 21 — gray connecting branches; 22 - superior cervical ganglion of the sympathetic trunk; 23 - vagus nerve

1. Gray connecting branches(rr. communicantens grisei) - to the cervical and brachial plexuses.

2. Internal carotid nerve(p. caroticus internus) usually departs from the upper and middle cervical nodes to the internal carotid artery and forms around it internal carotid plexus(plexus caroticus internus), which extends to its branches. Branches off from the plexus deep petrosal nerve (p. petrosus profundus) to the pterygopalatine ganglion.

3. The jugular nerve (n. jugularis) starts from the upper cervical node, within the jugular opening is divided into two branches: one goes to the upper node of the vagus nerve, the other to the lower node of the glossopharyngeal nerve.

4. Vertebral nerve(n. vertebralis) departs from the cervicothoracic node to the vertebral artery, around which it forms vertebral plexus (plexus vertebralis).

5. Cardiac cervical superior, middle and inferior nerves (pp. cardiaci cervicales superior, medius et inferior) originate from the corresponding cervical nodes and are part of the cervicothoracic nerve plexus.

6. External carotid nerves(pp. carotid externi) depart from the upper and middle cervical nodes to the external carotid artery, where they participate in the formation external carotid plexus (plexus caroticus externus), which extends to the branches of the artery.

7. Laryngo-pharyngeal branches(rr. laryngopharyngei) go from the upper cervical node to the pharyngeal plexus and as a connecting branch to the superior laryngeal nerve.

8. Subclavian branches(rr. subclavii) depart from subclavian loop (ansa subclavia), which is formed by the division of the internodal branch between the middle cervical and cervicothoracic nodes.

Cranial division of the parasympathetic nervous system

Centers cranial department The parasympathetic part of the autonomic nervous system is represented by nuclei in the brainstem (mesencephalic and bulbar nuclei).

Mesencephalic parasympathetic nucleus - accessory nucleus of the oculomotor nerve(nucleus accessories n. oculomotorii)- located at the bottom of the midbrain aqueduct, medial to the motor nucleus of the oculomotor nerve. Preganglionic parasympathetic fibers go from this nucleus as part of the oculomotor nerve to the ciliary ganglion.

The following parasympathetic nuclei lie in the medulla oblongata and pons:

1) superior salivary nucleus(nucleus salivatorius superior), associated with the facial nerve, - in the bridge;

2) inferior salivary nucleus(nucleus salivatorius inferior), associated with the glossopharyngeal nerve, - in the medulla oblongata;

3) dorsal nucleus of the vagus nerve(nucleus dorsalis nervi vagi), - in the medulla oblongata.

Preganglionic parasympathetic fibers pass from the cells of the salivary nuclei as part of the facial and glossopharyngeal nerves to the submandibular, sublingual, pterygopalatine and auricular nodes.

Peripheral department The parasympathetic nervous system is formed by preganglionic nerve fibers originating from the indicated cranial nuclei (they pass through the corresponding nerves: III, VII, IX, X pairs), the nodes listed above and their branches containing postganglionic nerve fibers.

1. Preganglionic nerve fibers running as part of the oculomotor nerve follow to the ciliary ganglion and end at synapses on its cells. Depart from the node short ciliary nerves(pp. ciliares breves), in which, along with sensory fibers, there are parasympathetic fibers: they innervate the sphincter of the pupil and the ciliary muscle.

2. Preganglionic fibers from the cells of the superior salivary nucleus spread as part of the intermediate nerve, from it through the greater petrosal nerve they go to the pterygopalatine ganglion, and through the chorda tympani - to the submandibular and hypoglossal nodes, where they end in synapses. From these nodes, postganglionic fibers follow along their branches to the working organs (submandibular and sublingual salivary glands, glands of the palate, nose and tongue).

3. Preganglionic fibers from the cells of the inferior salivary nucleus go as part of the glossopharyngeal nerve and further along the lesser petrosal nerve to the ear ganglion, on the cells of which they end in synapses. Postganglionic fibers from the cells of the ear ganglion emerge as part of the auriculotemporal nerve and innervate the parotid gland.

