Nerves of the Thoracic Region
Nerve: Abdominopelvic splanchnic
Origin: Lower thoracic and lumbar segments of sympathetic trunk
Course: Passes medially and inferiorly to prevertebral ganglion of paraaortic plexus
Innervation: Abdominopelvic blood vessels and viscera
Nerve: Cardiac plexus
Origin: Cervical and cardiac branches of vagus nerve and cardiopulmonary splanchnic nerve from sympathetic trunk
Course: From arch of aorta, posterior surface of heart, extends along coronary arteries and to SA node
Innervation: SA nodal tissue, coronary arteries; parasympathetic fibers slow rate, reduce force of heartbeat, constrict arteries; sympathetic fibers have opposite effect
Nerve: Cardiopulmonary splanchnic
Origin: Cervical and upper thoracic ganglia of sympathetic trunk
Course: Descends anteromedially to cardiac, pulmonary and esophageal plexuses
Innervation: Conveys postsynaptic sympathetic fibers to nerve plexuses of thoracic viscera
Nerve: Cervical splanchnic
Origin: Cervical ganglia of sympathetic trunk
Course: Pass medially and inferiorly to cardiac and pulmonary plexuses
Innervation: Conducting tissue and coronary arteries
Nerve: Esophageal plexus
Origin: Vagus nerve; sympathetic ganglia, greater splanchnic nerve
Course: Tracheal bifurcation, Vagus, and sympathetic nerve form plexus around esophagus
Innervation: Vagal and sympathetic fibers to smooth muscles and glands of inferior 2/3 of esophagus
Nerve: Greater splanchnic
Origin: Thoracic sympathetic ganglia
Course: Highest abdominopelvic splanchnic nerve; anteromedially passes on bodies of thoracic vertebrae, through diaphragm to celiac trunk
Innervation: Celiac ganglia, innervation of celiac arteries
Nerve: Intercostal
Origin: Anterior rami of T1-T11 nerves
Course: Intercostal spaces between internal and innermost layers of intercostal muscles
Innervation: Intercostal muscles; muscles of anterolateral abdominal wall; skin overlying pleura/peritoneum deep to muscles
Nerve: Lateral pectoral
Origin: Brachial plexus
Course: Clavipectoral fascia to deep surface of pectoral muscles
Innervation: Pectoralis major, medial pectoral nerve that innervates pectoralis minor
Nerve: Least splanchnic
Origin: 12th thoracic ganglion of sympathetic trunk
Course: Diaphragm with sympathetic trunk, ends in renal plexus
Innervation: Renal arteries and derivatives
Nerve: Lesser splanchnic
Origin: 10th and 11th thoracic ganglia of sympathetic trunk
Course: Descends anteromedially to perforate diaphragm to reach aorticorenal ganglion
Innervation: Prevertebral ganglia; visceral afferents from upper GI tract
Nerve: Lumbar splanchnic
Origin: Lumbar ganglia of sympathetic trunk
Course: Passes anteromedially on bodies of lumbar vertebrae to prevertebral ganglia of paraaortic plexus
Innervation: Lower abdominal wall and pelvic viscera; visceral afferents from same
Nerve: Medial pectoral
Origin: Medial cord of brachial plexus
Course: Passes between axillary artery and vein, enters deep surface of pectoralis minor
Innervation: Pectoralis minor and part of pectoralis major
Nerve: Pulmonary plexus
Origin: Vagus nerve, cardiopulmonary splanchnic nerve from sympathetic trunk
Course: Forms of primary bronchi, extends along root of lung and bronchial subdivisions
Innervation: Parasympathetic fibers constrict bronchioles; sympathetic fibers dilate them
Nerve: Recurrent laryngeal
Origin: Vagus nerve
Course: Subclavian on right; left runs around aortic arch, ascends in tracheoesophageal groove
Innervation: Intrinsic muscles of larynx (except cricothyroid); inferior to level of vocal cords
Nerve: Subcostal
Origin: Anterior ramus of T12 spinal nerve
