Cervical plexus: Difference between revisions

Cervical plexus
Cervical plexus
	Dermatome distribution of the trigeminal nerve (Superficial cervical plexus visible in purple, at center bottom.)
Details
From	C1-C4
Identifiers
Latin	plexus cervicalis
MeSH	D002572
TA98	A14.2.02.012
TA2	6374
FMA	5904
	Anatomical terms of neuroanatomy [edit on Wikidata]

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The cervical plexus is a nerve plexus of the anterior rami of the first (i.e. upper-most) four cervical spinal nerves C1-C4.^[1]^[2]^[3]^[4] The cervical plexus provides motor innervation to some muscles of the neck, and the diaphragm; it provides sensory innervation to parts of the head, neck, and chest.^[1]

Anatomy

They are located laterally to the transverse processes between prevertebral muscles from the medial side and vertebral (m. scalenus, m. levator scapulae, m. splenius cervicis) from lateral side. There is anastomosis with accessory nerve, hypoglossal nerve and sympathetic trunk. It is located in the neck, deep to the sternocleidomastoid muscle.^[5]

The branches of the cervical plexus emerge from the posterior triangle at the nerve point, a point which lies midway on the posterior border of the sternocleidomastoid.

Relations

The cervical plexus is situated deep to the sternocleidomastoid muscle, internal jugular vein, and deep cervical fascia.^[1]

It is situated anterior to the middle scalene muscle, and levator scapulae muscle.^[1]

Branches

The cervical plexus has two types of branches: cutaneous and muscular.^[3]

Cutaneous (4 branches):
- Lesser occipital nerve - innervates the skin and the scalp posterosuperior to the auricle (C2)
- Great auricular nerve - innervates skin near concha auricle (outer ear) and external acoustic meatus (ear canal) (C2-C3)
- Transverse cervical nerve - innervates anterior region of neck (C2 and C3)
- Supraclavicular nerves - innervate the skin above and below the clavicle (C3-C4)^[6] ^{[clarification needed]}
Muscular
- Ansa cervicalis - a loop formed by C1-C3 that supplies most infrahyoid (a.k.a. "strap") muscles (sternothyroid, sternohyoid, omohyoid muscles) etc.
- Nerve to thyrohyoid - fibres from C1 that run with the hypoglossal nerve (cranial nerve XII) and do not participate in the formation of the superior root of ansa cervicalis, instead continuing for some further distance to reach and innervate the thyrohyoid muscle and the geniohyoid muscle.
- Phrenic (C3-C5, but mostly C4) - innervates thoracic diaphragm and the pericardium.
- Segmental branches (C1-C4) - innervate anterior and middle scalene muscles
- Levator scapulae muscle (C3-C4) (also innervated by dorsal scapular nerve (C5) of the brachial plexus)

Diagram

Additional images

Plan of the cervical plexus.
The nerves of the scalp, face, and side of neck.
The right sympathetic chain and its connections with the thoracic, abdominal, and pelvic plexuses.
Side of neck, showing chief surface markings.

