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Trunk
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The suboccipital muscles are innervated by dorsal rami and lie deep to the back muscles named the splenius capitis and semispinalis capitis (Plate 3.31a). They include, among others, the obliquus capitis inferior muscle (spinous processes of C2 to transverse processes of C1), the obliquus capitis superior muscle (transverse processes of C1 to occipital bone), and the rectus capitis posterior major muscle (spinous processes of C2 to occipital bone), which form the boundaries of the suboccipital triangle. Medial to these is the rectus capitis posterior minor, which extends from the posterior tubercle of the atlas to the occipital bone. These muscles extend and laterally bend the head at the atlanto-occipital joints, and rotate the head at the atlanto-axial joints. In the suboccipital triangle lie the vertebral artery and the suboccipital nerve (unique among dorsal primary rami in that it has no cutaneous distribution).
Head
Published in Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden, Human Sectional Anatomy, 2017
Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden
Obliquus capitis inferior (25) forms the lower outer limb of the suboccipital triangle. The vertebral artery (41), on emerging from the foramen transversarium of the atlas, enters this triangle on its ascending course to the foramen magnum.
The Spinal Cord and the Suboccipital Triangle
Published in Gene L. Colborn, David B. Lause, Musculoskeletal Anatomy, 2009
Gene L. Colborn, David B. Lause
The suboccipital region includes the structures dorsally at the base of the skull, including the elements involved in the atlantoccipital and atlantoaxial articulations, the muscles associated with the suboccipital triangle, the vertebral artery and veins and the first couple of cervical dorsal primary rami. The joints between the atlas and the occipital bone of the skull are associated especially with flexion and extension of the head upon the vertebral column; the atlantoaxial joints are of particular significance in rotation of the head - turning it from side to side.
Paracondylar process combined with persistent first intersegmental vertebral artery: an anatomic case report and literature review
Published in British Journal of Neurosurgery, 2023
Haigui Yang, Xiaofei Bai, Xiaoli Huan, Tingzhong Wang
For the right side, a postauricular C-shaped skin incision was used to expose the jugular foramen extradurally. After mastoidectomy and opening of the styloid foramen, the mastoid segment of the facial nerve was freed and mobilized anteriorly. The muscles constructing suboccipital triangle were detached. A PCP, projecting inferiorly from where the jugular process should be, was found to reach an ETP of C1 but did not form an articulus. The course of the VA and the C0–C1 condyle was normal (Figure 2).
Musculoskeletal ultrasound imaging and clinical reasoning in the management of a patient with cervicogenic headache: a case report
Published in Physiotherapy Theory and Practice, 2021
It has been previously suggested that cervical AROM assessment is valuable when examining patients with cervicogenic headaches (Blanpied et al., 2017). She displayed decreased cervical rotation to the left more than to the right. Forward, backward, and right side bending of the neck provoked pain. She reported neck pain during the Spurling’s test and the right Quadrant test; however, no radiating symptoms were reported. These test results could indicate the possible involvement of the facet joints which could account for the AROM loss (Magee, 2002). She displayed a negative bilateral upper limb tension test, normal bilateral muscle stretch reflexes in the UE’s, negative cranial nerve testing and normal bilateral myotomal strength in the upper quadrant. Palpation revealed hypertonicity of the suboccipital triangle (R > L), bilateral scalene (R > L), levator scapulae (R > L), and trapezius muscles. Palpation for position revealed what appeared to be a rotation of atlas in relationship to the occiput and axis to the right, which was evident by a relative anterior position of the left transverse process compared to the right palpated while the seated patient maintained a protrusion of the mandible. This positional default position and its possible relationship in a patient with cervicogenic headaches have previously been proposed by Sillevis and Wyss (2015) To further examine and confirm this position of atlas MSK US imaging was used. The patient was placed in the prone position with the cervical spine in a neutral position and the probe was placed on the spinous process of C2 and angled so the lateral tubercle of atlas came into view. Figure 1 displays the position of the probe when assessing the suboccipital triangle. Figure 2 contains the right and left comparison of the distance of the spinous process of C2 (SC2) and the transverse process of C1 (TC1) relationship. The right SC2TC1 distance (5.5 cm) was less than the left (6.42 cm) and the diameter of the obliquus capitis inferior muscle was larger on the right (0.83 cm vs 0,70 cm), possibly indicating a more hypertonic state. This would support the hypothesis that there was a positional fault of atlas present in this case.