SYMPATHETIC NERVE. 



423 



convert this part into a large receptacle, which 

 is hounded hy thick and solid cancerous walls. 

 Where the lower outlet of this cavity remains 

 patulous, life is sometimes preserved under 

 such an unfavourable condition during a con- 

 siderable period of time. 



(The NERVES of the Stomach and Intes- 

 tine are described in the article " SYMPA- 

 THETIC NERVE.") 



( William Brinton.) 



SYMPATHETIC NERVE. The term 

 sympathetic nerve is applied to denote a series 

 of ganglia arranged along each side of the 

 spinal column, connected hy intermediate 

 bands of nerve fibres, so as to present the 

 form of two gangliated cords. These extend 

 from the upper part of the cervical region to 

 the lower extremity of the sacrum, where the 

 cords of opposite sides are united in a single 

 ganglion or plexus situated in front of the 

 coccyx. The ganglia in each cord correspond 

 in number to the vertebrae, except in the cer- 

 vical region, where only three ganglia com- 

 monly exist. The gangliated cord of either 

 side forms communications with all the cor- 

 responding spinal nerves along its course. 

 Branches are also sent upwards from the 

 superior cervical ganglion into the head which 

 communicate with nearly all the cranial nerves, 

 and with which several small ganglia, arranged 

 in different parts of the skull, are connected. 

 From the gangliated cords branches also pass 

 inwards for the supply of the bloodvessels, as 

 well as to almost all the different viscera in 

 the body. These branches are remarkable 

 for their tendency to form plexuses, from 

 which subsidiary branches are sent off to the 

 various viscera in their vicinity. Connected 

 with these plexuses, as well as with the 

 branches which pass off from them, are nu- 

 merous ganglia of different sizes. 



This nerve has been variously named by 

 authors. The older anatomists described 

 it under the name of the great intercostal 

 nerve. From the fact of its being chiefly dis- 

 tributed to the viscera belonging to the cir- 

 culatory, digestive and generative systems, it 

 was termed by Chaussier the trisplanchnic 

 nerve ; and under the supposition that it alone 

 influences the organic processes, it was termed 

 by Bichat the nervous system of organic life. 

 The name sympathetic, or great sympathetic, 

 was given it by Winslow, from its being be- 

 lieved to be the channel through which are 

 effected the different sympathies sometimes 

 found to exist between distant organs when 

 in a morbid condition. 



For the sake of description the sympa- 

 thetic may be regarded as consisting of two 

 portions ; the one corresponding to the right 

 and left gangliated cords situated on each side 

 of the vertebral column, the other to the dif- 

 ferent plexuses occurring on the branches 

 which are sent inwards for the supply of the 

 viscera and bloodvessels. It is commonly 

 further subdivided into a cervical, thoracic, 

 lumbar, and sacral portion. In the following 



account of its descriptive anatomy it is pro- 

 posed to describe, 1st, the gangliated cord of 

 the sympathetic, and 2nd the different plexuses 

 formed by its branches in the several regions 

 of the body already specified. 



I. Cervical Portion of the Gangliated Cord. 

 The cervical portion of each gangliated cord 

 lies in front of the vertebral column, separated 

 from it by the rectus capitis anticus major 

 and longus colli muscles. It is situated behind 

 the internal and common carotid arteries, the 

 internal jugular vein, and pneumogastric nerve. 

 It presents commonly but three ganglia, named, 

 according to their situation, superior, middle, 

 and inferior. 



1. The superior cervical ganglion is situated 

 at the upper and lateral part of the neck, in 

 front of the transverse processes of the second 

 and third cervical vertebrae, upon the rectus 

 capitis anticus major muscle, behind and to 

 the inner side of the internal carotid artery 

 and the pneumogastric and glossopharyngeal 

 nerves, with the sheath of which it is more or 

 less intimately connected by some cellular 

 tissue. It is the largest of the ganglia in the 

 sympathetic cord ; it varies considerably in 

 its form and size. In general it presents an 

 elongated oval, or spindle-shape, and mea- 

 sures from 4 to 8 lines in length, 2 to 3 in 

 breadth, and about l in thickness. Accord- 

 ing to Flourens it is generally bifurcated at 

 its lower extremity, and frequently presents 

 a constriction about its middle which appears 

 to divide it into an upper and lower portion. 

 The branches connected with this ganglion are 

 the following : 



() Communicating branches pass between 

 it and the three or four upper cervical nerves. 

 They vary in number, and are connected with 

 the posterior aspect of the ganglion. It also 

 forms communications with the pneumo- 

 gastric, hypoglossal, and glossopharyngeal 

 nerves. The branch of communication with 

 the ninth, or hypoglossal nerve, consisting of 

 one or two delicate filaments, joins it near the 

 base of the skull. This communication is 

 regarded by Scemmering, Cloquet, Hirzel and 

 others as very rarely existing. In twelve bo- 

 dies examined by the latter, he found it pre- 

 sent only twice. Arnold, Longet and others 

 regard the communication as constant. The 

 communication with the pneumogastric nerve 

 is twofold. One small branch passes between 

 the superior cervical ganglion itself and the 

 ganglion on the trunk of the vagus; another 

 branch, also of small size, passes upwards from 

 the ascending branch of the superior cervical 

 ganglion, and divides at the base of the skull 

 into two filaments, one of which becomes con- 

 nected with the ganglion of the root of the 

 pneumogastric, while the other terminates in 

 the petrosal ganglion of the glossopharyngeal 

 nerve. 



(/;) Ascending or Carotid Branch. This 

 branch may be regarded as a prolongation up- 

 wards of the sympathetic cord. It is soft, 

 and presents a more or less greyish-red aspect. 

 On approaching the inferior orifice of the 



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