References

^ ^a ^b ^c ^d Standring, Susan (2020). Gray's Anatomy: The Anatomical Basis of Clinical Practice (42nd ed.). New York. pp. 595–596. ISBN 978-0-7020-7707-4. OCLC 1201341621.{{cite book}}: CS1 maint: location missing publisher (link)
^ Donofrio, P. D.; Clarke, C. D. (2014-01-01), "Neuropathies, Iatrogenic", in Aminoff, Michael J.; Daroff, Robert B. (eds.), Encyclopedia of the Neurological Sciences (Second Edition), Oxford: Academic Press, pp. 481–484, doi:10.1016/b978-0-12-385157-4.00679-5, ISBN 978-0-12-385158-1, retrieved 2020-10-25
^ ^a ^b Cesmebasi, Alper (2015-01-01), Tubbs, R. Shane; Rizk, Elias; Shoja, Mohammadali M.; Loukas, Marios (eds.), "Chapter 31 - Anatomy of the Cervical Plexus and Its Branches", Nerves and Nerve Injuries, San Diego: Academic Press, pp. 441–449, doi:10.1016/b978-0-12-410390-0.00032-9, ISBN 978-0-12-410390-0, retrieved 2020-10-25
^ Jo, Jasmin; Schiff, David (2014-01-01), Aminoff, Michael J.; Josephson, S. Andrew (eds.), "Chapter 26 - Metastatic Disease and the Nervous System", Aminoff's Neurology and General Medicine (Fifth Edition), Boston: Academic Press, pp. 539–562, doi:10.1016/b978-0-12-407710-2.00026-6, ISBN 978-0-12-407710-2, S2CID 78276004, retrieved 2020-10-25
^ Moskovitz, Joshua B.; Choi, Andrew (2015-01-01), Tubbs, R. Shane; Rizk, Elias; Shoja, Mohammadali M.; Loukas, Marios (eds.), "Chapter 11 - Regional Nerve Blocks of the Head and Neck", Nerves and Nerve Injuries, San Diego: Academic Press, pp. 147–151, doi:10.1016/b978-0-12-410390-0.00011-1, ISBN 978-0-12-410390-0, retrieved 2020-10-25
^ Clinically Oriented Anatomy by Moore and Dally's

External links

Anatomy figure: 25:03-02 at Human Anatomy Online, SUNY Downstate Medical Center - "Diagram of the cervical plexus"
MedicalMnemonics.com: 268
Diagram at msu.edu Archived 2019-06-03 at the Wayback Machine

[:224-1] Standring, Susan (2020). Gray's Anatomy: The Anatomical Basis of Clinical Practice (42nd ed.). New York. pp. 595–596. ISBN 978-0-7020-7707-4. OCLC 1201341621.{{cite book}}: CS1 maint: location missing publisher (link)

[2] Donofrio, P. D.; Clarke, C. D. (2014-01-01), "Neuropathies, Iatrogenic", in Aminoff, Michael J.; Daroff, Robert B. (eds.), Encyclopedia of the Neurological Sciences (Second Edition), Oxford: Academic Press, pp. 481–484, doi:10.1016/b978-0-12-385157-4.00679-5, ISBN 978-0-12-385158-1, retrieved 2020-10-25

[:0-3] Cesmebasi, Alper (2015-01-01), Tubbs, R. Shane; Rizk, Elias; Shoja, Mohammadali M.; Loukas, Marios (eds.), "Chapter 31 - Anatomy of the Cervical Plexus and Its Branches", Nerves and Nerve Injuries, San Diego: Academic Press, pp. 441–449, doi:10.1016/b978-0-12-410390-0.00032-9, ISBN 978-0-12-410390-0, retrieved 2020-10-25

[4] Jo, Jasmin; Schiff, David (2014-01-01), Aminoff, Michael J.; Josephson, S. Andrew (eds.), "Chapter 26 - Metastatic Disease and the Nervous System", Aminoff's Neurology and General Medicine (Fifth Edition), Boston: Academic Press, pp. 539–562, doi:10.1016/b978-0-12-407710-2.00026-6, ISBN 978-0-12-407710-2, S2CID 78276004, retrieved 2020-10-25

[5] Moskovitz, Joshua B.; Choi, Andrew (2015-01-01), Tubbs, R. Shane; Rizk, Elias; Shoja, Mohammadali M.; Loukas, Marios (eds.), "Chapter 11 - Regional Nerve Blocks of the Head and Neck", Nerves and Nerve Injuries, San Diego: Academic Press, pp. 147–151, doi:10.1016/b978-0-12-410390-0.00011-1, ISBN 978-0-12-410390-0, retrieved 2020-10-25

[6] Clinically Oriented Anatomy by Moore and Dally's

[1]

[2]

[3]

[4]

[5]

[6]

