NERVESNERVESOFOF

THE NECKTHE NECK

NERVESNERVESOFOF

THE NECKTHE NECK

Main Nerves of the neckMain Nerves of the neckMain Nerves of the neckMain Nerves of the neck

1.1. Vagus nerve.Vagus nerve.2.2. Accessory nerve.Accessory nerve.3.3. Hypoglossal nerve.Hypoglossal nerve.4.4. Cervical part of sympathetic Cervical part of sympathetic

trunk.trunk.5.5. Cervical plexus.Cervical plexus.6.6. Phrenic nerve.Phrenic nerve.

1.1. Vagus nerve.Vagus nerve.2.2. Accessory nerve.Accessory nerve.3.3. Hypoglossal nerve.Hypoglossal nerve.4.4. Cervical part of sympathetic Cervical part of sympathetic

trunk.trunk.5.5. Cervical plexus.Cervical plexus.6.6. Phrenic nerve.Phrenic nerve.

Vagus NerveVagus NerveVagus NerveVagus Nerve It is a mixed nerve, it leaves the skull through It is a mixed nerve, it leaves the skull through

the jugular foramen.the jugular foramen. It has two sensory ganglia (superior and It has two sensory ganglia (superior and

inferior ganglia).inferior ganglia). At its beginning, it is joined by the cranial At its beginning, it is joined by the cranial

part of accessory nerve (having motor fibers part of accessory nerve (having motor fibers to pharynx and palate).to pharynx and palate).

It descends in the neck within the carotid It descends in the neck within the carotid sheath in between carotid artery and internal sheath in between carotid artery and internal jugular vein.jugular vein.

It descends in front of the 1It descends in front of the 1stst part of part of subclavian artery, then enters the thorax.subclavian artery, then enters the thorax.

It is a mixed nerve, it leaves the skull through It is a mixed nerve, it leaves the skull through the jugular foramen.the jugular foramen.

It has two sensory ganglia (superior and It has two sensory ganglia (superior and inferior ganglia).inferior ganglia).

At its beginning, it is joined by the cranial At its beginning, it is joined by the cranial part of accessory nerve (having motor fibers part of accessory nerve (having motor fibers to pharynx and palate).to pharynx and palate).

It descends in the neck within the carotid It descends in the neck within the carotid sheath in between carotid artery and internal sheath in between carotid artery and internal jugular vein.jugular vein.

It descends in front of the 1It descends in front of the 1stst part of part of subclavian artery, then enters the thorax.subclavian artery, then enters the thorax.

Branches of Vagus NerveBranches of Vagus NerveBranches of Vagus NerveBranches of Vagus Nerve1.1. Meningeal branchMeningeal branch: for posterior cranial fossa.: for posterior cranial fossa.

2.2. Auricular branchAuricular branch: sensory for the medial : sensory for the medial surface of auricle, floor of external auditory surface of auricle, floor of external auditory meatus and adjacent parts of outer surface of meatus and adjacent parts of outer surface of tympanic membrane.tympanic membrane.

3.3. Pharyngeal branchPharyngeal branch: (its fibers come from : (its fibers come from cranial part of accessory nerve). It passes cranial part of accessory nerve). It passes between ext. and int. carotid arteries, and between ext. and int. carotid arteries, and shares in pharyngeal plexus around the wall of shares in pharyngeal plexus around the wall of pharynx. It supplies all muscles of palate pharynx. It supplies all muscles of palate (except tensor palati) and all muscles of (except tensor palati) and all muscles of pharynx (except stylopharyngeus).pharynx (except stylopharyngeus).

1.1. Meningeal branchMeningeal branch: for posterior cranial fossa.: for posterior cranial fossa.

2.2. Auricular branchAuricular branch: sensory for the medial : sensory for the medial surface of auricle, floor of external auditory surface of auricle, floor of external auditory meatus and adjacent parts of outer surface of meatus and adjacent parts of outer surface of tympanic membrane.tympanic membrane.

3.3. Pharyngeal branchPharyngeal branch: (its fibers come from : (its fibers come from cranial part of accessory nerve). It passes cranial part of accessory nerve). It passes between ext. and int. carotid arteries, and between ext. and int. carotid arteries, and shares in pharyngeal plexus around the wall of shares in pharyngeal plexus around the wall of pharynx. It supplies all muscles of palate pharynx. It supplies all muscles of palate (except tensor palati) and all muscles of (except tensor palati) and all muscles of pharynx (except stylopharyngeus).pharynx (except stylopharyngeus).

