Mnemonic

Sympathetic Trunk in the Thorax

A memory aid for the course of the thoracic sympathetic chain.

Expansion

Runs on the heads of the ribs, with about eleven or twelve ganglia and the stellate ganglion at its upper end

Expansion

  • Descends over the heads of the ribs, deep to the parietal pleura, in the posterior mediastinum
  • Carries about eleven or twelve ganglia
  • Connects to each intercostal nerve by white and grey rami communicantes
  • Gives the greater, lesser and least splanchnic nerves from the T5 to T12 segments
  • The stellate (cervicothoracic) ganglion lies at its upper end, on the neck of the first rib

Its position on the rib heads explains the clinical associations: an apical lung tumour invades the chain and produces Horner syndrome (ptosis, miosis, anhidrosis), while the T2 and T3 ganglia are the target of surgical sympathectomy for palmar hyperhidrosis.