Fetal topography of branches of the cervical and thoracic divisions of the vagus nerves

Authors

  • L. Ya. Lopushniak Higher State Educational Establishment of Ukraine “Bukovinian State Medical University”, Chernivtsi,
  • T. V. Khmara Higher State Educational Establishment of Ukraine “Bukovinian State Medical University”, Chernivtsi,
  • N. M. Palibroda Higher State Educational Establishment of Ukraine “Bukovinian State Medical University”, Chernivtsi,
  • A. A. Shostenko Higher State Educational Establishment of Ukraine “Bukovinian State Medical University”, Chernivtsi,
  • O. M. Boichuk Higher State Educational Establishment of Ukraine “Bukovinian State Medical University”, Chernivtsi,
  • A. O. Palamar Higher State Educational Establishment of Ukraine “Bukovinian State Medical University”, Chernivtsi,

DOI:

https://doi.org/10.14739/2310-1210.2020.4.208365

Keywords:

vagus nerve, anatomical variability, topography, fetus, human being

Abstract

 

The study of age and individual anatomical variability of vagus nerves and their branches in different age periods of human ontogenesis causes interest among both morphologists and doctors of different specialties.

The aim of the study. To find out the topography of the cervical and thoracic divisions of the vagus nerves in human fetuses aged from 4th to 10th gestational months.

Materials and methods. The research was conducted on 75 preparations of human fetuses ranging from 81.0 to375.0 mm in parietal-coccygeal length (PCL) using methods of macro-microscopic dissection and morphometry.

Results. In human fetuses, the left vagus nerve is placed anteriorly to the left subclavian artery, then on the lateral surface of the Botallo’s arterial duct and the aortic arch. In the neck region, the superior cardiac branch departs from the left vagus nerve and goes to the anterior surface of the left common carotid artery.

In the inferior part of the left common carotid artery, the superior cardiac branch gives off two branches: the middle one reaches the aortic arch wall, and the lateral one runs along the anterior surface of the left common carotid artery. The left recurrent laryngeal nerve departs from the left vagus nerve at the level of the inferior border of the aortic arch. The right vagus nerve passes from the right subclavian artery anteriorly and gives rise to the right recurrent laryngeal nerve, which continues inferiorly and posteriorly around the subclavian artery. The superior cardiac branch originates from the right vagus nerve at the level of the inferior border of the thyroid gland. The inferior cardiac branch departs inferiorly and medially from the right laryngeal nerve and is located on the right anterolateral surface of the trachea.

Conclusions. During the fetal period of human ontogenesis, age and individual anatomical variations of the branches of the cervical and thoracic vagus nerves is observed, which is manifested by the variability of the structure, asymmetry of the topography of the recurrent laryngeal nerves, bronchial, esophageal and cardiac branches. The left recurrent laryngeal nerve departs from the left vagus nerve at the level of the inferior border of the aortic arch, the right recurrent laryngeal nerve departs from the right vagus nerve at the level of the right subclavian artery. The esophageal nervous plexus is formed by esophageal branches of the vagus nerves, which then forms mainly the posterior vagal trunk. The anterior vagal trunk is a direct continuation of the left vagus nerve branches. The innervation of the aortic arch involves the common cardiac trunk, which is formed by the superior cardiac branch and the superior cardiac nerve and also anastomoses both with vagus nerve and with recurrent laryngeal nerves.

 

References

Breit, S., Kupferberg, A., Rogler, G., & Hasler, G. (2018). Vagus Nerve as Modulator of the Brain-Gut Axis in Psychiatric and Inflammatory Disorders. Frontiers in Psychiatry, 9, Article 44. https://doi.org/10.3389/fpsyt.2018.00044

Carabotti, M., Scirocco, A., Maselli, M. A., & Severi, C. (2015). The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Annals of gastroenterology, 28(2), 203-209.

