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O: ligamentum nuchae, spinous processes C7-T12
I: acromion process, spine of scapula, and lateral third of the clavicle

Trapezius innervation

spinal acessory n and ventral rami of C3-C4

Trapezius function

extend the head, elevate, retract and upwardly rotate or depress the pectoral girdle

Latissimus Dorsi

O: Spinous processes of T6 and lower, thoracolumbar fascia, illiac crest and lower ribs
I: intertubercular goove of the humerus

Latissimus Dorsi Innervation

Thoracodorsal n

Latissimus Dorsi function

extend, adduct and medially rotate arm

Rhomboid Major and Minor

O: spinous processes C7-T5
I: vertebral border of the scapula

Rhomboid Major and Minor Innervation

dorsal scapular n

Rhomboid Major and minor functions

downwardly rotate and retract scapula

Levator Scapulae

O: superior angle of the scapula
I: upper cervical vertebrae

Levator Scapulae innervation

dorsal scapular n

Levator scapulae function

elevate and downwardly rotate the scapula

Serratus Posterior Superior

just deep the the rhomboids

Serratus posterior inferior innervation

branches of intercostal nn

Serratus posterior superior function

weakly elevate upper ribs

Serratus posterior superior innervation

branches of intercostal nn

Serratus posterior inferior

lies deep to latissimus dorsi

serratus posterior inferior function

weakly depresses ribs

Innervation of all deep back muscles

posterior primary rami

Splenius Capitis and Cervicis

O: inferior half of ligamentum nuchae, spinous processes of C and upper T vertebrae
I: Splenius Capitis inserts in mastiod process and adjacent occipital bone. Cervicis inserts on transverse processes of upper cervical vertabrae


lateral column


intermediate column (only one that extends to the skull)


medial column

Semispinalis capitis, cervicis, and thoracis

originate from upper half of the spine, contralaterally rotate and extend the head


heaviest in the lumber spine, spans 3 segments, originates on mammillary processes and inserts on spinous processes


deep to multifidus, spans 1 or 2 interspaces. Stabilize spine and maintain alignment

superficial fascia

contains platysma m (supplied by facial n CN VII)

investing layer of deep fascia

encircles the neck and encloses SCM and trapezius

prevertebral fascia

surrounds posterior neck and encloses cervical spinal column and its mm. Makes the floor of the suboccipital triangle

pretracheal fascia

surrounds the anterior neck
trachea, esophagus, thyroid gland

carotid sheath

common corotid a
internal jugular v
vagus n

vertebral a

arises from subclavian and acends through C6 and up, passes over posterior arch of the atlas and pierces dura mater to go through foramen magnum

internal carotid arteries

provide blood to the brain along with vertebral artery

origination of CN XI

arises from C1-C5 and ascends through foramen magnum then descends through jugular foramen to supply Trapezius

suboccipital triangle borders

Rectus Capitis Posterior major
Inferior oblique
Superior oblique

suboccipital triangle contents

suboccipital n

Superior Oblique

O: transverse process of atlas
I: skull

Inferior Oblique

O: transverse process of atlas
I: spine of axis

Rectus Capitis Posterior major

O:spine of axis
I: skull

suboccipital n

only has motor fibers
innervates suboccipital mm, rectus capitis posterior minor, and semispinalis capitis

Semispinalis Capitis

forms the roof of the triangle

occipital a

enters lateral to superior oblique

greater occipital n

carries sensory for both itself and suboccipital
innervates semispinalis capitis


inserts at clavicle, sternum, and mastoid process

Functions of SCM

protects major blood vessels in the carotid sheath, flexes cervical spine,produces ipsilateral rotation of the head

posterior cervical triangle

"gateway to the upper limb"

Posterior cervical triangle contents

spinal accessory n divides it into superior (carefree) and inferior (careful) zones
posterior belly of the omohyoid

superficial structures of the posterior cervical triangle

external jugular v, cutaneous nn

cutaneous nn

C2-C3 (climb the tree)
greater auricular n
lesser occipital n - to scalp
transverse cervical n - proceeds anteriorly
C3-C4 (hit the floor)
medial, intermediate and lateral supraclavicular nn

muscles to the floor of the posterior cervical triangle innervated by posterior primary rami

part of semispinalis capitis

muscles to the floor of the posterior cervical triangle innervated by anterior primary rami

levator scapulae (dorsal scapular n and C3-C4)
scalenus anterior, medial and posterior

phrenic n

anterior surface of scalenus anterior
motor to the diaphragm

where does brachial plexus appear in the posterior cervical trangle?

in between scalenus anterior and scalenus medial

Subclavian v

passes anterior to scalenus anterior
drains upper limb

subclavian a

passes behind scalenus anterior
supplies upper limb

suprascapular a

supplies mm on the posterior surface of the scapula

thyrocervical trunk

branches from subclavian a
dorsal scapular and superficial cervical aa combined are called transverse cervical a which divides into superficial and deep branches

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