Preganglionic parasympathetic fibers, starting from the cells of the dorsal ganglion of the vagus nerve, pass as part of the vagus nerve, which is the main conductor of parasympathetic fibers. Switching to postganglionic fibers occurs mainly in small ganglia of the intramural nerve plexuses of most internal organs, therefore postganglionic parasympathetic fibers appear to be very short compared to preganglionic fibers.

Human Anatomy S.S. Mikhailov, A.V. Chukbar, A.G. Tsybulkin

The sympathetic trunk (also called the borderline sympathetic trunk) is a paired organ, part of the body’s sympathetic system, located on the anterolateral part of the spine. Below you will find out what role the sympathetic trunk plays in the human body and what are the consequences of disruption of its functions.

Structure

The sympathetic trunk consists of nodes, which are a group of autonomic neurons. With their help, the preganglionic fibers are switched, which, leaving the spinal cord, form the white connecting branches. Similar branches are located only in the upper lumbar and thoracic spine. In all other parts of the spine there are no connecting branches.

The nodes of the sympathetic trunk are connected to each other by gray connecting branches, which extend to all spinal branches, thus going to the peripheral organs.

The sympathetic trunk can be roughly divided into four sections.

The cervical region consists of three nodes. The upper node measures about 5 by 20 mm and is located on the 2-3 cervical vertebrae.

The following branches depart from it:

gray connective, extending to 1-3 spinal nerves;
the jugular nerve, which joins the glossopharyngeal, hypoglossal and glossopharyngeal nerves;
the internal carotid nerve, which penetrates the carotid artery and forms the carotid plexus. From here arise the plexuses that form the plexus of the tympanic cavity and the plexus of the ophthalmic artery;
the external carotid nerve, which forms the external plexus. Its fibers are responsible for supplying blood to the entire face, neck and dura mater of the brain;
laryngopharyngeal branches, which form the pharyngeal plexus, responsible for the swallowing process;
the superior cardiac nerve, which is one of the elements of the superficial cardiac plexus;
elements of the phrenic nerve.

The average node measures 2 by 2 mm. It is located at the level of the 6th cervical vertebra at the intersection of the carotid and inferior thyroid arteries.

The following branches come from here:

gray connecting branches to the spinal nerves;
the middle cardiac nerve, which is located behind the carotid artery;
internodal branch, which extends to the cervical node;
branches that form the nerve plexus of the subclavian and carotid arteries.

The inferior node is located behind the vertebral artery just above the subclavian artery. The following branches depart from this node:

gray connecting;
lower cardiac nerve;
to the plexus of the vertebral artery;
to the phrenic nerve;
to the plexus of the carotid artery;
to the subclavian artery.

The thoracic section of the sympathetic trunk is located on the necks of the ribs on the sides of the thoracic vertebrae. This department has the following groups of branches:

white connecting branches;
gray connecting branches;
thoracic cardiac nerves;
mediastinal branches, from which the bronchial and esophageal plexuses are formed;
thoracic cardiac nerves, which are part of the thoracic aortic and deep cardiac plexus;
the great splanchnic nerve, which is located under the intrathoracic fascia. The nerve contains a large number of preganglionic fibers;
small splanchnic nerve, which goes to organs located in the chest cavity.

The lumbar nodes are actually a continuation of the thoracic nodes. The nodes are located on the medial edge on the sides of the spine. The following branches depart from them:

white connecting branches;
gray communicating branches connecting the nodes and lumbar nerves;
lumbar splanchnic nerves.

The sacral nodes consist of 1 unpaired and 3-4 paired nodes. From them depart:

gray communicating rami connecting the sacral and spinal nerves;
inferior hypogastric plexus, consisting of splanchnic nerves.

