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Surgical Anatomy of the Accessory Phrenic Nerve

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1 Surgical Anatomy of the Accessory Phrenic Nerve
Marios Loukas, MD, PhD, Christopher R. Kinsella, MS, Robert G. Louis, MD, Sagar Gandhi, MS, Brian Curry, PhD  The Annals of Thoracic Surgery  Volume 82, Issue 5, Pages (November 2006) DOI: /j.athoracsur Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Drawing illustrates the different points of origin of the accessory phrenic nerve. These are ansa cervicalis, nerve to sternohyoid, and nerve to subclavius. Arrows indicate the structures from which the accessory phrenic nerves originate, and circles indicate the accessory phrenic nerves. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Drawing illustrates the different points of origin of the accessory phrenic nerve. These are hypoglossal nerve, spinal accessory nerve, and supraclavicular. Arrows indicate the structures from which the accessory phrenic nerves originate, and circles indicate the accessory phrenic nerves. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Drawing illustrates the different points of origin of the accessory phrenic nerve. These are C3, C4, and C5, nerves. Arrows indicate the structures from which the accessory phrenic nerves originate, and circles indicate the accessory phrenic nerves. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Drawing illustrates the different points that the accessory phrenic nerve joins the phrenic nerve in the thorax. Circle 1 demonstrates an accessory phrenic nerve that joins the phrenic nerve just inferiorly and anteriorly to the subclavian vein. Circle 2 demonstrates an accessory phrenic nerve that joins the phrenic nerve inferiorly and anteriorly to the subclavian artery looping around the internal thoracic artery. Circle 3 demonstrates an accessory phrenic nerve that joins the phrenic nerve inferiorly and anteriorly to the subclavian artery at the root of the lung. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 The communication of the accessory phrenic nerve with the phrenic nerve in the thorax anterior to the subclavian vein is shown. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

7 Fig 6 Two specimens dissected laparoscopically are demonstrated. In both specimens, the connection of the accessory phrenic nerve with the phrenic nerve between the mediastinal pleura and pericardium is evident. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

8 Fig 7 The communication of the accessory phrenic nerve with the phrenic nerve in the thorax anterior to the subclavian vein forming a loop with the right internal thoracic artery is shown. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

9 Fig 8 The communication of the accessory phrenic nerve with the phrenic nerve in the thorax posterior to the subclavian vein forming a loop with the left internal thoracic artery is shown. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions


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