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Nerve of Kuntz Stellate Bypass — FRCA Primary MCQ

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HardAnatomyNerve of Kuntz Stellate BypassFRCA Primary

The nerve of Kuntz is a variant nerve that can bypass the stellate ganglion. Its clinical significance is that:

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Correct answer: A — It can transmit sympathetic fibres to the upper limb that are not blocked by a standard stellate ganglion block causing incomplete sympathectomy

The nerve of Kuntz (and other variant intrathoracic communicating branches from T2/T3) can transmit sympathetic fibres to the upper limb brachial plexus that bypass the stellate ganglion. This can result in incomplete upper limb sympathectomy despite a technically successful stellate ganglion block. It is more relevant for surgical sympathectomy than for temporary blocks.

Reference: RCoA 2021 Primary FRCA Curriculum