Louisiana State University LSU Digital Commons LSU Historical Dissertations and Theses Graduate School 1954 Innervation of the Heart and Ductus Arteriosus and Other Features of the Autonomic Nervous System of the Full Term Human Fetus. Frank D. Allan Louisiana State University and Agricultural & Mechanical College Follow this and additional works at: https://digitalcommons.lsu.edu/gradschool_disstheses Part of the Life Sciences Commons Recommended Citation Allan, Frank D., "Innervation of the Heart and Ductus Arteriosus and Other Features of the Autonomic Nervous System of the Full Term Human Fetus." (1954). LSU Historical Dissertations and Theses. 8086. https://digitalcommons.lsu.edu/gradschool_disstheses/8086 This Dissertation is brought to you for free and open access by the Graduate School at LSU Digital Commons. It has been accepted for inclusion in LSU Historical Dissertations and Theses by an authorized administrator of LSU Digital Commons. For more information, please contact [email protected]. THE INNERVATION OF THE HEART AND DUCTUS ARTERIOSUS AND OTHER FEATURES OF THE AUTONOMIC NERVOUS SYSTEM OF THE FULL TERM HUMAN FETUS A Dissertation Submitted to the Graduate Faculty of the Louisiana State University and Agriculture and Mechanical College in partial fulfillment of the requirements for the degree of Doctor of Philosophy in The Department of Anatomy School of Medicine by Frank Duane Allan B.S., University of Utah, 1947 M.S., University of Utah, 1949 May, 1954 UMl Number: DP69464 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. UMl Dissertation Publishing UMl DP69464 Published by ProQuest LLC (2015). Copyright in the Dissertation held by the Author. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code ProQuestQue ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106- 1346 MANUSCRIPT THESES Unpublished theses submitted for the master*s and doctorTs degrees and deposited in the Louisiana State University Library are available for inspection* Use of any thesis is limited by the rights of the aiathor. Bibliographical references may be noted^ but passages may not be copied unless the author has given permission* Credit must be given in subsequent written or published work. A library which borrows this thesis for use by its clientele is expected to make sure that the borrower is aware of the above restrictions. LOUISIANA STATE UNIVERSITY LIBRARY 1 1 9 -a ACKNOWLEDGEMENT A complete acknowledgement of those to whom I am indebted for aid in preparation of this dissertation is impossible. To my wife, whose patience, understanding, and help have made my efforts possible, most credit is due. Many of the references used in this study were obtained by use of the Inter-library loan, and for help in this regard, 1 am grateful to the library staff, especially Miss Ann Hodge, The photographs, mounting, and labeling were done essentially by the Art Department to whom I am most grateful. Miss Merle Fowler typed the final manuscript. To Dr, Charles M, Goss, my major professor, thanks are given for his advice, and, with Dr. Ruth Miller, invaluable help in the organisation and correction of the manuscript. Similarly, gratitude is due the other members of the Anatomy De­ partment and my examining committee for their encouragement. TABUS OF CONTENTS I. INTRODUCTION * II. HISTORICAL. Comparative anatomy 2 Human anatomy 11 Ductus arteriosus 22 Intermediate cervical ganglion 25 Fetal studies 28 HL MATERIAL AND METHODS 30 IV. OBSERVATIONS Sympathetic trunk 34 Cervical sympathetic cardiac nerves Superior cervical sympathetic cardiac nerve 41 Middle cervical sympathetic cardiac nerve 43 Inferior cervical sympathetic cardiac nerve 45 Cardiac nerves of the intermediate ganglion 47 Thoracic sympathetic cardiac nerves 47 Intercommunications of sympathetic cardiac nerves 52 Accessory Ganglia associated with sympathetic cardiac nerves 54 Cardiac nerves of the vagus Superior cervical cardiac nerves 56 Inferior cervical cardiac nerves 59 Thoracic cardiac nerves 60 Communications between sympathetic and vagal cardiac nerves 61 Vago-sympathetic communications 62 Sympathetico-vagal communications 63 Superficial cardiac plexus 63 Deep cardiac plexus 67 Nerve supply of the ductus arteriosus 71 V. DISCUSSION Sympathetic trunk 7 9 Superior cervical sympathetic cardiac nerve 83 Middle cervical sympathetic cardiac nerve 84 Inferior cervical sympathetic cardiac nerve 85 Thoracic sympathetic cardiac nerves 8 8 Intercommunications of sympathetic cardiac nerves 89 Accessory ganglia associated with sympathetic cardiac nerves 90 Superior cervical cardiac nerve of