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Back of the neck
Muscles of the back4 layers from superficial to deep.
•
trapezius & latissimus dorsi
•
Levator scapulae, rhomboideus, serratus posterior superior,
serratus posterior inferior, splenius cervicis and splenius
capitis
•
Erector spinae or sacrospinalis( 3 columns)
i) iliocostalis- iliocostalis lumborum, iliocostalis thoracis &
iliocostalis cervicis
ii) Longissimus- longissimus thoracis, longissimus cervicis &
longissimus capitis
iii) Spinalis- spinalis lumborum, spinalis thoracis & spinalis
cervicis
4. Multifidus
Back of the neck
Back of the neck
Back of the neck
Back of the neck
Suboccipital triangleBoundaries
Superomedially- rectus capitis posterior major supplemented by
rectus capitis posterior minor
Superiolaterally-superior oblique muscle
Inferiorly- inferior oblique muscle
Roof- dense fibrous tissue covered by the semispinalis capitis
Laterally-longissimus capitis & sometimes by the splenius capitis
Floor- posterior arch of the atlas, posterior atlanto-occipital
membrane
Contents1. Third part of the vertebral a
2. Dorsal ramus of nerve C1- suboccipital nerve
3. Suboccipital plexus of veins
Back of the neck
Suboccipital muscles
Back of the neck
Back of the neck
Dorsal ramus of 1st
cervical nerveEmerges between
posterior arch of the
atlas & vertebral artery
Supplies 4 suboccipital
muscles & semispinalis
capitis
Nerve to inferior oblique
gives off communicating
branch to the greater
occipital nerve
Back of the neck
Greater occipital nerveMedial branch of the dorsal
ramus of the 2nd cervical
nerve
Winds round the middle of
lower border of the inferior
oblique muscle, & runs
upwards and medially.
Crosses the suboccipital
triangle & pierces
semispianlis capitis &
trapezius muscles to ramify
on the back of the head
reaching the vertex
Supplies the semispinalis and
scalp
Back of the neck
Third occipital nerveMedial branch of the dorsal ramus of the 3rd cervical
nerve
After piercing the semispinalis capitis & trapezius, it
ascends medial to the greater occipital nerve.
Supplies- skin to the back of the neck to the external
occipital protuberance
Back of the neck
Vertebral arteryBranch from the 1st part of
subsclavian artery
3part appears in the
suboccipital triangle
Foramen transversarium of the
atlas, grooves the atlas
leaves the triangle passing
deep to lateral edge of the
posterior atlanto-occipital
membrane.
It is separated from the
posterior arch of the atlas by
first cervical nerve & its
dorsal and ventral rami
Back of the neck
Occipital arteryBranch of ECA opposite to the origin of the facial artery
Runs backwards & upwards deep to the lower border
posterior belly of the digastric muscle, crossing the carotid
sheath, accessory and hypoglossal nerves.
Runs deep to mastoid process and sternocleidomastoid,
digastric, splenius capitis , longissimus capitis.
It crosses the rectus capitis lateralis, superior oblique and
semispinalis capitis muscles at the apex of the posterior
triangle
Finally pierces the trapezius 2.5cm from the midline & comes
to the lie along the greater occipital nerve.
It is tortuous in the superficial of the scalp
Branches- mastoid, meningeal & muscular
Back of the neck
Back of the neck
Deep cervical arteryBranch of costocervical trunk of the subclavian a
It passes into the back of the neck just above the neck
of the 1st rib
Ascends deep to the semispinalis & anastomoses with
descending branch of the occipital artery
Suboccipital plexusMuscular veins, occipital veins, internal vertebral
plexus & condylar emissary venous plexus.
Finally drains into the deep cervical and vertebral
plexus of the veins
Back of the neck
Clinical anatomy1. Neck rigidity2. Cisternal puncture3. Neurosurgeons approach the posterior
cranial fossa through this region