Brenda De Gama | UKZN (original) (raw)

Papers by Brenda De Gama

Research paper thumbnail of A quantitative evaluation of traditional health practitioners’ perspectives on mental disorders in KwaZulu-Natal: knowledge, diagnosis, and treatment practices

Journal of Spirituality in Mental Health

Research paper thumbnail of Anthropometric orbital measurements in a paediatric population

Translational Research in Anatomy

Research paper thumbnail of An anatomical investigation of the sympathetic and parasympathetic contributions to the cardiac plexus

So many times we think we cannot do something unless we take the small steps towards doing it. Th... more So many times we think we cannot do something unless we take the small steps towards doing it. This has been made up of small steps of learning and hard times thus I give gratitude to God Almighty for giving me the strength to continue and complete this when I felt I cannot anymore. I can do all things through Christ who strengthens me.

Research paper thumbnail of Arterial Variations of the Subclavian-Axillary Arterial Tree: Its Association with the Supply of the Rotator Cuff Muscles

International Journal of Morphology, 2014

The subclavian-axillary arterial tree is responsible for the arterial supply to the rotator cuff ... more The subclavian-axillary arterial tree is responsible for the arterial supply to the rotator cuff muscles as well as other shoulder muscles. This study comprised the bilateral dissection of the shoulder and upper arm region in thirty-one adult and nineteen fetal cadaveric specimens. The variable origins and branching patterns of the axillary, subscapular, circumflex scapular, thoracodorsal, posterior circumflex humeral and suprascapular arteries identified in this study corroborated the findings of previous studies. In addition, unique variations that are unreported in the literature were also observed. The precise anatomy of the arterial distribution to the rotator cuff muscles is important to the surgeon and radiologist. It will aid proper interpretation of radiographic images and avoid injury to this area during surgical procedures.

Research paper thumbnail of Anatomical Variations of the Anterior Belly of the Digastric Muscle

International Journal of Morphology, 2019

A routine dissection of the digastric muscle reflected that it originated by two muscle bellies n... more A routine dissection of the digastric muscle reflected that it originated by two muscle bellies namely. the anterior and posterior belly which are connected by an intermediate tendon (IT). These bellies originated from the mastoid process of the temporal bone and the digastric fossa of the mandible respectively. The digastric muscle serves as an important surgical landmark in surgical interventions involving the submental area however, accessory bellies may interfere with surgical intervention in this area. Therefore, this study aimed to document the occurrence of the anatomical variations in the anterior belly of the digastric muscle (ABDM) in a selected number of cadaveric samples. Ten bilateral adult cadaveric head and neck specimens (n = 20) were macro-dissected in order to document the morphology of the digastric muscle. The accessory bellies in the ABDM was observed in 60 % of the specimens. Unilateral and bilateral variations were observed in 20 % and 30 % of the specimens, respectively. These accessory bellies originated in the digastric fossa, ABDM, IT and hyoid bone, and inserted into the mylohyoid raphe, mylohyoid muscle and hyoid bone. In addition, an anomalous main ABDM was observed in 10 % of the specimens inserting through a transverse tendon into the hyoid bone. Variations in the digastric muscle are common especially the accessory bellies, therefore, a comprehensive understanding of these anatomical variations could be of clinical importance to the surgeons during head and neck radiological diagnosis and surgical interventions.

Research paper thumbnail of An anatomical investigation of the superficial and deep palmar arches

