Morphological investigations of the cervicothoracic sympathetic system in the horse (Equus ferrus caballus) in Egypt / Investigaciones morfológicas del sistema simpático cervicotorácico en el caballo (Equus ferrus caballus) en Egipto

The current study was performed on twelve healthy adult horses (E. ferrus caballus) collected from Egypt were dissected to provide anatomical descriptions of bilaterally cervicothoracic sympathetic system macroscopically. On the left side, cervicothoracic sympathetic system is represented only by the caudal cervical ganglion, which presents on lateral surface of esophagus, cranial to the level of first rib. On right side, cervicothoracic sympathetic system is represented by the caudal and middle cervical ganglion. Caudal cervical ganglion was consisted of the fusion of eighth cervical and first three thoracic nerve ganglia. Caudal directed continuation branch of left ansa subclavia gave off a pericardial branch and then gave branch for ligamentum arteriosum. There are special sympathetic­parasympathetic communicating branches; on left side, there is only one branch that was present on lateral surface of esophagus, while on right side, there were four branches; two from caudal cervical ganglion and two from middle cervical ganglion. The most suitable site of ganglion blocks from both sides; needle was placed medioventrally between the articulation of first and second rib.

Doce caballos (E. ferrus caballus) adultos sanos, procedentes de Egipto, fueron disecados para realizar descripciones anatómicas macroscópicas del sistema simpático cervicotorácico bilateralmente. En el lado izquierdo, el sistema simpático cervicotorácico estuvo representado sólo por el ganglio cervical caudal, en la superficie lateral del esófago, craneal en relación a la primera costilla. En el lado derecho, el sistema simpático cervicotorácico estuvo representado por los ganglios caudal y cervical medio. El ganglio cervical caudal consistió en la fusión del octavo ganglio cervical y el primero de los tres ganglios torácicos. Se observaron ramos comunicantes entre los sistemas simpático y parasimpático; en el lado izquierdo, sólo hubo una rama presente en la superficie lateral del esófago, mientras que en el lado derecho, se observaron cuatro ramos: dos del ganglio cervical caudal y dos del ganglio cervical medio. El sitio más adecuado para la ejecución de los bloqueos ganglionares de ambos lados es a nivel medioventral, entre la articulación de la primera con la segunda costilla.

Topography and morphology of the bovine cranial cervical ganglion and its branches / Topografía y morfología del ganglio cervical craneal bovino y sus ramos

A detailed submacroscopic anatomical study of the cranial cervical ganglion (CCG) and its branches with its adjoining structures was carried out by examining 14 halves of seven heads of Holstein cattle under a magnifying lens to provide comprehensive descriptions with color photographs of the location, relation to neighboring structures, morphometry, and morphology of CCG and its branches. Our results were compared with previously nerves including jugular nerve; internal and external carotid nerves extremely, obtained morphological data on CCG in other ungulates to clarify the detailed comparative anatomy of CCG among them. The morphology of CCG and its branches in bovine was significantly and tangibly different from that of in other reported ungulates, especially in the direction of the ventral and dorsal poles of CCG being caudodorsal and rostroventral respectively, being larger and slightly more rostral, covered laterally by the dorsal part of the stylohyoid bone and caudal stylopharyngeus muscle, close relation of CCG to the medial retropharyngeal lymph node, wider distributions of external carotid nerve and its plexus to the adjacent arteries and visceral structures, lacking a communicating branch with the cervical spinal nerve, although all typical branches including the jugular nerve, carotid sinus branch, internal and external carotid nerves, communicating branches to vagus, glossopharyngeal, hypoglossal, cranial laryngeal, pharyngeal branch of vagus nerves, and close relationship between CCG and the longus capitis muscle, vagus nerve, and internal carotid artery were almost consistently present among the ungulates. The site of origin and the number of the major nerves including jugular nerve, internal and external carotid nerves extremely differed among the ungulates.

Se realizó un estudio anatómico submi-croscópico detallado del ganglio cervical craneal (GCC) y sus ramos, con las estructuras adyacentes, mediante el examen de 14 hemicabezas, correspondientes a siete cabezas de ganado Holstein, bajo aumento, para proporcionar descripciones completas; además se tomaron fotografías a color de la ubicación, su relación con estructuras vecinas y la morfometría y morfología del GCC y sus ramos. Se compararon los resultados obtenidos relacionados con los nervios, incluyendo las arterias carótidas interna y externa; los datos morfológicos obtenidos del GCC de otros ungulados tal vez aclaren la anatomía comparativa detallada del GCC entre los ungulados. Encontramos diferencia significativas en la morfología del GCC y sus ramos en comparación con otros ungulados reportados en la literatura, particularmente en la dirección de los polos ventral y dorsal del GCC, siendo estos caudodorsal y rostroventral respectivamente, presentándose más grande y ligeramente más rostral, cubierto lateralmente por la parte dorsal del hueso estilohioídeo y el músculo estilofaríngeo caudal. Se evidenció una estrecha relación del GCC con los nodos linfáticos retrofaríngeos mediales, con distribuciones más amplias del nervio carotídeo interno y el plexo adyacente a las arterias y estructuras viscerales, careciendo de un ramo comunicante con el nervio espinal cervical. En todos los ungulados se encontraron consistentemente todos los ramos nerviosos típicos, incluyendo el nervio yugular, el ramo del seno carotídeo, los nervios carotídeos interno y externos, los ramos comunicantes para el nervio vago, glosofaríngeo, hipogloso, laringeo craneal, ramo faríngea del nervio vago, y la estrecha relación entre el GCC y el músculo largo de la cabeza, el nervio vago y la arteria carótida interna. Se determinaron diferencias importantes en el sitio y origen de la mayoría de los nervios, incluyendo el nervio yugular y los nervios carotídeos interno y externos.