Course: Inferior border of 12th rib in same manner as intercostal nerves
Innervation: Muscles of anterolateral abdominal wall; lateral cutaneous branch supplies skin inferior iliac crest
Nerve: Superior laryngeal
Origin: Vagus nerve
Course: Descends in parapharyngeal space; lateral to thyroid cartilage divides into internal and external laryngeal nerves; inferior pierces thyrohyoid membrane; runs inferomedially to gap between cricoid and thyroid cartilages
Innervation: Cricothyroid muscle; supraglottic
Nerve: Thoracic splanchnic
Origin: Thoracic ganglia of sympathetic trunk
Course: Anteromedially on thoracic vertebrae as lower cardiopulmonary splanchnic nerve to thoracic plexus; upper abdominopelvic splanchnic nerves to prevertebral ganglia of paraaortic plexuses
Innervation: 1st-5th splanchnic nerves; 6th-12th splanchnic nerves; thoracic ganglia; presynaptic sympathetic fibers to prevertebral ganglia
Nerve: Thoracoabdominal
Origin: Lower intercostal nerve
Course: Costal margin between 2nd and 3rd layers of abdominal muscles
Innervation: Anterolateral abdominal muscles; overlying skin, underlying peritoneum, periphery of diaphragm
Nerve: Thoracodorsal
Origin: Posterior cord of brachial plexus
Course: Between upper and lower subscapular nerves, runs inferolaterally along posterior axillary wall to latissimus dorsi
Innervation: Latissimus dorsi
Nerve: Vagus
Origin: Via 8-10 rootlets from medulla of brainstem
Course: Superior mediastinum posterior to sternoclavicular joint and brachiocephalic vein; gives rise to recurrent laryngeal nerve; continues into abdomen
Innervation: Voluntary muscle of larynx and upper esophagus; involuntary muscle/glands of tracheobronchial tree, gut, and heart via pulmonary, esophageal, and cardiac plexuses; pharynx, larynx, reflex afferents from same area as above
Origin: Lower thoracic and lumbar segments of sympathetic trunk
Course: Passes medially and inferiorly to prevertebral ganglion of paraaortic plexus
Innervation: Abdominopelvic blood vessels and viscera
Nerve: Cardiac plexus
Origin: Cervical and cardiac branches of vagus nerve and cardiopulmonary splanchnic nerve from sympathetic trunk
Course: From arch of aorta, posterior surface of heart, extends along coronary arteries and to SA node
Innervation: SA nodal tissue, coronary arteries; parasympathetic fibers slow rate, reduce force of heartbeat, constrict arteries; sympathetic fibers have opposite effect
Nerve: Cardiopulmonary splanchnic
Origin: Cervical and upper thoracic ganglia of sympathetic trunk
Course: Descends anteromedially to cardiac, pulmonary and esophageal plexuses
Innervation: Conveys postsynaptic sympathetic fibers to nerve plexuses of thoracic viscera
Nerve: Cervical splanchnic
Origin: Cervical ganglia of sympathetic trunk
Course: Pass medially and inferiorly to cardiac and pulmonary plexuses
Innervation: Conducting tissue and coronary arteries
Nerve: Esophageal plexus
Origin: Vagus nerve; sympathetic ganglia, greater splanchnic nerve
Course: Tracheal bifurcation, Vagus, and sympathetic nerve form plexus around esophagus
Innervation: Vagal and sympathetic fibers to smooth muscles and glands of inferior 2/3 of esophagus
Nerve: Greater splanchnic
Origin: Thoracic sympathetic ganglia
Course: Highest abdominopelvic splanchnic nerve; anteromedially passes on bodies of thoracic vertebrae, through diaphragm to celiac trunk
Innervation: Celiac ganglia, innervation of celiac arteries
Nerve: Intercostal
Origin: Anterior rami of T1-T11 nerves
Course: Intercostal spaces between internal and innermost layers of intercostal muscles
