Anatomical Science International

, Volume 86, Issue 1, pp 30–49 | Cite as

Anatomy of the cardiac nervous system with clinical and comparative morphological implications

Review Article

Abstract

Unlike autonomic nervous preservation in other surgeries for improving patient quality of life, autonomic cardiac nervous system (ACNS) preservation has been neglected in cardiovascular surgery because of technical difficulties and other unsolved issues. Because such ACNS preservation in cardiovascular surgery is anticipated in the future, detailed anatomical investigation of the human ACNS is required. Therefore, we have conducted morphological studies of the ACNS from macroscopic, clinical, and evolutionary anatomical viewpoints. In this study, I review detailed anatomical studies of the human ACNS together with their clinical implications. In addition, the evolutionary comparative anatomical significance of primate ACNS is also summarized to help understand and translate the findings of functional experiments to humans. These integrated findings will be the subject of a future study unifying molecular embryological and anatomical findings to clarify cardiac functions based on functional animal experiments, clinical applications such as improving surgery techniques and individual order-made surgery in cardiac surgery, and for future evaluation in regenerative medicine.

Keywords

Autonomic cardiac nervous system Clinical anatomy Comparative anatomy Evolution Primate Human heart Cardiac nerve Cardiac branch 

Abbreviations

AA

Ascending aorta

AI

Superior interventricular artery (anterior interventricular/descending branch of the coronary artery)

aMG

Accessory middle cervical ganglion

Ao

Aorta

Az

Azygos vein

AV

Anterior cardiac vein

BC

Brachiocephalic trunk

BP

Brachial plexus

Br-A

Bronchial artery

CB

Circumflex branch of the coronary artery

CC

Common carotid artery

CT

Cervicothoracic (stellate) ganglion

C1-8

First to eighth cervical nerves

Es

Esophagus

GV

Great cardiac vein

IB

Inferior (vagal) cardiac branch

IG

Inferior cervical ganglion

IN

Inferior cervical cardiac nerve

IVC

Inferior caval vein

L

Nerve branches to the lung

LA

Left atrium

LC

Left common carotid artery

LCA

Left coronary artery

LS

Left subclavian artery

LSVC

Left superior vena cava

LV

Left ventricle

MG

Middle cervical ganglion

MN

Middle cardiac nerve

NX

Vagus nerve

OV

Oblique vein of the left atrium

P

Pectoral nerve

PA

Pulmonary artery

PC

Pericardium

Ph

Phrenic nerve

PT

Pulmonary trunk

PV

Pulmonary vein

PVi

Inferior pulmonary vein

PVs

Superior pulmonary vein

RA

Right atrium

RC

Right common carotid artery

RCA

Right coronary artery

RERSA

Retroesophageal right subclavian artery

RL

Recurrent laryngeal nerve of the vagus nerve

RS

Right subclavian artery

RSVC

Right superior vena cava

RV

Right ventricle

SAN-B

Sinuatrial nodal branch of the coronary artery

SB

Superior (vagal) cardiac branch

SbC

Nerve to the subclavian muscle

SG

Superior cervical ganglion

SN

Superior cardiac nerve

SVC

Superior caval vein

TB

Thoracic (vagal) cardiac branch

TN

Thoracic cardiac nerve

T1-6

First to sixth thoracic nerves

VA

Vertebral artery

VG

Vertebral ganglion

VN

Vertebral nerve

X

Vagus nerve

XI

Accessory nerve

XII

Hypogastric nerve

2TG–6TG

Second to sixth thoracic ganglia

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Copyright information

© Japanese Association of Anatomists 2010

Authors and Affiliations

  1. 1.Department of Anatomy, School of MedicineTokyo Women’s Medical UniversityTokyoJapan

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