Download Cervical Spine Muscular Anatomy

Cervical Spine Muscular Anatomy
Cervical and Occipital Flexors
Sternocleidomastoid
Origin
Lateral surface of the mastoid process of the
temporal bone
Insertion
Superior anterior surface of the manubrium
sterni and medial clavicle
Action
Ipsilateral lateral flexion, contralateral
rotation, flexion
Nerve Supply
Accessory Nerve (11th Cranial Nerve)
Palpation
In supine, ipsilateral side flexion, contralateral
rotation. Palpate between origin and
insertion. Ask client to actively raise head off
bed
Longus Colli
Origin
Insertion
Upper part- anterior tubercles of transverse
processes C3-5
Middle part- anterior bodies of C6-T3
Lower part- anterior bodies of T1-3
Upper part- anterior tubercle of the atlas
Middle part- anterior bodies of C2-4
Lower part- anterior transverse tubercles of
C5-6
Action
Flexion
Nerve Supply
Anterior primary rami of C3-6
Palpation
NA
Cervical Spine Muscular Anatomy
Cervical and Occipital Flexors
Scalenus Anterior
Origin
Anterior tubercles of the transverse processes
of C3-6
Insertion
Scalene tubercle on the inner border of the
first rib
Action
Ipsilateral lateral flexion, flexion. Stabilise first
rib during inspiration when upper attachment
is fixed.
Nerve Supply
Anterior primary rami of C4-6
Palpation
Palpate lateral border of SCM at insertion.
Increase contralateral rotation to move SCM
medially. Move just lateral with fingers. Resist
ipsilateral side flexion.
Origin
Anterior tubercles of the transverse process
of C3-6
Insertion
Basilar aspect of the occipital bone
Action
Flexion of the head on neck
Nerve Supply
Anterior primary rami of C1-3
Palpation
NA
Longus Capitis
Cervical Spine Muscular Anatomy
Cervical and Occipital Flexors
Rectus Capitis Anterior
Origin
Anterior surface of the lateral atlas
Insertion
Basilar part of the occipital bone
Action
Flexion of the head on the neck
Nerve Supply
Anterior primary rami of C1-2
Palpation
NA
Cervical Spine Muscular Anatomy
Cervical and Occipital Extensors
Splenius Cervicis
Origin
Spinous process of T3-6
Insertion
Posterior tubercles of the transverse process
of C1-4
Action
Ipsilateral lateral flexion, extension, slight
ipsilateral rotation
Nerve Supply
Posterior primary rami of C5-7
Palpation
Supine, with contralateral rotation. Palpable
in the lamina groove of upper cervical
vertebrae along with splenius capitis
Origin
Lower half of ligamentum nuchae and the
spinous process of C7-T4
Insertion
Posterior aspect of the mastoid process of the
temporal bone
Action
Extension of the head and neck, ipsilateral
lateral flexion, ipsilateral rotation
Nerve Supply
Posterior primary rami of C3-5
Palpation
Prone. Locate upper fibres of trapezius.
Isolate lateral edge with cervical extension.
Palpate lateral to trapezius obliquely towards
mastoid process
Splenius Capitis
Cervical Spine Muscular Anatomy
Cervical and Occipital Extensors
Levator Scapulae
Origin
Transverse process of C1-4
Insertion
Medial margin of the scapula between
superior angle and spine of scapula
Action
Elevation, shoulder retraction, neck
extension, ipsilateral lateral flexion, medial
scapular rotation
Nerve Supply
Ventral rami of C3-4
Palpation
Supine, ipsilateral cervical rotation, hand
behind back. Palpate anterior to upper
trapezius fibres and follow down onto
superior angle of scapulae
Origin
Medial superior nuchal line, external occipital
protuberance, ligamentum nuchae and the
spinous process of C7-T12
Insertion
Posterior aspect of the lateral clavicle, medial
acromion and the upper border of the spine
of the scapula
Action
Upper fibres- elevation, neck extension,
ipsilateral lateral flexion, lateral rotation of
the scapula
Middle fibres- shoulder retraction
Lower fibres- depression, lateral rotation of
the scapula
Nerve Supply
Accessory nerve (11th Cranial Nerve)
Trapezius
Palpation
Cervical Spine Muscular Anatomy
Cervical and Occipital Extensors
Rectus Capitis Posterior
Major
Origin
Spinous process of the axis (C2)
Insertion
Lateral aspect of the inferior nuchal line of
the occipital bone
Action
Extension of the head on the neck, slight
rotation of head on neck
Nerve Supply
Posterior primary rami of C1
Palpation
Supine, cradle the head with both hands.
Slight upper cervical extension. Palpate
between superior nuchal line and spinous
process of C2. Sub occipitals are inferior to
upper trapezius and splenius capitis origins
Rectus Capitis Posterior Minor
Origin
Posterior tubercle of the atlas
Insertion
Medial aspect of the inferior nuchal line of
the occipital bone
Action
Extension of the head on the neck
Nerve Supply
Posterior primary rami of C1
Palpation
Supine, cradle the head with both hands.
