The origin, location, and distribution of ansa cervicalis branches document a significant variability level. Unusual origin of the ansa cervicalis observed during. The descendens hypoglossi is normal in its origin but varies in its course by passing superficial to the common facial vein and terminates by supplying to. It exists deep to the sternocleidomastoid and is a neural loop with two roots consisting of fibers from cervical ventral rami related to the cervical plexus. The phrenic nerve originates chiefly from the 4th cervical nerve c4 but receives contributions from the 3rd and 5th cervical nerves c3 and c5. Jelev 9 suggested a classification of the ansa cervicalis type. Superior root c1 innervates the superior belly of omohyoid2. The superior root of ac received a contribution from the hypoglossal nerve, a short distance later it formed a loop around the ijv to ascend to the ventral ramus of c2 as the inferior root. It is located in the carotid triangle of the neck, lying superficial to the carotid sheath. Branches from the ansa cervicalis innervate the sternohyoid muscle, sternothyroid muscle, and the inferior belly of the omohyoid muscle.
The ansa cervicalis or ansa hypoglossi in older literature is a loop of nerves that are part of the cervical plexus. A rare origin of upper root of ansa cervicalis from vagus nerve. During carotid endarterectomy, a rare anatomic variant of the origin of the upper root of the ansa cervicalis was found. The infrahyoid muscles function to depress the hyoid bone and larynx during swallowing and speech. The origin of the superior root of ac was found to be superior to the digastric muscle in 92 % of the cases. Download our english dictionary apps available for. The ansa cervicalis is a loop of nerves which are formed for the first three cervical nerves c1c3 and innervate the infrahyoid strap muscles. The branches to muscles are given directly by the roots. The ansa may arise from first, second and third, or only from the second and third cervical nerves. Rare communication of ansa cervicalis anatomical sciences. The ansa cervicalis and the infrahyoid muscles of the rat. Roots of the ansa cervicalis travel along multiple paths and have various origins.
The plexus is formed by the anterior rami divisions of cervical spinal. Ansa cervicalis without loop the origin of superior root can be superior to the digastric muscle or the phrenic nerve may also receive a contribution from the descendens hypoglossi 5. Ansa cervicalis complex, which innervates the infrahyoid muscles, is formed. Our findings describe bilateral occurrence of a unique. Schwannoma of the ansa cervicalis journal of surgical case. Ansa cervicalis definition of ansa cervicalis by the free. Vollala, venkata ramana and bhat, sm and nayak, satheesha b and raghunathan, deepthinath and samuel, vijay paul and rodrigues, vincent and mathew, jerry george 2005 a rare origin of upper root of ansa cervicalis from vagus nerve. The ansa cervicalis may arise from the first, second and third or only from the second and third cervical nerves. With standard macroanatomical dissection procedures, we clarified the location and origin of ansa cervicalis. The superior root of the ansa cervicalis is formed from cervical spinal nerve 1 of the cervical plexus. This loop innervates the infrahyoid muscles, which play a major role in swallowing and phonation. Its upper root is the descending branch of hypoglossal nerve, which joins the lower root that is formed by branches from the second and third cervical nerves.
It is located in the posterior triangle of the neck, halfway up the sternocleidomastoid muscle, and within the prevertebral layer of cervical fascia. Ansa cervicalis is a loop of nerves in the carotid triangle of neck. Ansa cervicalis variable course of the superior root. A case of granular cell tumor originating from the ansa. A case of an ansa cervicalis in which both roots are passing around the external carotid artery. Unusual origin of the ansa cervicalis observed during carotid. Pdf download for an anatomic variant of the ansa cervicalis precluding its. Vagal origin of the ansa cervicalis nerve report of two cases. Discussion numerous variations in the origin and course of ansa cervicalis have been described table 1. An anatomic variant of the ansa cervicalis precluding its. The superior root of the ansa cervicalis is formed from cervical spinal nerve 1. Flashcards are a great way to revise dense topics like the cervical plexus. Deeps is here with a whistle stop tour of the mighty ansa cervicalis.
