Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 1 of 9

MSAK101-I ndash Session 10

BLUE SKY SCHOOL OF PROFESSIONAL MASSAGE AND

THERAPEUTIC BODYWORK

Musculoskeletal Anatomy amp Kinesiology

ANTERIOR amp POSTERIOR NECK

MSAK101-I Session 10

LEARNING OBJECTIVES

By the end of this session the student will be expected to

1 Apply all review material

2 List and describe new structures

3 For the muscles of the anterior and posterior neck

Locate

Identify attachments points

Demonstrate fiber direction

List actions

Describe relationship or layering to other musculoskeletal structures

Palpate

1) QUICK REVIEW

a) Bones

i) Axial Skeleton

(1) Skull

(a) Mastoid Process of Temporal Bone

(b) Superior Nuchal Line

(2) Mandible

(3) Vertebral Column

(a) Atlas (C1)

(i) Transverse foramina

(ii) Anterior and Posterior tubercle

(b) Axis (C2)

(4) Hyoid

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 2 of 9

MSAK101-I ndash Session 10

2) STRUCTURES

a) Carotid Sinus

i) The carotid sinus is a localized dilation of the internal carotid artery It

contains numerous baroreceptors which function as a sampling area

for many homeostatic mechanisms for maintaining blood pressure The

carotid sinus often has atherosclerotic plaques because of disturbed

hemodynamics[1]

ii) These plaques if large and unstable predispose to ischemic strokes and

transient ischemic attacks The carotid sinus can be oversensitive to

manual stimulation a condition known as carotid sinus

hypersensitivity carotid sinus syndrome or carotid sinus syncope in

which manual stimulation causes large changes in heart rate andor

blood pressure[1]

iii) Carotid sinus reflex death is a disputed mechanism of death in which

manual stimulation of the carotid sinus allegedly causes strong vagus

nerve impulses leading to terminal cardiac arrest Studies have suggested that the carotid sinus reflex can be a

contributing factor in other mechanisms of death by reducing blood pressure and heart rate especially in the elderly

or in people suffering from carotid sinus hypersensitivity [3]

b) Vertebral Artery

i) They arise one on each side of the body then enter deep to the

transverse process of the level of the 6th cervical vertebrae

(C6) It then proceeds superiorly under the transverse process

of each cervical vertebra until C1 At C1 the vertebral arteries

travel across the posterior arch of the atlas before entering the

foramen magnum

c) Brachial Plexus

i) An arrangement of nerve fibers (a plexus) running from the

spine (vertebrae C5-T1) through the neck the axilla and into

the arm

d) Vertebral Triangle (or Suboccipital Triangle)

i) The suboccipital triangle is a region of the neck bounded by

(1) Rectus capitis posterior major - above and medially

(2) Obliquus capitis superior - above and laterally

(3) Obliquus capitis inferior - below and laterally

ii) The vertebral artery and the first cervical or

suboccipital nerve lie within this triangle

Carotid sinus

Vertebral A

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 2 of 9

MSAK101-I ndash Session 10

2) STRUCTURES

a) Carotid Sinus

i) The carotid sinus is a localized dilation of the internal carotid artery It

contains numerous baroreceptors which function as a sampling area

for many homeostatic mechanisms for maintaining blood pressure The

carotid sinus often has atherosclerotic plaques because of disturbed

hemodynamics[1]

ii) These plaques if large and unstable predispose to ischemic strokes and

transient ischemic attacks The carotid sinus can be oversensitive to

manual stimulation a condition known as carotid sinus

hypersensitivity carotid sinus syndrome or carotid sinus syncope in

which manual stimulation causes large changes in heart rate andor

blood pressure[1]

iii) Carotid sinus reflex death is a disputed mechanism of death in which

manual stimulation of the carotid sinus allegedly causes strong vagus

nerve impulses leading to terminal cardiac arrest Studies have suggested that the carotid sinus reflex can be a

contributing factor in other mechanisms of death by reducing blood pressure and heart rate especially in the elderly

or in people suffering from carotid sinus hypersensitivity [3]

b) Vertebral Artery

i) They arise one on each side of the body then enter deep to the

transverse process of the level of the 6th cervical vertebrae

(C6) It then proceeds superiorly under the transverse process

of each cervical vertebra until C1 At C1 the vertebral arteries

travel across the posterior arch of the atlas before entering the

foramen magnum

c) Brachial Plexus

i) An arrangement of nerve fibers (a plexus) running from the

spine (vertebrae C5-T1) through the neck the axilla and into

the arm

d) Vertebral Triangle (or Suboccipital Triangle)

i) The suboccipital triangle is a region of the neck bounded by

(1) Rectus capitis posterior major - above and medially

(2) Obliquus capitis superior - above and laterally

(3) Obliquus capitis inferior - below and laterally

ii) The vertebral artery and the first cervical or

suboccipital nerve lie within this triangle

Carotid sinus

Vertebral A

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 3 of 9

MSAK101-I ndash Session 10

ANTERIOR CERVICAL SPINE MUSCLES

a) Platysma

i) Origin Fascia covering the superior chest

ii) Insertion Mandible and fascia of lower face

iii) Fiber Direction Inferior to superior

iv) Actions

(1) Depresses mandible and lower lip

(2) Draws up skin of superior chest and neck to form ridges of

skin in the neck

v) Notes relationship to other musculoskeletal structures

(1) The most superficial muscle of the anterior neck

(2) The skeletal movement of depression of the mandible is extremely weak

(3) When platysma contracts it wrinkles the skin of the neck

b) Sternocleidomastoid

i) Origin Sternal head ndash Manubrium of sternum Clavicular head ndash Medial 13 of clavicle

ii) Insertion Mastoid process of temporal bone and lateral frac12 of superior nuchal line

iii) Fiber Direction Inferior to superior at lateral angle

iv) Actions

(1) Flexion of neck

(2) Lateral flexion of neck and head

(3) Contralateral rotation of neck and head

(4) Elevation of the sternum and clavicle

v) Notes relationship to other musculoskeletal structures

(1) The SCM is often injured as a result of motor vehicle

accidents (Whiplash)