Superior cervical sympathetic ganglion syndrome

Symptoms of the development of the syndrome are:

disturbances in the functioning of the facial muscles;
paroxysmal pain of a burning nature. In this case, the attack can pass in either a couple of hours or several days;
radiating pain to the neck and shoulders. In this case, the pain is usually localized in the back of the head;
drooping of the upper and raising of the lower eyelid, which reduces the size of the palpebral fissure;
decreased tone of the orbital muscle;
the color of the iris becomes lighter;
reduction or cessation of sweating.

Stellate (cervicothoracic) node syndrome

This syndrome manifests itself with the following symptoms:

pain in the area of the 5th-6th pair of ribs;
pain in the arm on the affected side;
impaired sweating in the affected area;
reduction in the sensation of pain.

Posterior cervical syndrome

This syndrome occurs due to compression, the development of an infectious or inflammatory process, or a violation of the circulatory process. Most often, damage to the sympathetic plexus occurs due to the development of osteochondrosis.

Symptoms of the development of posterior cervical sympathetic syndrome are:

severe headache that does not go away for a day or more. As a rule, pain is localized on the affected side and has an increasing or paroxysmal character;
vomiting caused by a very severe headache;
tinnitus, hearing loss;
hot flashes, sudden redness of the face;
numbness or shaking of the hands;
pain in the face in the throat area;
unnatural tilt of the head in the affected area;
photophobia;
pain in the area of the eyeball;
blurred vision.

Jugular foramen syndrome

This disease occurs due to damage to the accessory, vagus or glossopharyngeal nerve. The syndrome is usually caused by trauma or tumors.

Treatment

Treatment is aimed simultaneously at:

anesthesia. In this case, painkillers are prescribed, and in severe cases, tranquilizers. To speed up the effect, medications are administered intravenously;
treatment of a viral or bacterial infection. For this, antiviral drugs or antibiotics are prescribed;
To normalize the tone of sympathetic structures, cholinomimetic drugs are prescribed.

Physiotherapy procedures have a good effect: cold mud applications, UV irradiation, radon baths. It is advisable to take a massage course.

So, the sympathetic trunk is an element of the human sympathetic nervous system, which is responsible for the constancy of the internal environment of any person. Any problems with this organ are fraught with serious systemic disorders in the patient’s body and require immediate intervention.

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In this article we will look at what the sympathetic and parasympathetic nervous systems are, how they work, and what are their differences. We have previously covered the topic as well. The autonomic nervous system, as is known, consists of nerve cells and processes, thanks to which the regulation and control of internal organs occurs. The autonomic system is divided into peripheral and central. If the central one is responsible for the work of internal organs, without any division into opposite parts, then the peripheral one is divided into sympathetic and parasympathetic.

The structures of these departments are present in every internal organ of a person and, despite their opposing functions, they work simultaneously. However, at different times, one or another department turns out to be more important. Thanks to them, we can adapt to different climatic conditions and other changes in the external environment. The autonomic system plays a very important role; it regulates mental and physical activity, and also maintains homeostasis (constancy of the internal environment). If you rest, the autonomic system engages the parasympathetic system and the number of heartbeats decreases. If you start running and experience heavy physical activity, the sympathetic department turns on, thereby speeding up the heart and blood circulation in the body.

And this is only a small slice of the activity that the visceral nervous system carries out. It also regulates hair growth, contraction and dilation of pupils, the functioning of one or another organ, is responsible for the psychological balance of the individual, and much more. All this happens without our conscious participation, which is why at first glance it seems difficult to treat.

Sympathetic nervous system

Among people who are unfamiliar with the work of the nervous system, there is an opinion that it is one and indivisible. However, in reality everything is different. Thus, the sympathetic department, which in turn belongs to the peripheral, and the peripheral belongs to the autonomic part of the nervous system, supplies the body with the necessary nutrients. Thanks to its work, oxidative processes proceed quite quickly, if necessary, the work of the heart accelerates, the body receives the proper level of oxygen, and breathing improves.

