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Cheatography

Neck Muscles Cheat Sheet (DRAFT) by

Muscles of the neck and Trps

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Splenius Capitus

Orig­in: Mastoid process
Inse­rti­on: Tips of the SP of 7th Cx vertebra
Nerve: Lateral branches of the second and third Cx dorsal Rami
Acti­on: Ipsila­teral rotation - bilate­rally extends the head

Splenius Capitis - Palpation

- Get patient to extend head slightly to locate border of the traps
- Just lateral to the border of the traps lies Splenius Cap
- Get pt to rotate head towards since of palpation - muscle should contract

Trps

- Causes Headaches
- Associated with C2 manipu­lable lesions

Splenius Cervicis

Orig­in: TVPs of atlas and TVPs of the axis and posterior tubercle of the third cx vertebrae
Inse­rti­on: 3rd-6th Tx SP
Nerve: Lateral Branches of the lower cx dorsal rami
Acti­on: Ipsila­teral rotation of upper cx spine - bilate­rally extends upper cx
- Cervix = neck (Latin)

Trps

- Main muscle affected in Whiplash (Along with SCM)
- Causes Headaches

Levator Scapulae

Orig­in: TVPs of the atlas and axis + Posterior tubercles of the TVP of the 3rd and 4th cx
Inse­rti­on: Medial end of scapular spine
Nerve: Branches of 3rd and 4th Cx spine nerves + 5th Cx nerve - Dorsal Scapular Nerve
Acti­on: Rotation of the scapula - depresses shoulder Ipsila­teral + lateral flexion of the cx

LS - Palpation

- Just off superior angle of the scapula
- Should feel ropy, deep to the traps

Trps

Subocc­ipitals

Rectus Capitis Posterior Major:
Orig­in: Spine of the axis
Inse­rti­on: Lateral part of inferior nuchal line and the occupital bone
Rectus Capitis Posterior Minor:
Orig­in: Tubercle on the posterior arch of the atlas
Inse­rti­on: Medial part of inferior nuchal line and occupital bone - Can be attached to the posterior atlant­o-o­cci­pital membrane
Obliquus Capitis Inferi­or:
Orig­in: Lateral surface of the spine + adjacent upper part of the lamina
Inse­rti­on: Infero­pos­terior aspect of the TVP of the atlas
Obliquus Capitis Superi­or:
Orig­in: Upper surfaces of the TVP of the atlas
Inse­rti­on: Occupital bone
Nerve: Dorsal ramus of the 1st Cx nerve
Acti­on: Extension and ipsila­teral rotation of the head

Subocc­ipitals

Subocc­pitals - Palpation

Trps

Semisp­inalis Capitis

Orig­in: Medial part of the area between superior and inferior nuchal lines of the occupital bones
Inse­rti­on: Superior articular Processes of the lower 4 Cx Vb + Tips of the TVPs of the upper 6 or 7 Tx
Nerve: Descending branches of the greater occipital nerve C2 + third Cx nerve C3
Acti­on: Extension of the head

Trps

Can Trap the Greater Occipital Nerve when hypertonic

Semisp­inalis Cervicis

Orig­in: SP of 2-5th Cx VB
Inse­rti­on: Upper five/six Tx TVP
Nerve: Medial branches of the dorsal rami of adjacent spinal nerves
Acti­on: Extension of the neck

Longus Capitis

Orig­in: Posterior Edge of the mastoid process
Inse­rti­on: TVPs of lower 3 or 4 cx and upper 4 Tx
Nerve: Segmental Supply from the lateral branches of the dorsi rami
Acti­on: Stabil­isa­tio­n/p­rop­rio­ceptive role

Trp

 
- Below and Behind the ear + perior­bital region

Sterno­cle­oid­oma­stoid (SCM)

Origin:
Medi­al: Upper part of the anterior surface of the manubrium and sterni
Lateral head: Superior surface of the medial third of clavicle
Inse­rti­on: Lateral surface of mastoid process
Nerve: Spinal part of accessory nerve, branches from the ventral rami of 2nd, 3rd and sometimes 4th Cx nerves
Acti­on: Tilts head towards ipsila­teral shoulder, rotates the head (turns the face to the opposite side). From below, SCM draws the head forwards and raises head when the body is supine. When head is fixed, SCM helps elevates the tx in forced inspir­ation
- Tortic­ollis

Trp

- Important for Whiplash
- A big cause of myogenic headaches

Longus Colli

Longus Colis

Orig­in: Anterior surface of the vertebral column between 2nd and 3rd Tx
Inferior oblique: Front of the Vb of the first two or three Tx vertebra Inse­rti­on: Anterior tubercles of the TVPs of the 5th and 6th Cx
Superior Oblique: Anterior tubercles of the TVPs of the 3rd, 4th, 5th Cx vertebral Inse­rti­on: Antero­lateral surface of the rubercle on the anterior arch of the atlas.
Vertical Interm­edi­ate: Fronts of the bodies of the upper three tx and lower three Cx vertebrae Inse­rti­on: Fronts of the bodies of the second, third and fourth Cx VB
Nerve: Branches from the ventral rami of the second, third, fourth, fifth and sixth Cx spinal nerves
Acti­on: Flexion and assists in lateral flexion
- Also affected in whiplash (rear end)
- Can be affected by calcific tendinitis - neck pain, stiffness, dysphagia and odynop­hagia (MRI/CT needed) - Treated by NSAIDs

Scalanes

Scalenes

Scalenus Anteri­or:
Orig­in: Anterior tubercles of the TVP of the 3-6th Cx
Inse­rti­on: Scalene Tubercle on the inner border of the First rib + ridge on the upper surface of the rib, anterior to the groove for the subclavian artery
Nerve: Branches of the Ventral Rami of the 4-6th Cx spinal nerves
Acti­on: Lateral Flexion of the cx and elevation of first rib - respir­ation
Scalenus Medius:
Orig­in: Above the TVP of the axis and front of the posterior tubercles of the TVP of the lower 5 Cx, extends to the TVP of the atlas.
Inse­rti­on: Upper surface of the first rib
Nerve: Branches of the ventral rami of the 3-8th Cx spinal nerves
Acti­on: Lateral flexion of the Cx and elevation of the first rib - respir­ation
Scalenus Poster­ior:
: Orig­in: Posterior tubercles of the TVP of the 4-6th Cx
Inse­rti­on: Outer surface of the second rib
Nerve: Branches of the ventral rami of 6-8th Cx spinal nerves
Acti­on: Lateral Flexion of the cx and elevation of the 2nd rib - respir­ation
- Skalenos (Greek) = uneven
- A 4th Scalene can be present (Sibson's muscle) located behind lower portion of anterior scalene
- Brachial Plexu and subclavian artery pass through anterior and middle scalene (TOS)
- Subclavian vein and phrenic nerve pass anteriorly to the anterior scalene

Scalenes - Palpation

Trps

- Rotation of head fully to side of pain + pull chin down - aggravates Trps in scalenes
- Scalenes Trps cannot cause headaches
- Mimics a disc herniation
- Can be extremely painful - often causes a sympat­hetic response