Cervicothoracic ganglion

Cervicothoracic ganglion (a.k.a. stellate ganglion) is a large ganglion which can be found as part of the cervical sympathetic trunk and is formed by the union of inferior cervical ganglion with the first thoracic ganglion. In only 20% of the cases the two don’t fuse and hence, can be found as separate inferior cervical and first thoracic ganglia. Anatomically, the cervicothoracic ganglion is situated anterior to the transverse process of seventh cervical vertebra C7 and the neck of the first rib, while posterior to the first part of subclavian artery and the origin of the vertebral artery.

The cervicothoracic ganglion (or inferior cervical ganglion, when present separately) receives preganglionic sympathetic neurons from the lateral gray horns of the upper thoracic spinal segments. Here, the pre-ganglionic neurons synapse with cell bodies of postganglionic sympathetic neurons, which in turn, get distributed to various regions of the head and neck and mediastinum via the following routes:

• Post-ganglionic neurons reach out to the ventral rami of C7, C8 and T1 spinal nerves, through gray rami communicantes,

• Some post-ganglionic neurons wind around vertebral and subclavian arteries to form a neuronal plexus around them and innervate smooth muscles in the arteries,

• Lastly, post-ganglionic neurons reach out to the cardiac plexus via inferior cardiac nerves, to innervate the heart.

The arterial blood supply to the ganglion comes from the supreme intercostal branch of the costocervical trunk of the subclavian artery.