(2) The carotid sinus of the common carotid artery lies directly medial to the SCM

c) Hyoid Muscles

Four Suprahyoid muscles lie superior to the hyoid

bone and make up the floor of the mouth

Digastric

Mylohyoid

Geniohyoid (not discussed)

Stylohyoid (not discussed)

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 4 of 9

MSAK101-I ndash Session 10

Four Infrahyoid muscles lie inferior to the hyoid and

make up the muscles of the larynx

Sternohyoid

Omohyoid

Sternothyroid (not discussed)

Thyrohyoid (not discussed)

i) Suprahyoid muscles

(1) Digastric

(a) Origin Posterior Belly Temporal bone

Anterior Belly Mandible

(b) Insertion The hyoid

(c) Fiber Direction Posterior to anterior

(d) Actions

(i) Elevation of the hyoid

(ii) Depression of the mandible

(iii)Retraction of mandible

(e) Notes relationship to other musculoskeletal structures

(i) Except for Platysma the Digastric is a superficial muscle Posteriorly it is covered

by the SCM

(ii) This muscle is named for its two bellies

(2) Mylohyoid

(a) Origin Inner surface of mandible

(b) Insertion The hyoid

(c) Fiber Direction Fibers of the right and left Mylohyoid meet in the midline to form a

seam of tissue called a raphe

(d) Actions

(i) Elevation of the hyoid

(ii) Depression mandible

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 5 of 9

MSAK101-I ndash Session 10

ii) Infrahyoids

(1) Sternohyoid

(a) Origin Sternum

(b) Insertion The hyoid

(c) Fiber Direction Inferior to superior

(d) Actions Depression of the hyoid

(2) Omohyoid

(a) Origin Superior border of the Scapula

(b) Insertion Superior Belly The hyoid

Inferior Belly The clavicle

(c) Fiber Direction Inferior to superior and medial

(d) Actions Depression of the hyoid

d) Scalenes

(1) Anterior Scalene

(a) Origin TPrsquos of the cervical spine and Anterior tubercles of C3-6

(b) Insertion 1st rib

(c) Fiber Direction Superior to inferior

(d) Actions

(i) Flexion of neck

(ii) Lateral flexion of the neck

(iii)Elevation of the upper ribs

(iv) Contralateral rotation of neck

(2) Middle Scalene

(a) Origin TPrsquos of the cervical spine

Posterior tubercles of C2-7

(b) Insertion 1st rib

(c) Fiber Direction Superior to inferior

(d) Actions

(i) Flexion of neck

(ii) Lateral Flexion of neck

(iii)Elevation of upper ribs

(iv) Contralateral rotation of neck

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 6 of 9

MSAK101-I ndash Session 10

(3) Posterior Scalene

(a) Origin TPrsquos of C5-C7 Posterior tubercles of C5-7

(b) Insertion 2nd

rib

(c) Fiber Direction Superior to inferior

(d) Actions

(i) Flexion of neck

(ii) Lateral Flexion of neck

(iii)Elevation of upper ribs

(iv) Contralateral rotation of neck

(e) Notes for the Scalene Group

(i) Superior portion is deep to the SCM

(ii) Brachial plexus and subclavian artery are deep to muscle

(iii)Considered an accessory muscle of respiration

e) Longus Colli (DEEP ANTERIOR VIEW)

i) Origin Bodies of C-5 through T-3 TPs of C-3 through C-5

ii) Insertion bodies of C-3 and C-4 TPs of C-5 and C-6

iii) Fiber Direction Inferior to superior

iv) Actions

(1) Flexion of Neck

(2) Lateral Flexion of Neck

(3) Contralateral Rotation of Neck

v) Notes relationship to other musculoskeletal structures

(1) Deepest of the anterior neck muscles

f) Longus Capitis

i) Origin TPs of C3-C6

ii) Insertion Occiput

iii) Fiber Direction Inferior to superior

iv) Actions

(1) Flexion of Neck

(2) Lateral Flexion of Neck

v) Notes relationship to other musculoskeletal structures

(1) Located very deep in the anterior neck

(2) Distinguishing between Longus capitis and Longus colli can be difficult

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 7 of 9

MSAK101-I ndash Session 10

POSTERIOR CERVICAL SPINE MUSCLES

a) Trapezius (Covered in Shoulder Girdle section)

b) Splenius Capitis

i) Origin Nuchal Ligament and SPrsquos C7-T3

ii) Insertion Mastoid Process Lateral 13 of the superior

nuchal line of the occiput

iii) Fiber Direction Inferior to superior laterally

iv) Actions

(1) Extension of head and neck

(2) Lateral Flexion of head and neck

(3) Ipsilateral rotation of the head and neck

v) Notes relationship to other musculoskeletal

structures

(1) The left and right Splenius Capitis bilaterally form a v shape

(2) The mastoid attachment of the Splenius Capitis is between the attachments of the SCM and