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Interestingly, the sympathetic division is also divided into peripheral and central. If the central one is an integral part of the work of the spinal cord, then the peripheral part of the sympathetic has many branches and nerve nodes that connect. The spinal center is located in the lateral horns of the lumbar and thoracic segment. The fibers, in turn, extend from the spinal cord (1st and 2nd thoracic vertebrae) and 2,3,4 lumbar vertebrae. This is a very brief description of where the sympathetic system is located. Most often, the SNS is activated when a person finds himself in a stressful situation.

Peripheral department

It is not so difficult to imagine the peripheral part. It consists of two identical trunks, which are located on both sides along the entire spine. They start from the base of the skull and end at the tailbone, where they converge into a single unit. Thanks to the internodal branches, the two trunks are connected. As a result, the peripheral section of the sympathetic system passes through the cervical, thoracic and lumbar regions, which we will consider in more detail.

Cervical region. As you know, it starts from the base of the skull and ends at the transition to the thoracic (cervical 1st ribs). There are three sympathetic nodes here, which are divided into lower, middle and upper. All of them pass behind the human carotid artery. The upper node is located at the level of the second and third cervical vertebrae, has a length of 20 mm, a width of 4 - 6 millimeters. The middle one is much more difficult to find, as it is located at the intersections of the carotid artery and the thyroid gland. The lower node has the largest size, sometimes even merging with the second thoracic node.
Thoracic department. It consists of up to 12 nodes and has many connecting branches. They reach out to the aorta, intercostal nerves, heart, lungs, thoracic duct, esophagus and other organs. Thanks to the thoracic region, a person can sometimes feel the organs.
The lumbar region most often consists of three nodes, and in some cases has 4. It also has many connecting branches. The pelvic region connects the two trunks and other branches together.

Parasympathetic department

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This part of the nervous system begins to work when a person tries to relax or is at rest. Thanks to the parasympathetic system, blood pressure decreases, blood vessels relax, pupils constrict, heart rate slows down, and sphincters relax. The center of this department is located in the spinal cord and brain. Thanks to efferent fibers, the hair muscles relax, sweat secretion is delayed, and blood vessels dilate. It is worth noting that the structure of the parasympathetic includes the intramural nervous system, which has several plexuses and is located in the digestive tract.

The parasympathetic department helps to recover from heavy loads and performs the following processes:

Reduces blood pressure;
Restores breathing;
Dilates blood vessels in the brain and genital organs;
Constricts the pupils;
Restores optimal glucose levels;
Activates the digestive secretion glands;
Tones the smooth muscles of internal organs;
Thanks to this department, cleansing occurs: vomiting, coughing, sneezing and other processes.

In order for the body to feel comfortable and adapt to different climatic conditions, the sympathetic and parasympathetic parts of the autonomic nervous system are activated at different times. In principle, they work constantly, however, as mentioned above, one of the departments always prevails over the other. Once in the heat, the body tries to cool itself and actively secretes sweat; when it urgently needs to warm up, sweating is accordingly blocked. If the autonomic system works correctly, a person does not experience certain difficulties and does not even know about their existence, except for professional necessity or curiosity.

Since the topic of the site is dedicated to vegetative-vascular dystonia, you should know that due to psychological disorders, the autonomic system experiences disruptions. For example, when a person has suffered a psychological trauma and experiences a panic attack in a closed room, his sympathetic or parasympathetic department is activated. This is a normal reaction of the body to an external threat. As a result, a person feels nausea, dizziness and other symptoms, depending on. The main thing is that the patient should understand that this is only a psychological disorder, and not physiological deviations, which are only a consequence. This is why medication treatment is not an effective remedy; they only help relieve symptoms. For a full recovery, you need the help of a psychotherapist.

If at a certain point in time the sympathetic department is activated, blood pressure increases, the pupils dilate, constipation begins, and anxiety increases. When the parasympathetic action occurs, the pupils constrict, fainting may occur, blood pressure decreases, excess weight accumulates, and indecision appears. The most difficult thing is for a patient suffering from a disorder of the autonomic nervous system when he has it, since at this moment disorders of the parasympathetic and sympathetic parts of the nervous system are simultaneously observed.

