Trunk nerves (intercostal, sympathetic, vagus nerve)
Sympathetic branches and splanchnic nerves
Rami sympathici et nervi splanchnici (major, minor, imus, lumbales)
- Origin
- Arise from the medial aspect of the thoracic and lumbar sympathetic chains (greater splanchnic T5-T9, lesser splanchnic T10-T11, least splanchnic T12, lumbar splanchnics L1-L2)
- Insertion
- Pierce the diaphragmatic crura to synapse in prevertebral ganglia (celiac, superior mesenteric, aorticorenal, inferior mesenteric)
- Function
- Conveys preganglionic sympathetic efferents and visceral pain afferents from the abdominal organs
- Innervation
- Sympathetic and visceral nociceptive afferents
- Movement & chain
- Neural signal transmission
- Palpation
- Not palpated directly
- Clinical
- Celiac plexus neurolysis / splanchnic nerve block: chemical ablation (ethanol) to alleviate severe, intractable pain in unresectable pancreatic cancer or refractory chronic pancreatitis.
- Segmental innervation
- T5-L2 spinal segments
- In clinical practice
- Pain score tracking pre- and post-celiac neurolysis, managing transient post-procedure orthostatic hypotension and diarrhea resulting from visceral vasodilation
- Region in the model
- Trunk nerves (intercostal, sympathetic, vagus nerve)