The sympathetic trunks (sympathetic chain, gangliated cord) are a paired bundle of nerve fibers that run from the base of the skull to the coccyx.
The sympathetic trunk lies just lateral to the vertebral bodies for the entire length of the vertebral column. It interacts with the anterior rami of spinal nerves by way of rami communicantes. The sympathetic trunk permits preganglionic fibers of the sympathetic nervous system to ascend to spinal levels superior to T1 and descend to spinal levels inferior to L2/3.
The superior end of it is continued upward through the carotid canal into the skull, and forms a plexus on the internal carotid artery; the inferior part travels in front of the coccyx, where it converges with the other trunk at a structure known as the ganglion impar.
Along the length of the sympathetic trunk are sympathetic ganglia known as paravertebral ganglia.