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Suboccipital nerve

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The suboccipital nerve originates from the posterior/dorsal ramus of the first cervical spinal nerve (C1), which is why it is sometimes referred to as the dorsal ramus of the first cervical nerve. From its origin, the suboccipital nerve travels to the posterior neck region. On its course, this nerve accompanies the vertebral artery, which is why the injuries of these two structures often occur together.

The suboccipital nerve carries mainly motor fibers. The prime function of this nerve is to provide motor innervation for the suboccipital muscle group. These muscles include rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis superior, obliquus capitis inferior, and the semispinalis capitis muscles. Working in synergy, these muscles provide postural control of the head and neck.

This article will discuss the anatomy and function of the suboccipital nerve.

Key facts about the suboccipital nerve
Origin First cervical nerve (C1)
Branches Muscular branches
Supply Rectus capitis posterior minor muscle, rectus capitis posterior major muscle, obliquus capitis superior muscle, obliquus capitis inferior muscle, semispinalis capitis muscle
  1. Origin and course
  2. Branches and innervation
  3. Clinical relations
  4. Sources
+ Show all

Origin and course

Upon originating from the spinal cord, the first cervical nerve (C1) leaves the vertebral canal just inferior to the occipital bone and superior to the first cervical vertebra (atlas). Then, the nerve bifurcates into a smaller ventral ramus and a larger dorsal ramus, the suboccipital nerve. This nerve is named suboccipital (under occiput) because it emerges just below the occipital bone.

The suboccipital nerve courses inferior to the vertebral artery and superior to the posterior arch of the atlas.It pierces the posterior atlantooccipital membrane, and enters the suboccipital triangle. It runs through the middle of the suboccipital triangle, accompanying the extradural segment (horizontal part) of the vertebral artery, and terminates by giving off motor branches for innervation of the muscles of the suboccipital region.

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Branches and innervation

Upon entering the suboccipital triangle, the nerve gives off several branches for innervation of the muscles that comprise the suboccipital triangle and other suboccipital muscles.

The suboccipital triangle is formed by the rectus capitis posterior major muscle (superomedial border), obliquus capitis superior muscle (superolateral margin) and the obliquus capitis inferior muscle (inferolateral margin). Additionally, the suboccipital nerve innervates the semispinalis capitis muscle (that forms the roof of the suboccipital triangle) and the rectus capitis posterior minor muscle.

In some cases, the suboccipital nerve can give rise to a cutaneous branch that joins the occipital nerves in the innervation of the scalp.

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