Branches of Vagus NerveBranches of Vagus NerveBranches of Vagus NerveBranches of Vagus Nerve4.4. Superior laryngeal nerveSuperior laryngeal nerve: Descends toward the : Descends toward the

larynx and divides into:larynx and divides into:

A.A. External laryngeal nerveExternal laryngeal nerve that accompanies that accompanies the superior thyroid artery then deep to the the superior thyroid artery then deep to the thyroid gland to supplies the cricothyroid thyroid gland to supplies the cricothyroid muscle.muscle.

B.B. Internal laryngeal nerveInternal laryngeal nerve that pierces the that pierces the thyrohyoid membrane and supplies the thyrohyoid membrane and supplies the mucosa of the piriform fossa of pharynx and mucosa of the piriform fossa of pharynx and mucosa of larynx above the level of vocal fold.mucosa of larynx above the level of vocal fold.

5.5. Cardiac branchesCardiac branches: 2-3 nerves that share in : 2-3 nerves that share in formation of cardiac plexus.formation of cardiac plexus.

4.4. Superior laryngeal nerveSuperior laryngeal nerve: Descends toward the : Descends toward the larynx and divides into:larynx and divides into:

A.A. External laryngeal nerveExternal laryngeal nerve that accompanies that accompanies the superior thyroid artery then deep to the the superior thyroid artery then deep to the thyroid gland to supplies the cricothyroid thyroid gland to supplies the cricothyroid muscle.muscle.

B.B. Internal laryngeal nerveInternal laryngeal nerve that pierces the that pierces the thyrohyoid membrane and supplies the thyrohyoid membrane and supplies the mucosa of the piriform fossa of pharynx and mucosa of the piriform fossa of pharynx and mucosa of larynx above the level of vocal fold.mucosa of larynx above the level of vocal fold.

5.5. Cardiac branchesCardiac branches: 2-3 nerves that share in : 2-3 nerves that share in formation of cardiac plexus.formation of cardiac plexus.

Branches of Vagus NerveBranches of Vagus NerveBranches of Vagus NerveBranches of Vagus Nerve6.6. Right recurrent laryngeal nerveRight recurrent laryngeal nerve: arises from : arises from

the right vagus as it crosses the first part of the right vagus as it crosses the first part of the subclavian artery. It hooks backward and the subclavian artery. It hooks backward and upward behind the artery, then ascends in the upward behind the artery, then ascends in the groove between the trachea and esophagus. groove between the trachea and esophagus. It passes deep the thyroid gland with It passes deep the thyroid gland with accompany of inferior thyroid artery. It enters accompany of inferior thyroid artery. It enters the larynx and supplies all its intrinsic muscles the larynx and supplies all its intrinsic muscles (except cricothyroid) and mucosa of the (except cricothyroid) and mucosa of the larynx below the level of the vocal folds and larynx below the level of the vocal folds and upper part of trachea. (left recurrent laryngeal upper part of trachea. (left recurrent laryngeal nerve begins in the thorax).nerve begins in the thorax).

6.6. Right recurrent laryngeal nerveRight recurrent laryngeal nerve: arises from : arises from the right vagus as it crosses the first part of the right vagus as it crosses the first part of the subclavian artery. It hooks backward and the subclavian artery. It hooks backward and upward behind the artery, then ascends in the upward behind the artery, then ascends in the groove between the trachea and esophagus. groove between the trachea and esophagus. It passes deep the thyroid gland with It passes deep the thyroid gland with accompany of inferior thyroid artery. It enters accompany of inferior thyroid artery. It enters the larynx and supplies all its intrinsic muscles the larynx and supplies all its intrinsic muscles (except cricothyroid) and mucosa of the (except cricothyroid) and mucosa of the larynx below the level of the vocal folds and larynx below the level of the vocal folds and upper part of trachea. (left recurrent laryngeal upper part of trachea. (left recurrent laryngeal nerve begins in the thorax).nerve begins in the thorax).

Accessory NerveAccessory NerveAccessory NerveAccessory Nerve It is a motor nerve and consists of cranial and It is a motor nerve and consists of cranial and

spinal (upper 5 cervical segments) parts.spinal (upper 5 cervical segments) parts. It leaves the skull through the jugular foramen, It leaves the skull through the jugular foramen,

then the two parts separate again, then the two parts separate again, the cranial the cranial partpart joins the vagus nerve at its inferior joins the vagus nerve at its inferior ganglion and it is distributed through it (mainly ganglion and it is distributed through it (mainly in the pharyngeal plexus and recurrent in the pharyngeal plexus and recurrent laryngeal nerve).laryngeal nerve).