As a result, if you suffer from a disorder of the autonomic nervous system, the first thing you should do is undergo numerous tests to rule out physiological pathologies. If nothing is revealed, it is safe to say that you need the help of a psychologist who will quickly relieve you of your illness.

Each of the two sympathetic trunks is divided into four sections: cervical, thoracic, lumbar (or abdominal) and sacral (or pelvic).

The cervical region extends from the base of the skull to the neck of the first rib; located behind the carotid arteries on the deep muscles of the neck. It consists of three cervical

sympathetic nodes: upper, middle and lower.

Ganglion cervicale superius is the largest node of the sympathetic trunk, having a length of about 20 mm and a width of 4-6 mm. It lies at level 11 and part Ill of the cervical

vertebrae behind the internal carotid artery and medial to the n.vagus.

Ganglion cervicale medium of small size, usually located at the intersection of a.thyroidea inferior with the carotid artery, often absent or may

break into two knots.

Ganglion cervicale inferius is quite significant, located behind the initial part of the vertebral artery; often merges with the 1st and sometimes 11th thoracic node,

forming a common cervicothoracic, or stellate, node, ganglion cervicothoracicum s.ganglion stellatum.

Nerves for the head, neck and chest arise from the cervical ganglia. They can be divided into an ascending group heading towards the head, a descending group descending towards the heart,

and a group for the neck organs.

The nerves for the head depart from the upper and lower cervical nodes and are divided into a group penetrating the cranial cavity, and a group approaching the head from the outside.

The first group is represented by n.caroticus internus, extending from the upper cervical node, and n.vertebralis, extending from the lower cervical node. Both nerves, accompanying

arteries of the same name form plexuses around them: plexus caroticus internus and plexus vertebralis; together with the arteries they penetrate into the cranial cavity, where they anastomose

between themselves and give branches to the vessels of the brain, membranes, pituitary gland, trunks III, IV, V, VI pairs of cranial nerves and the tympanic nerve.

Plexus caroticus internus continues into the plexus cavernosus, which surrounds the a.carotis interna at the site of its passage through the sinus cavernosus.

The branches of the plexuses extend, in addition to the most internal carotid artery, also along its branches. Of the branches of the plexus caroticus internus, n.petrosus should be noted

profundus, which joins n.petrosus major and together with it forms n.canalis pterygoidei, suitable through the canal of the same name to ganglion pterygopalatinum.

The second group of sympathetic nerves of the head, external, is made up of two branches of the upper cervical node, nn.carotici externi, which, having formed a plexus around

external carotid artery, accompany its branches on the head. From this plexus, the trunk departs to the ear node, gangl. oticum; from the plexus accompanying the facial

artery, a branch departs to the submandibular node, gangl. submandibulare.

Through the branches that enter the plexuses around the carotid artery and its branches, the upper cervical node gives fibers to the vessels (vasoconstrictors) and glands of the head:

sweat, lacrimal, mucous and salivary, as well as to the muscles of the hair of the skin and to the muscle that dilates the pupil, m.dilatator pupillae. Pupil dilation center, centrum ciliospinale,

is located in the spinal cord at the level from the VIII cervical to the II thoracic segment.

The organs of the neck receive nerves from all three cervical ganglia; in addition, part of the nerves departs from the internodal sections of the cervical sympathetic trunk, and part - from

plexuses of the carotid arteries.

Branches from the plexuses follow the course of the branches of the external carotid artery, have the same names and, together with them, approach the organs, due to which the number of individual

sympathetic plexuses is equal to the number of arterial branches. From the nerves extending from the cervical part of the sympathetic trunk, the laryngeal-pharyngeal branches are noted from the upper

cervical node - rami laryngopharyngei, which often go from n.laryngeus superior (n.vagi branch) to the larynx, often descend to the side wall of the pharynx; here they are together with the branches

glossopharyngeal, vagus and superior laryngeal nerves form the pharyngeal plexus, plexus pharyngeus.

