This document describes the muscles and structures in the back of the neck. It discusses the superficial and deep muscles in the back of the neck, including the trapezius, levator scapulae, splenius capitis, and suboccipital muscles. It then focuses on the suboccipital triangle, bounded superiorly by the rectus capitis posterior major and minor, superolaterally by the obliquus capitis superior, and inferiorly by the obliquus capitis inferior. The suboccipital triangle contains the suboccipital nerve, vertebral artery, and venous plexus and is the site of cisternal puncture to access the cisterna magna through the

1. MUSCLES OF BACK &
SUBOCCIPITAL
TRIANGLE
DR VANI PC

2.  Above-External occipital protuberance
& superior nuchal line
 below – Spine of c7 vertebrae
Back of Neck-Extent

3. The back of neck consists of four layers
 Skin
 Superficial fascia
 Deep fascia
 Muscles
Back of Neck-Layers

4. Back of neck- skin

5. Back of neck- superficial fascia
The cutaneous nerves
 Greater occipital
 Third occipital
The cutaneous vessels
 Occipital artery
 Twigs of vertebral artery

6. Muscles are arranged
as
 Superficial group
 Deep Group
Back of neck- Muscles

7. SUPERFICIAL GROUP
 First layer - Trapezius
 Second layer – Levator scapulae

8. DEEP GROUP
 Superficial : Splenius Capitis, Splenius
Cervices
 Intermediate : Longissimus Capitis
 Deep : Semispinalis Capitis
 Deepest layer : Suboccipital muscles

9. SUBOCCIPITAL MUSCLES
 Rectus capitis posterior minor
 Rectus capitis posterior major
 Obliquus capitis inferior
 Obliquus capitis superior

11. SUBOCCIPITAL
TRIANGLE

12. Approach to Suboccipital triangle

13.  Superomedially : Rectus capitis posterior
major & minor
 Superolaterally : Obliquus capitis
superior
 Inferiorly : Obliquus capitis inferior
Boundaries

14.  Roof:
Semispinalis capitis
 Floor:
Posterior atlanto-occipital
membrane
Posterior arch of atlas
Boundaries

15.  Suboccipital nerve:
(Dorsal ramus of C1)
 III part of Vertebral artery
 Sub occipital venous plexus
Contents

16. Cisternal puncture
It is a procedure to approach cisterna
magna in the posterior cranial fossa
through the foramen magnum
To obtain CSF
Via the Suboccipital triangle
By piercing the posterior atlanto-
occipital membrane
Applied aspects