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Middle Cervical Ganglion
Nervous System

Middle Cervical Ganglion

Ganglion cervicale medium

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The middle cervical ganglion is the smallest of the three cervical sympathetic paravertebral ganglia. It is present in 48%-74% of the time and is situated in front of the transverse process between the fifth to seventh cervical vertebrae (Civelek et al., 2008).

The postganglionic neurons from the middle cervical ganglion may run along the following different routes.

—They may enter the anterior rami of the fifth and sixth cervical nerves via the gray rami communicantes.

—The middle cervical ganglion is connected to the inferior cervical ganglion by an anterior and posterior cord. The posterior cord splits to enclose the vertebral artery, while the anterior cord contributes to the ansa subclavia (Elias, 2000).

—Some fibers will accompany the inferior thyroid artery to provide vasomotor innervation to the thyroid and parathyroid glands.

—A few medial branches from the middle cervical ganglion are distributed to the heart via the middle cervical cardiac nerve.

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List of Clinical Correlates

—Cervical sympathetic and stellate ganglion blocks

—Horner’s syndrome


Civelek, E., Karasu, A., Cansever, T., Hepgul, K., Kiris, T., Sabanci, A. & Canbolat, A. (2008) Surgical anatomy of the cervical sympathetic trunk during anterolateral approach to cervical spine. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 17(8), 991-995.

Elias, M. (2000) Cervical sympathetic and stellate ganglion blocks. Pain Physician, 3(3), 294-304.

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Middle Cervical Ganglion

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The middle cervical ganglion lies at the C6 vertebral level, approximated by the cricoid cartilage or carotid tubercle.

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