Slight upper cervical extension. Palpate
between superior nuchal line and spinous
process of C2. Sub occipitals are inferior to
upper trapezius and splenius capitis origins
Cervical Spine Muscular Anatomy
Cervical and Occipital Extensors
Superior Oblique
Origin
Transverse process of the atlas (C1)
Insertion
In-between the superior and inferior aspect
of the nuchal line of the occipital bone
Action
Extension of the head on the neck
Nerve Supply
Posterior primary rami of C1
Palpation
Supine, cradle the head with both hands.
Slight upper cervical extension. Palpate
between superior nuchal line and spinous
process of C2. Sub occipitals are inferior to
upper trapezius and splenius capitis origins
Origin
Spinous process of the axis (C2)
Insertion
Posterior aspect of the transverse process of
the atlas (C1)
Action
Extension, ipsilateral rotation
Nerve Supply
Posterior primary rami of C1
Palpation
Supine, cradle the head with both hands.
Slight upper cervical extension. Palpate
between superior nuchal line and spinous
process of C2. Sub occipitals are inferior to
upper trapezius and splenius capitis origins
Inferior Oblique
Cervical Spine Muscular Anatomy
Cervical and Occipital Lateral Flexors
Scalenus Medius
Origin
Transverse process of C1-2 and the posterior
tubercles of C3-7
Insertion
Lateral aspect of the 1st rib behind the
subclavian artery groove
Action
Ipsilateral lateral flexion, stabilising first rib
during respiration when upper attachment is
fixed
Nerve Supply
Anterior primary rami of C3-8
Palpation
Palpate posterolateral to scalenus anterior.
Caution: Avoid brachial plexus and subclavian
artery
Origin
Posterior tubercles of the transverse process
of C4-6
Insertion
Outer surface of the 2nd rib posteriorly
Action
Ipsilateral lateral flexion
Nerve Supply
Anterior primary rami of C6-8
Palpation
Palpate posterolateral to scalenus medius
Scalenus Posterior
Cervical Spine Muscular Anatomy
Cervical and Occipital Rotators
Semispinals Cervicis
Origin
Transverse processes of T1-6
Insertion
Spinous processes of C2-6
Action
Cervical extension and cervical contralateral
rotation
Nerve Supply
Posterior primary rami of adjacent spinal
nerves
Palpation
N/A
Origin
Back of sacrum and fascia covering erector
spinae, mammillary processes of lumbar
vertebrae, transverse processes of thoracic
vertebrae and articular processes of C4-7
Insertion
Spines of all vertebrae from L5 to Axis (C2)
Action
Ipsilateral rotation, extension and ipsilateral
lateral flexion. Stabilising acting as extensible
ligaments.
Nerve Supply
Posterior primary rami of adjacent nerves
Palpation
N/A
Multifidus
Thoracic Spine Muscular Anatomy
Scapulae Retraction
Rhomboid Major
Origin
Spinous processes of T2 to T5 and
supraspinous ligament between them
Insertion
Medial border of scapula between base of
spine and inferior angle
Action
Scapulae retraction, medial scapula rotation
Nerve Supply
Dorsal Scapular Nerve
Palpation
Side lying, with arm hanging over edge of bed
to abduct scapula. Palpate obliquely
downwards and lateral from spinous process
to medial scapula border
Origin
Spinous process of C7 to T1 and supraspinous
ligament between them
Insertion
Upper medial border of scapula at base of
spine of scapula
Action
Scapulae retraction, medial scapula rotation
Nerve Supply
Dorsal Scapula Nerve
Palpation
Side lying, with arm hanging over edge of bed
to abduct scapule. Palpate obliquely
downwards and lateral from spinous process
to medial scapula border
Rhomboid Minor
Cervical Musculature
Sternocleidomastoid
Longus Colli
Cervical and Occipital Flexion
Longus Capitis
Scalenus Anterior
Rectus Capitis Anterior (Head Only)
Scalenus Anterior
Scalenus Medius
Cervical and Occipital Lateral
Flexion
Scalenus Posterior
Levator Scapulae
Sternocleidomastoid
Trapezius
Splenius Capitis
Erector Spinae
Spenius Cervicis
Levator Scapulae
Splenius Cervicis
Splenius Capitis
Cervical and Occipital Extension
Trapezius
Erector Spinae
Rectus Capitis Posterior Major (Head Only)
Rectus Capitis Posterior Minor (Head Only)
Superior Oblique (Head Only)
Inferior Oblique
Semispinalis Cervicis
Multifidus
Scalenus Anterior
Splenius Cervicis
Cervical and Occipital Rotation
Splenius Capitis
Sternocleidomastoid
Inferior Oblique (Head Only)
Rectus Capitis Posterior Major (Head Only)