Longissimus Capitis

c) Splenius Cervicis

i) Origin SPrsquos T3-T6

ii) Insertion TPrsquos of C1-C3 Posterior Tubercles of the TPrsquos

iii) Fiber Direction Inferior to superior laterally

iv) Actions

(1) Extension of head and neck

(2) Lateral flexion of head and neck

(3) Ipsilateral rotation of the head and neck

v) Notes relationship to other musculoskeletal structures

(1) The attachment of the Splenius Cervicis is between the cervical TP attachment of the Levator

Scapulae and the Scalenes

(2) The best place to palpate Splenius Cervicis is at the lower cervical spine C5-7 where it is

deep only to Upper Trapezius

d) Levator Scapulae (Covered in shoulder girdle)

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 8 of 9

MSAK101-I ndash Session 10

e) Suboccipitals

i) Rectus Capitis Posterior Major

(1) Origin SP of Axis (C2)

(2) Insertion Occiput

(3) Fiber Direction Inferior to superior laterally

(4) Actions

(i) Extension of head

(ii) Lateral Flexion and Ipsilateral rotation of the head

ii) Rectus Capitis Posterior Minor

(1) Origin Posterior tubercle of Atlas (C1)

(2) Insertion Occiput

(3) Fiber Direction Inferior to superior

(4) Action Extension of head

iii) Obliquus Capitis Inferior

(1) Origin SP of Axis (C2)

(2) Insertion TP of Atlas (C1)

(3) Fiber Direction Inferior to superior laterally

(4) Action Ipsilateral rotation of the Atlas

iv) Obliquus Capitis Superior

(1) Origin TP of Atlas (C1)

(2) Insertion Occiput

(3) Fiber Direction Inferior to superior

(4) Actions

(i) Extension of head

(ii) Lateral Flexion of head

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 9 of 9

MSAK101-I ndash Session 10

3) APPLICATION

a) Layering of the Anterior Neck

Layer Muscles

1 Platysma

2 Sternocleidomastoid

3 Hyoids

4 Scalenes

5 Longus Colli

b) Layering of the Posterior Neck

Layer Muscles

1 Trapezius

2 Splenius Capitis and Splenius Cervicis

3 Levator Scapulae

4 Suboccipital group

c) Motions of Cervical Spine

ACTION

AGONIST SYNERGISTS

Flexion Sternocleidomastoid Scalenes

Extension Splenius Group Upper trapezius

Erector Spinae

Semispinalis

Suboccipitals

Lateral Flexion Scalenes SCM

Upper trapezius

Levator Scapulae

Splenius Group

Rotation ( ie LEFT) Right SCM Left Splenius Group

d) Range of Motion 60 degrees for cervical flexion

45 degrees for cervical extension

45 degrees for cervical lateral flexion

70-90 degrees for cervical rotation

1 Glagov S Zarins C Giddens DP Ku DN Hemodynamics and atherosclerosis Insights and

perspectives gained from studies of human arteries degradable Arch Pathol Lab Med 1988 Oct112(10)1018-31

2 Lim SH Anantharaman V Teo WS Goh PP Tan AT Comparison of treatment of supraventricular

tachycardia by Valsalva maneuver and carotid sinus massage Ann Emerg Med 1998 Jan31(1)30-5

3 Passig K Carotid Sinus reflex death - a theory and its history wwwdatenschlagorg URL last

accessed February 28 2006

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 4 of 9

MSAK101-I ndash Session 10

Four Infrahyoid muscles lie inferior to the hyoid and

make up the muscles of the larynx

Sternohyoid

Omohyoid

Sternothyroid (not discussed)

Thyrohyoid (not discussed)

i) Suprahyoid muscles

(1) Digastric

(a) Origin Posterior Belly Temporal bone

Anterior Belly Mandible

(b) Insertion The hyoid

(c) Fiber Direction Posterior to anterior

(d) Actions

(i) Elevation of the hyoid

(ii) Depression of the mandible

(iii)Retraction of mandible

(e) Notes relationship to other musculoskeletal structures

(i) Except for Platysma the Digastric is a superficial muscle Posteriorly it is covered

by the SCM

(ii) This muscle is named for its two bellies

(2) Mylohyoid

(a) Origin Inner surface of mandible

(b) Insertion The hyoid

(c) Fiber Direction Fibers of the right and left Mylohyoid meet in the midline to form a