@@ Line 1: / Line 1: @@
+{{Short description|Network of nerves in the neck}}
 {{More citations needed |date=April 2014}}
-{{Infobox Nerve |
+{{Infobox Nerve
-  Name         = Cervical plexus |
+| Name         = Cervical plexus
-  Latin        = plexus cervicalis |
+|Latin        = plexus cervicalis
-  Image        = Gray784.png |
+|Image        = Gray784.png
-  Caption      = Dermatome distribution of the trigeminal nerve (Superficial cervical plexus visible in purple, at center bottom.) |
+|Caption      = Dermatome distribution of the trigeminal nerve (Superficial cervical plexus visible in purple, at center bottom.)
-  Image2       =  |
+|Image2       =
-  Caption2     =  |
+|Caption2     =
-  Innervates   = |
+|Innervates   =
-  BranchFrom   = [[Cervical nerves|C1-C4]] |
+|BranchFrom   = [[Cervical nerves|C1-C4]]
-  BranchTo     = |
+|BranchTo     =
 }}
+The '''cervical plexus''' is a [[plexus|nerve plexus]] of the [[anterior rami]] of the first (i.e. upper-most) four [[cervical spinal nerve]]s C1-C4.<ref name=":224">{{Cite book |last=Standring |first=Susan |url=https://www.worldcat.org/oclc/1201341621 |title=Gray's Anatomy: The Anatomical Basis of Clinical Practice |year=2020 |isbn=978-0-7020-7707-4 |edition=42nd |location=New York |pages=595–596 |oclc=1201341621}}</ref><ref>{{Citation|last1=Donofrio|first1=P. D.|title=Neuropathies, Iatrogenic|date=2014-01-01|url=http://www.sciencedirect.com/science/article/pii/B9780123851574006795|encyclopedia=Encyclopedia of the Neurological Sciences (Second Edition)|pages=481–484|editor-last=Aminoff|editor-first=Michael J.|place=Oxford|publisher=Academic Press|language=en|doi=10.1016/b978-0-12-385157-4.00679-5|isbn=978-0-12-385158-1|access-date=2020-10-25|last2=Clarke|first2=C. D.|editor2-last=Daroff|editor2-first=Robert B.}}</ref><ref name=":0">{{Citation|last=Cesmebasi|first=Alper|title=Chapter 31 - Anatomy of the Cervical Plexus and Its Branches|date=2015-01-01|url=http://www.sciencedirect.com/science/article/pii/B9780124103900000329|work=Nerves and Nerve Injuries|pages=441–449|editor-last=Tubbs|editor-first=R. Shane|place=San Diego|publisher=Academic Press|language=en|doi=10.1016/b978-0-12-410390-0.00032-9|isbn=978-0-12-410390-0|access-date=2020-10-25|editor2-last=Rizk|editor2-first=Elias|editor3-last=Shoja|editor3-first=Mohammadali M.|editor4-last=Loukas|editor4-first=Marios}}</ref><ref>{{Citation|last1=Jo|first1=Jasmin|title=Chapter 26 - Metastatic Disease and the Nervous System|date=2014-01-01|url=http://www.sciencedirect.com/science/article/pii/B9780124077102000266|work=Aminoff's Neurology and General Medicine (Fifth Edition)|pages=539–562|editor-last=Aminoff|editor-first=Michael J.|place=Boston|publisher=Academic Press|language=en|doi=10.1016/b978-0-12-407710-2.00026-6|isbn=978-0-12-407710-2|access-date=2020-10-25|last2=Schiff|first2=David|s2cid=78276004 |editor2-last=Josephson|editor2-first=S. Andrew}}</ref> The cervical plexus provides motor innervation to some muscles of the neck, and the [[Thoracic diaphragm|diaphragm]]; it provides sensory innervation to parts of the head, neck, and chest.<ref name=":224" />
-The '''cervical plexus''' is a [[plexus]] of the [[anterior rami]] of the first four [[cervical spinal nerve]]s which arise from C1 to C4 cervical segment in the [[neck]].  They are located laterally to the transverse processes between prevertebral muscles from the medial side and vertebral (m. [[Scalene muscles|scalenus]], m. [[levator scapulae]], m. [[splenius cervicis]]) from lateral side.  There is anastomosis with [[accessory nerve]], [[hypoglossal nerve]] and [[sympathetic trunk]].
