Anatomic localization of sympathetic nerves in the hand

The microscopic anatomical localization of the sympathetic nerves within the peripheral nerves and their relationship to the end arteries in the hand has not been fully evaluated. A preliminary study is presented that outlines a method of microscopic identification of sympathetic nerves in the hand. Fresh human tissue consisting of median and ulnar nerves and their arterial supply were used in the study. Sections of these were taken at multiple levels in the forearm, wrist, and hand after the tissue was frozen. The sections were then immersed in a glyoxylic acid solution in order to excite catecholamine fluorescence. Dark-field fluorescence microscopy was then used to view the sections. Light microscopy was also used to examine adjacent sections from the same specimens. The sympathetics are more plentiful in the median nerve as compared to the ulnar nerve at the wrist. They are mostly located, in clusters, in the peripheral aspect of the nerve. Control material consisting of motor nerve, sympathetic chain, and adrenal gland was used to standardize the fluorescence. Histofluorescence was then used as a method to define the anatomy of the sympathetic nerves in the hand.