Nuchal region Flashcards
Borders of nuchal region
Sup: imaginary line between External occipital protruberance and mastoid process.
Inf: C7 vertebral prominence level
Medial: Midline (imaginary line between ext. occipital protruberance and vertebral prominance.
Lateral:Follow margine of trapeziu mucle from mastoid proces down to the inferior border (C7)
Layer of Nuchal region
1) Skin
2) Subcutanious tissue + subcutn. nerves.
-lesser occipital n (from behind post. edge of SCM)
- Greater occipital n (Dorsal cervical n C2)
-Third occipital n (Dorsal cervical n C3)
3) Superficial layer of cervical fascia
4 ) Superficial Nuchal muscles
5) Deep cervical fascia
6) Deep Nuchal Muscles => suboccipital triangle.
7) Atlanto-occipital membrane (floor of triangle)
which are the superficial Nuhal muscles ?
superficial most : Trapezius, SCM (medial to lateral)
intermediate: Semispinalis capitis, Splenius capts. (medial
to lateral)
What pierces the superficial Nuchal muscles
Dorsal branches of medial cervical nerves
which are the deep nuchal muscles ?
Their innervation
-Rectus Capitis Posterior Minor
-Rectus Capitis Posterior Major
-Oblicuus capitis posterior superior
-Oblicuus capitis posterior Inferior
Theyre all innervated by the suboccipital n
give the borders and content of the suboccipital triangle
Borders: Sup: RCP major Inf: OCP Inferior Lateral: OCP superior. Base/floor: posterior Atlantooccipital membrane
Content:
- 3d part of vertebral a
- Suboccipital n (dorsal branch of c1)
=> They pierce the membrane.
Erbs Point
“Erb’s point” is also a term used in head and neck surgery to describe the point on the posterior border of the sternocleidomastoid muscle where the four superficial branches of the cervical plexus
—the greater auricular, lesser occipital, transverse cervical, and supraclavicular nerves—
emerge from behind the muscle.
This point is located approximately at the junction of the upper and middle thirds of this muscle.
From here, the accessory nerve courses through the posterior triangle of the neck to enter the anterior border of the trapezius muscle at a point located approximately at the junction of the middle and lower thirds of the anterior border of this muscle. The spinal accessory nerve can often be found 1 cm above Erb’s point.
Which blood vessels and nerves can be found in the nuchal region
- Occipital a. (from EXCA)
- Greater occipital n (Medial senory ramus of C2)
- 3d Occipital n (medial sensory ramus of c3)
- Vertebral a. (from subclanian a)
- Suboccipital n (C1 dorsal branch)
Borders of scapular region
Sup: Horizontal line between acromion of scapula and spinous process of T1 vertebra
Inf: horizontal line between inferior scapular angle and posterior axillary fold.
Medial: Midline of trunk
Lateral:oblique line connecting acromion with lateral en of inferior boundary.
Skin innervation of dorsal scapular region?
Dorsal rami of spinal nerve
Layers of dorsal scapular region
.