+== Anatomy ==
-It is located in the [[neck]], deep to [[sternocleidomastoid]] m. Nerves formed from the cervical plexus innervate the back of the [[head]], as well as some neck muscles.  The branches of the cervical plexus emerge from the [[posterior triangle]] at the [[Erb's point (neurology)|nerve point]], a point which lies midway on the posterior border of the sternocleidomastoid.
+They are located laterally to the transverse processes between prevertebral muscles from the medial side and vertebral (m. [[Scalene muscles|scalenus]], m. [[levator scapulae]], m. [[splenius cervicis]]) from lateral side. There is anastomosis with [[accessory nerve]], [[hypoglossal nerve]] and [[sympathetic trunk]]. It is located in the [[neck]], deep to the [[sternocleidomastoid]] muscle.<ref>{{Citation|last1=Moskovitz|first1=Joshua B.|title=Chapter 11 - Regional Nerve Blocks of the Head and Neck|date=2015-01-01|url=http://www.sciencedirect.com/science/article/pii/B9780124103900000111|work=Nerves and Nerve Injuries|pages=147–151|editor-last=Tubbs|editor-first=R. Shane|place=San Diego|publisher=Academic Press|language=en|doi=10.1016/b978-0-12-410390-0.00011-1|isbn=978-0-12-410390-0|access-date=2020-10-25|last2=Choi|first2=Andrew|editor2-last=Rizk|editor2-first=Elias|editor3-last=Shoja|editor3-first=Mohammadali M.|editor4-last=Loukas|editor4-first=Marios}}</ref>
-Also from the posterior ramus of C2 greater occipital nerve arises
+The branches of the cervical plexus emerge from the [[posterior triangle]] at the [[Erb's point (neurology)|nerve point]], a point which lies midway on the posterior border of the sternocleidomastoid.
-==Branches==
-The cervical plexus has two types of branches: [[Cutaneous innervation|cutaneous]] and muscular.
+=== Relations ===
+The cervical plexus is situated deep to the [[sternocleidomastoid muscle]], [[internal jugular vein]], and [[deep cervical fascia]].<ref name=":224" />
+It is situated anterior to the [[Middle scalene|middle scalene muscle]], and [[levator scapulae muscle]].<ref name=":224" />
+=== Branches ===
+The cervical plexus has two types of branches: [[Cutaneous innervation|cutaneous]] and muscular.<ref name=":0" />
 *Cutaneous (4 branches):
-**[[Great auricular nerve]] - innervates skin near concha auricle ([[Pinna (anatomy)|outer ear]]) and [[external acoustic meatus]] ([[ear canal]]) (C2&C3)
+**[[Lesser occipital|Lesser occipital nerve]] - innervates the skin and the scalp posterosuperior to the auricle (C2)
-**[[Transverse cervical nerve]] - innervates anterior region of neck (C2&C3)
+**[[Great auricular nerve]] - innervates skin near concha auricle ([[Pinna (anatomy)|outer ear]]) and [[external acoustic meatus]] ([[ear canal]]) (C2-C3)
-**[[Lesser occipital]] - innervates the skin and the scalp posterosuperior to the auricle (C2)
+**[[Transverse cervical nerve]] - innervates anterior region of neck (C2 and C3)
-**[[Supraclavicular nerves]] - innervate the skin above and below the clavicle (C3,C4) <ref>Clinically Oriented Anatomy by Moore and Dally's</ref>
+**[[Supraclavicular nerves]] - innervate the skin above and below the clavicle (C3-C4)<ref>Clinically Oriented Anatomy by Moore and Dally's</ref> {{Clarify|date=July 2023|reason=Clarify preceeding reference - which edition?}}
 *Muscular
-**[[Ansa cervicalis]] (loop formed from C1-C3), etc. ([[geniohyoid]] (C1 only), [[thyrohyoid]] (C1 only), [[sternothyroid]], [[sternohyoid]], [[omohyoid]])
