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The C3 vertebra is the third cervical vertebra in the spinal column, and it supports the soft tissues of the neck and the weight of the head. Many muscles are attached to the C3 vertebra, including the trapezius, levator scapulae, anterior and middle scalenes, rotatores, semispinalis cervicis, intertransversarii, and splenius cervicis muscles. These muscles work together to move various parts of the body and stabilize the vertebral column.
| Characteristics | Values |
|---|---|
| Name | C3, or third cervical vertebra |
| Description | One of the seven cervical vertebrae of the neck |
| Function | Supports the spinal cord, several muscles, and the vertebral blood vessels |
| Shape | First bone of the spinal column to have a standard vertebral shape |
| Muscle Attachments | Trapezius, levator scapulae, anterior and middle scalenes, rotatores, semispinalis cervicis, intertransversarii, splenius cervicis, longissimus, iliocostalis, spinalis |
| Innervation | C1-C3 spinal nerves, divided into ventral and dorsal rami |
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What You'll Learn
Trapezius and levator scapulae muscles
The trapezius and levator scapulae muscles are both located in the posterior triangle of the neck, which is an important area for surgeons and anaesthesiologists. The trapezius is the outer layer of neck muscles, with the levator scapulae lying underneath it.
The trapezius is a large, flat muscle that extends from the occipital bone of the skull, down to the thoracic vertebrae and out to the shoulder blades. It has a variety of functions, including moving the shoulder blades, supporting the weight of the arms, and helping to stabilise the spine.
The levator scapulae, as the name suggests, is responsible for elevating the scapula. It originates from the transverse processes of the first four cervical vertebrae (C1-C4) and inserts at the superior angle and medial border of the scapula. It also works with the trapezius, latissimus dorsi, rhomboids, pectoralis major and pectoralis minor muscles to stabilise the spine and move the neck.
The levator scapulae is a relatively small muscle, and it can be palpated in the middle part, which is the only area not covered by other muscles. The Eden-Lange procedure, first described in 1924, is a surgical procedure that involves transferring the tendon of the levator scapulae to the acromion to recreate the functionality lost in trapezius muscle palsy, or "winged scapula".
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Rotatores, semispinalis cervicis, intertransversarii, and splenius cervicis muscles
The rotatores are the deepest muscles in the transversospinalis group, the deep layer of intrinsic back muscles. They lie between the transverse and spinous processes and are grouped by the length of the fascicles and the region covered. The rotatores can be divided regionally into rotatores colli/cervicis, rotatores thoracis, and rotatores lumborum. The rotatores thoracis are the most developed and usually described the region. They are considered back extensors and spinal column stabilizers.
Intertransversarii are small muscles of the back found between the contiguous transverse processes of the cervical, lumbar, and some thoracic vertebrae. They comprise the deepest layer of the deep back muscles, along with interspinales and levatores costarum. The function of intertransversarii muscles is not entirely clear, but they are thought to assist other muscles in lateral flexion of the spine when contracting unilaterally and stabilize the lumbar spine when contracting bilaterally.
Semispinalis cervicis is part of the transversospinalis group, which also includes the rotatores and multifidus.
The splenius cervicis is one of the deep muscles of the cervical and thoracic spine. Its fibres run superiorly and laterally. It assists in ipsilateral cervical side flexion and rotation, and when both splenius cervicis muscles contract, they extend the cervical spine. Bilaterally, they extend the neck, and unilaterally, they laterally flex and rotate the head and neck to the ipsilateral side. The splenius cervicis also assists in supporting the head in the erect position.
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Levator scapulae and rhomboids
The levator scapulae is a long and slender muscle that is a part of the superficial layer of extrinsic muscles of the back. It functions to elevate the scapula and tilt the glenoid cavity inferiorly by rotating the scapula downward. It originates on the posterior tubercle of the transverse process of cervical vertebrae C1 to C4 and inserts onto the vertebral margin of the scapula between the superior angle and the root of the spine. The levator scapulae is innervated by the cervical nerve (C3-C4) and the dorsal scapular nerve (C5).
The levator scapulae muscle is prone to stiffening and chronic pain due to incorrect posture in everyday life. Common causes include carrying heavy shoulder bags, permanent lifting of the shoulders while sitting at a desk, and sleeping on one side of the body without proper head support. Pain or discomfort caused by the levator scapulae can be relieved by various modalities and active movements.
The rhomboid minor and levator scapulae muscles are interconnected and enclosed by connectives. They form a musculoskeletal "unit" with the rhomboids, and together they function in scapular motion. The rhomboids also participate in the inferior rotation of the glenoid cavity, stabilization of the spine, and lateral flexion and extension of the neck.