Revisitando a fisiologia do sistema nervoso simpático: o que há de novo? / Facing sympathetic nervous system physiology: what's new?

o sistema nervoso autônomo (SNA), descrito no inicio do século passado, é definido como sendo o sistema de neurônios motores que inervam as glândulas e a musculatura lisa e cardíaca, sendo fundamental para a manutenção do equilibrio organismo, definindo esta situação com o termo "homeostasia", Atualmente, entretanto, reconhece-se que este sistema também apresenta neurônios sensoriais (neurônios aferentes), que transmitem as informações recebidas de receptores sensoriais autonômicos, principalmente viscerais, para o sistema nervoso central. O termo autônomo, hoje consagrado, vem da ideia de que este sistema atuava somente de forma autônoma; no entanto, hoje se admite que a atividade deste sistema é gerada, ou pelo menos supervisionada, pelo sistema nervoso central. A ativação e a desativação tônicas e reflexas de seus dois componentes, simpático e do parassimpático, determinam em condições fisiológicas ajustes do débito cardíaco e da resistência vascular periférica, contribuindo para a estabilização e manutenção da pressão arterial sistêmica durante diferentes situações fisiológicas, ampliando a capacidade de adaptação e sobrevivência do organismo. Neste contexto, o termo disautonomia se refere àquelas condições em que a função autonômica se modificou de maneira a contribuir negativamente para a saúde. Estas mudanças têm sido quantificadas e têm permitido estimar a contribuição da hiperatividade simpática na instalação e na manutenção da doença cardiovascular. Neste artigo, são revisados aspectos anatômicos e funcionais do sistema nervoso simpático e parassimpático, destacando os principais métodos de avaliação do SNA, bem como o papel da hiperatividade simpática como mecanismo desencadeador e de agravamento de disfunções cardiovasculares.

The autonomic nervous system (ANS) described at the beginning of the last century is defined as the system of motor neurons that innervate glands as well as smooth and cardiac musc/es essential for maintaining the body's balance, defining this situation with the term "homeostasis". Current1y, however it is recognized that this system also provides sensory neurons (afferent neurons) that transmit information received from sensory autonomic receptors mainly visceral to the central nervous system. The use of the term autonomic comes from the idea that this system acts only in autonomic way; however, nowadays it is accepted that the activity of this system is generated or at least supervised by the central nervous system. The tonic and reflex acti vation and deacti vation of both of its components, the sympathetic and the parasympathetic system, can determine adjustments in cardiac output and peripheral vascular resistance contributing to the stabilization and maintenance of systemic blood pressure during different physiological situations, expanding the capacity of adaptation and survival of the organismo ln this context, the terrn dysautonomia refers to those conditions in which autonomic function was changed in a way that negatively contribute to health. These changes have been quantified and have alJowed to estimate the contribution of sympathetic hyperactivity in the installation and maintenance of cardiovascular disease. In this manuscript anatomical and functional, sympathetic and parasympathetic nervous system aspects are reviewed, highJighting key evaluation methods of ANS and the role of sympathetic overacti vity as a trigger and as a worsening mechanism that can contribute to cardiovascular dysfunctions.

Histomorphometric and sympathetic innervation of the human internal thoracic artery