Innervation: Intercostal muscles; muscles of anterolateral abdominal wall; skin overlying pleura/peritoneum deep to muscles
Nerve: Lateral pectoral
Origin: Brachial plexus
Course: Clavipectoral fascia to deep surface of pectoral muscles
Innervation: Pectoralis major, medial pectoral nerve that innervates pectoralis minor
Nerve: Least splanchnic
Origin: 12th thoracic ganglion of sympathetic trunk
Course: Diaphragm with sympathetic trunk, ends in renal plexus
Innervation: Renal arteries and derivatives
Nerve: Lesser splanchnic
Origin: 10th and 11th thoracic ganglia of sympathetic trunk
Course: Descends anteromedially to perforate diaphragm to reach aorticorenal ganglion
Innervation: Prevertebral ganglia; visceral afferents from upper GI tract
Nerve: Lumbar splanchnic
Origin: Lumbar ganglia of sympathetic trunk
Course: Passes anteromedially on bodies of lumbar vertebrae to prevertebral ganglia of paraaortic plexus
Innervation: Lower abdominal wall and pelvic viscera; visceral afferents from same
Nerve: Medial pectoral
Origin: Medial cord of brachial plexus
Course: Passes between axillary artery and vein, enters deep surface of pectoralis minor
Innervation: Pectoralis minor and part of pectoralis major
Nerve: Pulmonary plexus
Origin: Vagus nerve, cardiopulmonary splanchnic nerve from sympathetic trunk
Course: Forms of primary bronchi, extends along root of lung and bronchial subdivisions
Innervation: Parasympathetic fibers constrict bronchioles; sympathetic fibers dilate them
Nerve: Recurrent laryngeal
Origin: Vagus nerve
Course: Subclavian on right; left runs around aortic arch, ascends in tracheoesophageal groove
Innervation: Intrinsic muscles of larynx (except cricothyroid); inferior to level of vocal cords
Nerve: Subcostal
Origin: Anterior ramus of T12 spinal nerve
Course: Inferior border of 12th rib in same manner as intercostal nerves
Innervation: Muscles of anterolateral abdominal wall; lateral cutaneous branch supplies skin inferior iliac crest
Nerve: Superior laryngeal
Origin: Vagus nerve
Course: Descends in parapharyngeal space; lateral to thyroid cartilage divides into internal and external laryngeal nerves; inferior pierces thyrohyoid membrane; runs inferomedially to gap between cricoid and thyroid cartilages
Innervation: Cricothyroid muscle; supraglottic
Nerve: Thoracic splanchnic
Origin: Thoracic ganglia of sympathetic trunk
Course: Anteromedially on thoracic vertebrae as lower cardiopulmonary splanchnic nerve to thoracic plexus; upper abdominopelvic splanchnic nerves to prevertebral ganglia of paraaortic plexuses
Innervation: 1st-5th splanchnic nerves; 6th-12th splanchnic nerves; thoracic ganglia; presynaptic sympathetic fibers to prevertebral ganglia
Nerve: Thoracoabdominal
Origin: Lower intercostal nerve
Course: Costal margin between 2nd and 3rd layers of abdominal muscles
Innervation: Anterolateral abdominal muscles; overlying skin, underlying peritoneum, periphery of diaphragm
Nerve: Thoracodorsal
Origin: Posterior cord of brachial plexus
Course: Between upper and lower subscapular nerves, runs inferolaterally along posterior axillary wall to latissimus dorsi
Innervation: Latissimus dorsi
Nerve: Vagus
Origin: Via 8-10 rootlets from medulla of brainstem
Course: Superior mediastinum posterior to sternoclavicular joint and brachiocephalic vein; gives rise to recurrent laryngeal nerve; continues into abdomen
Innervation: Voluntary muscle of larynx and upper esophagus; involuntary muscle/glands of tracheobronchial tree, gut, and heart via pulmonary, esophageal, and cardiac plexuses; pharynx, larynx, reflex afferents from same area as above
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