Inferior cervical ganglion

Last revised by Yoshi Yu on 15 Apr 2023

The inferior cervical ganglion (plural: ganglia) is the second largest ganglion of the cervical sympathetic trunk and provides autonomic innervation to the head and neck region.

The inferior cervical ganglion is formed by embryologically fused C7 and C8 sympathetic ganglia. It has superior connections to the middle cervical ganglion and in 80% of individuals, it is fused with the first thoracic ganglion, in which it is called the stellate ganglion.

It is bilaterally located at the level of C7 anterior to the transverse processes.

The inferior cervical ganglion provides sympathetic innervation to the head and neck. 

It sends branches to the vertebral artery (form a vertebral plexus) which ascends on its surface through the transverse foramina. It gives off small branches to the posterolateral corners of the cervical interverte­bral discs and the cervical spinal meninges at each cervical segment. The vertebral plexus enters the skull on the vertebral and basilar arteries.

Small branches extend to the inferior thyroid artery, along with small branches from the recurrent laryngeal nerve and external laryngeal nerves, which enter the thyroid gland.

A large branch containing preganglionic efferent fibers forms the inferior cardiac nerve which courses inferiorly behind the subclavian artery and anterior to the trachea to join the deep part of the cardiac plexus. This branch also receives fibers from the recurrent laryngeal nerve and often fibers from the middle cardiac nerve of the middle cervical ganglion.

The ganglion supplies:

The inferior cervical ganglion is often fused with the first thoracic ganglion, forming the stellate ganglion, which is present in 80% of individuals.

Horner syndrome can be caused by pathology of the cervical sympathetic ganglia.

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Cases and figures

  • Figure 1: cervical sympathetic ganglia (Gray's illustrations)
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  • Figure 2: cervicothoracic sympathetic ganglia (Gray's illustrations)
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