Phrenic Nerve

The following variations in origin, course, and distribution of the phrenic nerve have been reported. The phrenic nerve may receive additional roots from one or more of the following nerves: nerve to subclavius; nerve to sternohyoid; second or rarely, sixth cervical nerve; descendens cervicalis; ansa cervicalis; and brachial plexus.

It may receive a branch from CN XII (hypoglossal) and may communicate with CN XI (spinal accessory).

The phrenic nerve may arise exclusively from the nerve to subclavius.

On occasion it supplies a branch to the subclavius muscle.

The phrenic may pass along the lateral border of or pierce the anterior scalene muscle.

The consolidation of the phrenic into a single trunk may not occur until it enters the thorax. The size of the nerve may vary bilaterally.

Instead of descending behind the subclavian vein the phrenic may pass anterior to it or even through a ring or annulus formed by the vein.

An accessory phrenic nerve may also arise from the fifth or fifth and sixth cervical nerves and pass in front or behind the subclavian vein to join the main trunk of the phrenic nerve at the root of the neck or within the thorax. The incidence of an accessory phrenic nerve was reported to be 75% in 309 cases studied.

The phrenic nerve may supply a branch to scalenus anterior.

The phrenic nerve may descend in contact with the posterior surface of the sternocleidomastoid, cross in front of the subclavian and right brachiocephalic veins, and lie about 1.5 cm in front of the scalenus anterior muscle and subclavian artery. In one case, the right phrenic was found passing through an annulus of the subclavian vein.

Origin of Accessory Phrenic Nerve from Yano, 1925

Accessory Phrenic Nerve

Author

No. Body Halves

No. of Cases

Percent

Vagus Nerve

Wrisburg

Luschka

37

32

1

0

2.7%

-

Accessory Nerve

Blandin

Henle

Unclear

1

-

-

Suprascapular Nerve

Casali

Unclear

1

-

-

Ansa Hypoglossi

Wrisburg

Haller

37

Unclear

5

5

14%

-

Nerve to Subclavius

Willy Felix

Goetze

Ruhemann

Yano

Unclear

25

17

22

3

12

5

12

18%

48%

32%

55%

Spinal Accessory, From C5

Willy Felix

Goetze

Ruhemann

Hara

Yano

Unclear

25

17

Unclear

22

Unclear

8

6

4

5

20%

32%

35%

-

23%

Accessory Phrenic Nerve from the Nerve to Subclavius Muscle

Accessory Phrenic Nerve from the Nerve to Subclavius Muscle

Accessory Phrenic Nerve from the Nerve to Subclavius Muscle

Riferimenti dell’opera originale

Elenco riportato come compare nella fonte, senza normalizzazione dei formati bibliografici.

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