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The first cervical vertebra (C1), also known as the atlas, is a complex structure of bones, discs, muscles, ligaments, nerves, and tendons. It is the uppermost part of the spinal column and is responsible for carrying the weight of the head, protecting the spinal cord, supplying blood to the brain, and allowing a wide range of head and neck movements. Several muscles are attached to the C1 vertebra, including the rectus capitis anterior, rectus capitis lateralis, and obliqus capitis superior muscles. These muscles help with head movements such as nodding, looking up and down, and rotating the head from side to side. The C1 vertebra also has a crucial role in providing sensation and motor control to various parts of the body, including the head, neck, and shoulders.
| Characteristics | Values |
|---|---|
| Muscles attached to C1 | Rectus Capitis Anterior, Rectus Capitis Lateralis, Obliquus Capitis Superior, Rectus Capitis Posterior Minor, Interspinalis Cervicis, Longus Capitis |
| Nerves | C1 is a spinal nerve of the cervical segment |
| Functions | C1 helps control the head and neck, including movements forward, backward, and to the sides. It also carries motor fibres and a small meningeal branch that supplies sensation to parts of the dura around the foramen magnum |
| Vertebrae | C1 is the first of seven cervical vertebrae (C1-C7) |
| Ligaments | The supraspinous ligament gives off extensions that spread to the spinous processes of the C1 vertebrae and forms a median, fibro-elastic band known as the ligamentum nuchae |
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What You'll Learn
Rectus Capitis Anterior and Rectus Capitis Lateralis muscles
The rectus capitis anterior and rectus capitis lateralis muscles are two of several muscles that receive direct innervation from the upper cervical nerve roots. These muscles receive innervation from cervical nerves C1 to C2. The rectus capitis anterior muscle fibres attach to the anterior aspect of the lateral mass of the atlas (C1 vertebra) and its transverse process. The rectus capitis anterior muscle courses superiorly to the basilar part of the occipital bone, which lies adjacent to the anterior aspect of the occipital condyle. This muscle is located deep to the longus capitis muscle and is responsible for flexing the head at the atlantooccipital joints.
The rectus capitis posterior major muscle, on the other hand, is one of four small suboccipital muscles, along with the rectus capitis posterior minor, obliquus capitis inferior, and obliquus capitis superior. These muscles are located in the suboccipital region, which is the area below the occipital bone at the base of the skull. The rectus capitis posterior major muscle attaches to the spinous process of the axis (C2 vertebra) and inserts via a broader attachment on the lateral part of the inferior nuchal line of the occipital bone.
When the rectus capitis posterior major and other suboccipital muscles contract bilaterally, they extend the head on the neck, allowing for movements such as nodding. Unilateral contraction of these muscles results in rotation of the head towards the same side at the atlanto-axial joint. This muscle also plays a role in stabilising the atlanto-occipital joint during movements, making it important for maintaining proper posture.
The cervical nerves, including C1 and C2, transmit motor and sensory information to and from the central nervous system. They form plexuses that give rise to peripheral nerves, which are responsible for major motor functions and sensory innervation in the head, neck, upper limbs, and diaphragm. A thorough understanding of cervical nerve anatomy is crucial for diagnosing and treating conditions such as cervical radiculopathy and nerve compression syndromes.
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Longus Capitis muscle
The longus capitis muscle is a prevertebral muscle of the neck that is innervated by muscular branches of the cervical plexus. In isolation, the longus capitis muscle laterally flexes and rotates the head. The unilateral action of the muscle serves to rotate and tilt the cervical vertebrae and head to the ipsilateral side. The longus capitis muscle is an anterior vertebral muscle that originates from four slender tendons, in line with those of the anterior scalene muscle, from the anterior tubercles of C3 to C6 transversally. The longus capitis muscle is supplied by C1 to C3, C4, or C5, depending on individual variation. The muscle receives its blood supply from muscular branches of the ascending cervical artery and the inferior thyroid artery.
The longus capitis muscle works synergistically with the longus colli and scalene muscles as a weak flexor of the head and cervical spine. The action of the muscle is assisted by gravity and by the powerful sternocleidomastoid muscles. The longus capitis muscle inserts into the basilar part of the occipital bone, which is the wedge-like portion of the occipital bone that lies anterior to the foramen magnum. At their insertion, the longus capitis muscles lie adjacent to one another alongside the pharyngeal tubercles.
The prevertebral fascia extends from the base of the skull in front of the longus capitis and rectus capitis lateralis muscles, extending as far inferiorly as the lower limit of the longus colli muscle at the body of the T3 vertebra. Retropharyngeal lymph nodes lie at the level of the lateral mass of the atlas and along the lateral aspect of the longus capitus muscles. The anterior ramus of C1 emerges lateral to the atlanto-occipital joint, then passes between the rectus capitis anterior and rectus capitis lateralis muscles before penetrating and supplying the longus capitis muscle.
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Sternocleidomastoid muscle
The sternocleidomastoid (SCM) muscle is a powerful neck muscle that allows you to bend your neck and turn or tilt your head. It is the largest muscle in the front of your neck and is located just below your skin. The SCM muscle extends from the mastoid process at the base of your skull to your collarbones (clavicles) and breastbone (sternum). It helps stabilize your neck and is activated when you turn your head to face left or right, tilt your head toward either shoulder, or tilt your head backward or forward.