The spinal partThe spinal part runs downward and laterally, runs downward and laterally, crosses the internal jugular vein, enters deep to crosses the internal jugular vein, enters deep to sternocleidomastoid, then crosses the posterior sternocleidomastoid, then crosses the posterior triangle (on the levator scapulae muscle) and triangle (on the levator scapulae muscle) and enters deep to the trapezius muscle. It supplies enters deep to the trapezius muscle. It supplies sternocleidomastoid and trapezius muscles.sternocleidomastoid and trapezius muscles.

It is a motor nerve and consists of cranial and It is a motor nerve and consists of cranial and spinal (upper 5 cervical segments) parts.spinal (upper 5 cervical segments) parts.

It leaves the skull through the jugular foramen, It leaves the skull through the jugular foramen, then the two parts separate again, then the two parts separate again, the cranial the cranial partpart joins the vagus nerve at its inferior joins the vagus nerve at its inferior ganglion and it is distributed through it (mainly ganglion and it is distributed through it (mainly in the pharyngeal plexus and recurrent in the pharyngeal plexus and recurrent laryngeal nerve).laryngeal nerve).

The spinal partThe spinal part runs downward and laterally, runs downward and laterally, crosses the internal jugular vein, enters deep to crosses the internal jugular vein, enters deep to sternocleidomastoid, then crosses the posterior sternocleidomastoid, then crosses the posterior triangle (on the levator scapulae muscle) and triangle (on the levator scapulae muscle) and enters deep to the trapezius muscle. It supplies enters deep to the trapezius muscle. It supplies sternocleidomastoid and trapezius muscles.sternocleidomastoid and trapezius muscles.

Hypoglossal NerveHypoglossal NerveHypoglossal NerveHypoglossal Nerve It is a motor nerve that supplies all muscles of It is a motor nerve that supplies all muscles of

the tongue (except palatoglossus).the tongue (except palatoglossus). It leaves the skull through the hypoglossal It leaves the skull through the hypoglossal

canal, then it has a short course in the carotid canal, then it has a short course in the carotid sheath (with internal carotid artery, internal sheath (with internal carotid artery, internal jugular vein, glossopharyngeal, vagus and jugular vein, glossopharyngeal, vagus and accessory nerves).accessory nerves).

It passes between the internal carotid artery It passes between the internal carotid artery and internal jugular vein (covered by the and internal jugular vein (covered by the posterior belly of digastric). It then curves up posterior belly of digastric). It then curves up and anteriorly crossing the first part of lingual and anteriorly crossing the first part of lingual artery and is distributed to the lingual muscles.artery and is distributed to the lingual muscles.

At its beginning, it is joined by branch from the At its beginning, it is joined by branch from the cervical plexus (containing fibers from C1) cervical plexus (containing fibers from C1) which supplies some muscles.which supplies some muscles.

It is a motor nerve that supplies all muscles of It is a motor nerve that supplies all muscles of the tongue (except palatoglossus).the tongue (except palatoglossus).

It leaves the skull through the hypoglossal It leaves the skull through the hypoglossal canal, then it has a short course in the carotid canal, then it has a short course in the carotid sheath (with internal carotid artery, internal sheath (with internal carotid artery, internal jugular vein, glossopharyngeal, vagus and jugular vein, glossopharyngeal, vagus and accessory nerves).accessory nerves).

It passes between the internal carotid artery It passes between the internal carotid artery and internal jugular vein (covered by the and internal jugular vein (covered by the posterior belly of digastric). It then curves up posterior belly of digastric). It then curves up and anteriorly crossing the first part of lingual and anteriorly crossing the first part of lingual artery and is distributed to the lingual muscles.artery and is distributed to the lingual muscles.

At its beginning, it is joined by branch from the At its beginning, it is joined by branch from the cervical plexus (containing fibers from C1) cervical plexus (containing fibers from C1) which supplies some muscles.which supplies some muscles.

Branches of Hypoglossal Branches of Hypoglossal NerveNerveBranches of Hypoglossal Branches of Hypoglossal NerveNerve1.1. Meningeal branchMeningeal branch: for posterior cranial fossa.: for posterior cranial fossa.

