Muscles of the Neck

The muscles of the neck can be divided into 3 groups: anterior, lateral, and posterior neck muscles. Each of the groups is subdivided according to function and the precise location of the muscles. The muscles of the neck are mainly responsible for the movements of the head (i.e., extension, flexion, lateral flexion-extension, and rotation), but the deep muscles also contribute to more intricate functions (i.e., speaking and swallowing).

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Editorial responsibility: Stanley Oiseth, Lindsay Jones, Evelin Maza

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Overview

Anterior muscles of the neck

Superficial layer:

  • Platysma: depresses the mandible and tenses the skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Structure and Function of the Skin of the neck
  • Sternocleidomastoid (SCM): flexion, extension, and rotation of the neck
  • Subclavius: anchors the clavicle

Scalenes: lateral and anterior flexion of the neck:

  • Anterior scalene
  • Medial scalene
  • Posterior scalene

Suprahyoids: elevate the hyoid bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones during swallowing:

  • Digastric 
  • Mylohyoid
  • Geniohyoid
  • Stylohyoid

Infrahyoids: depress the hyoid bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones and facilitate downward movement of the larynx Larynx The larynx, also commonly called the voice box, is a cylindrical space located in the neck at the level of the C3-C6 vertebrae. The major structures forming the framework of the larynx are the thyroid cartilage, cricoid cartilage, and epiglottis. The larynx serves to produce sound (phonation), conducts air to the trachea, and prevents large molecules from reaching the lungs. Larynx after swallowing:

  • Sternohyoid
  • Thyrohyoid
  • Omohyoid
  • Sternothyroid

Lateral (prevertebral) muscles of the neck

The function includes anterior and lateral flexion of the neck and stabilization of the cervical vertebral column Vertebral column The human spine, or vertebral column, is the most important anatomical and functional axis of the human body. It consists of 7 cervical vertebrae, 12 thoracic vertebrae, and 5 lumbar vertebrae and is limited cranially by the skull and caudally by the sacrum. Vertebral Column:

  • Longus capitis
  • Longus colli
  • Rectus capitis anterior
  • Rectus capitis lateralis

Posterior muscles of the neck

Splenius group: bilateral contraction (extension of the neck) and unilateral contraction (lateral flexion and ipsilateral rotation):

  • Splenius capitis
  • Splenius cervicis

Suboccipitals (postural muscles): aid in extension, lateral flexion, and rotation of the neck:

  • Rectus capitis posterior major
  • Rectus capitis posterior minor
  • Obliquus capitis inferior
  • Obliquus capitis superior

Transversospinalis group: rotation and extension of the vertebral column Vertebral column The human spine, or vertebral column, is the most important anatomical and functional axis of the human body. It consists of 7 cervical vertebrae, 12 thoracic vertebrae, and 5 lumbar vertebrae and is limited cranially by the skull and caudally by the sacrum. Vertebral Column:

  • Semispinalis capitis
  • Semispinalis cervicis
  • Rotatores cervicis
  • Interspinales cervicis
  • Intertransversarii

Anterior Neck Muscles

Superficial layer

Table: Superficial layer (anterior neck muscles)
Muscle Origin Insertion Blood supply Innervation Function
Platysma Skin/fascia of the supraclavicular and infraclavicular regions Base of the mandible, the skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Structure and Function of the Skin of the cheek/lower lip, the angle of the mouth, and the orbicularis oris Branches of the submental and suprascapular arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries Cervical branch of the facial nerve
  • Depresses the mandible and angle of the mouth
  • Tenses the skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Structure and Function of the Skin of the lower face and anterior neck
SCM Manubrium and medial portion of the clavicle Mastoid process of the temporal bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones and superior nuchal line Occipital and superior thyroid arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries
  • Spinal accessory nerve
  • Anterior rami of spinal nerves C1–C3
  • Bilaterally: cervical flexion and elevation of the sternum
  • Unilaterally: contralateral rotation and ipsilateral flexion
Subclavius 1st rib and cartilage Cartilage Cartilage is a type of connective tissue derived from embryonic mesenchyme that is responsible for structural support, resilience, and the smoothness of physical actions. Perichondrium (connective tissue membrane surrounding cartilage) compensates for the absence of vasculature in cartilage by providing nutrition and support. Cartilage Subclavian groove of the clavicle  Clavicular branch of the thoracoacromial trunk Subclavian nerve (from the upper trunk of the brachial plexus)
  • Depresses the clavicle
  • Elevates the 1st rib
SCM: Sternocleidomastoid
Anterior neck muscles - superficial layer