Folia Morphologica, 2017

Background: The superficial palmar arch (SPA) and deep palmar arch (DPA) provide the dominant vas... more Background: The superficial palmar arch (SPA) and deep palmar arch (DPA) provide the dominant vascular supply to the hand. The SPA is considered to be highly variable and can be classified as either complete or incomplete. The simplest definition states that the anastomosis between the vessels contributing to the arch represent a complete arch, while an incomplete arch is described as characterised by an absence of anastomosis between the vessels contributing to it. This study aimed to describe the anatomical landmarks, formation and branching patterns of the SPA and DPA. In this study, the SPA and DPA were dissected in 50 specimens (n = 100 adult hands), respectively. Materials and methods: A complete SPA was observed in 92% of specimens and classified into three types. In Type A (44%), the SPA was formed by the anastomosis of the superficial palmar branch of the radial artery with the ulnar artery. Type B (46%) was formed by the ulnar artery alone and Type C (2%) was formed by anastomosis of the ulnar artery with the superficial palmar branch of the radial artery and the persistent median artery. Results: An incomplete SPA was observed in 8% of the specimens and divided into three types formed by the radial and ulnar arteries. The DPA was divided into five types viz. Type G (72%), where the DPA was formed by anastomosis of the deep palmar branch of the radial artery (DPBRA) with the deep palmar branch of the ulnar artery (DPBUA). Type H (12%), was formed by anastomosis of the DPBRA, the DBUA and the interosseous artery. Type I (8%), was formed by the anastomosis of the DPBRA with the superior and inferior DPBUA. Type J (4%), the deep ulnar artery had two branches whereby either one branch anastomosed with the DPBRA to form the DPA. Type K (4%), the DBUA exhibited two deep branches with one branch anastomosing with the DPBRA to complete the DPA. Conclusions: The interosseous artery anastomosed with either the DPA or the additional DPBUA. Knowledge of the variability of the SPA and DPA is crucial for safe and successful hand surgeries.

Research paper thumbnail of Arterial Supply to the Rotator Cuff Muscles

International Journal of Morphology, 2014

The arterial supply to the rotator cuff muscles is generally provided by the subscapular, circumf... more The arterial supply to the rotator cuff muscles is generally provided by the subscapular, circumflex scapular, posterior circumflex humeral and suprascapular arteries. This study involved the bilateral dissection of the scapulohumeral region of 31 adult and 19 fetal cadaveric specimens. The subscapularis muscle was supplied by the subscapular, suprascapular and circumflex scapular arteries. The supraspinatus and infraspinatus muscles were supplied by the suprascapular artery. The infraspinatus and teres minor muscles were found to be supplied by the circumflex scapular artery. In addition to the branches of these parent arteries, the rotator cuff muscles were found to be supplied by the dorsal scapular, lateral thoracic, thoracodorsal and posterior circumflex humeral arteries. The variations in the arterial supply to the rotator cuff muscles recorded in this study are unique and were not described in the literature reviewed. Due to the increased frequency of operative procedures in the scapulohumeral region, the knowledge of variations in the arterial supply to the rotator cuff muscles may be of practical importance to surgeons and radiologists.

Research paper thumbnail of Arterial supply to rotator cuff muscles IJM

Research paper thumbnail of The variant course of the suprascapular artery

Folia Morphologica, 2014

The suprascapular artery (SSA) has been identified to be of clinical relevance in surgical interv... more The suprascapular artery (SSA) has been identified to be of clinical relevance in surgical intervention and fracture healing of the shoulder. Despite the classic description of its course and relation to the superior transverse scapular ligament, it is subject to much variation. The aims of this study were: (i) to describe the course of the SSA in relation to the superior transverse scapular ligament, (ii) to determine the prevalence of the course of the SSA in relation to the superior transverse scapular ligament, (iii) to determine the prevalence of the variant origin of the SSA in cases presenting with variant course of the latter, and (iv) to establish a difference in laterality and that between adults and foetuses. The course of the SSA was investigated through the macro-and microdissection of the antero-and postero-superior shoulder regions of 31 adult and 19 foetal cadaveric specimens (n = 100). The SSA was observed to pass inferior to the superior transverse scapular ligament accompanied by the suprascapular nerve (20%), which corroborated the findings of previous studies. Subsequently, this variant course of the SSA also appeared to present with the variant origin of it in many instances (13%): from the 3 rd part of the subclavian artery (4%), 1 st part of the axillary artery (2%), 2 nd part of the axillary artery (5%) and SSA (2%). Injury to the SSA may cause more serious trauma than that of arteries which are isolated from the great vessels, therefore the recognition and knowledge of variation in the origin and course of the SSA is significant in the treatment of diseases in the shoulder and cervical regions. Furthermore, the accompaniment of the suprascapular nerve with the SSA at the suprascapular notch inferior to the superior transverse scapular ligament may lead to neuropathy syndromes due to the pulsation of the artery against the nerve within the confined notch.

