Appendix – Anatomy
ventral rami of C1, C2, C3, C4 form the cervical plexus. C1 runs along hypoglossal and supplies geniohyoid and thyrohyoid. It also gives superior limb of ansa cervical, which supplies superior belly of omohyoid and joins wit \h inferior limb to form ansa. The inferior limb of ansa cervical is formed by ventral rami of C2, C3. Branches from ansa supply sternohyoid, sternothyroid, inferior belly of omohyoid. Cervical plexus also gives four cutaneous branches lesser occipital (C2) great auricular (C2, C3), supraclavicular (C3, C4) and transverse or anterior nerve of a neck (C2, C3).
Phrenic nerve arises primarily from ventral rami of C4 with small contributions from C3 and C5 nerve roots or through a nerve to subclavius. It is the only motor supply to its own half of diaphragm and sensory to mediastinal pleura, peritoneum, and fibrous pericardium. Inflammation of peritoneum under diaphragm causes referred pain in the area of supraclavicular nerves supply, the especially tip of the shoulders as their root values is also ventral rami of C3 and C4.
Branches of cervical sympathetic ganglia of the sympathetic trunk.
Situation: The submandibular ganglion lies superficial to hyoglossus muscle in the submandibular region. Functionally, it is connected to the facial nerve, while topographically it is connected to the lingual branch of the mandibular nerve.
The ganglion has sensory, sympathetic and secretomotor roots.
- Sensory root is from the lingual nerve. it is suspended by two roots of lingual nerve.
- Sympathetic root is from the sympathetic plexus around the facial artery. This plexus contains postganglionic fibers from the superior cervical ganglion of the sympathetic trunk. these fibers pass express through the ganglion and are vasomotor to the gland.
- Parasympathetic/secretomotor root is from superior salivatory nucleus through nerves intermedium via chords timpani which is a branch of cranial nerve VII. Chorda tympani joins lingual nerve. The parasympathetic fibers get relayed in the submandibular ganglion.
The ganglion gives direct branches to the submandibular salivary gland.
Some postganglionic fibers reach the lingual nerve to be distributed to the sublingual salivary gland.
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