Neck Extensors: Muscles That Support Your Head

which muscles are neck extensors

The neck is a complex musculoskeletal system that connects the skull to the torso. The neck muscles support the head and allow it to move in different directions. They also assist with chewing, swallowing, and breathing. Neck muscles can be divided into three main groups based on their position in the neck: anterior (front), lateral (side/prevertebral), and posterior (back). The posterior neck muscles are responsible for extending the neck. Some of the muscles that extend the neck include the suboccipitals, which are four pairs of small muscles that connect the cervical spine to the skull, and the transversospinalis muscles, which include the semispinalis capitis, semispinalis cervicis, rotatores cervicis, and multifidus.

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Sternocleidomastoid muscles

The sternocleidomastoid (SCM) muscle is a powerful neck muscle that allows you to bend your neck and turn or tilt your head. It is one of over 20 pairs of muscles acting on the neck. SCM is an important landmark in the neck which divides it into an anterior and a posterior triangle. The SCM muscle ends at the mastoid process, a section of bone located at the base of the skull behind the ears. The SCM muscle can help in head rotation and tilting the chin. It is a large muscle that also helps protect fragile structures within the neck.

The SCM muscle extends from the mastoid process at the base of the skull to the collarbones (clavicles) and breastbone (sternum). The SCM is the largest muscle in the front of the neck and can be felt on both the right and left sides of the neck. It is a superficially palpable muscle with importance as an anatomical landmark within the neck region and as part of neuromuscular pathologies such as torticollis.

The SCM muscle has dual innervation and multiple functions. Evidence shows that the SCM acts in concert with the entire muscular group of the cervicofacial region, responding and aiding in various complex physiological movements beyond its principal function as a lateral neck flexor. The SCM can also have inspiratory muscle action by taking a fixed point on the temporal bone and then lifting the sternum and the clavicles.

The SCM plays an important role in the posture of the neck and the body. It has been shown that vestibular stimulation electrically activates the SCM, indicating a close connection between the vestibular area and the SCM's motoneurons. The SCM helps stabilize the neck even when it is not moving. It also works with other neck muscles to lift the breastbone and collarbone when inhaling, creating space for the lungs to take in air.

The SCM muscle's size and complexity make it susceptible to strain and injury. Injuries and tension within the SCM can lead to pain and stiffness. Treatments for SCM issues include stretching, physical therapy, and osteopathic manipulation. It is important to manage stress and maintain good posture to care for the SCM.

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Erector spinae muscles

The neck is a complex structure of bones, muscles, nerves, blood vessels, lymphatics, and other connective tissues. The cervical spine is the bony part of the neck, and its primary function is to support the skull while allowing for movement. The neck muscles work together with tendons and ligaments to support and move the neck and head. Tendons attach muscle to bone, while ligaments attach bones to other bones.

The erector spinae (ES) is one of the core and paraspinal muscles. It is a large and superficial muscle that lies just deep to the thoracolumbar fascia. The ES is formed of three muscles with fibres running vertically throughout the lumbar, thoracic, and cervical regions. It lies in the groove to the side of the vertebral column. The erector spinae muscles comprise the intermediate layer of the deep (intrinsic) muscles of the back. They extend on either side of the vertebral column, between the base of the cranium and the pelvis.

The erector spinae is divided into three groups, from medial to lateral: spinalis, longissimus, and iliocostalis. The spinalis muscles are the most medial erector spinae muscles. They are divided into three regional groups, from superior to inferior: spinalis capitis, spinalis colli, and spinalis thoracis. The longissimus muscles are the central erector spinae muscles, and they are also the thickest and longest. Similar to the spinalis muscles, the longissimus muscles are divided into three regional groups: longissimus capitis, longissimus colli, and longissimus thoracis. The longissimus muscles have an identical innervation to the spinalis muscles. The iliocostalis muscles are the most lateral erector spinae muscles and are regionally divided into three groups, from superior to inferior: iliocostalis cervicis, iliocostalis thoracis, and iliocostalis lumborum.

The erector spinae muscles play an important role in spinal stability. They help to maintain posture by steadying the spine on the pelvis during walking. Bilateral contraction of the erector spinae muscles causes back and head extension, while unilateral contraction causes lateral flexion (ipsilateral).

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Levator scapulae muscle

The levator scapulae is a muscle that connects the upper limb to the vertebral column and lies in the posterior triangle of the neck. It is a posterior axio-appenducular muscle. The superior part of the levator scapulae is covered by the sternocleidomastoid muscle, and its inferior part is covered by the trapezius muscle. The levator scapulae originates on the posterior tubercle of the transverse process of cervical vertebrae one to four.

The levator scapulae inserts onto the vertebral margin of the scapula, between the superior angle and the root of the spine. The superior third of the levator scapulae lies deep to the sternocleidomastoid, while the inferior third is deep to the trapezius. From the transverse processes of the upper cervical vertebrae, the fibres of the levator scapulae pass inferiorly to the superomedial border of the scapula.

The levator scapulae is innervated by the cervical nerve (C3-C4) and the dorsal scapular nerve (C5). The dorsal scapular artery is the predominant blood supply of the levator scapulae muscle. The origin of this blood supply is currently in dispute, with the most frequently cited origin being the subclavian artery.