2.2. Descending branchDescending branch: Containing C1 fibers. It is : Containing C1 fibers. It is also called (descendens hypoglossi) and form also called (descendens hypoglossi) and form the superior root of ansa cervicalis.the superior root of ansa cervicalis.

3.3. Nerve to thyrohyoidNerve to thyrohyoid: also contains C1 fibers : also contains C1 fibers and supplies the thyrohyoid muscle.and supplies the thyrohyoid muscle.

4.4. Nerve to geniohyoidNerve to geniohyoid: also contains C1 fibers : also contains C1 fibers and supplies the geniohyoid muscle.and supplies the geniohyoid muscle.

5.5. Muscular branches of the tongueMuscular branches of the tongue: supplies all : supplies all intrinsic and extrinsic muscles of the tongue intrinsic and extrinsic muscles of the tongue except palatoglossus (from pharyngeal except palatoglossus (from pharyngeal plexus).plexus).

1.1. Meningeal branchMeningeal branch: for posterior cranial fossa.: for posterior cranial fossa.

2.2. Descending branchDescending branch: Containing C1 fibers. It is : Containing C1 fibers. It is also called (descendens hypoglossi) and form also called (descendens hypoglossi) and form the superior root of ansa cervicalis.the superior root of ansa cervicalis.

3.3. Nerve to thyrohyoidNerve to thyrohyoid: also contains C1 fibers : also contains C1 fibers and supplies the thyrohyoid muscle.and supplies the thyrohyoid muscle.

4.4. Nerve to geniohyoidNerve to geniohyoid: also contains C1 fibers : also contains C1 fibers and supplies the geniohyoid muscle.and supplies the geniohyoid muscle.

5.5. Muscular branches of the tongueMuscular branches of the tongue: supplies all : supplies all intrinsic and extrinsic muscles of the tongue intrinsic and extrinsic muscles of the tongue except palatoglossus (from pharyngeal except palatoglossus (from pharyngeal plexus).plexus).

Cervical sympathetic Cervical sympathetic trunktrunkCervical sympathetic Cervical sympathetic trunktrunk It extends upward till the base of the skull and It extends upward till the base of the skull and

below to the neck of the first rib where it below to the neck of the first rib where it continues in the thorax.continues in the thorax.

It lies behind the common and internal carotid It lies behind the common and internal carotid arteries (posterior to the carotid sheath).arteries (posterior to the carotid sheath).

It possesses three ganglia; superior, middle It possesses three ganglia; superior, middle and inferior.and inferior.

Superior ganglion is the larger and longer and Superior ganglion is the larger and longer and lies just below the skull.lies just below the skull.

Middle ganglion lies at the level of the cricoid Middle ganglion lies at the level of the cricoid cartilage (6cartilage (6thth cervical vertebra). cervical vertebra).

Inferior ganglion may fuse with 1Inferior ganglion may fuse with 1stst thoracic to thoracic to form stellate ganglion and it lies in front of form stellate ganglion and it lies in front of the neck of the 1the neck of the 1stst rib. rib.

It extends upward till the base of the skull and It extends upward till the base of the skull and below to the neck of the first rib where it below to the neck of the first rib where it continues in the thorax.continues in the thorax.

It lies behind the common and internal carotid It lies behind the common and internal carotid arteries (posterior to the carotid sheath).arteries (posterior to the carotid sheath).

It possesses three ganglia; superior, middle It possesses three ganglia; superior, middle and inferior.and inferior.

Superior ganglion is the larger and longer and Superior ganglion is the larger and longer and lies just below the skull.lies just below the skull.

Middle ganglion lies at the level of the cricoid Middle ganglion lies at the level of the cricoid cartilage (6cartilage (6thth cervical vertebra). cervical vertebra).

Inferior ganglion may fuse with 1Inferior ganglion may fuse with 1stst thoracic to thoracic to form stellate ganglion and it lies in front of form stellate ganglion and it lies in front of the neck of the 1the neck of the 1stst rib. rib.

Branches of superior Branches of superior ganglionganglionBranches of superior Branches of superior ganglionganglion1.1. Internal carotid nerveInternal carotid nerve: accompanies the : accompanies the

internal carotid artery and enters the carotid internal carotid artery and enters the carotid canal and form the plexus around the artery.canal and form the plexus around the artery.

2.2. Gray rami communicantesGray rami communicantes: to upper four : to upper four anterior rami of the cervical nerves.anterior rami of the cervical nerves.

