Thoracic part of Sympathetic Chain

1. Thoracic Part of
Sympathetic Chain
(Page 128)
Dr.Sherif Fahmy

2. Course & Relations
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3. Thoracic part of
Sympathetic
chain
Cervical part of
sympathetic
chain
Medial arcuate
lig. of diaphragm
Abdominal part of
sympathetic chain
Neck of 1st
rib
Dr.Sherif Fahmy

4. Sympathetic
chain
Medial arcuate
ligament
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5. Structure
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6. Sympathetic
ganglion
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7. Branches
- Rami communicants to
corresponding intercostal nerves.
- To autonomic plexuses in thorax.
- To aorta.
- To abdominal organs through
splanchnic nerves.
Dr.Sherif Fahmy

8. Dr.Sherif Fahmy

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10. Dr.Sherif Fahmy

11. Dr.Sherif Fahmy

12. Greater
splanchnic nerve
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13. Applied Anatomy
1- Spinal anesthesia at high level may
lead to temporary drop of blood
pressure.
2- In case of essential hypertension,
cutting of sympathetic chain between
T2 & T5 will lead to drop of blood
pressure.
Dr.Sherif Fahmy

14. Autonomic Plexes
(Page 136)
1- Pulmonary Plexuses.
2-Oesophageal plexuses.
3- Cardiac plexuses
(superficial and deep).
Dr.Sherif Fahmy

15. 1- Pulmonary Plexus
(Posterior & Anterior)
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17. Dr.Sherif Fahmy

18. 2- Oesophageal Plexus
(Anterior & Posterior)
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19. Dr.Sherif Fahmy

20. 3- Cardiac Plexus
(Superficial & Deep)
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22. Dr.Sherif Fahmy

23. Lymphatic Drainage
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24. Dr.Sherif Fahmy

25. Thoracic Lymph
Drainage
A- From Chest wall.
B- From thoracic contents.
Dr.Sherif Fahmy

26. A- From Chest Wall
1- Superficial lymph vessels:
- From front of chest to pectoral
lymph nodes, parasternal or lower
deep cervical lymph nodes.
- From back of chest to subscapular
nodes. Dr.Sherif Fahmy

27. 2- Deep lymph vessels:
A- From anterior chest wall to
parasternal nodes.
B- Posterior part of chest wall to
intercostal lymph nodes (opposite
neck of ribs).
C- Four diaphragmatic nodes
(anterior, posterior and 2 lateral)
which drain diaphragm and liver.
Dr.Sherif Fahmy

28. B- from Thoracic
Contents
1- Anterior mediastinal nodes.
2- Posterior mediastinal nodes.
3- Nodes of lungs, bronchi and
trachea.
Dr.Sherif Fahmy

29. •Lymph vessels from:
-Anterior mediastinal nodes.
-Tracheal lymph nodes.
-Parasternal lymph nodes.
Will unit together to form broncho-
medistinal lymph vessels which joins
thoracic duct on left side and right
lymphatic duct in right side.
Dr.Sherif Fahmy

30. Deep lymph nodes of chest wall
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31. Anterior
mediastinal
nodes
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32. Dr.Sherif Fahmy

33. Dr.Sherif Fahmy

34. Dr.Sherif Fahmy

35. Thoracic Duct
(Page 121)
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36. Dr.Sherif Fahmy

37. Cisterna chyli
Aortic opening
of diaphragme
Left brachio-cephalic
vein
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38. Dr.Sherif Fahmy

39. Tributaries of Thoracic Duct
1- Lymph from intestine, abdominal wall
and lower limb through cisterna chyli.
2- Left broncho-mediastinal lymph
vessels.
3- Left subclavian lymph vessels.
4- left jugular lymph vessels.
5- posterior mediatinal lymph nodes.
Dr.Sherif Fahmy

40. Dr.Sherif Fahmy

41. Esophagus
(Page 117)
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42. Parts & Course
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43. Level of C6 vertebra
Diaphragm
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44. Shape, Size and
Curves
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45. Dr.Sherif Fahmy

46. Relations
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47. Posterior
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48. Anterior
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49. Left & Right
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50. Constrictions
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51. Beginning
Esophageal
openning of
diaphragme
At level of left
bronchus
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53. Nerve Supply
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56. Blood Supply
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57. Left & Right
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58. Applied Anatomy
1- Impaction of food.
2- Barium swallow to
determine enlargement of
left atrium.
3- Esophageal varices.
Dr.Sherif Fahmy