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Muscular Anatomy and Soft Tissue of the Neck and Cervical Spine

 

 

Posterior Superficial Neck Muscles

 

Trapezius (Upper Fibers)

  • Origin: Occipital protuberance

  • Insertion: Lateral 1/3 of clavicle and acromion process

  • Action: Extend the head and neck, Laterally flex the head and neck to the same side, Rotate the head and neck to the opposite side

  • Nerve Innervation: Spinal portion of CN XI (Accessory) and ventral ramus C2,3,4 

 

Splenius Cervicis

  • Origin: Inferior 1/2 of ligamentum nuchae and spinour processes of C7-T4

  • Insertion: Mastoid process and lateral portion of superior nuchal line

  • Action: Rotate and laterally flex the head and neck to the same side, and extend the head and neck.

  • Nerve Innervation: Cervical

 

Semispinalis Capitis

  • Origin: Transverse processes of C4-T5 

  • Insertion: Between the superior and inferior nuchal lines of the occiput

  • Action: Extend the vertebral column and head

  • Nerve Innervation: Cervical

 

Splenius Capitis

  • Origin: Spinous processes of T3-T6

  • Insertion: Transverse processes of C1-C3

  • Action: Rotate and laterally flex the head and neck to the same side, and extend the head and neck.

  • Nerve Innervation: Cervical

 

Longissimus Capitis

  • Origin: Transverse processes of T1-T5

  • Insertion: Mastoid process of temporal bone

  • Action: Laterally flex vertebral column to the same side, extend vertebral column

  • Nerve Innervations: Spinal

 

Longissimus Cervicis

  • Origin: Transverse processes of T1-T5

  • Insertion: Transverse process of cervical vertebrae

  • Action: Laterally flex vertebral column to the same side, extend vertebral column

  • Nerve Innervations: Spinal

 

Longus Capitis

  • Origin: Transverse porcesses of C3-C6

  • Insertion: Inferior surface of occiput

  • Action: Laterally flex and rotate head and neck to the same side, flex head and neck

  • Nerve Innervation: C1,2,3,4

 

Longus Colli

  • Origin: Bodies of C5-T3, transverse processes of C3-C5

  • Insertion: Tubercle on anterior arch of the atlas, bodies of the axis, C3-C4, transverse processes of C5-C6

  • Action: Laterally flex and rotate head and neck to the same side, flex head and neck

  • Nerve Innervation: C2-6, 7

 

Flexion

  • Sternoclediomastoid

  • Anterior Scalene

  • Longus Capitis

  • Longus Colli

 

Extension

  • Trapezius

  • Levator Scapula

  • Splenius Capitis

  • Splenius Cervicis

  • Rectus Capitis Posterior Major

  • Rectus Capitis Posterior Minor

  • Oblique Capitis superior 

  • Semipinalis Capitis

  • Longissimus Capitis

  • Longissimus Cervicis

  • Iliocostalis Cervicis

  • Multifidi

  • Rotatores

  • Intertransversarii

  • Interspinalis

 

Rotation (Opposite side)

  • Trapezius (Upper Fibers)

  • Sternocleidomastoid

  • Anterior Scalene

  • Middle Scalene

  • Posterior Scalene

  • Mutifidi

  • Rotatores

Posterior Suboccipital Muscles

 

Rectus Capitis Posterior Major

  • Origin: Spinous process of C2

  • Insertion: Inferior nuchal line of the occiput

  • Action: Rock and tilt the head back into extension

  • Nerve Innervation: Suboccipital

 

Rectus Capitis Posterior Minor

  • Origin: Tubercle of the posterior arch of C1

  • Insertion: Inferior nuchal line of the occiput

  • Action: Rock and tilt the head back into extension, Rotate the head to the same side

  • Nerve Innervation: Suboccipital

 

Oblique Capitis Superior

  • Origin: Transverse process of C1

  • Insertion: Between the nuchal lines of the occiput

  • Action: Rock and tilt the head back into extension, Laterally flex the head to the same side

  • Nerve Innervation: Suboccipital

 

