Paralysis of the Diaphragm-Sympathetic Trunk in the Treatment of Raynaud Disease-Spinal Anesthesia and the Sympathetic Nervous System

Paralysis of the Diaphragm

The phrenic nerve may be paralyzed because of pressure from malignant tumors in the mediastinum. Surgical crushing or sectioning of the phrenic nerve in the neck, producing paralysis of the diaphragm on one side, was once used as part of the treatment of lung tuberculosis, especially of the lower lobes. The immobile dome of the diaphragm rests the lung

  

Sympathetic Trunk in the Treatment of Raynaud Disease

Preganglionic sympathectomy of the 2nd and 3rd thoracic ganglia can be performed to increase the blood flow to the fingers for such conditions as Raynaud disease. The sympathectomy causes vasodilatation of the arterioles in the upper limb.

Spinal Anesthesia and the Sympathetic Nervous System

A high spinal anesthetic may block the preganglionic sympathetic fibers passing out from the lower thoracic segments of the spinal cord. This produces temporary vasodilatation below this level, with a consequent fall in blood pressure.

Internal Thoracic Artery in the Treatment of Coronary Artery Disease- Lymph Drainage of the Thoracic Wall

Internal Thoracic Artery in the Treatment of Coronary Artery Disease

In patients with occlusive coronary disease caused by atherosclerosis, the diseased arterial segment can be bypassed by inserting a graft. The graft most commonly used is the great saphenous vein of the leg. In some patients, the myocardium can be revascularized by surgically mobilizing one of the internal thoracic arteries and joining its distal cut end to a coronary artery.


 Lymph Drainage of the Thoracic Wall

 The lymph drainage of the skin of the anterior chest wall passes to the anterior axillary lymph nodes; that from the posterior chest wall passes to the posterior axillary nodes. The lymph drainage of the intercostal spaces passes forward to the internal thoracic nodes, situated along the internal thoracic artery, and posteriorly to the posterior intercostal nodes and the para-aortic nodes in the posterior mediastinum.