+**[[Ansa cervicalis]] - a loop formed by C1-C3 that supplies most infrahyoid (a.k.a. "strap") muscles ([[sternothyroid]], [[sternohyoid]], [[omohyoid]] muscles) etc.
+**[[Thyrohyoid branch|Nerve to thyrohyoid]] - fibres from C1 that run with the [[Hypoglossal nerve|hypoglossal nerve (cranial nerve XII)]] and do not participate in the formation of the [[superior root of ansa cervicalis]], instead continuing for some further distance to reach and innervate the [[thyrohyoid muscle]] and the [[geniohyoid muscle]].
-**[[Phrenic]] (C3-C5 (primarily C4))-innervates diaphragm and the pericardium
-**Segmental branches (C1-C4)- innervates anterior and middle [[scalenes]]
+**[[Phrenic]] (C3-C5, but mostly C4) - innervates [[thoracic diaphragm]] and the [[pericardium]].
+**Segmental branches (C1-C4) - innervate [[scalenes|anterior and middle scalene muscles]]
+**[[Levator scapulae|Levator scapulae muscle]] (C3-C4) (also innervated by [[dorsal scapular nerve]] (C5) of the [[brachial plexus]])
-Additionally there are two branches formed by the posterior roots of spinal nerves:
-*[[Preauricular nerve]] (from the posterior roots of C2–C3)<ref name="Schwartzman2008">{{cite book|author=Robert Schwartzman|title=Neurologic Examination|url=https://books.google.com/books?id=OrPOgLPO6BUC&pg=PT58|date=15 April 2008|publisher=John Wiley & Sons|isbn=978-1-4051-7283-7|pages=58}}</ref><ref name="Schwartzman2006">{{cite book|author=R.J. Schwartzman|title=Differential Diagnosis in Neurology|url=https://books.google.com/books?id=XQLvAgAAQBAJ&pg=PA326|date=31 July 2006|publisher=IOS Press|isbn=978-1-60750-179-4|pages=326–}}</ref>
-*[[Postauricular nerve]] (from the posterior roots of C3–C4)<ref name="Schwartzman2006" />
 ==Diagram==
-<center>[[Image:Cervical plexus.PNG|650px]]</center>
+[[File:Cervical plexus.PNG|center|650px]]
 ==Additional images==
@@ Line 42: / Line 48: @@
  Image:Gray1210.png|Side of neck, showing chief surface markings.
 </gallery>
-==See also==
-* [[Cervical plexus block]]
 == References ==
@@ Line 52: / Line 55: @@
 * {{SUNYAnatomyFigs|25|03|02}} - "Diagram of the cervical plexus"
 * {{MedicalMnemonics|268|||}}
-* [http://kobiljak.msu.edu/cai/ANT551/Unit02/Topic04/U2_L4_O6.html Diagram at msu.edu]
+* [http://kobiljak.msu.edu/cai/ANT551/Unit02/Topic04/U2_L4_O6.html Diagram at msu.edu] {{Webarchive|url=https://web.archive.org/web/20190603153001/http://kobiljak.msu.edu/cai/ANT551/Unit02/Topic04/U2_L4_O6.html |date=2019-06-03 }}
 {{Spinal nerves}}
@@ Line 61: / Line 64: @@
 [[Category:Spinal nerves]]
 [[Category:Nerves of the head and neck]]
+[[Category:Thoracic nerves]]

v t e Spinal nerves
Cervical	C1 C2 C3 C4 C5 C6 C7 C8 anterior Cervical plexus Brachial plexus posterior Posterior branches of cervical nerves Suboccipital – C1 Greater occipital – C2 Third occipital – C3
Thoracic	T1 T2 T3 T4 T5 T6 T7 T8 T9 T10 T11 T12 anterior Intercostal Intercostobrachial – T2 Thoraco-abdominal nerves – T7–T11 Subcostal – T12 posterior Posterior branches of thoracic nerves
Lumbar	L1 L2 L3 L4 L5 anterior Lumbar plexus Lumbosacral trunk posterior Posterior branches of the lumbar nerves Superior cluneal L1–L3
Sacral	S1 S2 S3 S4 S5 anterior Sacral plexus posterior Posterior branches of sacral nerves Medial cluneal nerves
Coccygeal	anterior Coccygeal plexus posterior Posterior branch of coccygeal nerve

v t e Nerves of the cervical plexus
Superficial	C2 Lesser occipital C2–C3 Greater auricular Transverse cervical C3–C4 Supraclavicular
Deep	C1–C3 Ansa cervicalis superior root inferior root C3–C5 Phrenic

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