Research paper thumbnail of The Recurrent Laryngeal Cardiac Nerve in Fetuses

International Journal of Morphology, 2014

The recurrent laryngeal nerve has been reported to supply cardiac branches to the cardiac plexus.... more The recurrent laryngeal nerve has been reported to supply cardiac branches to the cardiac plexus. A review of anatomical literature on the existing term used to describe these branches revealed that varying interpretations and descriptions exist among various authors. Therefore, this study aimed to investigate the origin and incidence of branches from the recurrent laryngeal nerves to the cardiac plexus and their connections with sympathetic cardiac nerves. The sample comprised 40 cadaveric fetuses (n=80) (gestational ages: 16-30 weeks). The recurrent laryngeal cardiac nerve was described as the cardiac branch that originated directly from the recurrent laryngeal nerve and reached the superficial or deep parts of the cardiac plexus. This study found the recurrent laryngeal cardiac nerve in 76% of the cases contributing direct and indirect branches in 75% and 25% of the cases, respectively. This study recorded only two (2%) of these branches contributing to the superficial cardiac plexus while the rest (74%) of these branches contributed to the deep cardiac plexuses. The remaining 24% had no contributions from the recurrent laryngeal nerve to either the superficial or deep part of the cardiac plexus. The most common point of origin for the recurrent laryngeal cardiac nerve was at the lower distal part in 59% of the specimens. In the remaining 41% of branches, this nerve originated from the point of curvature, upper proximal part and both the point of curvature and lower distal part in 26%, 10% and 5% of the specimens.

Research paper thumbnail of Cultural practices of the Zulu ethnic group on the body and their influence on body donation

Anatomical Sciences Education, 2020

Cultural practices in the African continent have been thought to impact negatively on body donati... more Cultural practices in the African continent have been thought to impact negatively on body donation. Thus, most African countries continue to rely on unclaimed bodies for dissection programs, or bequests from the white population. The latter situation is dominant in South African medical schools. Since South Africa is multi-cultural with nine main ethnic groups of the Black African population, it is important to seek the reasons behind lack of participation in body donation. This report represents a move in this direction with its qualitative study of the cultural practices of the Zulu ethnic group in the province of KwaZulu-Natal from the perspective of a variety of participants, with emphasis on their treatment of the human body after death. Four themes emerged from interviews: (1) Death is not the end; (2) Effect of belief in ancestors; (3) Significance of rituals and customs carried out on human tissue; and (4) Burial as the only method of body disposal. Each of these themes is discussed in relation to the likelihood of body donation being seen by Zulus as an acceptable practice. It is concluded that this is unlikely, on account of the need to preserve the linkage between the physical human body and the spirit of the deceased person, and the perceived ongoing relationship between the spirit of the dead and the living. In view of these conclusions, a number of options are canvassed about the manner in which anatomists in KwaZulu-Natal might obtain bodies for dissection. These possibilities have implications for anatomists working in comparable cultural contexts.

Research paper thumbnail of The Sympathetic and Parasympathetic Contributions to the Cardiac Plexus: a Fetal Study

International Journal of Morphology, 2012

The cardiac plexus is formed by sympathetic nerves originating from the superior, middle, inferio... more The cardiac plexus is formed by sympathetic nerves originating from the superior, middle, inferior cervical or cervicothoracic ganglia as well as from the first to the fifth thoracic ganglia. Furthermore, the vagus nerve and its counterpart, the recurrent laryngeal nerve supply the cardiac plexus with parasympathetic cardiac nerves. This investigation aimed to review and record the medial contributions of the cervical ganglia, first to fifth thoracic ganglia and medial contributions of the vagus and recurrent laryngeal nerves to the cardiac plexus. The study involved bilateral micro-dissection of forty cadaveric fetal specimens (n=80). The origins of sympathetic contributions to the cardiac plexus were described as either ganglionic, inter-ganglionic or from both the ganglion and the inter-ganglionic sympathetic chain. The number of cervical sympathetic ganglia varied from two to five in this study; the superior cervical ganglion was constant while the middle cervical, vertebral, inferior cervical or cervicothoracic ganglia were variable. The prevalence of cardiac nerves were as follows: superior cervical cardiac nerve (95%); middle cervical cardiac nerve (73%); vertebral cardiac nerve (41%); inferior cervical cardiac nerve (21%) and cervicothoracic cardiac nerve (24%). This investigation records the thoracic caudal limit of the thoracic sympathetic contributions to the cardiac plexus as the T5 ganglion. The findings of this study highlight the importance of understanding the medial sympathetic contributions and their variations to the cardiac plexus as this may assist surgeons during minimal access surgical procedures, sympathectomies, pericardiectomies and in the management of diseases like Raynaud's Phenomenon and angina pectoris.