Anterior neck muscles: superficial layer

Image by BioDigital, edited by Lecturio

Scalenes

Table: Scalenes (anterior neck muscles)
Muscle Origin Insertion Blood supply Innervation Function
Anterior scalene Anterior tubercle of transverse processes of vertebrae C3–C6 Tubercle on the superior border of the 1st rib Ascending cervical artery (branch of the inferior thyroid artery) Anterior rami of spinal nerves C4–C6
  • Bilateral contraction: neck flexion
  • Unilateral: lateral flexion and rotation of the neck, elevates the 1st rib
Medial (middle) scalene Posterior tubercles of the transverse processes of vertebrae C3–C7 Superior border of the 1st rib Anterior rami of spinal nerves C3–C8
  • Lateral flexion of the neck
  • Elevates the 1st rib
Posterior scalene Posterior tubercles of the transverse processes of vertebrae C5–C7 External surface of the 2nd rib Anterior rami of spinal nerves C6–C8
  • Lateral flexion of the neck
  • Elevates the 2nd rib


Suprahyoids

Table: Suprahyoids (anterior neck muscles)
Muscle Origin Insertion Blood supply Innervation Function
Digastric
  • Anterior belly: digastric fossa of the mandible
  • Posterior belly: mastoid notch of the temporal bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones
Intermediate tendon on the body of the hyoid bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones
  • Anterior belly: submental branch of the facial artery
  • Posterior belly: occipital artery
  • Anterior belly: mandibular division of the trigeminal nerve
  • Posterior belly: facial nerve
Opens the jaw Jaw The jaw is made up of the mandible, which comprises the lower jaw, and the maxilla, which comprises the upper jaw. The mandible articulates with the temporal bone via the temporomandibular joint (TMJ). The 4 muscles of mastication produce the movements of the TMJ to ensure the efficient chewing of food. Jaw and Temporomandibular Joint when the masseter and temporalis are relaxed
Mylohyoid Mylohyoid line of the mandible Body of the hyoid bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones and median ridge Submental artery and branch of the inferior alveolar artery Mylohyoid nerve: branch of the mandibular nerve
  • Raises the oral cavity floor, hyoid, and tongue Tongue The tongue, on the other hand, is a complex muscular structure that permits tasting and facilitates the process of mastication and communication. The blood supply of the tongue originates from the external carotid artery, and the innervation is through cranial nerves. Oral Cavity: Lips and Tongue
  • Depresses the mandible
Geniohyoid Inferior mental spine of the mandible Anterior surface of the hyoid bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones Branches of the lingual artery Hypoglossal nerve (C1) Raises the hyoid and tongue Tongue The tongue, on the other hand, is a complex muscular structure that permits tasting and facilitates the process of mastication and communication. The blood supply of the tongue originates from the external carotid artery, and the innervation is through cranial nerves. Oral Cavity: Lips and Tongue during swallowing
Stylohyoid Styloid process of the temporal bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones Greater cornu of the hyoid bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones Branches of the posterior auricular and lingual arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries Facial nerve Raises the hyoid during swallowing
Suprahyoid muscles

Suprahyoid muscles: digastric, mylohyoid, and stylohyoid.
The muscles are superficial to the geniohyoid muscle.

