Summary
The segmental organization of the thoracic sympathetic trunk and all its ramifications was studied in 6 human fetuses (16–22 weeks) by means of the acetylcholinesterase in toto staining method. Each trunk was divided into 12 sympathetic segments. A segment is defined as that part of the sympathetic trunk which is connected via its rami communicates with one spinal nerve, without discriminating between grey and white rami. The diameter of the rami communicantes and their direction towards the spinal nerves are variable. The number of peripheral segmental ramifications of the trunk is much larger than assumed previously. Each thoracic sympathetic segment gives off at least 4–5 nerves. Three categories of nerves are discerned: (1) large splanchnic rootlets confined to the greater, lesser and least thoracic splanchnic nerves, (2) medium-sized splanchnic nerves directed towards thoracic viscera, some of which give off branches towards costovertebral joint plexuses and, described for the first time in man, (3) small nerves which ramify extensively and form nerve plexuses in the capsule of the costovertebral joints. The majority of the ramifications is formed by the nerves of the third category. The existence of Kuntz's nerve, connecting the 2nd intercostal nerve and 1st thoracic spinal nerve, is confirmed in four specimens. The nerve plexuses of the costovertebral joints receive a segmentally organized innervation: they receive their input from the neighbouring sympathetic segment and the one cranial to it.
It is concluded that the thoracic sympathetic branches in man show a complex, segmentally organized pattern and may have a considerable component of somatosensory nerve fibers. The complex relationships must be taken into account in surgical sympathectomies.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Baker DG, McDonald DM, Basbaum CB, Mitchell RA (1986) The architecture of nerves and ganglia of the ferret trachea as revealed by acetylcholinesterase histochemistry. J Comp Neurol 246:513–526
Baljet B, Drukker J (1975) An acetylcholinesterase method for in toto staining of peripheral nerves. Stain Technol 50:31–36
Baljet B, Drukker J (1979) The extrinsic innervation of the abdominal organs in the female rat. Acta Anat 104:243–267
Baljet B, Drukker J (1981) Some aspects of the innervation of the abdominal and pelvic organs in the human female fetus. Acta Anat 111:222–230
Baljet B, Boekelaar AB, Groen GJ (1985) Retroperitoneal paraganglia and the peripheral autonomic nervous system in the human fetus. Acta Morphol Neerl-Scand 23:137–149
Baljet B, Groen GJ (1986) Some aspects of the peripheral nervous system in the human fetus as revealed by the acetylcholinesterase in toto staining method. Acta Histochem [Suppl] 32:69–75
Braeucker W (1927) Der Brustteil des vegetativen Nervensystems und seine klinisch chirurgische Bedeutung. Beitr Klin Tuberk 66:1–65
Boyd JD (1957) Intermediate sympathetic ganglia. Br Med Bull 13:207–213
Deuschl G, Illert M, Aschoff A, Holländer H (1981) Single preganglionic sympathetic neurons of the cat branch intraspinally and project through different rami communicantes albi—a retrograde double labelling study with fluorescent tracers. Neurosci Lett 21:1–5
Holt SJ, Hobbiger EE, Pawan GLS (1959) Preservation of integrity of rat tissues for cytochemical staining purposes. J Biophys Biochem Cytol 7:383–386
Hovelacque A (1927) Anatomie des nerfs craniens et rachidiens et du système grand sympathique chez l'homme. Doin, Paris
Karnovsky MJ, Roots L (1964) A “direct-colouring” thiocholine method for cholinesterases. J Histochem Cytochem 12:219–221
Kuntz A (1927) Distribution of the sympathetic rami to the brachial plexus: its relation to sympathectomy affecting the upper extremity. Arch Surg Chicago 15:871–877
Kuntz A (1953) The autonomic nervous system (4th edn) Lea & Febiger, Philadelphia
