Reading
- p. 968 (Posterior ...) - 975
- p. 72 - 73
- p. 99 (Suboccipital muscles) - 100
- p. 443 - 446 (Thoracic)
- p. 457 (Dislocation) - 460 (Lumbar ...)
- p. 467 (Craniovertebral ...) - 469
- p. 476 - 478
- p. 492 (Suboccipital ...) - 495
- p. 287 (Craniovertebral ...) - 289
- p. 304 (Suboccipital ...) - 305
- p. 308 - 309
Body Surface
The primary surface landmarks of the posterior neck are associated with the occipital (external occipital protuberance) and temporal (mastoid process) bones, and spine (C7 spinous process, T1 spinous process and nuchael ligament). Branches of the greater occipital and lesser occipital nerves, and dorsal rami of cervical and upper thoracic spinal nerves innervate the skin overlying the posterior neck.
Skeleton and Joints
The bones associated with the posterior neck are the occipital and temporal bones and cervical vertebrae, including the atlas and axis. The cervical spine is supported by the anterior longitudinal, posterior longitudinal, ligamenta flava, intertransverse, interspinous and supraspinous ligaments. There are facet (zygapophyseal) joints between adjacent superior and inferior articular processes, and symphases (intervertebral discs) between the adjacent vertebral bodies. The cervical spine moves in flexion, extension, lateral flexion and rotation. The atlantoaxial and atlanto-occipital joints are supported by fibrous joint capsules, the cruciate and alar ligaments, and the tectorial and anterior and posterior atlanto-occipital membranes. The two atlanto-occipital joints (superior articular processes and occipital condyles) form an ellipsoidal articulation allowing flexion and extension and slight lateral flexion of the head. The median atlantoaxial joint is a pivot articulation, and the two lateral joints are gliding articulations. Together they allow for rotation of the head.
Organization
There are three layers (investing, pretracheal and prevertebral) of deep cervical fascia. The investing fascia covers the anterior and posterior cervical triangles extending from the ligamentum nuchae to the midline and splitting around the trapezius and sternocleidomastoid muscles.
The posterior neck includes the cervical continuation of the erector spinae group (back) and the suboccipital triangle. The prevertebral fascia passes superficial to the cervical erector spinae muscles. The suboccipital triangle is bounded by the rectus capitis posterior major, obliquus capitis superior and obliquus capitis inferior muscles. The greater occipital nerve passes superficial to the triangle and the vertebral artery and suboccipital nerves lie in the floor of the triangle.
Muscles
The cervical erector spinae muscles function in extension, lateral flexion and ipsilateral rotation of the head and neck. The muscles of the suboccipital triangle function in flexion, lateral flexion and ipsilateral rotation of the head.
Innervation
Branches of dorsal rami of cervical spinal nerves innervate (sensory, motor and postganglionic sympathetic) the muscles of the posterior neck.
Blood Supply
Branches of the transverse cervical, deep cervical, occipital and vertebral arteries supply the muscles of the posterior neck. Tributaries of the corresponding veins drain the muscles of the posterior neck.