Image by BioDigital, edited by Lecturio

Infrahyoids

Table: Infrahyoids (anterior neck muscles)
Muscle Origin Insertion Blood supply Innervation Function
Sternohyoid Manubrium of the sternum Lower border of the body of the hyoid Superior thyroid artery Branch of ansa cervicalis (C1–C3) Depresses the hyoid
Thyrohyoid Thyroid cartilage Cartilage Cartilage is a type of connective tissue derived from embryonic mesenchyme that is responsible for structural support, resilience, and the smoothness of physical actions. Perichondrium (connective tissue membrane surrounding cartilage) compensates for the absence of vasculature in cartilage by providing nutrition and support. Cartilage Greater cornu of the hyoid bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones Superior thyroid artery Hypoglossal nerve (C1) Elevates the thyroid and lowers the hyoid
Omohyoid
  • Inferior belly: upper border of the scapula
  • Superior belly: intermediate tendon
  • Inferior belly: intermediate tendon
  • Superior belly: hyoid
Inferior thyroid artery Ansa cervicalis (C1–C3)
  • Lowers the hyoid and larynx Larynx The larynx, also commonly called the voice box, is a cylindrical space located in the neck at the level of the C3-C6 vertebrae. The major structures forming the framework of the larynx are the thyroid cartilage, cricoid cartilage, and epiglottis. The larynx serves to produce sound (phonation), conducts air to the trachea, and prevents large molecules from reaching the lungs. Larynx
  • Pushes the hyoid posterolaterally
Infrahyoids

Infrahyoids: thyrohyoid, sternohyoid, and omohyoid

Image by BioDigital, edited by Lecturio

Lateral (Prevertebral) Neck Muscles

Table: Lateral neck muscles
Muscle Origin Insertion Blood supply Innervation Function
Longus capitis Anterior tubercles of the transverse processes of the 3rd–6th cervical vertebrae Basilar part of the occipital bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones Branches of the ascending cervical and inferior thyroid arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries Nerves C1–C3/C4 Flexes the neck at the atlantooccipital joint
Longus colli Transverse processes of C5–T3 Anterior arch of the atlas Ascending pharyngeal and vertebral arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries Nerves C2–C6 Flexes the neck and head
Rectus capitis anterior Anterior surface of the lateral mass of the atlas Basilar part of the occipital bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones Ascending artery Ventral primary rami of spinal nerves C1–2 Flexion of the neck at the atlantooccipital joint
Rectus capitis lateralis Upper surface of the transverse process of the atlas Inferior surface of the jugular process of the occipital bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones Ascending cervical artery Nerves C1–C2 Lateral flexion, stabilizes the atlantooccipital joint
Lateral neck muscles: rectus capitis lateralis and rectus capitis anterior

Lateral neck muscles: The rectus capitis lateralis and rectus capitis anterior flex the head and neck and stabilize the atlantooccipital joint.

Image by BioDigital, edited by Lecturio

Posterior Neck Muscles

Splenius group

Table: Splenius group (posterior neck muscles)
Muscle Origin Insertion Blood supply Innervation Function
Splenius capitis Nuchal ligament and spinous process of C7–T3 Mastoid process of the temporal and occipital bones Branches of the occipital artery: branch of the external carotid artery Posterior ramus of spinal nerves C3–C4 Extends, rotates, and laterally flexes the head
Splenius cervicis Spinous processes of T3–T6 Transverse processes of C1–C3 Transverse cervical and occipital arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries Posterior rami of the lower cervical spinal nerves
  • Bilaterally: extends the head and neck
  • Unilaterally: ipsilateral flexion and rotation
Superficial layer of the intrinsic back muscles

Splenius capitis and splenius cervicis muscles

Image by BioDigital, edited by Lecturio

Suboccipitals

Table: Suboccipitals (posterior neck muscles)
Muscle Origin Insertion Blood supply Innervation Function
Rectus capitis posterior major Spinous process of the axis (C2) Inferior nuchal line of the occipital bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones Vertebral artery, deep descending branch of the occipital artery Dorsal ramus of C1, suboccipital nerve Ipsilateral rotation and extension of the head
Rectus capitis posterior minor Tubercle on the posterior arch of the atlas (C1) Medial part of the inferior nuchal line of the occipital bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones Extends the head at the neck
Obliquus capitis inferior Spinous process of the axis Lateral mass of the atlas Rotation of the head and neck
Obliquus capitis superior Lateral mass of the atlas Lateral half of the inferior nuchal line Extends and ipsilaterally flexes the head
Suboccipital neck muscles