Kuntz A (1956) Components of splanchnic and intermesenteric nerves. J Comp Neurol 105:251–268
Kuo DC, Yamasaki DS, Krauthamer GM (1980) Segmental organization of sympathetic preganglionic neurons of the splanchnic nerve as revealed by retrograde transport of horseradish peroxidase. Neurosci Lett 17:11–16
Larnicol N, Rose D, Marlot D, Duron B (1982) Spinal localization of the intercostal motoneurones innervating the upper thoracic spaces. Neurosci Lett 31:13–18
Lemmens HAJ (1979) Thoracodorsal sympathectomy en bloc. In: Greep JM, Lemmens HAJ, Roos DB, Urschel HC (eds) Pain in shoulder and arm: an integrated view, Martinus Nijhoff, The Hague Boston London
Lemmens HAJ, Drukker J (1985) Thoracodorsal sympathectomy en bloc. Anatomical variations versus results. In: Gelderman PW (ed) Symposium on pathological blushing and sweating. Acta Neurochir 74:148–157
Lobstein JF (1823) De nervi sympathici humani fabrica. FG Lavrault, Paris
Low PA, Dyck PJ (1978) Splanchnic preganglionic neurons in man. III. Morphometry of myelinated fibers of rami communicantes. J Neuropath Exp Neurol 37:734–740
Malinský J (1959) The ontogenetic development of nerve terminals in the intervertebral discs of man. Acta Anat 38:96–113
Mitchell GAG (1953) Anatomy of the Autonomic Nervous System, Livingstone, Edinburgh London
Mizeres NJ (1955) The anatomy of the autonomic nervous system of the dog. Am J Anat 96:285–318
Monro PAG (1959) Sympathectomy, Oxford University Press, London
Nomina Anatomica (1983) (5th edn), Williams & Wilkins, Baltimore London
Pick J, Sheehan D (1946) Sympathetic rami in man. J Anat 80:12–20
Pick J (1957) The identification of sympathetic segments. Ann Surg 145:355–364
Pick J (1970) The autonomic nervous system. Morphological, comparative, clinical and surgical aspects. Lippincott, Philadelphia
Potts TK (1925) The main peripheral connections of the human sympathetic nervous system. J Anat 59:129–135
Rhede van der Kloot E van, Drukker J, Lemmens HAJ, Greep JM (1986) The high thoracic sympathetic nerve system-its anatomic variability. J Surg Res 40:112–119
Rubin E, Purves D (1980) Segmental organization of sympathetic preganglionic neurons in the mammalian spinal cord. J Comp Neurol 192:163–174
Saccomanno G (1943) The components of the upper thoracic sympathetic nerves. J Comp Neurol 79:355–378
Sheehan D, Pick J (1943) The rami communicantes in the rhesus monkey. J Anat 77:125–139
Stilwell DL (1956) The nerve supply of the vertebral column and its associated structures in the monkey. Anat Rec 125:139–169
Streckfuss H (1931) Untersuchungen über die ganglionäre Natur des Nervus Splanchnicus major beim Menschen. Z Anat Entwicklungsgesch 96:473–487
Van den Broek AJP (1908) Untersuchungen über den Bau des sympathischen Nervensystems der Säugetiere. Morphol Jb 38:532–589
Vrettos XC, Wyke BD (1974) Articular reflexogenic systems in the costovertebral joints. J Bone Joint Surg 56B:382
White JC, Smithwick RH, Simeone FM (1952) The autonomic nervous system. McMillan, New York
White JC, Sweet W (1969) Pain and the neurosurgeon. Ch Thomas, Springfield III
Wrete M (1943) Die intermediären vegetativen Ganglien der Lumbalregion beim Menschen. Z Mikrosk Anat Forsch 53:122–133
Wrete M (1959) The anatomy of the sympathetic trunks in man. J Anat 93:448–459
Wyke BD (1967) The neurology of joints. Ann R Coll Surg Engl 41:25–50
Wyke BD (1975) Morphological and functional features of the innervation of the costovertebral joints. Folia Morphol 23:296–305
Zuckerman S (1938) Observations on the autonomic system and on vertebral and neural segmentation in monkeys. Trans Zool Soc Lond 23:315–378
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Groen, G.J., Baljet, B., Boekelaar, A.B. et al. Branches of the thoracic sympathetic trunk in the human fetus. Anat Embryol 176, 401–411 (1987). https://doi.org/10.1007/BF00310082
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00310082