The SCM muscle is an important landmark in the neck, dividing it into an anterior and a posterior triangle. This muscle protects the vertical neurovascular bundle of the neck, branches of the cervical plexus, deep cervical lymph nodes, and soft tissues of the neck from damage. It also acts as an accessory muscle of respiration, working with other neck muscles to lift your breastbone and collarbone when you inhale, creating space for your lungs to take in air.
The SCM muscle is susceptible to strain and injury, which can lead to neck stiffness, pain, and other symptoms. Treatments for SCM-related issues include massage, osteopathic manipulation, physical therapy, and surgery in severe cases. Maintaining good posture and managing stress can also help care for the SCM muscle.
The SCM has a variable organizational pattern and can be arranged into five distinct topographical parts: the superficial sternomastoid, profound sternomastoid, sterno-occipital, cleidomastoid, and cleido-occipital parts. These parts are arranged in superficial and deep layers, with muscle fibers lying within a common fascial sheath and traversing in the same direction.
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Trapezius muscle
The trapezius muscle is a large, paired trapezoid-shaped surface muscle that extends longitudinally from the occipital bone to the lower thoracic vertebrae of the spine and laterally to the spine of the scapula. It is one of the commonly affected muscles in facioscapulohumeral muscular dystrophy (FSHD). The lower and middle fibres are affected initially, and the upper fibres are usually spared until late in the disease. The trapezius muscle is also used for active movements, such as side bending and turning the head, elevating and depressing the shoulders, and internally rotating the arm.
The trapezius muscle is made up of particularly long muscle fibres that span a large width of the upper back. This enables the trapezius to assist in mainly postural attributes, allowing and supporting the spinal column to remain erect when the person is standing. The trapezius muscle works in conjunction with several muscles to produce coordinated movements, primarily involving the scapula. Some key muscle pairings include the rhomboids, serratus anterior, deltoid, and pectoralis minor.
The trapezius muscles are two large muscles in your upper back. They help you move your head, neck, and upper back, and maintain and adjust your posture. Each trapezius muscle has three sections. They run from the base of your neck down to the middle of your back. The upper section connects to your skull and neck (cervical spine). The middle and lower sections attach to the bones in your thoracic spine. They are also connected to the back (lateral) sides of your shoulder blade (scapula) and collarbone (clavicle).
The trapezius muscles are big, and you use them a lot throughout your day. They get their name from their shape. If you look at them together, they form a trapezoid (a shape with four sides, two of which are parallel). They’re shaped a bit like a kite. The sensory innervation to the trapezius originates from C2 or C3 to C4.
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Obliquus Capitis Superior muscle
The Obliquus Capitis Superior muscle is one of the small, deep muscles of the neck, and as the name suggests, it is superior (above) to its counterpart, the Obliquus Capitis Inferior muscle. This muscle is found in the upper part of the neck, and it originates from the transverse process of the atlas (C1), which is the first cervical vertebra, and inserts into the lateral mass of the occipital bone, which is the bone that forms the back and sides of the skull. The function of this muscle is to primarily provide support and stability to the head and neck, especially during movements. It works in conjunction with other suboccipital muscles to produce a variety of movements, including small rotations and side-to-side movements of the head. The muscle also assists in maintaining the position of the head and neck during movements such as nodding and shaking the head.
The Obliquus Capitis Superior, along with the other suboccipital muscles, plays a crucial role in maintaining posture and balance. It helps in fine-tuning head position and stabilizing the occipitocervical (occipital-cervical) junction, which is the area where the skull and spine meet. This muscle receives its blood supply from the vertebral artery and is innervated by the suboccipital nerve, which is a branch of the cervical spinal nerve. This nerve supply is important for coordinating the actions of this muscle with other neck muscles to ensure smooth and controlled movements.
Due to its attachment to the atlas vertebra, the Obliquus Capitis Superior is believed to be involved in conditions affecting the upper cervical spine. For example, in cases of atlas misalignment or fixation, this muscle may become strained or go into spasm. This can lead to headaches, neck pain, and even referred pain into the arms and hands due to the proximity of the vertebral artery and associated nerve roots. Therefore, this muscle is often targeted in manual therapy and chiropractic treatments for patients experiencing such symptoms.
In terms of strengthening and stretching, specific exercises for the Obliquus Capitis Superior muscle are not commonly prescribed, as this muscle primarily functions in a supportive and postural role rather than producing large, forceful movements. However, general neck strengthening and mobility exercises can help maintain the health and function of this muscle. Additionally, in cases of neck pain or stiffness, gentle neck stretches and range-of-motion exercises can aid in relieving tension and improving overall neck flexibility, which includes the Obliquus Capitis Superior and surrounding muscles and tissues.
In summary, the Obliquus Capitis Superior muscle is a small yet important muscle of the upper neck, attaching to the atlas (C1) vertebra and the occipital bone. Its functions include providing stability and fine-tuning head position, working in coordination with other suboccipital muscles. Due to its attachment to C1, it is implicated in some cervical spine conditions, and its health is important for overall neck health and function. While specific exercises for this muscle are not usually prescribed, general neck strengthening and mobility exercises can help maintain its function and alleviate neck-related symptoms.
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Frequently asked questions
The rectus capitis anterior muscle is attached to the anterior surface of C1.
The rectus capitis lateralis, obliquus capitis superior, rectus capitis posterior minor, and interspinalis cervicis muscles are all attached to C1.
The rectus capitis anterior muscle helps you look down, so it is a flexor of the head.
The rectus capitis lateralis muscle receives innervation from C1 to C2 and helps supply sensation to the dura around the foramen magnum.