Suboccipital neck muscles

Image by BioDigital, edited by Lecturio

Transversospinalis group

Table: Transversospinalis group (posterior neck muscles)
Muscle Origin Insertion Blood supply Innervation Function
Semispinalis capitis
  • Articular processes of C4–C7
  • Transverse processes of T1–T6
Between the superior and inferior nuchal lines of the occipital bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones Branches of the occipital and superior intercostal arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries Branches of the greater occipital nerve (C2) and spinal nerve (C3)
  • Bilaterally: head and cervical extension
  • Unilaterally: ipsilateral flexion of the head and cervical spine and contralateral rotation
Semispinalis cervicis Transverse processes of T1–T6 Spinous processes of C2–C5 Deep cervical artery Dorsal rami of cervical spinal nerves
  • Bilaterally: extension of the cervical spine
  • Unilaterally: lateral flexion of the neck and rotation to the opposite side
Rotatores cervicis Transverse processes
  • Junction of the transverse process and lamina
  • Spinous processes
Vertebral and occipital arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries Postural control
Interspinales cervicis Side of the apex of the spinous process of C3–T1 Side of the apex of the spinous process of C2–C7 Extension of the spine
Intertransversarii 7 pairs of transverse processes: 1 pair between the atlas and the axis; the remaining pairs between C7 and T1 Vertebral arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries Anterior rami of the spinal nerves Lateral flexion of the neck

Clinical Relevance

  • Torticollis (also known as wry neck): an abnormal, asymmetrical head or neck position due to trauma, muscle tone disorders, congenital muscle tightness, or extrinsic masses. Torticollis is characterized by abnormal tone or length of the cervical muscles. Even without treatment, the pain Pain Pain has accompanied humans since they first existed, first lamented as the curse of existence and later understood as an adaptive mechanism that ensures survival. Pain is the most common symptomatic complaint and the main reason why people seek medical care. Physiology of Pain usually goes away after a few days. Torticollis is predominantly a clinical diagnosis and management includes physical therapy and dystonia Dystonia Dystonia is a hyperkinetic movement disorder characterized by the involuntary contraction of muscles, resulting in abnormal postures or twisting and repetitive movements. Dystonia can present in various ways as may affect many different skeletal muscle groups. Dystonia medication.
  • Triangles of the neck Triangles of the neck The neck is bound by the mandible, upper border of the clavicle, midline of the neck, and anterior margin of the trapezius. This space is divided into an anterior and posterior triangle by the sternocleidomastoid muscle (SCM). The anterior and posterior triangles are the two primary subdivisions and are delineated by easily recognized anatomic structures. Triangles of the Neck: The neck is quadrangular. The boundaries of the quadrangular shape include the mandible, the upper border of the clavicle, the midline, and the anterior margin of the trapezius. The quadrangular shape is divided into an anterior and posterior triangle by the SCM muscle. The triangles are again subdivided into the anterior and posterior triangles, and then further divided. The triangles serve as anatomic landmarks for many important structures (e.g., the carotid sheath and the spinal accessory nerve).

References

  1. Richard L. Drake, et al. (Ed.) 2020. Neck. In Richard L. Drake, et al. (Ed.), GRAY’S ANATOMY FOR STUDENTS (4th ed., pp. 995–1006).
  2. Moore, K. L., et al. (Ed.) (2014). Neck. In Moore, K. L., et al. (Ed.), Clinically Oriented Anatomy (7th ed., pp. 989–1007).
  3. Khan, Y. S. Bordoni, B. (2021). Anatomy, Head and Neck, Suprahyoid Muscle. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK546710/
  4. George, T. Tadi, P. (2021). Anatomy, Head and Neck, Suboccipital Muscles. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK567762/

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