A specimen with an ansa cervicalis that is located anterior to the internal jugular vein and the common carotid artery. Describe the path of the ansa cervicalis roots superior root. Its vertical descent was found to be superficial t. Results superior root of ansa cervicalis in 25 specimens 50 sides 100%, the hypoglossal nerve gave the superior root of ansa cervicalis ac. The inferior root of the ansa cervicalis is comprised of nerve fibers arising from. The ansa cervicalis has a superior and inferior root. Ancient schwannoma of ansa cervicalis is a rare disease and only a few cases had been reported till date.
Ansa cervicalis is a loop of nerves found in the anterior wall of the carotid sheath in the carotid triangle of neck. Cervical and cranial nerves questions and study guide. It lies superficial to the internal jugular vein in the carotid triangle. Morphological study of the ansa cervicalis and the phrenic. The cervical plexus is a network of nerve fibres that supplies innervation to some of the structures in the neck and trunk. Ansa cervicalis was derived from a combination of c1c4 spinal segments, with c1c3 being the most frequent pattern 87.
In the present case, the ansa cervicalis supplies the infrahyoid muscles without forming the loop. Ansa cervicalis as a variant of spinal accessory nerve plexus. All of the infrahyoid muscles are innervated by the ansa cervicalis from the cervical plexus c1c3 except the thyrohyoid muscle, which is innervated by fibers only from the first cervical spinal nerve travelling with the hypoglossal nerve. This definition incorporates text from the wikipedia website wikipedia. Followup revealed that this was without any clinical consequences. The ansa cervicalis or ansa hypoglossi, an archaic synonym is a component of the cervical plexus which gives muscular branches to the geniohyoid muscle of the suprahyoid group and most of the infrahyoid strap muscles excluding the thyrohyoid muscle it lies within the carotid triangle, superficial to the carotid sheath. Ansa cervicalis which is an anastomosing loop formed by descendens hypoglossi and descendens cervicalis is known for its high degree of variation in its formation, course and branching. Those loops and the branches from them form the cervical plexus.
Indrasingh i, abraham s, vettivel s, chandi g 1999 a rare vagal origin of the superior root of ansa cervicalis. A rare origin of upper root of ansa cervicalis from vagus. Ansa cervicalis synonyms, ansa cervicalis pronunciation, ansa cervicalis translation, english dictionary definition of ansa cervicalis. In summary, schwannoma of the ansa cervicalis is rare and is difficult to diagnose preoperatively. Ansa definition and meaning collins english dictionary. We examined 100 adult human formalinfixed cadavers. Branches from the ansa cervicalis innervate most of the infrahyoid muscles, including the sternothyroid. Simply select your manager software from the list below and click on download.
Ansa cervicalis article about ansa cervicalis by the free. The cervical plexus is a network of nerve fibres that supplies innervation to some of the structures in the neck and trunk it is located in the posterior triangle of the neck, halfway up the sternocleidomastoid muscle, and within the prevertebral layer of cervical fascia. The plexus is formed by the anterior rami divisions of cervical spinal nerves c1c4. The ansa cervicalis is a loop of nerves that are part of the cervical plexus. The origin of the superior root of ac was found to be superior to the digastric muscle in 92% of the cases. Bhanu prakash usmle, fmge and neet pg 45,962 views. A functional evaluation of ansa cervicalis nerve transfer. Cureus an unusual superior root of the ansa cervicalis. The ansa cervicalis is useful for cranial nerve repair, and may be.