seam of tissue called a raphe

(d) Actions

(i) Elevation of the hyoid

(ii) Depression mandible

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 5 of 9

MSAK101-I ndash Session 10

ii) Infrahyoids

(1) Sternohyoid

(a) Origin Sternum

(b) Insertion The hyoid

(c) Fiber Direction Inferior to superior

(d) Actions Depression of the hyoid

(2) Omohyoid

(a) Origin Superior border of the Scapula

(b) Insertion Superior Belly The hyoid

Inferior Belly The clavicle

(c) Fiber Direction Inferior to superior and medial

(d) Actions Depression of the hyoid

d) Scalenes

(1) Anterior Scalene

(a) Origin TPrsquos of the cervical spine and Anterior tubercles of C3-6

(b) Insertion 1st rib

(c) Fiber Direction Superior to inferior

(d) Actions

(i) Flexion of neck

(ii) Lateral flexion of the neck

(iii)Elevation of the upper ribs

(iv) Contralateral rotation of neck

(2) Middle Scalene

(a) Origin TPrsquos of the cervical spine

Posterior tubercles of C2-7

(b) Insertion 1st rib

(c) Fiber Direction Superior to inferior

(d) Actions

(i) Flexion of neck

(ii) Lateral Flexion of neck

(iii)Elevation of upper ribs

(iv) Contralateral rotation of neck

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 6 of 9

MSAK101-I ndash Session 10

(3) Posterior Scalene

(a) Origin TPrsquos of C5-C7 Posterior tubercles of C5-7

(b) Insertion 2nd

rib

(c) Fiber Direction Superior to inferior

(d) Actions

(i) Flexion of neck

(ii) Lateral Flexion of neck

(iii)Elevation of upper ribs

(iv) Contralateral rotation of neck

(e) Notes for the Scalene Group

(i) Superior portion is deep to the SCM

(ii) Brachial plexus and subclavian artery are deep to muscle

(iii)Considered an accessory muscle of respiration

e) Longus Colli (DEEP ANTERIOR VIEW)

i) Origin Bodies of C-5 through T-3 TPs of C-3 through C-5

ii) Insertion bodies of C-3 and C-4 TPs of C-5 and C-6

iii) Fiber Direction Inferior to superior

iv) Actions

(1) Flexion of Neck

(2) Lateral Flexion of Neck

(3) Contralateral Rotation of Neck

v) Notes relationship to other musculoskeletal structures

(1) Deepest of the anterior neck muscles

f) Longus Capitis

i) Origin TPs of C3-C6

ii) Insertion Occiput

iii) Fiber Direction Inferior to superior

iv) Actions

(1) Flexion of Neck

(2) Lateral Flexion of Neck

v) Notes relationship to other musculoskeletal structures

(1) Located very deep in the anterior neck

(2) Distinguishing between Longus capitis and Longus colli can be difficult

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 7 of 9

MSAK101-I ndash Session 10

POSTERIOR CERVICAL SPINE MUSCLES

a) Trapezius (Covered in Shoulder Girdle section)

b) Splenius Capitis

i) Origin Nuchal Ligament and SPrsquos C7-T3

ii) Insertion Mastoid Process Lateral 13 of the superior

nuchal line of the occiput

iii) Fiber Direction Inferior to superior laterally

iv) Actions

(1) Extension of head and neck

(2) Lateral Flexion of head and neck

(3) Ipsilateral rotation of the head and neck

v) Notes relationship to other musculoskeletal

structures

(1) The left and right Splenius Capitis bilaterally form a v shape

(2) The mastoid attachment of the Splenius Capitis is between the attachments of the SCM and

Longissimus Capitis

c) Splenius Cervicis

i) Origin SPrsquos T3-T6

ii) Insertion TPrsquos of C1-C3 Posterior Tubercles of the TPrsquos

iii) Fiber Direction Inferior to superior laterally

iv) Actions

(1) Extension of head and neck

(2) Lateral flexion of head and neck

(3) Ipsilateral rotation of the head and neck

v) Notes relationship to other musculoskeletal structures

(1) The attachment of the Splenius Cervicis is between the cervical TP attachment of the Levator

Scapulae and the Scalenes

(2) The best place to palpate Splenius Cervicis is at the lower cervical spine C5-7 where it is

deep only to Upper Trapezius

d) Levator Scapulae (Covered in shoulder girdle)

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 8 of 9

MSAK101-I ndash Session 10

e) Suboccipitals

i) Rectus Capitis Posterior Major

(1) Origin SP of Axis (C2)

(2) Insertion Occiput

(3) Fiber Direction Inferior to superior laterally

(4) Actions

(i) Extension of head

(ii) Lateral Flexion and Ipsilateral rotation of the head

ii) Rectus Capitis Posterior Minor

(1) Origin Posterior tubercle of Atlas (C1)

(2) Insertion Occiput

(3) Fiber Direction Inferior to superior

(4) Action Extension of head

iii) Obliquus Capitis Inferior

(1) Origin SP of Axis (C2)

(2) Insertion TP of Atlas (C1)

(3) Fiber Direction Inferior to superior laterally

(4) Action Ipsilateral rotation of the Atlas

iv) Obliquus Capitis Superior

(1) Origin TP of Atlas (C1)

(2) Insertion Occiput

(3) Fiber Direction Inferior to superior

(4) Actions

(i) Extension of head

(ii) Lateral Flexion of head

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 9 of 9

MSAK101-I ndash Session 10

3) APPLICATION

a) Layering of the Anterior Neck

Layer Muscles

1 Platysma

2 Sternocleidomastoid

3 Hyoids

4 Scalenes

5 Longus Colli

b) Layering of the Posterior Neck

Layer Muscles

1 Trapezius

2 Splenius Capitis and Splenius Cervicis

3 Levator Scapulae

4 Suboccipital group

c) Motions of Cervical Spine

ACTION

AGONIST SYNERGISTS

Flexion Sternocleidomastoid Scalenes

Extension Splenius Group Upper trapezius

Erector Spinae

Semispinalis

Suboccipitals

Lateral Flexion Scalenes SCM

Upper trapezius

Levator Scapulae

Splenius Group

Rotation ( ie LEFT) Right SCM Left Splenius Group

d) Range of Motion 60 degrees for cervical flexion

45 degrees for cervical extension

45 degrees for cervical lateral flexion

70-90 degrees for cervical rotation

1 Glagov S Zarins C Giddens DP Ku DN Hemodynamics and atherosclerosis Insights and

perspectives gained from studies of human arteries degradable Arch Pathol Lab Med 1988 Oct112(10)1018-31