Oblique Capitis Inferior

  • Origin: Spinous process of C2

  • Insertion: Transverse process of C1

  • Action: Rotate the head to the same side

  • Nerve Innervation: Suboccipital

Lateral Neck Muscles

 

Sternocleidomastoid

  • Origin: Medial Head-Cranial oart if manubrium

  • Origin: Lateral Head-Medial 1/3 of clavicle

  • Insertion: Lateral surface of mastoid process

  • Action: Neck Flexion and rotation

  • Nerve Innervation: C1,2,3

 

Levator Scapulae

  • Origin: Transverse process of C1-C4

  • Insertion: Medial border of scapula, between superior angle and superior portion of spine scapula

  • Action: Laterally flex the head and neck, Rotate the head and neck to the same side

  • Nerve Innervation: Cervical 3 & 4, Dorsal Scapular C4, 5

 

Anterior Scalene

  • Origin: Transverse Process of C3-C6

  • Insertion: Cranial crest of first rib

  • Action: Lateral flexion and rotation of the cervical spine

  • Nerve Innervation: C(3), 4-8

 

Middle Scalene

  • Origin: Transverse Process of C2-C7

  • Insertion: Cranial surface of first rib

  • Action: Lateral flexion and rotation of the cervical spine

  • Nerve Innervation: C(3), 4-8

 

Posterior Scalene

  • Origin: Posterior tubercles of transverse processes C5-C7

  • Insertion: Outer surface of second rib

  • Action: Lateral flexion and rotation of the cervical spine

  • Nerve Innervation: C(3), 4-8

 

Anterior Neck Muscles

 

Suprahyoids (Geniohyoid, Mylohyoid, and Stylohyoid)

  • Origin: (Geniohyoid and Mylohyoid) Underside of mandible (Stylohyoid) Styloid process

  • Insertion: Hyoid Bone

  • Action: Elevate hyoid and tounge

  • Nerve Innervation: (Geniohyoid) C1,2 (Mylohyoid) Trigeminal (Stylohyoid) Facial

 

Digastric

  • Origin: Mastoid Process

  • Insertion: Inferior border of the mandible

  • Action: Depress, Elevate and Retract mandible

  • Nerve Innervation: (Anterior Belly) Trigeminal (Posterior Belly) Facial

 

Infrahyoids (Sternohyoid, Sternothyroid, Thyrohyoid, Omohyoid)

  • Origin: (Sternohyoid and Sternothyroid) Top of the manubrium (Thyrohyoid) Thyroid Cartilage (Omohyoid) Superior border of scapula

  • Insertion: (Sternohyoid, Thyrohoid and Omohyoid) Hyoid Bone (Sternothyroid) Thyroid Cartilage

  • Action: Depress the hyoid bone and thyroid cartilage

  • Nerve Innervation: (Sternothryoid And Omohyoid) C1,2,3 (Throhyoid) C1,2

 

Retrieved Novemeber 13th, 2014 from: http://www.apmct.com

Retrieved Novemeber 13th, 2014 from: http://www.fpnotebook.com

Retrieved Novemeber 13th, 2014 from: http://www.kregweiss.ca

Retrieved Novemeber 13th, 2014 from: http://www.rci.rutgers.edu

Retrieved Novemeber 13th, 2014 from: https://www.youtube.com

Retrieved Novemeber 13th 2014 from: http://www.proloterapia.it

Muscles of the Neck and Cervical Spine

Whiplash

  • A neck sprain or strain that is usually a collection of symptoms that occur following damage to the neck.

  • MOI: An abrupt jerking motion of the head in a certain direction that forces strain on the neck. It is usually a result of a car accident.

  • S/S: Neck pain and stiffness, headaches, low back pain, dizziness, ringing in ears, irritability, difficulty sleeping or concentrating and fatigue. Can also be delayed for a day after the initial trauma.

  • Treatment: Treating the symptoms, since no single treatment for it is proven effective. Medication and gentle exercises are usually the most common treatment plans. Immoblization and ice may also be used if the injury has occurred in the first 24 hours.

  • Diagnostic Tools: CT scan or MRI. X-rays cannot be used because damage often occurs to the soft tissue rather than the bone.

