Ganglion impar

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Ganglion impar
Gray's	subject #214 984

The pelvic portion of each sympathetic trunk is situated in front of the sacrum, medial to the anterior sacral foramina. It consists of four or five small sacral ganglia, connected together by interganglionic cords, and continuous above with the abdominal portion. Below, the two pelvic sympathetic trunks converge, and end on the front of the coccyx in a small ganglion, the ganglion impar (or ganglion of Walther).

Clinical significance

Physicians at New Jersey Medical School specializing in Physical Medicine and Rehabilitation have published that sometimes even just a single local nerve block injection at the ganglion impar can give 100% relief of coccydynia (tailbone pain, also called coccyx pain), when performed under fluoroscopic guidance.^[1]

References

↑ Foye P, Buttaci C, Stitik T, Yonclas P (2006). "Successful injection for coccyx pain.". Am J Phys Med Rehabil 85 (9): 783–4. doi:10.1097/01.phm.0000233174.86070.63. PMID 16924191.

Munir MA, Zhang J, Ahmad M. (2004) "A modified needle-inside-needle technique for the ganglion impar block." Can J Anaesth. 2004 Nov;51(9):915-7.

External links

"Ganglion Impar Injections to Treat Tailbone Pain" at www.TailboneDoctor.com
"Treatment of coccydynia by injection of local anesthetic to the ganglion impar", at coccyx.org
Human anatomy at Dartmouth figures/chapter_32/32-6.HTM
Tailbone pain (coccyx pain, coccydynia) Peer-reviewed medical article online at eMedicine (Medscape)

This article incorporates text from a public domain edition of Gray's Anatomy.

Nerves – autonomic nervous system (sympathetic nervous system/ganglion/trunks and parasympathetic nervous system/ganglion) (TA A14.3, GA 9.968)

Head/
cranial

Sympathetic	Ciliary ganglion: roots Sensory Sympathetic Short ciliary

Parasympathetic	Ciliary ganglion: roots Sensory Parasympathetic Short ciliary Pterygopalatine ganglion: deep petrosal nerve of pterygoid canal branches of distribution: greater palatine inferior posterior nasal branches lesser palatine nasopalatine medial superior posterior nasal branches pharyngeal Submandibular ganglion Otic ganglion

Neck/
cervical

Sympathetic	paravertebral ganglia: Cervical ganglia Superior Middle Inferior Stellate ganglion prevertebral plexus: Cavernous plexus Internal carotid

Chest/
thorax

Sympathetic	paravertebral ganglia: Thoracic ganglia prevertebral plexus: Cardiac plexus Esophageal plexus Pulmonary plexus Thoracic aortic plexus splanchnic nerves: cardiopulmonary thoracic cardiac nerves: Superior Middle Inferior

Abdomen/
Lumbar

Sympathetic	paravertebral ganglia: Lumbar ganglia prevertebral ganglia: Celiac ganglia Aorticorenal Superior mesenteric ganglion Inferior mesenteric ganglion prevertebral plexus: Celiac plexus Hepatic Splenic Pancreatic aorticorenal Abdominal aortic plexus Renal/Suprarenal Superior mesenteric Gastric Inferior mesenteric Spermatic Ovarian Superior hypogastric hypogastric nerve Superior rectal Inferior hypogastric Vesical Prostatic / Cavernous nerves of penis Uterovaginal Middle rectal splanchnic nerves: Lumbar splanchnic nerves

Enteric	Meissner's plexus Auerbach's plexus

Pelvis/
sacral

Sympathetic	paravertebral ganglia: Sacral ganglia Ganglion impar splanchnic nerves: Sacral splanchnic nerves

Parasympathetic	splanchnic nerves: Pelvic splanchnic nerves

M: PNS

anat (h/r/t/c/b/l/s/a)/phys (r)/devp/prot/nttr/nttm/ntrp

noco/auto/cong/tumr, sysi/epon, injr

proc, drug (N1B)

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Ganglion impar

Clinical significance

See also

References

External links