Research paper thumbnail of A quantitative evaluation of traditional health practitioners’ perspectives on mental disorders in KwaZulu-Natal: knowledge, diagnosis, and treatment practices

Journal of Spirituality in Mental Health

Research paper thumbnail of Anthropometric orbital measurements in a paediatric population

Translational Research in Anatomy

Research paper thumbnail of An anatomical investigation of the sympathetic and parasympathetic contributions to the cardiac plexus

So many times we think we cannot do something unless we take the small steps towards doing it. Th... more So many times we think we cannot do something unless we take the small steps towards doing it. This has been made up of small steps of learning and hard times thus I give gratitude to God Almighty for giving me the strength to continue and complete this when I felt I cannot anymore. I can do all things through Christ who strengthens me.

Research paper thumbnail of Arterial Variations of the Subclavian-Axillary Arterial Tree: Its Association with the Supply of the Rotator Cuff Muscles

International Journal of Morphology, 2014

The subclavian-axillary arterial tree is responsible for the arterial supply to the rotator cuff ... more The subclavian-axillary arterial tree is responsible for the arterial supply to the rotator cuff muscles as well as other shoulder muscles. This study comprised the bilateral dissection of the shoulder and upper arm region in thirty-one adult and nineteen fetal cadaveric specimens. The variable origins and branching patterns of the axillary, subscapular, circumflex scapular, thoracodorsal, posterior circumflex humeral and suprascapular arteries identified in this study corroborated the findings of previous studies. In addition, unique variations that are unreported in the literature were also observed. The precise anatomy of the arterial distribution to the rotator cuff muscles is important to the surgeon and radiologist. It will aid proper interpretation of radiographic images and avoid injury to this area during surgical procedures.

Research paper thumbnail of Anatomical Variations of the Anterior Belly of the Digastric Muscle

International Journal of Morphology, 2019

A routine dissection of the digastric muscle reflected that it originated by two muscle bellies n... more A routine dissection of the digastric muscle reflected that it originated by two muscle bellies namely. the anterior and posterior belly which are connected by an intermediate tendon (IT). These bellies originated from the mastoid process of the temporal bone and the digastric fossa of the mandible respectively. The digastric muscle serves as an important surgical landmark in surgical interventions involving the submental area however, accessory bellies may interfere with surgical intervention in this area. Therefore, this study aimed to document the occurrence of the anatomical variations in the anterior belly of the digastric muscle (ABDM) in a selected number of cadaveric samples. Ten bilateral adult cadaveric head and neck specimens (n = 20) were macro-dissected in order to document the morphology of the digastric muscle. The accessory bellies in the ABDM was observed in 60 % of the specimens. Unilateral and bilateral variations were observed in 20 % and 30 % of the specimens, respectively. These accessory bellies originated in the digastric fossa, ABDM, IT and hyoid bone, and inserted into the mylohyoid raphe, mylohyoid muscle and hyoid bone. In addition, an anomalous main ABDM was observed in 10 % of the specimens inserting through a transverse tendon into the hyoid bone. Variations in the digastric muscle are common especially the accessory bellies, therefore, a comprehensive understanding of these anatomical variations could be of clinical importance to the surgeons during head and neck radiological diagnosis and surgical interventions.

Research paper thumbnail of An anatomical investigation of the superficial and deep palmar arches

Folia Morphologica, 2017

Background: The superficial palmar arch (SPA) and deep palmar arch (DPA) provide the dominant vas... more Background: The superficial palmar arch (SPA) and deep palmar arch (DPA) provide the dominant vascular supply to the hand. The SPA is considered to be highly variable and can be classified as either complete or incomplete. The simplest definition states that the anastomosis between the vessels contributing to the arch represent a complete arch, while an incomplete arch is described as characterised by an absence of anastomosis between the vessels contributing to it. This study aimed to describe the anatomical landmarks, formation and branching patterns of the SPA and DPA. In this study, the SPA and DPA were dissected in 50 specimens (n = 100 adult hands), respectively. Materials and methods: A complete SPA was observed in 92% of specimens and classified into three types. In Type A (44%), the SPA was formed by the anastomosis of the superficial palmar branch of the radial artery with the ulnar artery. Type B (46%) was formed by the ulnar artery alone and Type C (2%) was formed by anastomosis of the ulnar artery with the superficial palmar branch of the radial artery and the persistent median artery. Results: An incomplete SPA was observed in 8% of the specimens and divided into three types formed by the radial and ulnar arteries. The DPA was divided into five types viz. Type G (72%), where the DPA was formed by anastomosis of the deep palmar branch of the radial artery (DPBRA) with the deep palmar branch of the ulnar artery (DPBUA). Type H (12%), was formed by anastomosis of the DPBRA, the DBUA and the interosseous artery. Type I (8%), was formed by the anastomosis of the DPBRA with the superior and inferior DPBUA. Type J (4%), the deep ulnar artery had two branches whereby either one branch anastomosed with the DPBRA to form the DPA. Type K (4%), the DBUA exhibited two deep branches with one branch anastomosing with the DPBRA to complete the DPA. Conclusions: The interosseous artery anastomosed with either the DPA or the additional DPBUA. Knowledge of the variability of the SPA and DPA is crucial for safe and successful hand surgeries.