The descending group of branches of the cervical part of the sympathetic trunk is represented by nn.cardiaci cervicales superior, medius et inferior, extending from the corresponding cervical

nodes The cervical cardiac nerves descend into the chest cavity, where, together with the sympathetic thoracic cardiac nerves and branches of the vagus nerve, they participate in

formation of cardiac plexuses.

The thoracic region of the sympathetic trunk is located in front of the necks of the ribs and is covered in front by the pleura. It consists of 10-12 nodes of more or less triangular shape.

The thoracic region is characterized by the presence of white communicating branches, rami communicantes albi, connecting the anterior roots of the spinal nerves with the nodes

sympathetic trunk. Branches of the thoracic region:

1) nn.cardiaci thoracici depart from the upper thoracic nodes and participate in the formation of the plexus cardiacus (for a detailed description of the cardiac plexuses, see the description of the heart);

2) rami communicantes grisei, unmyelinated - to the intercostal nerves (somatic part of the sympathetic department);

3) rami pulmonales - to the lungs, forming plexus pulmonalis;

4) rami aortici form a plexus on the thoracic aorta, plexus aorticus thoracicus, and partly on the esophagus, plexus esophageus, as well as on the thoracic duct (in all of these

n.vagus also takes part in the plexuses);

5) nn.splanchnici major et minor, large and small splanchnic nerves; n.splanchnicus major begins with several roots extending from the V-IX thoracic nodes;

the roots of n.splanchnicus major go in the medial direction and merge at the level of the IX thoracic vertebra into one common trunk, penetrating through the gap between

muscle bundles of the legs of the diaphragm into the abdominal cavity, where it is part of the plexus coeliacus; n.splanchnicus minor starts from the X - XI thoracic nodes and is also included in

plexus coeliacus, penetrating the diaphragm with the greater splanchnic nerve. Vasoconstrictor fibers run in these nerves, as can be seen from the fact that when

when these nerves are cut, the intestinal vessels become heavily filled with blood; nn.splanchnici contains fibers that inhibit the movement of the stomach and intestines, as well as fibers that serve

conductors of sensations from the viscera (afferent fibers of the sympathetic part).

The lumbar, or abdominal, section of the sympathetic trunk consists of four, sometimes three nodes. Sympathetic trunks in the lumbar region are located more

close distance from each other than in the chest cavity, so that the nodes lie on the anterolateral surface of the lumbar vertebrae along the medial edge of m. psoas major.

Rami communicantes albi are present with only two or three upper lumbar nerves.

A large number of branches depart from the abdominal part of the sympathetic trunk throughout, which, together with nn.splanchnici major et minor and the abdominal parts

vagus nerves form the largest unpaired celiac plexus, plexus coeliacus. Numerous also participate in the formation of the celiac plexus

spinal nodes (C5 - L3), axons of their neurocytes. It lies on the anterior semicircle of the abdominal aorta, behind the pancreas, and surrounds the initial parts

celiac trunk (truncus coeliacus) and superior mesenteric artery. Plexus occupies the area between the renal arteries, adrenal glands and aortic opening

diaphragm and includes a paired celiac node, ganglion coeliacum, and sometimes an unpaired superior mesenteric node, ganglion mesentericum superius.

A number of smaller paired plexuses depart from the celiac plexus to the diaphragm, adrenal glands, kidneys, as well as plexus testicularis (ovaricus), following along the course

arteries of the same name. There are also a number of unpaired plexuses to individual organs along the walls of the arteries, the name of which they bear.

Of the latter, the superior mesenteric plexus, plexus mesentericus superior, innervates the pancreas, small and large intestine up to half its extent

transverse colon.

