CERVICAL REGION - POSTERIOR NECK Boundaries Anterior - Posterior border of the SCM Posterior - Anterior border of the trapezius
Inferior - Clavicle SUBTRIANGLES 1. Occipital - isosceles shaped 2. Subclavian STRUCTURES IN THE OCCIPITAL 1. Nerves 1. Supraclavicular Nerve - UNION OF C2-C4; descends along the posterior SCM 1. medial branch - along the clavicle; "referred pain" 2. middle branch - along the clavicle; "referred pain" 3. lateral branch -along the clavicle; "referred pain" 2. Spinal Accessory Nerve 1. Emerges from the JUGULAR FORAMEN 2. Innervates the: 1. SCM - C3/C4 2. Trapezius - C3/C4 3. Termination: anterior surface of the trapezius 2. Superior end of the sympathetic trunk 1. Composed of 3 CERVICAL SYMPATHETIC GANGLIA 2. located in FRONT OF THE TRANSVERSE PROCESS OF THE CERVICAL VERTEBRAE 3. "Interganglionic Cords" joins them together
2. 1. 2. 3. 3. 1. 2. 4. 1. 2. 5. 1. Superior Cervical Ganglion Largest Upper end of the SCM; level of the hyoid bone and C2-C3 elliptical superior end tapers to and inferior end to continue as the 1st INTERGANGLIONIC CORD Middle Cervical Sympathetic Ganglion Level of the Cricoid Cartilage On the TRANSVERSE PROCESS OF C6 Inferior Cervical Sympathetic Ganglion Stellate Ganglion(Cervico-Thoracic) C7-T1 Postganglionic Fibers Superior ganglion
Plexus around the internal carotid artery to reach the intrinsic muscle in the eyeball 2. plexus around the external carotid artery to be distributed to smooth muscles and glands of scalp and face 3. Cardiac Branch - Cardiac plexus 4. Communicating Branches to the VAGUS, GLOSSOPHARYNGEAL, CERVICAL SPINAL NERVE, PHARYNGEAL PLEXUS 2. Middle Ganglion 1. cardiac branch 2. plexus around the subclavian and vertebral artery 3. Inferior/stellate ganglion 1. Cardiac branch - cardio-pulmonary plexus 6. Superior end of the sympathetic trunk, stimulated by synapses w/ preganglionic fivers from T1-T2 of the spinal cord 3. CERVICAL PLEXUS 1. located deep to the SCM 2. formed by entwining ANTERIOR RAMI OF C1-C4 1. Branches: 1. Lesser occipital Nerve C2 1. Innervates the Occipital Area 2. Great Auricular Nerve C2-C3 1. Innervates: 1. Angle of the Mandible 2. Mastoid process 3. Skin of the auricle 4. Parotid gland 3. Transverse cervical nerve C2-C3 1. Innvervates the skin of the Anterior Neck 4. Supraclavicular nerve C2-C4 Sensory Cutaneous Nerve C1-C3 Motor Branches C3-C4: SCM, Traps, Levator Scapula, Scalene C1-C3: Ansa Cervicalis to the infra hyoid muscle Phrenic Nerve C3-C5 superior the upper trunk of the brachial plexus C3,C4,C5 - Afferent/Efferent respiratory diaphragm C4 - more efferent C3/C5 - more afferent MUSCLES Forms the FLOOR of the posterior
Covered by the PRE-VERTEBRAL layer of the deep cervical fascia descending order: 1. Splenius Capitis 1. Origin: Ligamentum Nuchae and Spines of the LAST 4 Cervical Vert. 2. Insertion: Superior Nuchal Line and Mastoid Process 3. Innervation: C3/C4 4. Action: Primary extensor of the head; Lateral rotation and flexion of cervical vert. 2. Levator Scapula 1. Origin: Transverse process of C1-C4 2. Insertion: Medial Border of the scapula 3. Innervation: Dorsal Scapular Nerve (C5-C6) and C3-C4 4. Action: Elevates Scapula 3. Scalenus Muscles 1. Posterior 1. Origin: C4-C6 2. Insertion: shaft of the 2nd rib 3. Innervation: Branches of the brachial plexus 4. Action: Lift 1st and 2nd rib during inspiration 2. Medius 1. Origin: Transverse process of all CV 2. Insertion: Superior surface of 1st rib 3. Innervation: Branches of the brachial plexus 4. Action: Lift 1st and 2nd rib during inspiration 3. Anterior 1. Origin: Transverse process of C3-C6 2. Insertion: Scalene tubercle (1st rib/Subclavian Artery) 3. Innervation: Branches of the brachial plexus 4. Action: Lift 1st and 2nd rib during inspiration CONTENTS OF THE OCCIPITAL Nerves Spinal Accessor Nerve Supraclavicular Nerve Superior end of sympathetic Muscles Splenius Capitis Levator Scapulae Scalenus muscle
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