2 Lim SH Anantharaman V Teo WS Goh PP Tan AT Comparison of treatment of supraventricular

tachycardia by Valsalva maneuver and carotid sinus massage Ann Emerg Med 1998 Jan31(1)30-5

3 Passig K Carotid Sinus reflex death - a theory and its history wwwdatenschlagorg URL last

accessed February 28 2006

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 5 of 9

MSAK101-I ndash Session 10

ii) Infrahyoids

(1) Sternohyoid

(a) Origin Sternum

(b) Insertion The hyoid

(c) Fiber Direction Inferior to superior

(d) Actions Depression of the hyoid

(2) Omohyoid

(a) Origin Superior border of the Scapula

(b) Insertion Superior Belly The hyoid

Inferior Belly The clavicle

(c) Fiber Direction Inferior to superior and medial

(d) Actions Depression of the hyoid

d) Scalenes

(1) Anterior Scalene

(a) Origin TPrsquos of the cervical spine and Anterior tubercles of C3-6

(b) Insertion 1st rib

(c) Fiber Direction Superior to inferior

(d) Actions

(i) Flexion of neck

(ii) Lateral flexion of the neck

(iii)Elevation of the upper ribs

(iv) Contralateral rotation of neck

(2) Middle Scalene

(a) Origin TPrsquos of the cervical spine

Posterior tubercles of C2-7

(b) Insertion 1st rib

(c) Fiber Direction Superior to inferior

(d) Actions

(i) Flexion of neck

(ii) Lateral Flexion of neck

(iii)Elevation of upper ribs

(iv) Contralateral rotation of neck

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 6 of 9

MSAK101-I ndash Session 10

(3) Posterior Scalene

(a) Origin TPrsquos of C5-C7 Posterior tubercles of C5-7

(b) Insertion 2nd

rib

(c) Fiber Direction Superior to inferior

(d) Actions

(i) Flexion of neck

(ii) Lateral Flexion of neck

(iii)Elevation of upper ribs

(iv) Contralateral rotation of neck

(e) Notes for the Scalene Group

(i) Superior portion is deep to the SCM

(ii) Brachial plexus and subclavian artery are deep to muscle

(iii)Considered an accessory muscle of respiration

e) Longus Colli (DEEP ANTERIOR VIEW)

i) Origin Bodies of C-5 through T-3 TPs of C-3 through C-5

ii) Insertion bodies of C-3 and C-4 TPs of C-5 and C-6

iii) Fiber Direction Inferior to superior

iv) Actions

(1) Flexion of Neck

(2) Lateral Flexion of Neck

(3) Contralateral Rotation of Neck

v) Notes relationship to other musculoskeletal structures

(1) Deepest of the anterior neck muscles

f) Longus Capitis

i) Origin TPs of C3-C6

ii) Insertion Occiput

iii) Fiber Direction Inferior to superior

iv) Actions

(1) Flexion of Neck

(2) Lateral Flexion of Neck

v) Notes relationship to other musculoskeletal structures

(1) Located very deep in the anterior neck

(2) Distinguishing between Longus capitis and Longus colli can be difficult

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 7 of 9

MSAK101-I ndash Session 10

POSTERIOR CERVICAL SPINE MUSCLES

a) Trapezius (Covered in Shoulder Girdle section)

b) Splenius Capitis

i) Origin Nuchal Ligament and SPrsquos C7-T3

ii) Insertion Mastoid Process Lateral 13 of the superior

nuchal line of the occiput

iii) Fiber Direction Inferior to superior laterally

iv) Actions

(1) Extension of head and neck

(2) Lateral Flexion of head and neck

(3) Ipsilateral rotation of the head and neck

v) Notes relationship to other musculoskeletal

structures

(1) The left and right Splenius Capitis bilaterally form a v shape

(2) The mastoid attachment of the Splenius Capitis is between the attachments of the SCM and

Longissimus Capitis

c) Splenius Cervicis

i) Origin SPrsquos T3-T6

ii) Insertion TPrsquos of C1-C3 Posterior Tubercles of the TPrsquos

iii) Fiber Direction Inferior to superior laterally

iv) Actions

(1) Extension of head and neck

(2) Lateral flexion of head and neck

(3) Ipsilateral rotation of the head and neck

v) Notes relationship to other musculoskeletal structures

(1) The attachment of the Splenius Cervicis is between the cervical TP attachment of the Levator

Scapulae and the Scalenes

(2) The best place to palpate Splenius Cervicis is at the lower cervical spine C5-7 where it is

deep only to Upper Trapezius

d) Levator Scapulae (Covered in shoulder girdle)

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 8 of 9

MSAK101-I ndash Session 10

e) Suboccipitals

i) Rectus Capitis Posterior Major

(1) Origin SP of Axis (C2)

(2) Insertion Occiput

(3) Fiber Direction Inferior to superior laterally

(4) Actions

(i) Extension of head

(ii) Lateral Flexion and Ipsilateral rotation of the head

ii) Rectus Capitis Posterior Minor

(1) Origin Posterior tubercle of Atlas (C1)

