musculoskeletal anatomy & kinesiology...i) the carotid sinus is a localized dilation of the...
TRANSCRIPT
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 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 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 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