INTRODUCTION: Internal thoracic artery (ITA) is an established arterial graft for the coronary artery by-pass surgery. Special micro-anatomical features of the ITA wall may protect it from age related pathological changes. One of the complications seen after coronary artery bypass grafting is vasospasm. Sympathetic nerves may be involved in vasospasm. OBJECTIVE: To ascertain the sympathetic innervation of the internal thoracic artery and to assess the effect of aging on this artery by histomorphometry. METHOD: Fifty-four human internal thoracic artery samples were collected from 27 cadavers (19 male and 8 female) with ages of 19 to 83 years. Samples were divided into three age groups: G1, 19-40 years; G2, 41-60 years; G3, >61 years. Sections (thickness 5 mm) of each sample were taken and stained with hematoxylin-eosin and Verhoeff-Van Gieson stains. Five of fifty-four samples were processed for tyrosine hydroxylase immunostaining. RESULTS: The thickness of the tunica intima was found to be constant in all age groups, whereas the thickness of the tunica media decreased in proportion to age. Verhoeff-Van Gieson staining showed numerous elastic laminae in the tunica media. Significant differences (p<0.0001) in the number of elastic laminae were found between G1 with G2 cadavers, between G2 and G3 cadavers and between G3 and G1 cadavers. Tyrosine hydroxylase immunostaining demonstrated sympathetic fibers, located mainly in the tunica adventitia and the adventitia-media border. The sympathetic nerve fiber area and sympathetic index were found to be 0.0016 mm² and 0.012, respectively. DISCUSSION: Histology of the ITA showed features of the elastic artery. This may be associated with lower incidence of Atherosclerosis or intimal hyperplasia in ITA samples even in elderly cases. Low sympathetic index (0.012) of ITA may be associated with fewer incidences of sympathetic nervous systems problems (vasospasm) of the ITA. CONCLUSION: Sympathetic ...

Sympathetic Nerve Reconstruction for Compensatory Hyperhidrosis after Sympathetic Surgery for Primary Hyperhidrosis

We performed sympathetic nerve reconstruction using intercostal nerve in patients with severe compensatory hyperhidrosis after sympathetic surgery for primary hyperhidrosis, and analyzed the surgical results. From February 2004 to August 2007, sympathetic nerve reconstruction using intercostal nerve was performed in 19 patients. The subjected patients presented severe compensatory hyperhidrosis after thoracoscopic sympathetic surgery for primary hyperhidrosis. Reconstruction of sympathetic nerve was performed by thoracoscopic surgery except in 1 patient with severe pleural adhesion. The median interval between the initial sympathetic surgery and sympathetic nerve reconstruction was 47.2 (range: 3.5-110.7) months. Compensatory sweating after the reconstruction surgery improved in 9 patients, and 3 out of them had markedly improved symptoms. Sympathetic nerve reconstruction using intercostal nerve may be one of the useful surgical options for severe compensatory hyperhidrosis following sympathetic surgery for primary hyperhidrosis.

Bloqueo del ganglio estrellado en el dolor simpáticamente mantenido del miembro superior / Stellate ganglion block to treat upper limb pain maintained by sympathetic activity

Introucción: El bloqueo del ganglio estrellado (BGE) es un procedimiento diagnóstico y terapéutico empleado en el dolor neuropático simpáticamente mantenido del miembro superior. Objetivos: a) hacer una introducción de la historia del abordaje de las estructuras simpáticas en el tratamiento del dolor y la anatomía del sistema simpático cervicotorácico; b) reseñar las técnicas descriptas para el BGE, enumerando sus principales indicaciones, efectos colaterales y complicaciones; c) comentar la fisiopatología relacionada con la genésis de los cuadros de dolor simpáticamente mantenido (DSM); d) presentar un estudio de cohorte única "antes y después" realizado en 12 pacientes con diagnóstico clínico de dolor simpáticamente mantenido de miembro superior tratados con esta técnica. Material y Métodos: en primer lugar se presenta una revisión no sistemática de los aspectos más relevantes del BGE, describiendo las técnicas de abordaje, sus indicaciones, contraindicaciones, efectos colaterales y complicaciones, con una especial alusión a la fisiopatología del DSM. En segundo lugar se presenta un estudio de cohorte única compuesta por doce pacientes portadores de diversos síndromes dolorosos neuropáticos, cuya perpetuación suponía una mayor o menor activación del sistema simpático. Además se presentan los datos epidemiológicos, tabulados y la respuesta al tratamiento intervensionista de los casos tratados. Institución: Unidad Docente-Asistencial de la Fundación Dolor de la AAARBA; Htal. Gral. de Agudos "Dr. J.M. Ramos Mejía" del GCBA. Discusión: procedimiento analgésico descrito a comienzos del siglo XX por Leriche, en EE.UU., para el alivio del dolor causálgico y de la distrofia simpática refleja del miembro superior, el BGE tuvo gran auge a partir de la Segunda Guerra Mundial en el tratamiento del dolor originado en graves lesiones traumáticas de las extremidades superiores. Un mayor conocimiento fisiopatológico del dolor llevó a relacionar los mecanismos de neuroplasticidad descubiertos con la activación anómala y la sensibilización del sistema nervioso, tanto en sus componentes periféricos como centrales y simpáticos, contribuyendo a la genésis y perpetuación del dolor o explicando, al menos parcialmente, algunos epifenómenos acompañantes. A fines del siglo XX, la escasez de estudios de alta evidencia científica que dieron soporte a la eficacia de estas técnicas y a la existencia de síndromes específicos de DSM...