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Superior, middle, inferior cervical sympathetic ganglion

Connected to cervical spinal nerves via rami communicantes

Superior ganglion

Long fusiform ganglion

Inferior ganglion: head of rib 1

Often fused with 1st thoracic ganglion-->cervicothoracic or stellate ganglion

Prevertebral and lateral vertebral regions

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Deep investing fascia

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covers prevertebral muscles and laterally positioned lateral vertebral muscles: scalenes

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Two layers, separated by loose connective tissue

Anterior layer: alar fascia

Posterior layer: prevertebral fascia

B/w layers: danger space: passageway for infections from neck region to posterior mediastinum

Exterior of Base of Skull

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Anterior transverse line

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Passes thru both mandibular notches across base of skull

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Passes across foramen ovale

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Posterior transverse line

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Crosses both stylomastoid foramina

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Jugular foramen: 3 compartments

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Anterior compartment: Inferior petrosal sinus

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Intermediate compartment: CN IX, X, XI

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Posterior compartment: largest

Sigmoid dural sinus-->IJV

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Pharynx: hangs from pharyngeal tubercle: anterior to foramen magnum

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Great vessels and nerves lie posterolateral to posterior wall of pharynx

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Vagus nerve

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Belongs to digestive and respiratory tracts

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Proceeds straight inferiorly

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B/w IJV and ICA

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Inferior ganglion (nodose): just inferior to jugular foramen

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Branches

Superior laryngeal: arises about 2.5 cm inferior to base of skull

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Goes to larynx

Pharyngeal branch:

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Arises at high level

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B/w internal and external carotid arteries

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Goes to pharyngeal wall-->pharyngeal plexus

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Accessory nerve

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Supplies sternocleidomastoid and trapezius

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@ base of skull: lies lateral to vagus nerve

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b/w IJV and ICA

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70% crosses anterior to IJV

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glossopharyngeal

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goes to pharynx and back of tongue: swings anteriorly

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passes b/w ICA and ECA

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applied to lateral side of stylopharyngeus

goes b/w arteries

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hypoglossal

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supplies muscle of tongue except palatoglossus

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adherent to inferior ganglion of vagus

Pharynx

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