(2) Insertion Occiput

(3) Fiber Direction Inferior to superior

(4) Action Extension of head

iii) Obliquus Capitis Inferior

(1) Origin SP of Axis (C2)

(2) Insertion TP of Atlas (C1)

(3) Fiber Direction Inferior to superior laterally

(4) Action Ipsilateral rotation of the Atlas

iv) Obliquus Capitis Superior

(1) Origin TP of Atlas (C1)

(2) Insertion Occiput

(3) Fiber Direction Inferior to superior

(4) Actions

(i) Extension of head

(ii) Lateral Flexion of head

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 9 of 9

MSAK101-I ndash Session 10

3) APPLICATION

a) Layering of the Anterior Neck

Layer Muscles

1 Platysma

2 Sternocleidomastoid

3 Hyoids

4 Scalenes

5 Longus Colli

b) Layering of the Posterior Neck

Layer Muscles

1 Trapezius

2 Splenius Capitis and Splenius Cervicis

3 Levator Scapulae

4 Suboccipital group

c) Motions of Cervical Spine

ACTION

AGONIST SYNERGISTS

Flexion Sternocleidomastoid Scalenes

Extension Splenius Group Upper trapezius

Erector Spinae

Semispinalis

Suboccipitals

Lateral Flexion Scalenes SCM

Upper trapezius

Levator Scapulae

Splenius Group

Rotation ( ie LEFT) Right SCM Left Splenius Group

d) Range of Motion 60 degrees for cervical flexion

45 degrees for cervical extension

45 degrees for cervical lateral flexion

70-90 degrees for cervical rotation

1 Glagov S Zarins C Giddens DP Ku DN Hemodynamics and atherosclerosis Insights and

perspectives gained from studies of human arteries degradable Arch Pathol Lab Med 1988 Oct112(10)1018-31

2 Lim SH Anantharaman V Teo WS Goh PP Tan AT Comparison of treatment of supraventricular

tachycardia by Valsalva maneuver and carotid sinus massage Ann Emerg Med 1998 Jan31(1)30-5

3 Passig K Carotid Sinus reflex death - a theory and its history wwwdatenschlagorg URL last

accessed February 28 2006

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 6 of 9

MSAK101-I ndash Session 10

(3) Posterior Scalene

(a) Origin TPrsquos of C5-C7 Posterior tubercles of C5-7

(b) Insertion 2nd

rib

(c) Fiber Direction Superior to inferior

(d) Actions

(i) Flexion of neck

(ii) Lateral Flexion of neck

(iii)Elevation of upper ribs

(iv) Contralateral rotation of neck

(e) Notes for the Scalene Group

(i) Superior portion is deep to the SCM

(ii) Brachial plexus and subclavian artery are deep to muscle

(iii)Considered an accessory muscle of respiration

e) Longus Colli (DEEP ANTERIOR VIEW)

i) Origin Bodies of C-5 through T-3 TPs of C-3 through C-5

ii) Insertion bodies of C-3 and C-4 TPs of C-5 and C-6

iii) Fiber Direction Inferior to superior

iv) Actions

(1) Flexion of Neck

(2) Lateral Flexion of Neck

(3) Contralateral Rotation of Neck

v) Notes relationship to other musculoskeletal structures

(1) Deepest of the anterior neck muscles

f) Longus Capitis

i) Origin TPs of C3-C6

ii) Insertion Occiput

iii) Fiber Direction Inferior to superior

iv) Actions

(1) Flexion of Neck

(2) Lateral Flexion of Neck

v) Notes relationship to other musculoskeletal structures

(1) Located very deep in the anterior neck

(2) Distinguishing between Longus capitis and Longus colli can be difficult

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 7 of 9

MSAK101-I ndash Session 10

POSTERIOR CERVICAL SPINE MUSCLES

a) Trapezius (Covered in Shoulder Girdle section)

b) Splenius Capitis

i) Origin Nuchal Ligament and SPrsquos C7-T3

ii) Insertion Mastoid Process Lateral 13 of the superior

nuchal line of the occiput

iii) Fiber Direction Inferior to superior laterally

iv) Actions

(1) Extension of head and neck

(2) Lateral Flexion of head and neck

(3) Ipsilateral rotation of the head and neck

v) Notes relationship to other musculoskeletal

structures

(1) The left and right Splenius Capitis bilaterally form a v shape

(2) The mastoid attachment of the Splenius Capitis is between the attachments of the SCM and

Longissimus Capitis

c) Splenius Cervicis

i) Origin SPrsquos T3-T6

ii) Insertion TPrsquos of C1-C3 Posterior Tubercles of the TPrsquos

iii) Fiber Direction Inferior to superior laterally

iv) Actions

(1) Extension of head and neck

(2) Lateral flexion of head and neck

(3) Ipsilateral rotation of the head and neck

v) Notes relationship to other musculoskeletal structures

(1) The attachment of the Splenius Cervicis is between the cervical TP attachment of the Levator

Scapulae and the Scalenes

(2) The best place to palpate Splenius Cervicis is at the lower cervical spine C5-7 where it is

deep only to Upper Trapezius

d) Levator Scapulae (Covered in shoulder girdle)

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 8 of 9

MSAK101-I ndash Session 10

e) Suboccipitals

i) Rectus Capitis Posterior Major

(1) Origin SP of Axis (C2)

