Cheatography
https://cheatography.com
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 |
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
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 |
Suboccpitals - Palpation
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 |
Trp
- Important for Whiplash
- A big cause of myogenic headaches
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
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
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
|