The unusual origin of the ansa cervicalis and its course made it necessary for the surgeon to sacrifice it to improve exposure of the carotid bifurcation. Ansa cervicalis is a loop of nervers usually by c1, c2 and c3 fibres in the lateral aspect of the neck, occasionally the superior root of the ansa derived from c1 may original from the vagus either party or entirely, but the fibres can be traced back to their true cases of ansa cervicalis arising from the nagal trunk observed in dissection room cadavers is described here. Anatomical study of the human ansa cervicalis nerve and. Its vertical descent was found to be superficial to the external carotid artery in 72% and superficial to the internal carotid artery in 28% of the. Its name means handle of the neck in latin branches from the ansa cervicalis innervate most of the infrahyoid muscles, including the sternothyroid muscle, sternohyoid muscle, and the omohyoid muscle. They supply the infrahyoid muscles in the anterior cervical triangle. Anatomical study of the human ansa cervicalis nerve and its variations ahmed m. The lower root of ansa cervicalis figure 1 was formed from the second and third cervical nerves, but the upper root came from the vagus.
To find the ansa cervicalis, cut the attachment of the superior belly of the omohyoid muscle to its tendon and reflect it superiorly. It lies under the sternocleidomastoid scm muscle, opposite the upper four cervical vertebrae. The muscular branches to sternohyoid, sternothyroid and inferior belly of. Rare communication of ansa cervicalis mohsen noorozian 1, mohammad bayat 1, reza mastery farahani, mohammadamin abdollahifar, hadi azimi 2, ali noorizadeh 3, azam asemi rad 1, somayeh fallah nejhad, maryam salimi 1, rabieh mohammadi,abdullah a mini 1, hojjatallah abbaszadeh 1 1. The ramus descendens hypoglossi may be replaced by the vagus cn x. Apr 11, 2020 they subsequently unite with branches of the adjacent cervical nerve to form loops, for example, the loop formed between c2 and c3 that contributes branches to the ansa cervicalis. Ansa cervicalisrln anastomosis gives recovery in phonatory function in patients who had the rln resected, although the vocal cord does not restore normal motions. An anatomic variant of the ansa cervicalis precluding its use as a. The ansa cervicalis is useful for cranial nerve repair, and may be harvested without apparent morbidity. The ansa cervicalis revisited loukas folia morphologica. Ansa cervicalis definition of ansa cervicalis by medical. Inferior root of the ansa cervicalis the inferior root of the ansa cervicalis irac was present in 34 89. The ansa cervicalis is located around the carotid sheath and forms a neural loop, which consists of superior and inferior roots. A phrenic nerve receiving a root of origin from the.
These nerve fibers travel in the hypoglossal nerve before. In this case, the inferior root of the ansa cervicalis was formed by the joining of two rootlets, one originating from spinal accessory nerve and the other from a branch of the cervical plexus to the sternocleidomastoid muscle. Caliot and dumont 9 in a series of 80 dissections showed that the superior root. In their recent study of 100 cadavers, loukas et al. Herein we report an unusual and surgically relevant anatomic variant of the ansa. It lies superficial to the internal jugular vein in the carotid triangle the superior root of the ansa cervicalis is formed from cervical spinal nerve 1 of the cervical plexus. When no ansa is present, the innervation of the infrahyoid muscles is by branches arising directly from c2 and c3. Laryngeal reinnervation using ansa cervicalis for thyroid. It lies superficial to the internal jugular vein in the carotid sheath branches from the ansa cervicalis innervate three of the four infrahyoid muscles. The ansa cervicalis or ansa hypoglossi, an archaic synonym is a component of the cervical plexus which gives muscular branches to the geniohyoid muscle of the suprahyoid group and most of the infrahyoid strap muscles excluding the thyrohyoid muscle it lies within the carotid triangle, superficial to.
Pdf the ansa cervicalis is a neural loop in the neck formed by connecting the superior root from the cervical spinal nerves c12 and. Cervical plexus and ansa cervicalis questions and study. Anatomical study of the human ansa cervicalis nerve and its. A rare case of formation of double ansa cervicalis. Schwannoma of the ansa cervicalis journal of surgical. Summary of background data uvfp remains a serious complication of thyroid surgery. Herein, we present an extremely rare case of the superior root of the ansa cervicalis arising both from the hypoglossal and vagus nerves.
