The Neck: Musculature and Bony Anatomy

Bony Framework 7 cervical vertebrae Atlas (C1) Axis (C2) C3 - C7

Atlas 1 – Articular process 2 – Transverse process 3 – Posterior arch

Axis 1 – Dens/Odontoid process 2 – Spinous process

Cervical Vertebra 1 – Transverse foramen 2 – Body 3 – Vertebral foramen 4 – Transverse process 5 – Spinous process 6 – Articular process

Palpation of bony anatomy Spinous process; vertebra prominens (C7) Transverse process

Palpation of Bony Anatomy Hyoid bone Clavicle Thyroic cartilage Cricoid cartilage

Intervertebral Discs Annulus fibrosus Nucleus pulposus Shock absorbers for spine

Nerves of the Cervical Spine 7 vertebrae, but 8 nerves Emerge above corresponding vertebra, except C8 nerve Brachial plexus – C5-T1 Myotomes and Dermatomes

NERVE MYOTOME C5 Shoulder Abduction C6 Elbow Flexion, Wrist Extension C7 Elbow Extension, Wrist Flexion C8 Thumb Extension, Ulnar Deviation

Muscles of the Neck MUSCLE ORIGIN INSERTION ACTION Trapezius Occiput, Nuchal ligament, SP of C7-T12 Lateral clavicle, Acromion, Spine of scapula Extends, Ipsi lateral flex, Contra rotation Levator Scapulae TP C1-C4 Medial border of scapula Extends, Ipsi lateral flex, elevate scapula Sternocleidomastoid Sternal: manubrium Clavicular: medial 1/3 of clavicle Mastoid process Flexes, Ipsi lat flex, Contra rotation

MUSCLE ORIGIN INSERTION ACTION Anterior Scalene TP C3-C6 1st rib Ipsi lat flex, Elevate 1st rib Middle Scalene TP C2-C7 Posterior Scalene TP C5-C7 2nd rib Lat flex, Elevate 2nd rib Longus Colli and Longus Capitus Ant TP C1-C6 Occiput Flexion Rectus Capitis TP C1 Flexion, Lat flexion

The Neck: Common Injuries and Problems

Pain Generators Myogenic Discogenic Facet joint, Arthritic Stenotic (central canal, neuroforamen) Neurogenic

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