(2) Insertion Occiput

(3) Fiber Direction Inferior to superior laterally

(4) Actions

(i) Extension of head

(ii) Lateral Flexion and Ipsilateral rotation of the head

ii) Rectus Capitis Posterior Minor

(1) Origin Posterior tubercle of Atlas (C1)

(2) Insertion Occiput

(3) Fiber Direction Inferior to superior

(4) Action Extension of head

iii) Obliquus Capitis Inferior

(1) Origin SP of Axis (C2)

(2) Insertion TP of Atlas (C1)

(3) Fiber Direction Inferior to superior laterally

(4) Action Ipsilateral rotation of the Atlas

iv) Obliquus Capitis Superior

(1) Origin TP of Atlas (C1)

(2) Insertion Occiput

(3) Fiber Direction Inferior to superior

(4) Actions

(i) Extension of head

(ii) Lateral Flexion of head

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 9 of 9

MSAK101-I ndash Session 10

3) APPLICATION

a) Layering of the Anterior Neck

Layer Muscles

1 Platysma

2 Sternocleidomastoid

3 Hyoids

4 Scalenes

5 Longus Colli

b) Layering of the Posterior Neck

Layer Muscles

1 Trapezius

2 Splenius Capitis and Splenius Cervicis

3 Levator Scapulae

4 Suboccipital group

c) Motions of Cervical Spine

ACTION

AGONIST SYNERGISTS

Flexion Sternocleidomastoid Scalenes

Extension Splenius Group Upper trapezius

Erector Spinae

Semispinalis

Suboccipitals

Lateral Flexion Scalenes SCM

Upper trapezius

Levator Scapulae

Splenius Group

Rotation ( ie LEFT) Right SCM Left Splenius Group

d) Range of Motion 60 degrees for cervical flexion

45 degrees for cervical extension

45 degrees for cervical lateral flexion

70-90 degrees for cervical rotation

1 Glagov S Zarins C Giddens DP Ku DN Hemodynamics and atherosclerosis Insights and

perspectives gained from studies of human arteries degradable Arch Pathol Lab Med 1988 Oct112(10)1018-31

2 Lim SH Anantharaman V Teo WS Goh PP Tan AT Comparison of treatment of supraventricular

tachycardia by Valsalva maneuver and carotid sinus massage Ann Emerg Med 1998 Jan31(1)30-5

3 Passig K Carotid Sinus reflex death - a theory and its history wwwdatenschlagorg URL last

accessed February 28 2006

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 7 of 9

MSAK101-I ndash Session 10

POSTERIOR CERVICAL SPINE MUSCLES

a) Trapezius (Covered in Shoulder Girdle section)

b) Splenius Capitis

i) Origin Nuchal Ligament and SPrsquos C7-T3

ii) Insertion Mastoid Process Lateral 13 of the superior

nuchal line of the occiput

iii) Fiber Direction Inferior to superior laterally

iv) Actions

(1) Extension of head and neck

(2) Lateral Flexion of head and neck

(3) Ipsilateral rotation of the head and neck

v) Notes relationship to other musculoskeletal

structures

(1) The left and right Splenius Capitis bilaterally form a v shape

(2) The mastoid attachment of the Splenius Capitis is between the attachments of the SCM and

Longissimus Capitis

c) Splenius Cervicis

i) Origin SPrsquos T3-T6

ii) Insertion TPrsquos of C1-C3 Posterior Tubercles of the TPrsquos

iii) Fiber Direction Inferior to superior laterally

iv) Actions

(1) Extension of head and neck

(2) Lateral flexion of head and neck

(3) Ipsilateral rotation of the head and neck

v) Notes relationship to other musculoskeletal structures

(1) The attachment of the Splenius Cervicis is between the cervical TP attachment of the Levator

Scapulae and the Scalenes

(2) The best place to palpate Splenius Cervicis is at the lower cervical spine C5-7 where it is

deep only to Upper Trapezius

d) Levator Scapulae (Covered in shoulder girdle)

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 8 of 9

MSAK101-I ndash Session 10

e) Suboccipitals

i) Rectus Capitis Posterior Major

(1) Origin SP of Axis (C2)

(2) Insertion Occiput

(3) Fiber Direction Inferior to superior laterally

(4) Actions

(i) Extension of head

(ii) Lateral Flexion and Ipsilateral rotation of the head

ii) Rectus Capitis Posterior Minor

(1) Origin Posterior tubercle of Atlas (C1)

(2) Insertion Occiput

(3) Fiber Direction Inferior to superior

(4) Action Extension of head

iii) Obliquus Capitis Inferior

(1) Origin SP of Axis (C2)

(2) Insertion TP of Atlas (C1)

(3) Fiber Direction Inferior to superior laterally

(4) Action Ipsilateral rotation of the Atlas

iv) Obliquus Capitis Superior

(1) Origin TP of Atlas (C1)

