Suboccipital triangle
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This is a presentation on the suboccipital triangle. The objectives of this presentation are to provide an overview of the deepest set of pre-vertebral muscles. The presentation gives an overview of the suboccipital triangle, the borders, contents and it's clinical importance. For further reading please refer to Keith Moore - Clinically Oriented Anatomy and Snell's Clinical Anatomy by Regions.
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Posterior triangle of neck - Powerpoint lecture notes by Dr.N.Mugunthan.
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- Spinal nerves arise in pairs from the spinal cord. Each nerve has a dorsal root containing a ganglion and a ventral root.
- The spinal cord has gray matter on the outside containing nuclei and white matter on the inside. It also contains ascending and descending tracts that connect to the brain.
- Ascending tracts like the anterior and lateral spinothalamic tracts transmit sensory information from
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Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
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MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
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Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
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Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
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Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
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Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Qualifications:
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Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
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Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
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Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
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Membrane Potential and Action Potential:
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Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
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Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Suboccipital triangle
- 2. Objectives i. The suboccipital muscles ii. Borders of suboccipital triangle iii. Contents of suboccipital triangle
- 3. Suboccipital Muscles •The suboccipital muscles are group of deep muscles located in the upper cervical region at the base of the occipital bone
- 4. Suboccipital Muscles •These muscles attach the atlas to the axis and attach both to the base of the skull (caput) •These muscles are located deep to the sternocleidomastoid muscle, trapezius muscle, splenius and semispinalis muscles. •There are 4 muscles collectively
- 6. Suboccipital Muscles 1. Rectus Capitis Posterior Major •Origin – spinous process of axis •Insertion – lateral part of inferior nuchal line of occipital bone •Actions – extension and rotation of head •Innervation –posterior ramus of suboccipital nerve Rectus Capitis Posterior Major
- 7. Suboccipital Muscles 2. Rectus Capitis Posterior Minor •Origin – posterior tubercle of atlas •Insertion – medial part of inferior nuchal line of occipital bone •Actions – extension of head •Innervation –posterior ramus of suboccipital nerve Rectus Capitis Posterior Minor
- 8. Suboccipital Muscles 3. Obliquus Capitis Superior •Origin – transverse process of atlas •Insertion – occipital bone between superior and inferior nuchal line •Actions – extension head •Innervation –posterior ramus of suboccipital nerve Obliquus Capitis Superior
- 9. Suboccipital Muscles 4. Obliquus Capitis Inferior •Origin – spinous process of axis •Insertion – transverse process of atlas •Actions – rotation of face to same side •Innervation –posterior ramus of suboccipital nerve Obliquus Capitis Inferior
- 10. Suboccipital Muscles •Contraction of suboccipital muscles extends the head at the atlanto-axial joint Vascular Supply and Drainage •Branches of vertebral and occipital arteries •Suboccipital venous plexus
- 12. Suboccipital Triangle •The suboccipital triangle is bordered by three out of the four suboccipital muscle. a. Superomedial – Rectus Capitis Posterior Major b. Superolateral – Obliquus Capitis Superior c. Inferior – Obliquus Capitis Inferior d. Floor – posterior arch of atlas and alanto- occipital membrane e. Roof – Semispinalis capitis
- 13. Suboccipital Triangle Superomedial border Superolateral border Inferior border Roof
- 14. Contents of Suboccipital Triangle 1. Vertebral artery – originates as a branch of subclavian artery; leaves transverse foramen of atlas, courses through the suboccipital triangle, pierces through the posterior altanto- occipital membrane and finally enters the skull through foramen magnum 2. Suboccipital nerve 3. Suboccipital venous plexus
- 15. Contents of Suboccipital Triangle 1. Vertebral artery 2. Suboccipital nerve – posterior ramus of C1 spinal nerve. Courses between posterior arch of C1 vertebrae to innervate the 4 suboccipital muscles 3. Suboccipital venous plexus
- 16. Contents of Suboccipital Triangle 1. Vertebral 2. Suboccipital nerve 3. Suboccipital venous plexus – deoxygenated blood from back of scalp drains into the occipital vein. Pierces through trapezius muscle to drain into suboccipital venous plexus. Finally drains into deep cervical vein, vertebral vein and brachiocephalic vein
- 17. Clinical Correlate •The vertebral artery bends torturously as the artery leaves the transverse foramen of C1 vertebrae and courses through the suboccipital triangle •This makes the vertebral artery susceptible to aneurysms in the suboccipital triangle and major cause of stroke in individuals <45 years
- 18. Questions 1. Branch from external carotid artery? 2. Spinal nerves or nerve roots existing the 4th foramina? 3. Pain perceived as coming from dermatome supplied by that nerve may be accompanied by localized pain?
- 19. Questions 4. Branch of subclavian travels through transverse foramen and through the foramen magnum feeds into the circle of Willis? 5. Give short notes on the suboccipital triangle and its contents.