The levator scapulae muscle helps with lifting the shoulder blade, bending the neck to the side, and rotating the head. When the scapula is fixed, a contraction of the levator scapulae leads to the lateral flexion of the cervical vertebral column to the side and stabilizes the vertebral column during rotation. If the cervical spine is fixed, the levator scapulae helps in elevating and rotating the scapula, such that the lateral angle moves inferiorly (rotates the point of the shoulder down).

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Transversospinalis muscles

The transversospinalis muscle group is a deep group of back muscles that lies deep to the Erector Spinae. It consists of three major subgroups: semispinalis, multifidus, and rotatores. The transversospinalis muscles group runs obliquely and medially from the transverse process of the vertebra below to the spinous process, filling the groove on either side of the spinous process.

The semispinalis is the most superficial of the transversospinalis muscle group. Its attachment sites are the thoracic vertebrae (semispinalis thoracis), cervical vertebrae (semispinalis cervicis), and occipital bone at the base of the skull (semispinalis capitis). It originates from the transverse process and crosses between four and six vertebrae to attach to the spinous process. The semispinalis thoracis muscle is also known as a neck extensor.

The multifidus muscle lies deep to the semispinalis and spans the entire length of the vertebral column, but it is most developed in the lumbar region. The multifidus is divided regionally into three: Multifidus cervicis, that arises from the superior articular processes of vertebrae C4-C7; Multifidus thoracis, that originates from the transverse process of the thoracic vertebra; and Multifidus lumborum, that arises from the mammillary processes of lumbar vertebrae, the posterior aspect of the sacrum, the posterior superior iliac spine (PSIS) of the ilium, and the posterior sacroiliac ligament. The multifidus cervicis is also known as a deep neck extensor.

The rotatores muscle lies deep to the multifidus and spans the entire length of the vertebral column, but it is most developed in the thoracic region. It consists of two parts: the long (longus) and short (brevis) rotatores. Long rotatores pass from the transverse process medially to the spinous process, crossing two vertebrae, while rotatores brevis pass from the transverse process and insert at the base of the spinous process of the vertebrae above the origin. Its attachment sites are the lumbar vertebrae (rotatores lumborum), thoracic vertebrae (rotatores thoracis), and cervical vertebrae (rotatores cervicis). The rotatores cervicis is also known as a deep neck extensor.

The transversospinalis muscles share the same nerve supply from the dorsal rami of the spinal nerves. Branches of the vertebral, deep cervical, occipital, transverse cervical, posterior intercostal, subcostal, lumbar, and lateral sacral arteries supply these muscles. The muscles of the transversospinalis group stabilize the vertebrae during localized movements of the intervertebral joints of the vertebral column. Bilateral contraction of the transversospinalis muscles extends the spine, and unilateral contraction rotates the spine to the opposite side of the contracting muscle.

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Suboccipital muscles

The suboccipital muscles are a group of four muscles located in the posterior region of the neck, underneath the occipital bone. These muscles are the rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis superior, and obliquus capitis inferior. The suboccipital muscles are needed for head extension and rotation. They are located deep to the sternocleidomastoid, trapezius, splenius, and semispinalis muscles.

The suboccipital muscles are important clinically due to their proximity to the vertebral artery and their role in providing surgical access to the posterior cranial fossa. They are also associated with cervicogenic headaches due to their connection with the dura mater. The suboccipital nerve, formed by the dorsal ramus of C1, innervates all the suboccipital muscles.

The rectus capitis posterior major is the larger of the two rectus capitis muscles. It originates from the spinous process of the C2 vertebra and attaches to the lateral part of the inferior nuchal line of the occipital bone. This muscle contributes to the superomedial boundary of the suboccipital triangle.

The rectus capitis posterior minor is the most medial of the suboccipital muscles. It originates from the posterior tubercle of the C1 vertebra and attaches to the medial part of the inferior nuchal line of the occipital bone. There may also be a soft tissue attachment to the posterior atlanto-occipital membrane, which forms the floor of the suboccipital triangle.

The obliquus capitis superior is smaller than the obliquus capitis inferior. It originates from the transverse process of the C1 vertebra and attaches to the occipital bone between the superior and inferior nuchal lines. The obliquus capitis superior forms the superolateral boundary of the suboccipital triangle.

The obliquus capitis inferior is the most inferiorly positioned of the suboccipital muscles, and it is the only suboccipital muscle that does not attach to the cranium. It originates from the posterior tubercle of the C2 vertebra and inserts into the transverse process of the C1 vertebra. The obliquus capitis inferior forms the inferolateral boundary of the suboccipital triangle.

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Frequently asked questions

Neck extensors are muscles that help with the extension of the neck, allowing you to move your head backward.

The muscles that extend the neck are the suboccipitals, the transversospinalis, and the sternocleidomastoid.

Suboccipital muscles are a group of four pairs of small muscles that connect the top of the cervical spine with the base of the skull. They help with head extension and rotation.

Transversospinalis muscles are a group of deep neck extensors that help move the head forward and backward, as well as tilt it from side to side. They include the semispinalis capitis, semispinalis cervicis, rotatores cervicis, and multifidus.

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