Research paper thumbnail of Arterial Supply to the Rotator Cuff Muscles

International Journal of Morphology, 2014

The arterial supply to the rotator cuff muscles is generally provided by the subscapular, circumf... more The arterial supply to the rotator cuff muscles is generally provided by the subscapular, circumflex scapular, posterior circumflex humeral and suprascapular arteries. This study involved the bilateral dissection of the scapulohumeral region of 31 adult and 19 fetal cadaveric specimens. The subscapularis muscle was supplied by the subscapular, suprascapular and circumflex scapular arteries. The supraspinatus and infraspinatus muscles were supplied by the suprascapular artery. The infraspinatus and teres minor muscles were found to be supplied by the circumflex scapular artery. In addition to the branches of these parent arteries, the rotator cuff muscles were found to be supplied by the dorsal scapular, lateral thoracic, thoracodorsal and posterior circumflex humeral arteries. The variations in the arterial supply to the rotator cuff muscles recorded in this study are unique and were not described in the literature reviewed. Due to the increased frequency of operative procedures in the scapulohumeral region, the knowledge of variations in the arterial supply to the rotator cuff muscles may be of practical importance to surgeons and radiologists.

Research paper thumbnail of Arterial supply to rotator cuff muscles IJM

Research paper thumbnail of The variant course of the suprascapular artery

Folia Morphologica, 2014

The suprascapular artery (SSA) has been identified to be of clinical relevance in surgical interv... more The suprascapular artery (SSA) has been identified to be of clinical relevance in surgical intervention and fracture healing of the shoulder. Despite the classic description of its course and relation to the superior transverse scapular ligament, it is subject to much variation. The aims of this study were: (i) to describe the course of the SSA in relation to the superior transverse scapular ligament, (ii) to determine the prevalence of the course of the SSA in relation to the superior transverse scapular ligament, (iii) to determine the prevalence of the variant origin of the SSA in cases presenting with variant course of the latter, and (iv) to establish a difference in laterality and that between adults and foetuses. The course of the SSA was investigated through the macro-and microdissection of the antero-and postero-superior shoulder regions of 31 adult and 19 foetal cadaveric specimens (n = 100). The SSA was observed to pass inferior to the superior transverse scapular ligament accompanied by the suprascapular nerve (20%), which corroborated the findings of previous studies. Subsequently, this variant course of the SSA also appeared to present with the variant origin of it in many instances (13%): from the 3 rd part of the subclavian artery (4%), 1 st part of the axillary artery (2%), 2 nd part of the axillary artery (5%) and SSA (2%). Injury to the SSA may cause more serious trauma than that of arteries which are isolated from the great vessels, therefore the recognition and knowledge of variation in the origin and course of the SSA is significant in the treatment of diseases in the shoulder and cervical regions. Furthermore, the accompaniment of the suprascapular nerve with the SSA at the suprascapular notch inferior to the superior transverse scapular ligament may lead to neuropathy syndromes due to the pulsation of the artery against the nerve within the confined notch.