3.3. Arterial branchesArterial branches: with form plexus around the : with form plexus around the common and external carotid arteries and are common and external carotid arteries and are distributed with them.distributed with them.

4.4. Branches to the cranial nervesBranches to the cranial nerves: join the : join the glossopharyngeal, vagus and hypoglossal glossopharyngeal, vagus and hypoglossal nerves.nerves.

5.5. Pharyngeal branchesPharyngeal branches: to the pharyngeal plexus.: to the pharyngeal plexus.6.6. Superior cardiac branchSuperior cardiac branch: to the cardiac plexus : to the cardiac plexus

in thorax.in thorax.

1.1. Internal carotid nerveInternal carotid nerve: accompanies the : accompanies the internal carotid artery and enters the carotid internal carotid artery and enters the carotid canal and form the plexus around the artery.canal and form the plexus around the artery.

2.2. Gray rami communicantesGray rami communicantes: to upper four : to upper four anterior rami of the cervical nerves.anterior rami of the cervical nerves.

3.3. Arterial branchesArterial branches: with form plexus around the : with form plexus around the common and external carotid arteries and are common and external carotid arteries and are distributed with them.distributed with them.

4.4. Branches to the cranial nervesBranches to the cranial nerves: join the : join the glossopharyngeal, vagus and hypoglossal glossopharyngeal, vagus and hypoglossal nerves.nerves.

5.5. Pharyngeal branchesPharyngeal branches: to the pharyngeal plexus.: to the pharyngeal plexus.6.6. Superior cardiac branchSuperior cardiac branch: to the cardiac plexus : to the cardiac plexus

in thorax.in thorax.

Branches of middle Branches of middle ganglionganglionBranches of middle Branches of middle ganglionganglion1.1. Gray rami communicantesGray rami communicantes: to the anterior : to the anterior

rami of the 5rami of the 5thth and 6 and 6thth cervical nerves. cervical nerves.2.2. Arterial branchesArterial branches: with form plexus around : with form plexus around

the inferior thyroid artery to be distributed the inferior thyroid artery to be distributed to the thyroid gland.to the thyroid gland.

3.3. Middle cardiac branchMiddle cardiac branch: to the cardiac : to the cardiac plexus in thorax.plexus in thorax.

4.4. Ansa subclaviaAnsa subclavia: descends in front of the : descends in front of the first part of subclavian artery then rotates first part of subclavian artery then rotates around it and ascends again to join the around it and ascends again to join the inferior cervical (or stellate) ganglion.inferior cervical (or stellate) ganglion.

1.1. Gray rami communicantesGray rami communicantes: to the anterior : to the anterior rami of the 5rami of the 5thth and 6 and 6thth cervical nerves. cervical nerves.

2.2. Arterial branchesArterial branches: with form plexus around : with form plexus around the inferior thyroid artery to be distributed the inferior thyroid artery to be distributed to the thyroid gland.to the thyroid gland.

3.3. Middle cardiac branchMiddle cardiac branch: to the cardiac : to the cardiac plexus in thorax.plexus in thorax.

4.4. Ansa subclaviaAnsa subclavia: descends in front of the : descends in front of the first part of subclavian artery then rotates first part of subclavian artery then rotates around it and ascends again to join the around it and ascends again to join the inferior cervical (or stellate) ganglion.inferior cervical (or stellate) ganglion.

Branches of inferior Branches of inferior ganglionganglionBranches of inferior Branches of inferior ganglionganglion

1.1. Gray rami communicantesGray rami communicantes: to the : to the anterior rami of the 7anterior rami of the 7thth and 8 and 8thth cervical nerves.cervical nerves.

2.2. Arterial branchesArterial branches: with form plexus : with form plexus around the subclavian and vertebral around the subclavian and vertebral arteries to be distributed along them.arteries to be distributed along them.

3.3. Inferior cardiac branchInferior cardiac branch: to the cardiac : to the cardiac plexus in thorax.plexus in thorax.

4.4. Ansa subclaviaAnsa subclavia: mentioned before.: mentioned before.

1.1. Gray rami communicantesGray rami communicantes: to the : to the anterior rami of the 7anterior rami of the 7thth and 8 and 8thth cervical nerves.cervical nerves.

2.2. Arterial branchesArterial branches: with form plexus : with form plexus around the subclavian and vertebral around the subclavian and vertebral arteries to be distributed along them.arteries to be distributed along them.