The rhomboid minor and levator scapulae are united, forming a bridge of connective tissue that contains fat. This unification is separate from the rhomboid major muscle but overlaps with it dorsally. It connects to the superior angle of the scapula and its upper medial borders, respectively, and cranially to the root of the spine of the scapula.
The levator scapulae and rhomboid minor muscles are both affected by an isolated lesion of the dorsal scapular nerve, resulting in paralysis and atrophy of these muscles.
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Anterior and middle scalenes
The scalene muscles are a group of three muscles on each side of the neck: the anterior, middle, and posterior. The anterior and middle scalene muscles lift the first rib and bend the neck to the same side as the acting muscle.
The scalenus anterior (anterior scalene) is the foremost of the three scalene muscles. It originates from the anterior tubercles of the transverse processes of the vertebrae C3-C6 and attaches to the scalene tubercle on the inner border of the first rib. The muscle takes an inferior, almost vertical, course towards the thoracic cage. The anterior scalene is located deep to the sternocleidomastoid on the lateral aspect of the neck. It is related to many structures of the neck, including the brachial plexus, the subclavian artery, the suprapleural membrane, the pleura, and the phrenic nerve. The scalenus anterior muscle forms the anterior border of the scalene triangle, with the posterior border formed by the scalenus medius. The anterior scalene muscle is supplied by the anterior rami of the spinal nerves C4-C6.
The scalenus medius (middle scalene) is the largest and longest of the three scalene muscles. It arises from the posterior tubercles of the transverse processes of the lower six cervical vertebrae (C2-C7) and inserts into the upper surface of the first rib. The middle scalene has several long, thin muscle bellies that converge into one large belly. The brachial plexus and the subclavian artery pass anterior to the middle scalene. The middle scalene is supplied by the anterior rami of C3-C8.
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Semispinalis capitis and longissimus capitis
The semispinalis capitis is a long, paired muscle that belongs to the deep layer of muscles of the back. It is the superior and largest component of the three-part semispinalis muscle. The semispinalis capitis spans the neck and upper back regions, running from the cervical and thoracic vertebrae to the occipital bone. It arises from the articular processes of vertebrae C4-C7 and the transverse processes of vertebrae T1-T6. The muscle fibres converge into a single muscle belly that runs superiorly across the lateral side of the vertebral column. The semispinalis capitis assists in extending, laterally flexing, and rotating the head, cervical and thoracic spine.
The longissimus capitis is part of the longissimus system of muscles, which attach to the transverse processes of the vertebrae near their bases. The longissimus muscles are large at lumbar levels but minuscule at cervical levels. The longissimus capitis lies underneath the splenius capitis muscle in the superficial layer. It is located in the back of the neck, deep to the semispinalis capitis. Under the semispinalis capitis and longissimus capitis are four muscles: rectus capitis posterior minor, rectus capitis posterior major, obliquus capitis superior, and obliquus capitis inferior. These muscles connect the skull, atlas, and axis and are innervated by nerve fibres originating from the dorsal root of the upper cervical ganglia.
The semispinalis capitis and longissimus capitis are part of the complex musculature of the back and neck. These muscles work together to support the spine, hold it upright, and control movement. They are innervated and receive nerve impulses from the brain through the spinal cord, which allows them to contract and relax, facilitating movements such as extension, lateral flexion, and rotation of the head and neck.
The semispinalis capitis and longissimus capitis have distinct roles in maintaining posture, stabilising the spine, and enabling various head and neck movements. Their specific functions include extending and rotating the head, neck, and spine, as well as contributing to lateral flexion. These muscles work in synergy with other muscles in the region, such as the splenius capitis, to facilitate a wide range of motions and provide structural support to the body.
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Frequently asked questions
The C3 vertebra is the third cervical vertebra in the spinal column. It is the first bone in the spinal column to have the standard vertebral shape. It supports the soft tissues of the neck and the weight of the head.
The trapezius and levator scapulae muscles attach to the C3 vertebra. The levator scapulae is supplied by the dorsal scapular artery and elevates the scapula and rotates its inferior angle medially. The trapezius elevates the scapulae and shrugs the shoulders.
The anterior and middle scalenes attach to the transverse processes of the C3 vertebra. They elevate the rib cage during deep breathing. The rotatores, semispinalis cervicis, intertransversarii, and splenius cervicis muscles also attach to the C3 vertebra and work together to extend the neck.
The levator scapulae works in combination with other muscles such as the rhomboids and pectoralis minor to produce downward rotation of the scapula. The upper fibres of the trapezius, which is an upward rotator, prevent downward rotation.