the vagus 9 2 Inferior cervical cardiac nerve of the vagus 9 3 iii Thoracic cardiac nerves of the vagus 94 Vago-sympathetic intercommunications 95 Superficial cardiac plexus 96 Deep cardiac plexus 99 Ductus arteriosus 102 VI. SUMMARY 106 VII. SELECTED BIBLIOGRAPHY 109 vm. VITA 138 TABLES I. Intermediate Cervical Sympathetic Ganglion 129 II, Superior Cervical Sympathetic Cardiac Nerve(s) 130 III, Middle Cervical Sympathetic Cardiac Nerve(s) 131 IV, Inferior Cervical Sympathetic Cardiac Nerve(s) 132 V. Thoracic Cardiac Sympathetic Nerves 133 VI. Vagal Cardiac Nerves 134 VII, Superficial Cardiac Plexus 135 VIII. Deep Cardiac Plexus 136 IX. Innervation of the Ductus Arteriosus 137 v FIGURES 1. Left Sympathetic Trunk and Branches 35 2. Right Sympathetic Trunk and Branches 36 3. Types of Intermediate Cervical Ganglia 3S 4. Sympathetic Cardiac Nerves with an Anomalous Right Subclavian Artery 48 5. Chart of Thoracic Sympathetic Cardiac Nerves 51 6 . Left Vagus Nerve and Branches 57 7. Right Vagus Nerve and Branches 58 8 . Relations of Cardiac Plexuses to Vessels and Pericardial Sinuses 6 8 9. Innervation of the Ductus Arteriosus 72 10, Innervation of the Ductus Arteriosus 73 11, Innervation of the Ductus Arteriosus 74 12, Photograph (Dissection 11) 122 13, Photograph (Dissection 8 } 123 14, Photograph (Dissection 15) 124 15, Photograph (Dissection 13, on left) 125 16, Photograph (Dissection 14 before removal of the Subclavian Artery) 126 17, Photograph (Dissection 14 after removal of the Subclavian Artery) 127 18, Photograph (Dissection 13, on right) 128 v i LIST OF ABBREVIATIONS (used in Figures and Tables ) A. artery Ant, anterior Ao. Aorta Br. large branch br. small branch c. cervical Card. Cardiac Car. Carotid Ccrv. cervical Collai. collateral Com. common Coron. Coronary D.# D.A. or Duct. Ductus arteriosus Ext. external G. ganglion ICCSN Inferior Cervical Sympathetic Cardiac Nerve ICG Inferior Cervical Ganglion IGTsg Inter ganglionic Trunk near superior cervical ganglion IGT luterganglionic Trunk IGTamg Inter ganglionic Trunk above middle cervical ganglion In. Innominate Inf. Inferior Int. Internal Intcrmed. Inte rmediat e lint. C. G. Intermediate Cervieal Ganglion D. left Dat. lateral A. Deft Atrium or Auricle DCCA Deft Common Carotid Artery D.V. Deft Ventricle Daryng. Daryngeal MCCSH Middle Cervical Sympathetic Cardiac Nerve MCG Middle Cervical Ganglion Mam. Mammary Med. medial Mid. middle N. nerve P or Plex. plexus Phren. N. Phrenic nerve Prox. proximal P.T. Pulmonary Trunk Pulm. Pulmonary R. right R.A. Right Atrium or Auricle R. V. Right Ventricle Rec. N. Recurrent Nerve Rt. roots SCCSN Superior Cervical Sympathetic Cardiac Nerve SCG Superior Cervical Ganglion Sl-X Superior Laryngeal Nerve of the Vagus Sp. spinal Stell. Stellate Sub. Subclavian Sup. superior Sup. Plex. Superficial Cardiac Plexus S.V.C. Superior Vena Cava Sym. Sympathetic T or Tbor. Thoracic Tbyr. Thyroid Thyrocerv. Thyrocervical Tr. Trunk Trans. Transverse Trans. S. Transverse Sinus V. Vein Vert. Vertebra or Vertebral X Vagus nerve v iii ABSTRACT Although studies of the autonomic nervous system of the cervicothoracic region in man have been numerous, certain features have escaped notation, whereas, others are in need of reexamination in order that a more accurate knowledge may be obtained. Further­ more, most previous work has been done on the adult, with few sys - tematic studies existing regarding this system in the fetus. Thus, no detailed consideration of the origin and distribution of the extrinsic nerves to the ductus arteriosus has taken place. The technics of this study were simple, but required tedious and delicate dissection of the neck and upper thorax of the full term fetus with detailed records, written and graphic, regarding the auto­ nomic system in that area. The study demonstrates that innervation of the ductus arterio­ sus is accomplished by the left inferior cervical sympathetic car­ diac nerve by way of a plexus on the proximal part of the left sub­ clavian artery, and by branches from the inferior cervical cardiac nerve of the vagus primarily as branches of the superficial cardiac plexus. The plexus upon the ductus distributes fibers to it and the pulmonary trunk, continuing to the left coronary plexus. Sympathetic and vagal cardiac nerves are analyzed in regard to their frequency, origin, course, termination, communications, and association with accessory ganglia. These are largely confirmation of previous studies but present a more detailed knowledge of each. and reconsiders features which have been lost from previous studies. Of the cervical