(2) Insertion Occiput

(3) Fiber Direction Inferior to superior

(4) Actions

(i) Extension of head

(ii) Lateral Flexion of head

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 9 of 9

MSAK101-I ndash Session 10

3) APPLICATION

a) Layering of the Anterior Neck

Layer Muscles

1 Platysma

2 Sternocleidomastoid

3 Hyoids

4 Scalenes

5 Longus Colli

b) Layering of the Posterior Neck

Layer Muscles

1 Trapezius

2 Splenius Capitis and Splenius Cervicis

3 Levator Scapulae

4 Suboccipital group

c) Motions of Cervical Spine

ACTION

AGONIST SYNERGISTS

Flexion Sternocleidomastoid Scalenes

Extension Splenius Group Upper trapezius

Erector Spinae

Semispinalis

Suboccipitals

Lateral Flexion Scalenes SCM

Upper trapezius

Levator Scapulae

Splenius Group

Rotation ( ie LEFT) Right SCM Left Splenius Group

d) Range of Motion 60 degrees for cervical flexion

45 degrees for cervical extension

45 degrees for cervical lateral flexion

70-90 degrees for cervical rotation

1 Glagov S Zarins C Giddens DP Ku DN Hemodynamics and atherosclerosis Insights and

perspectives gained from studies of human arteries degradable Arch Pathol Lab Med 1988 Oct112(10)1018-31

2 Lim SH Anantharaman V Teo WS Goh PP Tan AT Comparison of treatment of supraventricular

tachycardia by Valsalva maneuver and carotid sinus massage Ann Emerg Med 1998 Jan31(1)30-5

3 Passig K Carotid Sinus reflex death - a theory and its history wwwdatenschlagorg URL last

accessed February 28 2006

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 8 of 9

MSAK101-I ndash Session 10

e) Suboccipitals

i) Rectus Capitis Posterior Major

(1) Origin SP of Axis (C2)

(2) Insertion Occiput

(3) Fiber Direction Inferior to superior laterally

(4) Actions

(i) Extension of head

(ii) Lateral Flexion and Ipsilateral rotation of the head

ii) Rectus Capitis Posterior Minor

(1) Origin Posterior tubercle of Atlas (C1)

(2) Insertion Occiput

(3) Fiber Direction Inferior to superior

(4) Action Extension of head

iii) Obliquus Capitis Inferior

(1) Origin SP of Axis (C2)

(2) Insertion TP of Atlas (C1)

(3) Fiber Direction Inferior to superior laterally

(4) Action Ipsilateral rotation of the Atlas

iv) Obliquus Capitis Superior

(1) Origin TP of Atlas (C1)

(2) Insertion Occiput

(3) Fiber Direction Inferior to superior

(4) Actions

(i) Extension of head

(ii) Lateral Flexion of head

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 9 of 9

MSAK101-I ndash Session 10

3) APPLICATION

a) Layering of the Anterior Neck

Layer Muscles

1 Platysma

2 Sternocleidomastoid

3 Hyoids

4 Scalenes

5 Longus Colli

b) Layering of the Posterior Neck

Layer Muscles

1 Trapezius

2 Splenius Capitis and Splenius Cervicis

3 Levator Scapulae

4 Suboccipital group

c) Motions of Cervical Spine

ACTION

AGONIST SYNERGISTS

Flexion Sternocleidomastoid Scalenes

Extension Splenius Group Upper trapezius

Erector Spinae

Semispinalis

Suboccipitals

Lateral Flexion Scalenes SCM

Upper trapezius

Levator Scapulae

Splenius Group

Rotation ( ie LEFT) Right SCM Left Splenius Group

d) Range of Motion 60 degrees for cervical flexion

45 degrees for cervical extension

45 degrees for cervical lateral flexion

70-90 degrees for cervical rotation

1 Glagov S Zarins C Giddens DP Ku DN Hemodynamics and atherosclerosis Insights and

perspectives gained from studies of human arteries degradable Arch Pathol Lab Med 1988 Oct112(10)1018-31

2 Lim SH Anantharaman V Teo WS Goh PP Tan AT Comparison of treatment of supraventricular

tachycardia by Valsalva maneuver and carotid sinus massage Ann Emerg Med 1998 Jan31(1)30-5

3 Passig K Carotid Sinus reflex death - a theory and its history wwwdatenschlagorg URL last

accessed February 28 2006

Updated 211 copy Blue Sky School of Professional Massage and Therapeutic Bodywork Page 9 of 9

MSAK101-I ndash Session 10

3) APPLICATION

a) Layering of the Anterior Neck

Layer Muscles

1 Platysma

2 Sternocleidomastoid

3 Hyoids

4 Scalenes

5 Longus Colli

b) Layering of the Posterior Neck

Layer Muscles

1 Trapezius

2 Splenius Capitis and Splenius Cervicis

3 Levator Scapulae

4 Suboccipital group

c) Motions of Cervical Spine

ACTION

AGONIST SYNERGISTS

Flexion Sternocleidomastoid Scalenes

Extension Splenius Group Upper trapezius

Erector Spinae

Semispinalis

Suboccipitals

Lateral Flexion Scalenes SCM

Upper trapezius

Levator Scapulae

Splenius Group

Rotation ( ie LEFT) Right SCM Left Splenius Group

d) Range of Motion 60 degrees for cervical flexion

45 degrees for cervical extension

45 degrees for cervical lateral flexion

70-90 degrees for cervical rotation

1 Glagov S Zarins C Giddens DP Ku DN Hemodynamics and atherosclerosis Insights and

perspectives gained from studies of human arteries degradable Arch Pathol Lab Med 1988 Oct112(10)1018-31

2 Lim SH Anantharaman V Teo WS Goh PP Tan AT Comparison of treatment of supraventricular

tachycardia by Valsalva maneuver and carotid sinus massage Ann Emerg Med 1998 Jan31(1)30-5

3 Passig K Carotid Sinus reflex death - a theory and its history wwwdatenschlagorg URL last

accessed February 28 2006