3.3. Inferior cardiac branchInferior cardiac branch: to the cardiac : to the cardiac plexus in thorax.plexus in thorax.

4.4. Ansa subclaviaAnsa subclavia: mentioned before.: mentioned before.

Cervical plexusCervical plexusCervical plexusCervical plexus Formed by the anterior rami of the upper cervical Formed by the anterior rami of the upper cervical

nerves.nerves. Lies in front of the origin of levator scapulae and Lies in front of the origin of levator scapulae and

scalenus medius muscles.scalenus medius muscles. It is covered by the prevertebral fascia.It is covered by the prevertebral fascia. BranchesBranches::1.1. Cutaneous branchesCutaneous branches: lesser occipital, great : lesser occipital, great

auricular, transverse cervical and supraclavicular auricular, transverse cervical and supraclavicular nerves.nerves.

2.2. Muscular branchesMuscular branches: to prevertebral muscles, : to prevertebral muscles, sternocleidomastoid & trapezius (proprioceptive), sternocleidomastoid & trapezius (proprioceptive), levator scapulae, geniohyoid & thyrohyoid levator scapulae, geniohyoid & thyrohyoid (through C1 fibers that join hypoglossal nerve and (through C1 fibers that join hypoglossal nerve and infrahyoid muscle (through ansa cervicalis).infrahyoid muscle (through ansa cervicalis).

3.3. Phrenic nervePhrenic nerve: to the diaphragm.: to the diaphragm.

Formed by the anterior rami of the upper cervical Formed by the anterior rami of the upper cervical nerves.nerves.

Lies in front of the origin of levator scapulae and Lies in front of the origin of levator scapulae and scalenus medius muscles.scalenus medius muscles.

It is covered by the prevertebral fascia.It is covered by the prevertebral fascia. BranchesBranches::1.1. Cutaneous branchesCutaneous branches: lesser occipital, great : lesser occipital, great

auricular, transverse cervical and supraclavicular auricular, transverse cervical and supraclavicular nerves.nerves.

2.2. Muscular branchesMuscular branches: to prevertebral muscles, : to prevertebral muscles, sternocleidomastoid & trapezius (proprioceptive), sternocleidomastoid & trapezius (proprioceptive), levator scapulae, geniohyoid & thyrohyoid levator scapulae, geniohyoid & thyrohyoid (through C1 fibers that join hypoglossal nerve and (through C1 fibers that join hypoglossal nerve and infrahyoid muscle (through ansa cervicalis).infrahyoid muscle (through ansa cervicalis).

3.3. Phrenic nervePhrenic nerve: to the diaphragm.: to the diaphragm.

Phrenic nervePhrenic nervePhrenic nervePhrenic nerve It is the only motor nerve supply to the It is the only motor nerve supply to the

diaphragm.diaphragm. It also contains sensory and sympathetic It also contains sensory and sympathetic

nerves.nerves. It supplies the pleura and peritoneum on It supplies the pleura and peritoneum on

both surfaces of diaphragm, mediastinal both surfaces of diaphragm, mediastinal pleura, pericardium and proprioceptive pleura, pericardium and proprioceptive sensation of the diaphragm.sensation of the diaphragm.

It arises from C3,4,5 and runs over the It arises from C3,4,5 and runs over the scalenus anterior muscle (from its lateral to scalenus anterior muscle (from its lateral to medial borders) and covered by prevertebral medial borders) and covered by prevertebral fascia and enters the thorax by passing in fascia and enters the thorax by passing in front of the subclavian artery.front of the subclavian artery.

It is the only motor nerve supply to the It is the only motor nerve supply to the diaphragm.diaphragm.

It also contains sensory and sympathetic It also contains sensory and sympathetic nerves.nerves.

It supplies the pleura and peritoneum on It supplies the pleura and peritoneum on both surfaces of diaphragm, mediastinal both surfaces of diaphragm, mediastinal pleura, pericardium and proprioceptive pleura, pericardium and proprioceptive sensation of the diaphragm.sensation of the diaphragm.

It arises from C3,4,5 and runs over the It arises from C3,4,5 and runs over the scalenus anterior muscle (from its lateral to scalenus anterior muscle (from its lateral to medial borders) and covered by prevertebral medial borders) and covered by prevertebral fascia and enters the thorax by passing in fascia and enters the thorax by passing in front of the subclavian artery.front of the subclavian artery.