The suboccipital region

Question 1

What is the suboccipital region?

Answer 1

The suboccipital region is the space between the occiput and spine of axis vertebra[C2]

Question 2

What is the suboccipital triangle?

Answer 2

The suboccipital triangle is the muscular space situated deep in the suboccipital region

Question 3

List the structures that form the boundaries of the suboccipital region/triangle

Answer 3

Superomedially
• Rectus capitis posterior major
• Rectus capitis posterior minor

Superolaterally
* Superior oblique

Inferiorly
* Inferior oblique

Question 4

What does the roof of the suboccipital region/triangle consist of medially and laterally?

Answer 4

Medially
• Dense fibrous tissue covered by semispinalis capitis
Laterally
• Longissimus capitis 
• Splenius capitis

Question 5

What does the floor of the suboccipital region/triangle consist of?

Answer 5

• Posterior arch of atlas

* Posterior atlanto-occipital membrane

Question 6

What are the contents of the suboccipital region/triangle?

Answer 6

• Third part of vertebral artery
• Dorsal ramus of nerve C1 (suboccipital nerve)
• Suboccipital plexus of veins

Question 7

List the suboccipital muscles.

Answer 7

• Rectus capitis posterior major
• Rectus capitis posterior minor
• Obliquus capitis inferior
• Obliquus capitis superior

Question 8

Where does the rectus capitis posterior major originate?

Answer 8

Spine of axis

Question 9

List the actions of the rectus capitis posterior major.

Answer 9

• Mainly postural
• Turns face to same side (single muscle)
• Extends head (both muscles)

Question 10

Where is the insertion of rectus capitis posterior major?

Answer 10

At the lateral part of area below

inferior nuchal line

Question 11

Which nerve supplies the rectus capitis posterior major?

Answer 11

The suboccipital nerve

Question 12

Where does the rectus capitis posterior minor originate?

Answer 12

Posterior tubercle of atlas

Question 13

List the actions of the rectus capitis posterior minor.

Answer 13

• Mainly postural

* Extends head

Question 14

Where is the insertion of the rectus capitis posterior minor?

Answer 14

At the medial part of the area below inferior

nuchal line

Question 15

Which nerve supplies the rectus capitis posterior minor?

Answer 15

Suboccipital nerve

Question 16

Where does the obliquus capitis superior originate?

Answer 16

At the transverse process of the atlas

Question 17

List the actions of the obliquus capitis superior.

Answer 17

• Extends head (both muscles)

* Laterally flexes (bends) head

Question 18

Where is the insertion of the obliquus capitis superior?

Answer 18

At the lateral area between nuchal lines

Question 19

Which nerve supplies the obliquus capitis superior?

Answer 19

Suboccipital nerve

Question 20

Where does the obliquus capitis inferior originate?

Answer 20

Spine of axis

Question 21

List the actions of the obliquus capitis inferior.

Answer 21

• Mainly postural

* Turns face to same side

Question 22

Which nerve supplies the obliquus capitis inferior?

Answer 22

Suboccipital nerve

Question 23

List the nerves and vessels of the suboccipital region/triangle

Answer 23

• Dorsal[posterior] ramus of the 1st cervical nerve
• Greater occipital nerve
• Third occipital nerve
• Vertebral artery
• Occipital artery
• Deep cervical artery
• Suboccipital plexus of veins

Question 24

Where does the dorsal ramus of the 1st cervical nerve emerge?

Answer 24

The dorsal ramus of the 1st cervical nerve emerges between the posterior arch of atlas & vertebral artery

Question 25

Which structures does the dorsal ramus of the 1st cervical nerve supply ?

Answer 25

The dorsal ramus of the 1st cervical nerve supplies the 4 suboccipital muscles and semispinalis capitis

Question 26

What does the nerve of the inferior oblique muscle do?

Answer 26

The oculomotor nerve gives off a communicating branch to the greater occipital nerve

Question 27

Describe the greater occipital nerve

Answer 27

• The greater occipital nerve is the large medial branch of the dorsal ramus of occipital[C2] nerve
• The greater occipital is the thickest cutaneous nerve in the body

Question 28

What does the greater occipital nerve wind around?

Answer 28

The greater occipital nerve winds around the lower border of the inferior oblique & then runs upwards & medially

Question 29

What does the greater occipital nerve cross?

Answer 29

The greater occipital nerve crosses the suboccipital triangle

Question 30

What does the greater occipital nerve pierce?

Answer 30

The greater occipital nerve pierces the semispinalis capitis & trapezius muscles to ramify on back of head to vertex

Question 31

Which structures does the greater occipital nerve supply?

Answer 31

The greater occipital nerve supplies the semispinalis capitis & scalp

Question 32

Describe the third occipital nerve

Answer 32

The third occipital nerve is the medial branch of the dorsal ramus of the c3 nerve

Question 33

Where does the third occipital nerve ascend?

Answer 33

The third occipital nerve ascends medial to the greater occipital nerve

Question 34

Which structure[s] does the third occipital nerve supply?

Answer 34

The third occipital nerve supplies the skin of the back and the neck up to the external occipital protuberance

Question 35

Describe the vertebral artery

Answer 35

The vertebral artery is the first and the largest branch of the 1st part of the subclavian artery and it consists of 4 parts

Question 36

Which part of the vertebral artery appears in the suboccipital region?

Answer 36

Only the third part appears in

suboccipital region

Question 37

Where does the 3rd part of the vertebral artery appear and where does it leave the suboccipital triangle?

Answer 37

This part appears at the foramen 
transversarium of atlas, grooves 
atlas & leaves the triangle by 
passing deep to the posterior 
atlanto-occipital membrane

Question 38

How is the vertebral artery separated from the posterior arch of the atlas?

Answer 38

The vertebral artery is separated from the posterior arch of the atlas by the C1 nerve and its dorsal and ventral rami

Question 39

Where does the occipital artery arise?

Answer 39

The occipital artery arises from the external carotid artery

Question 40

The occipital artery runs deep to the…

Answer 40

posterior belly of the digastric

Question 41

What does the occipital artery cross?

Answer 41

The occipital artery crosses the carotid sheath & XI and XII cranial nerves

Question 42

What does the occipital artery pierce and where does it lie?

Answer 42

The occipital artery pierces the trapezius and lies along the greater occipital nerve

Question 43

List the branches of the occipital artery .

Answer 43

Mastoid
Meningeal
Muscular

Question 44

Name the branch of the costocervical trunk of the subclavian artery

Answer 44

The deep cervical artery

Question 45

Where does the deep cervical artery pass?

Answer 45

The deep cervical artery passes into the back of neck and the first rib

Question 46

Where does the deep cervical artery ascend?

Answer 46

The deep cervical artery ascends deep to the semispinalis capitis & anastomoses with descending branch
of occipital artery

Question 47

Where does the suboccipital plexus of veins lie?

Answer 47

The suboccipital plexus of veins lies in and around the suboccipital triangle

Question 48

List the structures that the suboccipital plexus of veins

Answer 48

Muscular veins
Occipital veins
Internal vertebral venous plexus
Condylar emissary vein

Question 49

What does the suboccipital plexus of veins drain into?

Answer 49

The plexus itself drains into the deep

cervical & vertebral plexus of veins