The ansa consists of a superior and an inferior radix receiving fibers from the hypoglossal nerve and from c, respectively. The five motor branches of the ansa cervicalis loop listed above, originate from c1 to c3 nerves. For the purposes of photo documentation we used the digital camera nikon d60, objective nikon 60 mm ed afs. Learn vocabulary, terms, and more with flashcards, games, and other study tools. The anastomosis can be performed at an easy position in the vicinity of the larynx. During routine dissection, unilateral variation of the ansa cervicalis was observed. The variable origin of ansa cervicalis, its course and the branching pattern were recorded and photographed by close up camera under a light source. Here, we present an unusual case of an ansa cervicalis encountered upon routine dissection of an adult male cadaver. Anatomical variations of the superior root of the ansa cervicalis are uncommon.
Unilateral anatomical variation of the ansa cervicalis. An anatomic variant of the ansa cervicalis precluding its use. The position of the schwannoma between the strap muscles was consistent of the nerve of origin being a branch of the ansa cervicalis. Vagal origin of the ansa cervicalis nerve report of two. The ansa cervicalis or ansa hypoglossi, an archaic synonym is a component of the cervical plexus which gives muscular branches to the geniohyoid muscle of the suprahyoid group and most of the infrahyoid strap muscles excluding the thyrohyoid. Ansa cervicalis was located medial to the internal jugular vein in 63% medial type and lateral to the vein in 33. The ansa cervicalis is a loop of nerves that is usually formed by the union of ventral rami of spinal nerves c1, c2, and c3. The surgical approach of the carotid artery for carotid endarterectomy demands knowledge of normal anatomy and anatomic variation. Intraoperative evoked electromyography showed no activity in the vocalis muscle following stimulation of the left rln, indicating a true paralysis. The patient was taken to the operating room, where she underwent a left arytenoid adduction and reinnervation of the left recurrent laryngeal nerve rln with a branch of the ansa cervicalis. The ansa cervicalis is located anterior to the internal jugular vein. Unusual origin of the ansa cervicalis observed during carotid endarterectomy. Objective to evaluate the longterm efficacy of delayed laryngeal reinnervation using the main branch of the ansa cervicalis in treatment of unilateral vocal fold paralysis uvfp caused by thyroid surgery.
They utilized the superior root of the ansa cervicalis and achieved an improved surgical outcome in five of 10 patients. Ansa cervicalis is a loop of nervers usually by c1, c2 and c3 fibres in the lateral aspect of the neck, occasionally the superior root of the ansa derived from c1 may original from the vagus. Hegazy anatomy and embryology, department of anatomy, faculty of medicine, benha university, egypt. Find its innervation, and trace the nerve back to its origin. The topographical anatomy of the ansa cervicalis and the infrahyoid muscles sternohyoid, sternothyroid, omohyoid as well as the qualitative and quantitative muscle fiber composition have been studied in the rat. May 24, 2015 check out our free medical education platform and practical exams at. The origin of the lesion from ansa cervicalis was confirmed by intraoperative finding. The ansa cervicalis showed a great degree of variation regarding origin and distribution. It rests upon the levator anguli scapulae and scalenus medius muscles, and emerges from the posterior border of the scm. This root passes in the fibers of the hypoglossal nerve. A recent investigation reported a case of bilat eral absence of ansa cervicalis.
Department of biology and anatomical sciences, school of. Up to now, a completely satisfactory surgical treatment of uvfp has been elusive. The superior root of the ansa cervicalis is created by the first cervical nerve c1. Sensory innervation for posterior aspect of neck and scalp. The cervical plexus spinal nerves branches teachmeanatomy. The ansa cervicalis or ansa hypoglossi in older literature is a loop of nerves that are part of the first, second and third spinal nerve from the cervical plexus. An unusual superior root of the ansa cervicalis cureus.
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