Hammer, N., Glätzner, J., Feja, C., Kühne, C., Meixensberger, J., Planitzer, U., Schleifenbaum, S., Tillmann, B. N., & Winkler, D. (2015). Human vagus nerve branching in the cervical region. PLOS ONE, 10(2), Article e0118006. https://doi.org/10.1371/journal.pone.0118006

Seki, A., Green, H. R., Lee, T. D., Hong, L., Tan, J., Vinters, H. V., Chen, P. S., & Fishbein, M. C. (2014). Sympathetic nerve fibers in human cervical and thoracic vagus nerves. Heart rhythm, 11(8), 1411-1417. https://doi.org/10.1016/j.hrthm.2014.04.032

Inamura, A., Nomura, S., Sadahiro, H., Imoto, H., Ishihara, H., & Suzuki, M. (2017). Topographical features of the vagal nerve at the cervical level in an aging population evaluated by ultrasound. Interdisciplinary Neurosurgery, 9, 64-67. https://doi.org/10.1016/j.inat.2017.03.006

Miyake, N., Hayashi, S., Kawase, T., Cho, B. H., Murakami, G., Fujimiya, M., & Kitano, H. (2010). Fetal Anatomy of the Human Carotid Sheath and Structures In and Around It. The Anatomical Record, 293(3), 438-445. https://doi.org/10.1002/ar.21089

Kamani, D., Potenza, A. S., Cernea, C. R., Kamani, Y. V., & Randolph, G. W. (2015). The nonrecurrent laryngeal nerve: anatomic and electrophysiologic algorithm for reliable identification. Laryngoscope, 125(2), 503-508. https://doi.org/10.1002/lary.24823

Yuan, H., & Silberstein, S. D. (2016). Vagus Nerve and Vagus Nerve Stimulation, a Comprehensive Review: Part I. Headache, 56(1), 71-78. https://doi.org/10.1111/head.12647

Halychanska, O. M., & Khmara, T. V. (2013). Correlative interrelations of the vagus nerves in human fetusesand newborns. VISNYK VDNZU «Ukrainska medychna stomatolohichna akademiia», 13(4), 107-111.

Gürleyik, E. (2015). Non-recurrent nerve from the vagus anterio-medially located in the carotid sheath. Ulusal cerrahi dergisi, 31(3), 182-184. https://doi.org/10.5152/UCD.2015.2854

Donatini, G., Carnaille, B., & Dionigi, G. (2013). Increased detection of non-recurrent inferior laryngeal nerve (NRLN) during thyroid surgery using systematic intraoperative neuromonitoring (IONM). World journal of surgery, 37(1), 91-93. https://doi.org/10.1007/s00268-012-1782-y

Scheid, S. C., Nadeau, D. P., Friedman, O., & Sataloff, R. T. (2004). Anatomy of the thyroarytenoid branch of the recurrent laryngeal nerve. Journal of voice, 18(3), 279-284. https://doi.org/10.1016/j.jvoice.2003.08.003

Ellwanger, J. H., da Costa Rosa, J. P., dos Santos, I. P., da Rosa, H. T., Jotz, G. P., Xavier, L. L., & de Campos, D. (2013). Morphologic evaluation of the fetal recurrent laryngeal nerve and motor units in the thyroarytenoid muscle. Journal of voice,27(6), 668-673. https://doi.org/10.1016/j.jvoice.2013.07.004

Lee, J. H., Cheng, K. L., Choi, Y. J., & Baek, J. H. (2017). High-resolution Imaging of Neural Anatomy and Pathology of the Neck. Korean journal of radiology, 18(1), 180-193. https://doi.org/10.3348/kjr.2017.18.1.180

Nerurkar, N. K., & Dighe, S. N. (2019). Anatomical Course of the Thyroarytenoid Branch of the Recurrent Laryngeal Nerve. Laryngoscope, 129(3), 704-708. https://doi.org/10.1002/lary.27491

Marchuk, O. F. (2008).Topohrafiia stravokhodu v 4-5-misiachnykh plodiv [Topography of the esophagus 4-5-month old fetuses]. Klinichna anatomiia ta operatyvna khirurhiia, 7(1), 34-38. [in Ukrainian].

Downloads

How to Cite

1.
Lopushniak LY, Khmara TV, Palibroda NM, Shostenko AA, Boichuk OM, Palamar AO. Fetal topography of branches of the cervical and thoracic divisions of the vagus nerves. Zaporozhye Medical Journal [Internet]. 2020Jul.22 [cited 2024Nov.23];22(4). Available from: http://zmj.zsmu.edu.ua/article/view/208365

Issue

Section

Original research