Research paper thumbnail of The Recurrent Laryngeal Cardiac Nerve in Fetuses

International Journal of Morphology, 2014

The recurrent laryngeal nerve has been reported to supply cardiac branches to the cardiac plexus.... more The recurrent laryngeal nerve has been reported to supply cardiac branches to the cardiac plexus. A review of anatomical literature on the existing term used to describe these branches revealed that varying interpretations and descriptions exist among various authors. Therefore, this study aimed to investigate the origin and incidence of branches from the recurrent laryngeal nerves to the cardiac plexus and their connections with sympathetic cardiac nerves. The sample comprised 40 cadaveric fetuses (n=80) (gestational ages: 16-30 weeks). The recurrent laryngeal cardiac nerve was described as the cardiac branch that originated directly from the recurrent laryngeal nerve and reached the superficial or deep parts of the cardiac plexus. This study found the recurrent laryngeal cardiac nerve in 76% of the cases contributing direct and indirect branches in 75% and 25% of the cases, respectively. This study recorded only two (2%) of these branches contributing to the superficial cardiac plexus while the rest (74%) of these branches contributed to the deep cardiac plexuses. The remaining 24% had no contributions from the recurrent laryngeal nerve to either the superficial or deep part of the cardiac plexus. The most common point of origin for the recurrent laryngeal cardiac nerve was at the lower distal part in 59% of the specimens. In the remaining 41% of branches, this nerve originated from the point of curvature, upper proximal part and both the point of curvature and lower distal part in 26%, 10% and 5% of the specimens.

Research paper thumbnail of Cultural practices of the Zulu ethnic group on the body and their influence on body donation

Anatomical Sciences Education, 2020

Cultural practices in the African continent have been thought to impact negatively on body donati... more Cultural practices in the African continent have been thought to impact negatively on body donation. Thus, most African countries continue to rely on unclaimed bodies for dissection programs, or bequests from the white population. The latter situation is dominant in South African medical schools. Since South Africa is multi-cultural with nine main ethnic groups of the Black African population, it is important to seek the reasons behind lack of participation in body donation. This report represents a move in this direction with its qualitative study of the cultural practices of the Zulu ethnic group in the province of KwaZulu-Natal from the perspective of a variety of participants, with emphasis on their treatment of the human body after death. Four themes emerged from interviews: (1) Death is not the end; (2) Effect of belief in ancestors; (3) Significance of rituals and customs carried out on human tissue; and (4) Burial as the only method of body disposal. Each of these themes is discussed in relation to the likelihood of body donation being seen by Zulus as an acceptable practice. It is concluded that this is unlikely, on account of the need to preserve the linkage between the physical human body and the spirit of the deceased person, and the perceived ongoing relationship between the spirit of the dead and the living. In view of these conclusions, a number of options are canvassed about the manner in which anatomists in KwaZulu-Natal might obtain bodies for dissection. These possibilities have implications for anatomists working in comparable cultural contexts.

Research paper thumbnail of The Sympathetic and Parasympathetic Contributions to the Cardiac Plexus: a Fetal Study

International Journal of Morphology, 2012

The cardiac plexus is formed by sympathetic nerves originating from the superior, middle, inferio... more The cardiac plexus is formed by sympathetic nerves originating from the superior, middle, inferior cervical or cervicothoracic ganglia as well as from the first to the fifth thoracic ganglia. Furthermore, the vagus nerve and its counterpart, the recurrent laryngeal nerve supply the cardiac plexus with parasympathetic cardiac nerves. This investigation aimed to review and record the medial contributions of the cervical ganglia, first to fifth thoracic ganglia and medial contributions of the vagus and recurrent laryngeal nerves to the cardiac plexus. The study involved bilateral micro-dissection of forty cadaveric fetal specimens (n=80). The origins of sympathetic contributions to the cardiac plexus were described as either ganglionic, inter-ganglionic or from both the ganglion and the inter-ganglionic sympathetic chain. The number of cervical sympathetic ganglia varied from two to five in this study; the superior cervical ganglion was constant while the middle cervical, vertebral, inferior cervical or cervicothoracic ganglia were variable. The prevalence of cardiac nerves were as follows: superior cervical cardiac nerve (95%); middle cervical cardiac nerve (73%); vertebral cardiac nerve (41%); inferior cervical cardiac nerve (21%) and cervicothoracic cardiac nerve (24%). This investigation records the thoracic caudal limit of the thoracic sympathetic contributions to the cardiac plexus as the T5 ganglion. The findings of this study highlight the importance of understanding the medial sympathetic contributions and their variations to the cardiac plexus as this may assist surgeons during minimal access surgical procedures, sympathectomies, pericardiectomies and in the management of diseases like Raynaud's Phenomenon and angina pectoris.