The second ocular source of innervation of the organs of the abdominal cavity is the plexus on the aorta, plexus aorticus abdominalis, composed of two trunks extending from

celiac plexus, and branches from the lumbar nodes of the sympathetic trunk. The inferior mesenteric plexus, plexus mesentericus inferior, departs from the aortic plexus, for

transverse and descending part of the colon, sigmoid and upper parts of the rectum (plexus rectalis superior). At the origin of the plexus mesentericus inferior

there is a node of the same name, gangl. mesentericum inferius. Its postganglionic fibers run in the pelvis as part of the nn.hypogastrici.

The aortic plexus initially continues into the unpaired superior hypogastric plexus, plexus hypogastricus superior, which bifurcates at the promontory and passes into

pelvic plexus, or lower hypogastric plexus (plexus hypogastricus inferior s.plexus pelvinus).

The fibers originating from the upper lumbar segments, in their function, are vasomotor (vasoconstrictors) for the penis, motor for

uterus and bladder sphincter.

The sacral, or pelvic, section usually has four nodes; located on the anterior surface of the sacrum along the medial edge of the anterior sacral foramina, both

the trunks gradually approach each other downwards, and then end in one common unpaired node - ganglion impar, located on the anterior surface of the coccyx. Nodes

The pelvic region, like the lumbar region, is connected to each other not only by longitudinal, but also by transverse trunks.

A number of branches depart from the nodes of the sacral section of the sympathetic trunk, which connect with branches that separate from the inferior mesenteric plexus and form

a plate extending from the sacrum to the bladder; this is the so-called inferior hypogastric, or pelvic, plexus, plexus hypogastricus inferior s.plexus pelvinus.

The plexus has its own nodes - ganglia pelvina. The plexus has several sections:

1) anterior inferior section, in which the upper part innervates the bladder - plexus vesicalis, and the lower part, which supplies the prostate gland in men, are distinguished

(plexus prostaticus), seminal vesicles and vas deferens (plexus deferentialis) and cavernous bodies (nn.cavernosi penis);

2) the posterior section of the plexus supplies the rectum (plexus rectales medii et inferiores).

In women, there is also a middle section, the lower part of which gives branches to the uterus and vagina (plexus uterovaginalis), cavernous bodies of the clitoris (nn.cavernosi clitoridis), and

upper - to the uterus and ovaries.

Connecting branches, rami communicantes, depart from the nodes of the sacral section of the sympathetic trunk, joining the spinal nerves innervating

lower limb. These connecting branches constitute the somatic part of the sympathetic division of the autonomic nervous system, innervating the lower limb. IN

The rami communicantes and spinal nerves of the lower limb contain postganglionic fibers that distribute in the vessels, glands and hair muscles

skin, as well as in skeletal muscles, providing its trophism and tone.

PARASYMPATHETIC PART OF THE AUTONOMIC NERVOUS SYSTEM

The parasympathetic part historically develops as a suprasegmental department, and therefore its centers are located only in the spinal cord, but also in the brain.

Parasympathetic centers

The central part of the parasympathetic division consists of the head, or cranial, division and the spinal, or sacral, division. Some authors believe that

parasympathetic centers are located in the spinal cord not only in the region of the sacral segments, but also in other parts of it, in particular in the lumbar-thoracic region between

anterior and posterior horn, in the so-called intermediary zone. The centers give rise to efferent fibers of the anterior roots, causing vasodilation, delay

sweating and inhibition of contraction of involuntary hair muscles in the torso and limbs.

The cranial section, in turn, consists of centers located in the midbrain (mesencephalic part), and in the rhombencephalon - in the pons and medulla oblongata

(bulbar part).

1. The mesencephalic part is represented by the nucleus accessorius n.oculomotorii and the median unpaired nucleus, due to which the muscles of the eye are innervated - m.sphincter

pupillae and m.ciliaris.

2. The bulbar part is represented by the nucleus salivatorius superior n.facialis (more precisely, n.intermedius), nucleus salivatorius inferior n.glossopharyngei and nucleus dorsalis n.vagi.

Sacred department. The parasympathetic centers lie in the spinal cord, in the substantia intermedialateralis of the lateral horn at the level of the II - IV sacral segments.