This slide depicts over all the neurovascular
structures that can be observed within the
suboccipital region, the suboccipital triangle.
So, if we take a look here, here is our triangle
in through this area here and you can see
a lot of neurovascular structures in view.
The nerve of the triangle is your suboccipital
nerve and we see that yellow nerve coming
out here and if we look at some of the twigs
of that nerve, we will see that they then
penetrate the suboccipital muscles. And so,
we do see some twigs of the suboccipital nerve,
for example, going in to the rectus major.
This large nerve that we see entering the
suboccipital region and ascending toward
the midline of the cervical area in the skull
is the greater occipital nerve and you can
see it enters this region by passing just
inferior to the inferior oblique that we see
right in through here. This provides for sensory
innervation of the skin associated with the
posterior portion of your scalp.
We also have the third occipital nerve coming
into play. This is a branch coming from the
posterior ramus of the third cervical nerve.
It will have a communicating branch into the
greater occipital nerve and also, have a branch,
not shown here, extends a course upwards
and medial to your greater occipital nerve.
And then lastly, within the triangle and crossing
on the superior portion of the posterior arch
of C1, we have our vertebral artery and accompanying
that artery would be the vertebral vein.
Some additional neurovascular structures that
relate to the back that we have talked about
previously would be the accessory nerve and
the dorsal scapular nerve. And then we have
a couple of arteries that we have not talked
about yet, but want to introduce at this point
that will be the superficial branch of the
transverse cervical artery and the deep branch
of the transverse cervical artery.
So, let’s take a look at what is depicted
here. We will begin with this nerve that is
crossing onto the deep surface of your trapezius
muscle. The trapezius muscle is being reflected.
This is your accessory nerve that is providing
motor innervation to your trapezius. The artery
that accompanies it is seen branching off
here and coming into the substance of the
trapezius. This is the superficial branch
of the transverse cervical artery.
We also have innervating the levator scapulae
and the two rhomboids, the dorsal scapular
nerve. That nerve is seen right along in
through here, this yellow nerve and it’s
running deep to the rhomboids after it supplies
twigs to the levator scapulae, will run deep
to the rhomboids in the area where they attach
to the medial aspect or medial border of the
The artery that accompanies it is shown here.
This is the deep branch of the transverse
cervical artery. And then it will disappear
under the rhomboid minor and then major along
the medial border of the scapula. We also
made reference to the thoracodorsal nerve
as it innvervates the latissimus dorsi muscle.
That nerve is seen in this particular illustration
right in through here in yellow and it will
penetrate and ramify or branch within the
substance of the latissimus and we are just
seeing the latissimus come up this way. The
artery that is in here and travelling with
the thoracodorsal nerve is your thoracodorsal
artery and certainly, you will have a vein
by the same name, thoracodorsal vein.
This is a more global look at the neural vasculature
of the back. If we take a look here, we can
see a deeper dissection on the left side of
the image, more of a superficial view or dissection
on the right side of the image. These branches
that we see crossing along here with some
of the terminal twigs going into the iliocostalis
column of the erector spinae, these are the
posterior rami of the spinal nerves in this
general location. More superficially branches
of these posterior rami will pierce through
the back musculature and will then provide
innervation to the skin that’s lying at
the back more centrally.
We would also have, but not clearly in view,
we would have some deep cervical arteries
in the cervical area, they would provide for
some branches that would cross posteriorly
and help supply some of the musculature in
the cervical area that we have discussed.
We have already mentioned the vertebral arteries
as being members of the back region. And then
we have posterior branches, intercostal vessels,
so you see some of those branches here and
there are some other branches up in through
here as well, intercostal vessels travelling
in the initial segment of the intercostal
There will be branches that will poke through
the back musculature and will help supply
the back muscles as well as the skin overlying
those muscles. When you are in the lumbar
area, as we would be down through in here,
you see some penetrating arteries as well.
These are from segmental lumbar arteries helping
to supply the lower back musculature in this
area and the overlying skin that’s been