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Sympathetic Pathways: Collateral Ganglia and Adrenal Medulla01:27

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The sympathetic pathways of the collateral ganglia and adrenal medulla serve unique but interconnected roles in the sympathetic response.
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Sympathetic preganglionic axons reach the collateral ganglia along the route of splanchnic nerves. These nerves bypass the sympathetic trunk and communicate with sympathetic postganglionic neurons housed in the prevertebral ganglia. These ganglia supply the organs of the abdominopelvic cavity.
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The Peripheral Nervous System (PNS) is a crucial component of the body's neural network, extending beyond the central nervous system (CNS) to bridge the gap between the CNS and the external environment. It encompasses nerves, ganglia, and sensory receptors.
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The nerve is a bundle of axons that serves as the communication highway in the PNS. Each nerve is ensheathed in a protective layer of connective tissue called the epineurium. This outermost layer safeguards the nerve and supports the...
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Sympathetic Signaling

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Sympathetic signaling, a vital part of the autonomic nervous system, plays a crucial role in mobilizing the body's resources in response to stress or emergencies. It involves the transmission of nerve impulses from sympathetic preganglionic fibers to postganglionic fibers. This results in the release of specific neurotransmitters and activation of adrenergic receptors.
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Cranial Part of Parasympathetic Division01:18

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The cranial part of the parasympathetic division plays a crucial role in regulating the visceral functions of the head and specific structures in the neck, thoracic, and abdominopelvic cavities. Preganglionic fibers of the parasympathetic division exit the brain through cranial nerves III (oculomotor), VII (facial), IX (glossopharyngeal), and X (vagus), delivering parasympathetic output to the respective visceral structures.
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The sympathetic chain ganglia, also known as the sympathetic trunk ganglia or paravertebral ganglia, are a series of ganglia located bilaterally on either side of the spinal column. These ganglia serve as relay stations for the sympathetic nervous system. Preganglionic neurons originating in the spinal cord project their axons to the sympathetic chain ganglia. Within the ganglia, these preganglionic fibers synapse with postganglionic neurons.The postganglionic neurons of the sympathetic trunk...
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The pituitary is a small endocrine organ in the sphenoid bone under the hypothalamus. Primarily, the pituitary in adults has two distinct anatomical and functional regions— the anterior and posterior lobes. During human fetal development, a third pituitary gland region called the pars intermedia atrophies and disappears. However, some of its cells migrate and exist adjacent to the anterior pituitary in adults.
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Clinical differences between small and large pheochromocytomas and paragangliomas.

Lin Zhao1, ZhiMao Li2, Xu Meng1

  • 1Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/National Center for Cardiovascular Disease, Beijing, China.

Frontiers in Endocrinology
|March 27, 2023
PubMed
Summary

Large pheochromocytomas and paragangliomas (PPGLs) are more common in males and on adrenal glands, with higher catecholamine levels. These factors help predict large PPGLs, aiding clinical decisions.

Keywords:
catecholamineclinical featuresparagangliomapheochromocytomatumor diameter

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Area of Science:

  • Endocrinology
  • Oncology
  • Medical Diagnostics

Background:

  • Pheochromocytomas and paragangliomas (PPGLs) are neuroendocrine tumors releasing catecholamines.
  • Limited understanding exists regarding clinical differences between small and large PPGLs.

Purpose of the Study:

  • To investigate and compare clinical features of small and large PPGLs.
  • To identify risk factors and diagnostic predictors for large PPGLs.

Main Methods:

  • Retrospective analysis of 263 PPGL patients (Jan 2018 - June 2020).
  • Comparison of clinical characteristics between small (<1cm) and large (≥1cm) PPGL groups.
  • Logistic regression and ROC curve analysis for risk factor identification and diagnostic performance evaluation.

Main Results:

  • Large PPGLs were more frequent in males (p=0.009) and located in adrenal glands (p<0.001).
  • Patients with large PPGLs had higher rates of hypertension (p<0.001) and diabetes (p=0.002).
  • Elevated 24-h urinary epinephrine (24hU-E) and norepinephrine (24hU-NE) were associated with large tumors.
  • Male sex, higher 24hU-E and 24hU-NE, and adrenal location were significant predictors of large PPGLs (AUC=0.772).

Conclusions:

  • Significant clinical differences exist between small and large PPGLs.
  • Male sex, adrenal location, and catecholamine levels are key indicators for larger PPGLs.
  • This information can improve clinical decision-making for PPGL management.