  • Effect on Athletic Performance: Athletes with whiplash are not allowed to participate until cleared by a doctor because it could worsen. Gentle exercises are used to treat whiplash.

 

 

Retrieved Novemeber 14th 2014 from: http//:www.sandiegospinalcare.com

Torticollis

  • A twist in the neck in which the head is tipped to one side while the chin is turned to the opposite side.

  • MOI: Caused by genes or can result from damage to the nervous system, upper spine, or muscles. If it is occurs without known cause, then it is called idiopathic torticollis.

  • S/S: Limited range of motion to the head, headaches, head tremors, neck pain, uneven shoulders, stiffness in the neck muscles and swelling in the neck.

  • Treatment: Surgery to correct it. Applying heat, traction to the cervical spine and massage may also be included to loosen up the muscles. Stretching and neck braces are also very common to correct the posture of the neck.

  • Diagnostic Tools: CT scans of the neck, MRI of the brain and EMG to see the affect muscle. Special tests may also be done to observe the problem.

  • Effect on Athletic Performance: Because it can be congenital, people with torticollis can participate in athletics as long as they feel they can. Those who have it as a result of an injury should consult their doctor first.

 

Retrieved Novemeber 14th 2014 from: http//:www.healthhype.com

Rotation (Same side)

  • Levator scapula 

  • Splenius Capitis

  • Splenius Cervicis

  • Rectus Capitis Posterior Major

  • Obliaue Capitis Inferior

  • Longus Colli

  • Longus Capitis

  • Longissimus Capitis

  • Longissimus Cervicis

  • Iliocostalis Cervicis

 

Lateral Flexion (Same side)

  • Trapezius (Upper Fibers)

  • Levator Scapula 

  • Sternocleidomastoid

  • Anterior Scalene (with ribs fixed)

  • Middle Scalene (with ribs fixed)

  • Posterior Scalene (with ribs fixed)

  • Splenius Capitis

  • Splenius Cervicis

  • Longus Capitis

  • Longu Colli

  • Longissimus Capitis

  • Longissimu Cervicis

  • Iliocostalis Cervicis

  • Oblique Capitis Superior

  • Intertransversarii

Synergists of Motions of the Cervical Spine

Soft Tissue and Ligaments of the Neck and Cervical Spine

Ligaments are fibrous bands of connective tissue that connect two or more bones, cartilages or structures together to allow for stability along with resitriction of motions during mobility. There are numerous ligaments in the cervical spine, along with the rest of the spinal cord, that provibe stability. The primary cervical ligaments are:  

 

  • Alar 

  • Anterior atlantooccipital

  • Posterior atlantooccipital

  • Anterior atlantoaxial

  • Posterior atlantoaxial

  • Ligamentum Nuchae

  • Anterior longitudinal*

  • Posterior longitudinal*

  • Ligamentum flavum*

  • Supraspinous*

  • Infraspinous*

 

* Indicate ligaments are present in thoracic, lumbar and sacral regions.

Retrieved November 14th, 2014 from: http://www.anatomy_atlas.academic.ru

Cervical Strain/Sprain

  • Strains are injuries to the ligaments in the neck. Sprains are injuries to the tendons or muscles.

  • MOI: Trauma that causes a sudden jerk of the head and neck.

  • S/S: Pain in the neck, decreased ROm, pain with movement, swelling and tenderenss, discoloration. Torticollis may be present. 

  • Treatment: Rest, NSAIDS to reduce inflammation, ice and rehabilitation excersises.

  • Diagnostic Tools:A physical examination can be done to rule out other causes. Special tests can determine if muscular weakness is present. If severe enough, a MRI should be done to rule out more severe damage. 

  • Effect on Athletic Performance: Athlete can return to participation once symptoms have been cleared and differential diagnoses have be omitted. 

 

Retrieved Novemeber 14th 2014 from: http//:www.healthhype.com

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Information retrieved from:

Biel, A, (2012). Trail Guide to the Body. A.B. Boulder, CO: Books of Discovery 

Krali, J. (2013). Head Injury Notebook. Retrieved November 14th, 2014.

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