Phrenic nerve

Nerves and neurovascular bundles

N. Phrenicus - phrenic nerve; starts from the lower part of the medulla oblongata, above the upper cervical ganglion of the vagus nerve. Together with the phrenic vessel, it forms the internal mammary artery. It descends together with the intrathoracic artery into the posterior mediastinum and gives off branches to the pericardium, diaphragm and esophagus.

Following behind the esophagus, the phrenic nerve separates from the medial trunk of the vagus, forming a wide ganglion loop, with its expanded upper end facing the anterior part of the body. During its insertion in the chest, the phrenic ganglion is located medial to the border of the chest and abdomen, immediately anterior to the posterior surface of the pericardium. Directly at the gate surrounding the upper third of the esophagus from above, these fibers connect with the hypoglossal and accessory nerves, as well as with the vasomotor and parasympathetic fibers of the right and left vagus nerves. From here the three nerves common to the vagus are again directed from the diaphragm dorsally, lateral to the aoa into the jugular fossa and then into the chest cavity, where they follow to the anterior chest wall, the upper part of the abdominal wall and the lower wall of the thoraco-abdominal junction; they supply the diaphragm, abdominal wall and diaphragmatic pleurae. Before exiting through the jugular foramen into the back of the neck, this nerve forms a fan-shaped branched nerve that lies